9 Signs Your Teen May Need a Therapist (and How to Help)
Every parent of a teenager has wondered, “Is this normal, or is something wrong?” Teens are supposed to pull away a little, sleep late and roll their eyes. But sometimes the shift runs deeper, and the right support early can change how the next few years go.
As a Licensed Clinical Social Worker in Christiansburg who works with preteens and teens across the New River Valley, I see families at this crossroads every week. Here are nine signs it may be time to talk with a therapist — and what to do next.
1. Mood changes that last more than two weeks
Bad days are normal. Sadness, irritability or flatness that sticks around for two weeks or more is different. Watch for a teen who seems hopeless, cries often, or snaps at everyone over small things.
2. Pulling away from friends and favorite activities
Outgrowing a hobby is part of growing up. Dropping every friend and interest at once, and spending most free time alone in their room, can point to depression or anxiety.
3. Changes in sleep or eating
Sleeping far more or far less than usual, or big changes in appetite or weight, are often the body’s first signal that a teen is struggling emotionally.
4. Grades slipping or school refusal
A sudden drop in grades, frequent “stomachaches” on school mornings, or calls from teachers about focus and behavior can reflect anxiety, ADHD, bullying or stress at home.
5. Worry that gets in the way of life
Some nerves before a test are healthy. Constant worry, panic attacks, avoiding driving, parties or school, or needing repeated reassurance suggests an anxiety problem that therapy treats well.
6. Anger, defiance or risky behavior
Outbursts, fights, breaking rules, or experimenting with alcohol, vaping or other substances are often a teen’s way of coping with pain they can’t put into words.
7. A hard experience they haven’t bounced back from
Divorce, a move, the loss of a loved one, an accident, abuse, or witnessing violence can all be traumatic. If your teen seems jumpy, avoids reminders, has nightmares or seems “not themselves” months later, trauma-focused therapy can help.
8. Low self-esteem or harsh self-talk
Listen for statements like “I’m stupid,” “Nobody likes me,” or “I ruin everything.” Persistent self-criticism, body-image worries, or comparing themselves constantly on social media are worth addressing early.
9. Any talk of self-harm or not wanting to be here
Comments about death, hurting themselves, or feeling like a burden always need a response — even when they sound like jokes. If you are worried your teen is in immediate danger, call or text 988 (the Suicide & Crisis Lifeline) or call 911.
How to start the conversation
- Pick a low-pressure moment. Car rides and walks work better than face-to-face “we need to talk” sit-downs.
- Lead with what you’ve noticed, not a diagnosis. “You’ve seemed really tired and quiet lately. I’m wondering how you’re doing.”
- Listen more than you fix. Teens open up when they feel heard rather than lectured.
- Frame therapy as support, not punishment. “A counselor is someone outside the family you can talk to. Lots of people your age see one.”
- Give them a voice. Let your teen help choose between in-person and telehealth sessions, and meet the therapist before committing.
What teen therapy looks like at That Counseling Place
Therapy with teens is a partnership. In the first sessions, I get to know your teen and your family, learn what is hard right now, and set goals together. Depending on your teen’s needs, we may use approaches like Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT) skills, mindfulness, or Trauma-Focused CBT, in which I am certified.
Parents are part of the process. You’ll get guidance on how to support your teen at home, while your teen keeps a private space to talk openly — with clear limits around safety that we explain up front.
Sessions are available in person in Christiansburg and by secure telehealth anywhere in Virginia. Some clients also enjoy the calm presence of Shyanne, our optional therapy-office dog.
Using insurance for teen counseling
We accept Anthem, Aetna, Cigna, Humana, Tricare, United HealthCare (Optum), Optima/Sentara, Virginia Medicaid plans including Aetna Better Health of VA and Virginia Premier, and more. A sliding scale is available. See our Insurance & Fees page for the full list.
Frequently asked questions
What age does That Counseling Place see? Preteens from age 11, teens and adults.
Will I know what my teen says in therapy? You’ll hear about goals and progress. Details stay private unless there is a safety concern, which helps your teen trust the process.
Can my teen do therapy online? Yes. Telehealth works well for many teens and is available anywhere in Virginia.
How long does teen therapy take? It varies. Some families need a few months of focused work; others benefit from longer support.
Ready to talk?
If you recognized your teen in this list, you don’t have to figure it out alone. Call 540-944-4994 or email selina@thatcounselingplace.com to schedule a first session in Christiansburg or online.
This article is for general information and is not a substitute for professional diagnosis or treatment.
