Dear Therapist:

As a high school teacher, I often have the opportunity to speak to my students on a one-on-one basis. I would love guidance on differentiating between a teenager going through regular ups and downs and needing some advice and a listening ear, and a girl who is struggling in a way that warrants professional help. Additionally, in your experience is there a way to get the girl on board to get the help she needs if she does not want/think she needs the help. And lastly, is it worth forcing her to go, or will it just backfire. Thank you.



Similar questions have been submitted in the past. As such, much of what appears below is a reiteration from previous responses.

It’s always nice to hear that school faculty is caring and engaged enough to become involved in our children’s emotional needs. Simply knowing that their teachers and other faculty members are concerned for them can be a tremendous help for many of our children. Assisting them in obtaining the help that they need is indeed holy work, and can be lifesaving.

Each individual is just that—individual. We would like to believe that there is a formula for everything, and that we can make determinations based on scientific findings. In real life, however, this is a recipe for failure. Human beings cannot—and should not—be viewed from a generalist perspective. The study of the human mind should be viewed as a very general guide. Much more important is the study of the particular person.

Whenever we address others about concerns that we have, we need to be mindful of their personalities, our relationship with them, and their likely responses. When there is an obvious problem, the decision to approach a student is easier, since they clearly need help. In many instances the approach itself is easier as well, since the person is in pain and is desperately seeking a solution.

Your question is about those whose issues are not as evident, and about differentiating between those who need help and those who do not. Your question may be whether to approach these students; or it may be whether to suggest—or perhaps insist—that they obtain professional help.

Some people are concerned that approaching a teenager may suggest to them that they have a problem when, in fact, none exists. For the most part, the proper approach will allow the person to feel cared for, and help them feel like their struggles are a normal part of teenage life. Simply helping them to feel that they are important to someone can be very beneficial.

I would be hard put to find a teenager who is not struggling emotionally with something. Helping them to normalize this—to recognize that we all struggle emotionally—can go a long way toward helping them feel better about their feelings. This can also help to mitigate any negative stereotypes related to seeing a therapist.

Sometimes people have a problem that has a seemingly small impact on their lives. In many cases this may be true. When this is the case, the question is whether discussing the problem is more likely to be helpful or harmful. In many instances, the person is aware of the problem, and being approached in the proper manner can be helpful. In other instances, the person may be (consciously or unconsciously) avoiding the issue. This might be due to various concerns and emotions. When considering whether, how, when, and through whom to approach someone, we should try and get a sense of these factors.

In some cases what appears to us as a relatively minor issue can be much more significant to the person experiencing the issue. For one girl who is introspective and has few friends, this may be simply a matter of dissimilar interests or personality. For another, this could be indicative of deeper issues. The first girl may be happy with her friends, and feels good about her introspective personality, while the other may feel like a failure or a loser—thus leading to feelings of anxiety and depression.

You are a teacher who presumably has a close relationship with your students, and who has the opportunity to study them in their “natural habitat.” Additionally, you are hopefully not overly emotionally enmeshed, and are thus in a singular position to make more dispassionate determinations than their parents might.

When most of us see someone struggling, we naturally want to help. One thing that we should question is whether we are trying to address their needs or ours? Is our concern legitimately about the other person, or are we projecting our feelings onto them? For example, if we had trouble making friends in high school—and this strongly affected our self-esteem—are we making unfounded assumptions about others who appear to have few friends?

If your objective determination is that someone could benefit from therapy, there are a few things to bear in mind. The approach should be specific to the individual. For some, being straightforward about your concerns is the best way to go. For others, it is important to first be certain that they understand that you care about them and are not judging them. (Even if it is clear to you that this is not about judgment, it can easily be perceived as such.) For some, having a five-minute discussion will be sufficient; for others the issues will need to be broached slowly over time.

To what extent to involve girls’ parents in the discussion is a separate matter. With regard to the actual approach, however, the decision may be for the parents to initiate the discussion. Or it may be determined that a more positive result can be obtained when a confidant from within the school is the first to address the issue. Sometimes, a team approach is indicated.

There is no broad answer to your question. However, there are some general guidelines that can help to attain a positive response. It is important to take each child’s emotional needs into consideration. Be sure to show them that you are not in any way judging them. Help them to understand that their issues are normal, and that they are okay. Help to normalize therapy, so that they feel that there is nothing “wrong with them.” And make sure they know that you care about them, and only want them to be happy and to succeed.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer / 516-218-4200


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