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Getting to Yes

How to spur treatment for mental health

Today, I’ve asked Ken Duckworth to share his Tip of the Week. 

“You’re depressed and need help.”    

“Not going to happen.” 

So begins and ends countless discussions when we ask teens to open up about mental health. I have seen so many loving parents fall into this pattern—urging action but getting resistance in return. Sometimes this direct strategy works, but often it does not. 

What can be more effective? Motivational interviewing.  

Motivational interviewing is a way of talking to someone who needs support but doesn’t want to be told what to do—which is most of us. This method can be particularly useful with teens, who are at a stage in life where, naturally, they’re looking to establish an identity separate from their parents. 

How does motivational interviewing work? Inside each and every one of us, there is a kind of committee—inner voices that can disagree with each other. When a parent asks their child if they need help, one of these voices might be enthusiastic (Yes, please help me), but another, louder voice wants to keep things just as they are (No, go away!). 

Research shows that if you listen carefully, you can hear the ambivalence and then, gently, support your child’s own inclination to change. By asking thoughtful questions, you can help your child arrive at a good decision all by themselves. For example, you might ask: “If you did decide to get help, what qualities would you look for in a therapist, given what you know about yourself?” 

Ask with curiosity and listen without judgment. If your child sounds ambivalent, echo back both sides. Start with the reluctance, insert an and, then state the pro-change side they’ve expressed. For instance, if your teen reports a pattern of disrupted sleep, you can say, “Part of you wants to manage on your own without help, and another part hopes that a doctor would have some good ideas.”  

Using motivational interviewing takes a lot of patience. But it often produces better results for someone you love who does not yet see the need for support the way you do.   

Don’t tell a young person there’s something wrong with them and expect an enthusiastic response. 

Do listen for subtle clues of interest in change, then use motivational interviewing to encourage, engage, and support it. 

With gratitude,


Ken Duckworth, chief medical officer of the National Alliance on Mental Illness (NAMI), is the author of You Are Not Alone: The NAMI Guide to Navigating Mental Health—With Advice From Experts and Wisdom From Real People and Families.