No single therapy is best for every teenager. The right choice depends on what your teenager is struggling with, their age, how safe they are right now, and above all whether they trust the person sitting across from them. For most teenagers, good teen counselling starts with talking things through and then moves to more focused work, such as cognitive behavioural therapy (CBT), family sessions or online support, if that would help.
If you're a parent reading this late at night, or a teenager wondering whether this is for you, you're in the right place. Therapy for young people is confidential and suited to their age, and it is far more ordinary than it might feel.
Choosing the right therapy for a teenager
We think the choice should come from an initial assessment, not from a label. In the first session or two, a therapist gets a picture of what is happening, how long it has been going on and what your teenager wants to change. Sometimes the right next step is outside therapy altogether. The therapist may suggest a GP visit, a psychologist or psychiatrist, or specialist HSE services if the difficulties are severe or risk is high.
It helps to know that an approach (such as CBT) is different from a format (such as online or group sessions). Almost any approach can be offered in more than one format. The table below sets out the main approaches used with teenagers. No single method works for everyone, and not every practice offers all of them.
| Therapy | It may be considered for | What teenagers can expect |
|---|---|---|
| Counselling or psychotherapy | Emotional distress, low self-esteem, bullying, grief and life changes | Supportive conversations exploring feelings, relationships and ways of coping |
| CBT | Anxiety, depression, obsessive-compulsive difficulties and unhelpful patterns | Practical work on the links between thoughts, feelings and behaviour |
| DBT-informed therapy | Intense emotions, impulsivity and self-harm | Skills for managing emotions, coping with distress and handling relationships |
| Family therapy | Conflict, communication problems or difficulties affecting the whole family | Sessions with family members that look at patterns between people |
| ACT or interpersonal therapy | Getting stuck in difficult feelings, or relationship-related low mood | Values-based skills, or a focus on relationships and life changes |
| Exposure-based therapy | Phobias, anxiety and some obsessive-compulsive difficulties | Gradual, supported contact with feared situations |
| Group or creative therapy | Peer support, or difficulty putting feelings into words | Shared sessions, art, sand tray or other age-appropriate ways to communicate |
One thing matters as much as the approach. Teenagers are quick to sense whether an adult is really listening. A therapist with real experience of adolescents, and a young person who feels respected in the room, can count for as much as the name of the method. For younger teenagers or pre-teens who find talking hard, creative approaches like child play therapy can be a gentler way in.
How CBT helps teenagers
CBT helps a teenager notice the thoughts that drive how they feel and act, test whether those thoughts hold up, and try different ways of responding. Take a teenager with social anxiety who is convinced nobody in their class likes them. They may start avoiding lunch, then group projects, then school. CBT looks at that loop and builds small, manageable steps out of it.
The evidence is strongest for anxiety and depression. For young people aged 12 to 18 with moderate or severe depression, the NICE guideline on depression in children and young people recommends individual CBT as the first psychological therapy to offer. If that doesn't meet their needs, it lists interpersonal therapy for adolescents, family therapy and psychodynamic psychotherapy as alternatives. In other words, CBT is a strong starting point, but it is not the only good option.
A typical CBT session is structured. Your teenager and the therapist agree a focus, look at how the week went, learn or practise a skill, and choose a small task to try before the next appointment. Some teenagers like that clarity. Others feel boxed in by it and need more room simply to be heard first. Our cognitive behavioural therapy service works with that balance in mind, and we never promise that any one method will work.
Signs a teenager may need support
Every teenager has bad weeks. Moodiness, slammed doors and long hours in their room are part of growing up. What we'd pay attention to is change that lasts for weeks, keeps getting worse or starts to affect daily life, such as:
- pulling away from friends, family or activities they used to enjoy
- persistent low mood, irritability or worry
- changes in sleep or appetite
- falling behind at school or refusing to go
- frequent headaches or stomach aches with no clear physical cause
- more conflict at home than usual
Therapy can help with a wide range of things teenagers carry: low self-esteem, bullying, friendship fallouts, family conflict, exam pressure, grief, questions about identity, trauma, anxiety and depression. Our article on parenting teens in the digital age looks at how phones and social media fit in.
If you're worried, start with a calm conversation at a quiet moment, perhaps in the car or on a walk, when it feels less like an interrogation. Listen more than you advise. Then talk to your GP or a qualified therapist about what you've noticed.
If your teenager is in immediate danger, has said they intend to end their life or has seriously harmed themselves, call 112 or 999 or go to your nearest emergency department. You can also call Samaritans free on 116 123, and young people can reach Childline on 1800 66 66 66, 24 hours a day. The HSE's urgent and emergency care page shows where to find help near you.
How therapy with teenagers works
Therapy with a teenager is something done with them, not adults talking about them behind their back. We think that matters more at this age than at almost any other, because so many decisions in a teenager's life are made for them. The therapy room should be one place where their view counts.
In a first session, the therapist will introduce themselves, ask what has brought your teenager along and explain confidentiality, including the limits. They will ask about relevant history, and just as importantly about strengths, interests and what is going well. Together they agree some realistic goals and decide whether further sessions make sense. Our guide on what to expect in your first therapy session goes into more detail.
After that, sessions are usually regular, often weekly at first. We can't give a fixed timeline, because it depends on the young person and what they bring. Progress is reviewed along the way and the plan changes if something isn't working. Teenagers are always welcome to ask questions, push back or say "this isn't helping". That kind of honesty is useful. Between sessions, small things help: noticing moments that felt hard, trying the agreed task and jotting down anything they want to bring next time.
Online and in-person therapy for teenagers
Neither format is better across the board. Online therapy cuts out travel, fits around school and sport, and can feel less exposed for a teenager who dreads being seen walking into a therapist's office. In-person sessions may suit teenagers who open up more face to face, or who have no private space at home where they can talk without a sibling or parent overhearing.
What suits your teenager depends on their age, how they like to communicate, what they're dealing with, safety considerations and whether the technology works for them. Online sessions may not be right in every high-risk or complex situation, and the therapist should assess that with you rather than treating the two as interchangeable. We see teenagers online and at our locations in Dublin and Galway. Our article on online therapy vs in-person therapy compares the two in more depth.
Finding a qualified teen therapist in Ireland
Look for a therapist with specific experience of adolescents, a recognised qualification, regular clinical supervision and membership of a professional body. The Irish Association for Counselling and Psychotherapy (IACP) explains how counselling and psychotherapy work and links to its directory of accredited therapists across the country, and the Psychological Society of Ireland (PSI) keeps a directory of chartered psychologists.
Questions worth asking before you book:
- Which age groups do you work with?
- What approaches do you use with teenagers?
- How do you involve parents?
- How do you handle confidentiality and risk?
- Do you offer online and in-person sessions?
A good fit means your teenager feels respected, heard and reasonably safe. If after a few sessions it isn't working, it is fine to say so and to try someone else. That isn't failure. Finding the right person is part of the process.
We have therapists working with adolescents across Dublin, Galway and online. Our website clearly shows which therapists are qualified to work with teenagers and adolescents. If you are not sure who to choose, our team can help you match your teenager with the right person.
FAQs
How much does therapy for a teenager cost in Ireland?
Fees vary by provider, therapist and type of session. Our current rates are on our prices page, and we keep a low-cost counselling option for people who would otherwise go without. Your health insurance may also cover some sessions, so it is worth checking your policy.
Will parents be involved, and is teenage therapy confidential?
That depends on your teenager's age, maturity and circumstances, and on the service's policy, so it is agreed at the start. Privacy is what lets a young person speak freely, so parents usually won't hear the details of sessions. The exception is a serious safety or safeguarding concern, when a therapist must act to protect them.
What can I do if my teenager refuses to go to therapy?
Listen to why. They may be afraid of being judged or of being "the problem". Avoid threats, and offer real choices, such as which therapist, online or in person, and the time of day. Suggest a single introductory session with no commitment. If they still say no, you can speak to a therapist yourself for guidance on how to support them.
Taking the next step
If something has been on your mind, start with a gentle conversation with your teenager and let them have a say in what kind of support feels right. You don't need to have everything worked out first. Whenever you feel ready, get in touch with our team and we'll help you find a therapist and an appointment format, in Dublin, Galway or online, that suits your teenager.