[6 MIN READ]
In this article:
- Adolescence is a time of lots of changes for your teen. Although it’s not always easy, one of the best ways you can help them navigate this period is by having some difficult conversations.
- Some of the important conversations you should have with your teen cover topics like mental health, conflict resolution, toxic relationships, body image and self-esteem, bullying, contraception and consent, and substance use.
- A Providence Swedish behavioral health expert has some guidance for connecting with your kiddos, including some things to avoid doing and why some approaches work better than others.
Adolescence and the teenage years are times of great emotional and physical change for kids. Those formative years also come with lots of pressure around everything from academics to social networks. They can be a fraught for kids and parents. Just ask any parent who has tried to start a sensitive talk with a teen. You can hear the bedroom door slam just thinking about it.
To help us learn more about effective strategies for talking with our teens, we spoke with a Providence Swedish behavioral health expert, Janarthan Sivaratnam, Ph.D, a psychologist with Providence Swedish South Lake Union Primary Care. Dr. Sivaratnam shared some advice for navigating challenging topics with teens; how to start a conversation with your kid; and, perhaps most important, what you may consider not saying when addressing a sensitive subject with your kiddo.
"Puberty and adolescence is a challenging time for kids in basically every family, but I encourage parents to stay connected and keep their eyes and ears open, especially during these critical developmental years," says Dr. Sivaratnam. "It may not feel like it, but you know your kids best and if your gut is telling you that you should connect with them about an issue or topic, respect that. Just try your best to do it in a way that gives you each the best chance of opening up lines of communication and being heard."
Are there suggestions for tailoring our talks based on age range?
Yes, tailoring mental health talks by age range is crucial because cognitive, emotional, and social development differs significantly across stages. Here's a breakdown of how to adjust your approach for each group:
Early Adolescence
- Use relatable stories and visuals. Keep messages simple, concrete, and tied to real-life situations (e.g., school stress, friendship problems).
- Normalize emotions. Emphasize that it’s okay to feel sad, angry, or anxious.
- Introduce basic coping tools. Teach basic breathing techniques, journaling, or identifying "safe adults" to talk to.
Mid Adolescence
- Acknowledge their autonomy. Present mental health care as a form of self-empowerment.
- Use peer-related scenarios. Include examples about social media, academic pressure, or body image.
- Discuss stigma. Frame help-seeking as strength, not weakness.
- Introduce more nuanced topics. You can begin to talk about anxiety disorders, depression, and substance use in age-appropriate ways.
Late Adolescence
- Be direct and open. Use mature, respectful language and provide concrete resources (e.g., how to find a therapist, manage health insurance).
- Include real-life challenges. Discuss burnout, relationships, finances, and independence-related stress.
- Talk about preventative care. Encourage mental health maintenance just like physical health.
- Empower peer support. Encourage them to look out for friends and themselves.
What is some guidance on what not to do or say when talking to my teen?
While there are no universal “do’s and don’t’s” when talking with teens, here are some things you might potentially do not want to do or otherwise want to avoid doing routinely:
- Don’t minimize or dismiss their feelings. This invalidates their experience and can shut down future conversations.
- Don’t Jump to Fix-It Mode Too Quickly. Teens often want to be heard more than advised. Jumping to solutions may feel dismissive or controlling.
- Don’t Use Guilt or Shame. Guilt and shame can increase isolation and discourage openness.
- Don’t Make It About You. While well-meaning, this can feel like a comparison and may discourage vulnerability.
- Don’t Invalidate Privacy. This breaks trust. While safety comes first, open dialogue is more effective long term than covert monitoring.
- Don’t Force the Conversation
Why: Teens may need time or space to process. Forcing conversations can sometimes backfire.
What if my teen pushes me away or refuses to talk to me?
It's important for you to stay present without pressuring your kids.
Say things like:
- “I’m here if you ever want to talk — no pressure.”
- “You don’t have to explain everything, but I want you to know I care.”
Why: Teens often test your response before they open up. Your calm consistency builds trust.
You can also use "side-by-side moments, for example:
- Talk while doing something else: driving, walking, cooking.
Why: Teens often feel safer opening up when eye contact isn’t intense and the focus is shared.
Make sure that you acknowledge their autonomy. Try saying:
- “You don’t have to tell me everything, but you don’t have to handle everything alone either.”
Why: It empowers them without abandoning them.
Model mental health openness for your kids:
- Share small, age-appropriate examples of your own stress, coping tools, or therapy experience.
Why: This reduces stigma and signals that it’s safe to talk.
When should I worry about my teen being uncommunicative?
While some withdrawal is normal during adolescence, there are red flags that suggest your teen’s silence might reflect something more serious than typical moodiness or growing independence. Keep an eye out for the following clusters/patterns:
- Behavioral changes. Suddenly dropping grades or skipping school; loss of interest in things they used to enjoy; avoiding friends or social isolation; increased irritability, aggression, or apathy; major changes in sleep or eating patterns.
- Emotional signs. Frequent hopelessness or worthlessness; saying things like “what’s the point” or “no one understands me;” crying spells or intense mood swings.
- Physical or verbal cues. Consistent expressions of self-hate or guilt; talking about death, disappearing, or being a “burden;” unexplained injuries (such as cuts or burns); substance use or risky behaviors.
What you can do is gently but clearly express your concerns and seek help. If the acute needs are more serious (e.g., suicidal ideations, plans, intent), then contacting a mental health professional or even the 988 24/hr hotline can be a good place to start.
Can you offer advice for talking about specific subjects: body image, sex (including gender and sexual orientation), challenges at school, and drugs and alcohol?
Body Image
What to Say/Do:
- Normalize body changes during puberty. Try saying things like: “Everyone develops differently — that’s completely normal.”
- Emphasize health over appearance.
- Compliment traits unrelated to looks (e.g., kindness, creativity).
- Watch your own language about bodies — they’re listening even when you talk about yourself.
Avoid:
- Critiquing their appearance (even jokingly).
- Comparing them to siblings, peers, or celebrities.
- Praising weight loss as always “good.”
Sex, Gender, and Sexual Orientation
What to Say/Do:
- Create safety by being nonjudgmental and clear, while also providing space for them to explore as they see fit.
- Use inclusive language, such as saying “partner” instead of assuming “boyfriend/girlfriend.”
- Clarify facts about consent, healthy relationships, and STIs — don’t rely on school or media to cover it all.
- Affirm that exploring gender and sexuality is normal. You can say things like, “Some people know early, some later. All of it is okay.”
Avoid:
- Acting shocked, dismissive, or trying to “fix” or redirect their orientation or identity.
- Treating conversations about sex as “once and done.
Challenges at School (Academic, Social, or Emotional)
What to Say/Do:
- Ask open-ended questions. For example: “What’s the hardest part of school right now?”
- Offer support, not solutions right away. You can say: “That sounds tough. Do you want help figuring it out, or just to vent?”
- Normalize academic struggles as part of learning. Assure your child with saying things like, “Needing help doesn’t mean you’re failing.”
Avoid:
- Focusing only on grades or college pressure.
- Comparing them to other students or siblings.
- Minimizing social stress by saying things like “Just ignore them.” or “Friends come and go."
Drugs and Alcohol
What to Say/Do:
- Be honest about risks without fear tactics. “I trust you to make smart choices, but I also want you to know the facts.”
- Talk about peer pressure and safety plans: “If you’re ever in a situation where you need a ride, no questions asked — just call.”
- Make the conversation ongoing, not just one-time.
Avoid:
- Using scare tactics (“Your brain will fry!”)
- Assuming “good kids” don’t experiment.
- Lecturing instead of listening.
General things to keep in mind when talking with your adolescents and teens, regardless of the topic:
- Pick the right moment: Try when you’re both relaxed — car rides, walks, etc.
- Ask more than you tell. Teens often respond better to questions than advice.
- Stay calm. Even if what they say surprises or worries you, keep your reaction grounded to keep the door open.
- Where’s a good place to start (in general) when having difficult or big conversations with kids
While there is no “one size fits all approach,” there are some routine things you can practice and keep an eye out for that can make it easier to start having big conversations.
Step 1: Create safety in everyday moments by using casual, low-pressure time (car rides, chores, TV time) to build connection. Say things like:
- “I like talking with you, even if it’s about small stuff.”
- “You don’t have to tell me everything, but I’m always here.”
Tip: Show you're emotionally available without forcing big talks.
Step 2: Begin with the easiest topic for them. Choose a subject that feels least threatening. Many teens open up more easily about:
- School challenges ("How are your classes feeling lately?")
- Stress or sleep ("Have you been feeling more tired than usual?")
- Body image/media ("Does social media ever make you feel pressured to look a certain way?")
Tip: Keep questions open and non-judgmental. Avoid rapid-fire or “yes/no” questions.
Step 3: Normalize conversations about mental health
- You can casually mention emotions, therapy, or stress management in daily life by saying things like: “I was feeling overwhelmed the other day — deep breaths actually helped.” or “Sometimes talking to someone outside the family helps too.”
Tip: De-stigmatize talking about feelings so it’s just part of life, not a crisis response.
Step 4: Watch for their “open window”
- Teens sometimes open up suddenly and briefly — at night, during a meltdown, or after an event.
Tip: Be ready to pause what you’re doing and just listen when they do.
Step 5: Introduce One Sensitive Topic at a Time
If they’re receptive, pick one area (e.g., body image or peer pressure) and let them guide.
Tip: Let them decide what and how much they are willing to share on any given topic.
Learn more and find a physician or advanced practice clinician (APC)
If you are looking for help managing holiday stress or learning to deal with holiday stress, support is available at Providence Swedish Behavioral Health. Whether you require an in-person visit or want to consult a doctor virtually, you have options. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can use our provider directory to find a specialist or primary care physician near you.
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Related resources
Choosing a therapist: identifying your mental health goals and what to keep in mind
Anchor yourself: tips for managing big feelings in turbulent times
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