Individual Counseling for Teens: What to Expect at 13 and Up

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By Nicole Wilkerson, LMHCA · Washington Licensed Mental Health Counselor Associate

Individual counseling for teens gives you time to talk with a clinician about what life has been like from your point of view. You might have asked for the appointment yourself, be considering a parent’s suggestion, or still be deciding how you feel about the idea.

Starting counseling as a teen does not require a prepared speech. You can bring a specific problem, a lot of questions, or an honest “I’m not sure what I want to talk about yet.” This guide is for teens age 13 and older who want a clearer picture of a first appointment, including video counseling in Washington.

What individual counseling for teens can focus on

You can bring concerns about school, friends, family, relationships, pressure, worry, or a change that has been hard to make sense of. You might also want to understand a pattern, such as feeling tense before a conversation or replaying something long after it happened.

The most important topic may not be the one other people expect. A parent may be focused on mornings or homework while you want to talk about a friendship or the feeling that expectations keep changing. A counselor can help explore how those experiences connect without assuming that one person’s first explanation is the whole story.

My counseling page describes some of the concerns I work with. The practice can help you and the clinician decide whether the services fit what you need.

What may happen at your first appointment

The clinician will want to understand what brought you in and what your life has been like. You may be asked about home, school, relationships, routines, health, previous support, and safety. You can ask why a question matters or what an unfamiliar word means.

The appointment also gives you a chance to learn how the counselor works. You can ask what future visits could involve, how a starting focus is chosen, and how to say when something does not feel useful. You do not have to decide everything about counseling immediately.

The first-session overview is a short introduction to that conversation. If you will meet by video, this video counseling guide explains the practical setup.

You can start with one thing that happened

If “Tell me about yourself” feels too big, choose one recent moment. Maybe you had a hard time getting ready for school, felt left out of a conversation, or could not stop thinking about a decision. Tell the counselor what happened and what it was like for you.

What you want help explaining	Something you could say
The problem feels hard to name	“I know something feels off, but I do not know what to call it.”
Adults have a different explanation	“I want to explain what this looks like from my side.”
You worry about being misunderstood	“I’m not sure that came out the way I meant it.”
The question is too broad	“Could we start with something more specific?”

These are examples you can change, not lines you have to use. You might prefer to make a short note on your phone, bring a notebook, or begin without notes and ask the counselor to help you organize what you want to say.

Ask about privacy before making assumptions

Privacy is an important part of understanding counseling. Ask what stays between you and the clinician, what might be shared with a parent or caregiver, and what happens if the clinician is concerned about safety. Avoid relying on a general promise that everything will always be private.

You can ask for a clear explanation of who will receive paperwork, how messages are handled, and whether a caregiver will join any part of a visit. If you are worried about a particular kind of information being shared, bring that question to the clinician or practice.

• “What can my parent or caregiver be told?”
• “Are there times you would have to share information?”
• “Would you talk with me about that process?”
• “How can my caregiver share a concern with you?”

These questions are part of getting informed. They do not have to mean that you are hiding something or planning to discuss a particular topic.

Counseling for teens age 13 and older in Washington

Washington law allows adolescents age 13 and older to request outpatient treatment without a parent’s consent. You can read the state’s outpatient treatment law and its definition of adolescent. The practice should explain how the rules apply to your situation.

Consent and information sharing are different subjects. Washington also has specific rules for adolescent treatment information, including safety and other legal considerations. Ask for a plain-language explanation rather than assuming that turning 13 answers every question about privacy, billing, or family involvement.

My services are for teens age 13 and older and adults. An inquiry can begin with your age and a general question about the service. The intake team can explain the paperwork and practical arrangements before you schedule.

Think about the space you would use for video

If you meet online, choose a place where you can speak privately and use a stable device and connection. You do not need a perfect room or a professional background. You do need to think about who could hear you or walk in.

You can ask a caregiver for help arranging the space without giving them an account of the whole appointment. If privacy is difficult at home, tell the practice before the visit so you can discuss a workable plan. Headphones do not prevent someone nearby from hearing your voice.

For video appointments with me, you need to be physically in Washington during the session. Ask what to do if the connection drops, and tell the practice in advance if you will be traveling.

Help the work reflect what matters to you

A starting goal can be small and practical. You might want to understand a particular worry, make sense of a friendship change, or find a way to describe something people keep misunderstanding. You can ask how the counselor would connect the conversation to that goal.

You can also give feedback. If a question feels confusing, an idea does not fit your life, or the focus seems different from what you need, say so. That feedback gives the clinician information they would not have by guessing.

If you are still deciding who to see, the Washington therapist guide offers broader questions about choosing support. A trusted adult or the practice intake team may also help with practical details while you consider your own questions.

Frequently asked questions

What if I did not ask for counseling?

You can tell the counselor how you feel about being there and ask what the appointment is meant to involve. Your perspective is useful information, including uncertainty or frustration about the process.

Do I need to talk a lot in the first session?

You can begin with a small example or ask for more specific questions. The clinician will also explain what information is needed to understand your concerns and provide appropriate care.

Will my parent be in the room?

Ask the practice how the first visit is arranged and how caregiver involvement is decided. It may depend on the service, clinical needs, applicable rules, and the plan discussed with you.

Can I talk about friendships instead of school?

You can tell the counselor what feels most important to you. The clinician may ask about different areas of life to understand the broader picture, and you can discuss how the focus is chosen.

Can I ask questions before booking?

Yes. You or a caregiver can ask the practice about age eligibility, paperwork, costs, scheduling, and how counseling works. Save personal health details for its intake process.

A next step with Nicole

I’m Nicole Wilkerson, LMHCA, a Washington Licensed Mental Health Counselor Associate practicing with clinical supervision. I work with teens age 13 and older and adults. My approach is warm and collaborative, with room for your questions, experiences, and feedback.

To ask about working together, explore appointment options and request Nicole Wilkerson, LMHCA, by name. The practice intake team can confirm current availability, clinical fit, appointment format, fees, and your specific insurance benefits.

For a general question about my approach, contact me here. Keep the initial message brief and save personal health information for the practice’s intake process.

Sources and further reading

• National Institute of Mental Health: Children and Mental Health
• Washington Legislature: RCW 71.34.530—Outpatient Treatment
• Washington Legislature: RCW 70.02.265—Adolescent Treatment Information

This article provides general information. A clinician can assess your individual circumstances and discuss appropriate care. This website and email are not emergency services.