When an Older Loved One Refuses Therapy

If you’ve got an older loved one in your life who’s refusing to go to therapy (even if they really seem to need it!), you might be asking yourself: Why do boomers hate therapy? It’s a common and understandable question that many of us have.

The thing is, many older adults don’t actually “hate” therapy. Instead, they may feel resistance to the idea of therapy because they associate it with shame, a loss of control, or a sign of weakness. They may have had bad past experiences with therapy, or feel like they’ve powered through life this long and don’t see a need to try a different method.

In other words, it’s not just a question of, “Why do older people hate therapy,” but rather: what biases might they have around therapy, and how can loved ones help support them so they’ll feel more comfortable trying therapy?

Here, we’ll unpack reasons why some older adults refuse therapy, and also empower you to support your loved one in a helpful and productive way. 

Why therapy can feel threatening to older adults

Between 20-22% of older adults meet the criteria for a mental health disorder. Yet only about half of older adults seek mental health treatment. Why do so many older adults refuse therapy, and why do some boomers seem to “hate” the idea of going to therapy?

The answer is complicated, and varies from one person to another. Overall, though, the “hate” and resistance you might be seeing in your loved one is usually only the surface-level reaction they’re expressing. Often, beneath this are feelings of fear, mistrust, embarrassment, and alienation from the idea of therapy altogether.

Boomers are defined as people born between 1946 and 1964, after World War II. They were children in the 1950s and early 1960s, when therapy was virtually unheard of and heavily stigmatized as something only “crazy” people did.

Additionally, this generation grew up with values that centered around self-sufficiency, competition, goal-setting, and not appearing “weak.” Introspection wasn’t always valued and the concept of “work-life balance” hadn’t been invented yet.

In other words, this generation’s barriers to therapy aren’t really about being stubborn. They come from stigmas and biases that sometimes date all the way back to childhood. When an older adult hears from you that therapy might be a good idea, they may immediately jump to, “You think I’m weak” or “You think I’ve become a burden” or “You think I’m broken.”

The hidden fears behind therapy refusal

Besides ideas about what it means to go to therapy (i.e., “Going to therapy means I’m weak” or “Therapy is only for seriously mentally ill people”), older people can have real emotional barriers to the idea of therapy.

For instance, many older adults fear that:

• The therapist will judge them about their feelings and experiences
• They’ll end up losing their independence by exposing a weakness
• They’ll be diagnosed with a mental health condition that they perceive as “bad”

Other reasons that older people often refuse therapy include:

• The belief that feeling depressed or anxious is just part of getting older
• The fear that someone will find out they went to therapy and judge them for it
• Concerns about the cost of therapy and whether insurance will cover it
• A bad prior experience with counseling or therapy, or witnessing someone close to them have a negative therapy experience

Male bias against therapy

If you’re wondering, “Why do men refuse therapy?” you’re far from alone. Many of us notice that the men in our life have an even harder time accepting the idea of seeking care for their mental health. A lot of this has to do with the mentality that men tend to be brought up with, which is that the idea of showing your feelings makes you weak or less masculine.

Simply being aware of this issue, and knowing that societal pressures are part of the reason your loved one is so resistant, may help you to lead with more compassion as you talk to them about therapy. 

Crucially, just because a man is resistant to therapy doesn’t mean you should give up. Men have a significantly higher suicide risk than women, and while female suicide risk tends to decrease with age, it actually tends to increase as men get older. 

Likewise, because of a tendency to experience emotional distress in the form of anger, sleep issues, pain, or irritability, it may be harder for men to identify when they are struggling. As a loved one who sees what’s going on, you can gently guide them toward help.

Why “just go to therapy” rarely works

Ever had someone suggest you do something you’re not sure you want to do by coming on strong and listing all the reasons you need to do it? This type of pressure can make anyone who is hesitant feel even more resistant. This is especially true when it comes to persuading someone to do something emotionally vulnerable like starting therapy.

When you take the tactic of direct persuasion, such as saying something like, “You really need to go to therapy,” your older relative is likely to view this as nothing but criticism. They may feel infantilized or talked down to. And they may end up feeling like it’s really you who has the problem, because they perceive you to be treating them unfairly.

Instead, you want to use methods that put your loved one in the driver’s seat, using language like, “Would you be open to talking to a therapist?” Additionally, instead of focusing on what’s wrong with your loved one, focus on concrete benefits they may get from therapy, like better sleep, less loneliness, or better ways of coping with their feelings.

Above all, never frame this discussion as a threat, and don’t mock your loved one for their beliefs about therapy. Also, it’s best not to “diagnose” your loved one with something, or use therapy as a weapon in a family conflict.

How to bring up therapy without a fight

Importantly, just because someone you love seems adamantly against going to therapy, it doesn't mean they are entirely unreachable. But it means that the way you talk to them about going to therapy needs to feel safe and non-judgmental, without as much of an emphasis on “fixing their mental health.”

Here are some tips for helping this conversation go smoothly:

• Start the conversation in a safe and private space, not in a place associated with stress or where other people may overhear
• Validate the person’s feelings throughout the conversation
• Connect the idea of therapy to their own articulated goals
• Offer options, so that even if they reject one path, they won’t be rejecting all help
• Offer to support them throughout the process, including finding a therapist, and even accompanying them to therapy
• Point out out your loved one’s positive attributes, and the ways they’ve navigated difficult times in the past, connecting this to the idea of them seeking care now
• Give your loved one examples of people they know or admire who have sought mental health care, and consider sharing your own experience

When to step back, keep trying, or get more support

Most of the time, you don’t have to feel like you’re in a huge rush to get your loved one the care that they need. You can have several conversations about the idea of therapy, and let them gradually open up to the idea.

But sometimes, you’ll need to intervene more immediately. For example, you should strongly encourage your loved one to get care if:

• They’re having trouble functioning in their day to day life
• They’re are showing signs of worrying personality changes
• They’re withdrawing from their social life
• You think they’re danger to themselves

Sometimes loved ones misinterpret signs like these as simply refusing therapy, but when your loved one is having severe symptoms like this, something more is going on.

What to do when you see these signs? For reluctant family members, this might look like seeking help from their PCP at first, and having you tag along so you can share insight about the situation. If you have immediate safety concerns, you should call 911 or seek emergency care.

Most of the time, though, if an older person refuses to see a therapist, despite multiple attempts – even when every effort is made to encourage them in a compassionate, non-judgmental way – it might be time for you to step back. You can’t force someone to go to therapy if they simply will not, even when you know it’s best for them. Making peace with that can be difficult, but there comes a point where it’s best for everyone involved for you to step back.

That doesn’t mean the conversation is 100% over. Sometimes a loved one will be more open to the conversation in a few months, or may even come to you later, when they feel ready to talk about what they need. Continue to model openness, and work on building trust between yourself and your loved one.

How Sailor Health helps make support easier to accept

When an older relative feels hesitant about therapy, reducing friction and protecting their sense of independence can make all the difference. For someone who fears judgment, travel, or clinical office settings, having a comfortable, low-pressure option can make taking that first step feel less intimidating.

Sailor Health removes common barriers to therapy by bringing care directly to older adults at home. Sessions happen over video or phone (including landlines) so there’s no driving, no sitting in waiting rooms, and no fear of being seen walking into a therapist’s office.

Our therapists are experienced older adults themselves who understand the unique life transitions, health changes that come with aging, as well as generational perspectives on psychotherapy. They recognize that effective support doesn't require formal or uncomfortable 'therapy talk,' and they adapt evidence-based approaches to fit each person’s comfort level and goals.

Getting started is straightforward, and therapy is often available within 24 hours of signing up. All of our providers accept Medicare, and most patients have a $0 copay out of pocket. If you're helping an older loved one explore their options, support may be much closer and more accessible than they think. When they’re ready, Sailor Health is here to help them take that next step.

Therapy avoidance FAQ

Why do older adults refuse therapy even when they seem unhappy?

This is common and happens because of stigmas and biases many older people have about the idea of therapy.

Is therapy really effective for Baby Boomers and older adults?

Yes, research has found that therapy can be effective for older adults.

Why do some older men avoid therapy?

Older men may refuse therapy because they view going to therapy as a sign of weakness or reduced masculinity.

How do I suggest therapy to my parent without offending them?

You can do this by tying it to goals that your parent already has about their health and wellness, emphasizing their inborn resilience, and discussing the benefits of therapy.

What should I avoid saying to someone who is against therapy?

You shouldn’t emphasize what’s “wrong” with them, or argue strongly against their point-of-view.

Can therapy help someone who doesn’t like talking about feelings?

Yes, and not all therapy is about “feelings,” but about ways of coping and understanding thoughts and behaviors.

What if my parent says therapy is only for “crazy people”?

You can validate that they feel that way, and then explain that nowadays, you don’t need to be severely mentally ill to go to therapy. It can also help to name “normal” people they know who have benefitted from therapy.

Is virtual therapy a good option for older adults who are uncomfortable going to an office?

Virtual therapy is a great option for older adults, because they can do it from the comfort of their own home, which may feel less intimidating or stressful than going to a therapy office.

Does Medicare cover therapy for older adults?

Yes, Medicare Part B covers therapy for older adults.

When should I be more concerned about an older adult refusing mental health support?

You should be more concerned when your older loved one is having trouble functioning in their daily life, is showing signs of suicidal ideation, is withdrawing from social life, or showing signs of significant personality changes.

References

1. Practitioners Working With Older Adults (2014). American Psychological Association. https://www.apa.org/pi/aging/resources/guides/practitioners-should-know?item=7
2. Why We Must Address the Rising Mental Health Needs of Our Growing Older Adult Population (2023). National Council on Aging. https://www.ncoa.org/article/why-we-must-address-the-rising-mental-health-needs-of-our-growing-older-adult-population/
3. The Changing Generational Values (n.d.). Johns Hopkins University. https://imagine.jhu.edu/blog/2022/11/17/the-changing-generational-values/
4. Elshaikh, U., Sheik, R., Saeed, R. K. M., Chivese, T., & Alsayed Hassan, D. (2023). Barriers and facilitators of older adults for professional mental health help-seeking: a systematic review. BMC geriatrics, 23(1), 516. https://doi.org/10.1186/s12877-023-04229-x
5. Global suicide rates highest among older adults, particularly men, study finds (2025). Harvard School of Public Health. https://hsph.harvard.edu/news/global-suicide-rates-highest-among-older-adults-particularly-men-study-finds/
6. Suicide Among Adults Age 55 and Older, 2021 (2023). Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db483.htm
7. How to Convince Someone to Get Help (n.d.). National Alliance on Mental Health. https://namimd.org/get-help-and-support/crisis-help/how-to-convince-someone-to-get-help/
8. Saunders, R., Buckman, J. E. J., Stott, J., Leibowitz, J., Aguirre, E., John, A., Lewis, G., Cape, J., Pilling, S., & NCEL network (2021). Older adults respond better to psychological therapy than working-age adults: evidence from a large sample of mental health service attendees. Journal of affective disorders, 294, 85–93. https://doi.org/10.1016/j.jad.2021.06.084