How to Talk to Someone About Getting Help When They Don’t Think They Need ItHow to Talk to Someone About Getting Help When They Don’t Think They Need It
A Little Help For Our Friends
Dr Kibby McMahon talks through why loved ones often refuse therapy or treatment and shares practical, research-backed ways to speak with them about change without escalating conflict. The episode touches on addiction, intense emotions and crisis situations, emphasising empathy, shared goals and safety.
54:05•22 Jul 2026
When ‘You Need Therapy’ Backfires: A Kinder Way to Get Someone Help
Episode Overview
- Pushing or convincing someone to get help often backfires by triggering shame and a fight to protect their autonomy.
- Shift from telling someone they are the problem to trying to understand their perspective, feelings and what they see as the real issue.
- Use the LEAP steps—listen, empathise, agree on common ground, and partner—to build cooperation around change rather than conflict.
- Offer genuine choices in support options so the person feels ownership over their path, which increases engagement with treatment.
- In situations of serious risk to self or others, prioritise safety even if it means limiting autonomy and involving emergency or crisis services.
“You don’t want them to get therapy. You want them to change.”
How do people cope with the challenges of staying sober or managing intense emotions when they don’t even think anything’s wrong? This episode of *A Little Help For Our Friends* zooms in on that sticky moment where you’re watching someone you care about struggle, thinking, "They really need help," while they insist they’re fine. Dr Kibby McMahon walks through why people push back against therapy or treatment, even when their lives are obviously affected.
She talks about shame, fear of being labelled "the problem", past bad experiences with therapists or hospitals, and the way coping strategies like drinking or avoidance can feel like a lifeline rather than the issue. Using examples such as her mum’s drinking and her own experience with infertility-related depression, she shows how being told "you need therapy" can feel invalidating, even when the person secretly knows they’re not okay.
You’ll hear about practical frameworks used in addiction and mental health work, including CRAFT, motivational interviewing, and the LEAP method. Instead of pushing or threatening, Kibby suggests focusing on understanding the person’s perspective, validating their feelings, finding shared goals (like reducing screaming rows or keeping a job), and then partnering with them on solutions. As she puts it, "You don’t want them to get therapy.
You want them to change." There’s also clear guidance on when safety has to come first, such as suicidal threats or risk of violence, where calling crisis services or going to A&E may be necessary even if it means limiting someone’s autonomy.
If you’re worn out from telling a loved one "you need help" and getting nowhere, this episode offers concrete language shifts, gentle humour, and a more collaborative approach that can protect your relationship while still taking their struggles seriously. Could changing the conversation from "you need to change" to "what do you wish were different?" be the turning point you’ve been looking for?
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