A teen therapy check-in should help the therapist and young person choose what needs attention today. A useful opening offers a manageable response and leads to a shared next step, rather than collecting a mood score and moving on.
This guide is for therapists and counsellors working with adolescents. The scenarios and activities are original educational examples, not a validated treatment programme. Adapt them to the young person’s goals, communication preferences and clinical context.
Keep the opening purposeful
Choose one brief check-in rather than an entire battery. Explain why you are asking, how answers will be used and any relevant privacy limits. Offer an appropriate private follow-up if a group answer raises a concern. These informal prompts do not replace required assessment or risk review.
Use blank paper, words or simple cards. Ask the teen whether the format is useful and keep a familiar option available. Repeating a chosen check-in can be more helpful than continually introducing novelty.
Eight check-ins with actual follow-through
1. What would make today useful?
Run it: Offer three choices: understand something, practise something or make a plan. Invite the teen to add their own.
Example: “I want to leave knowing how to start the conversation.” Follow through: Reflect the chosen goal and agree whether it fits the session; do not treat the menu as the only acceptable agenda.
2. One event, three possible routes
Run it: Ask for one ordinary event or use a fictional example. Offer routes: what happened, what it meant or what to do next.
Example: A cancelled plan can lead to exploring disappointment, checking assumptions or drafting a request. Follow through: Ask which route the teen wants first rather than automatically completing all three.
3. Energy and support map
Run it: Use two separate scales or words for available energy and support needed. Ask what each means to the teen.
Example: Low energy with high support needs may call for a simpler activity and practical planning. Follow through: Do not infer risk or diagnosis from the scale; follow up clinically when concerns arise.
4. Keep, change, leave for later
Run it: Invite three optional notes about the previous session or current week. Ask permission before discussing each.
Example: “Keep written instructions; change the pace; leave the family topic for another day.” Follow through: A request to postpone may need discussion within the treatment plan, not automatic acceptance or confrontation.
5. What happened to the plan?
Run it: Ask what was tried, what got in the way and what should change. Accept that nothing was attempted.
Example: “I opened the worksheet but did not understand the first instruction.” Follow through: Use the answer to revise the task rather than restarting with a lecture about homework.
6. Choose the response mode
Run it: Offer speaking, writing, drawing, pointing, a fictional example or passing. Let the teen change their choice.
Example: A teen writes a topic on a card and asks the therapist to read it first. Follow through: Clarify whether they want reflection, a question or planning before responding.
7. Two things can be true
Run it: Invite two simultaneous experiences without requiring disclosure of the whole story.
Example: “I am glad to be back and do not want a difficult conversation today.” Follow through: Ask what support would make a manageable next step possible; do not insist one feeling cancel the other.
8. Question for the therapist
Run it: Offer a private way to ask about the session, treatment or what happens next. Explain boundaries around personal questions.
Example: “Why do we use these activities?” leads to an explanation and a shared decision. Follow through: Answer transparently where possible and invite correction if the purpose has not been clear.
A worked opening: turn an answer into an agenda
In a fictional session, Ash selects “change the pace.” The therapist asks which part of the last session felt too fast. Ash says they needed longer to choose an answer. The therapist offers written instructions and a pause before follow-up questions.
They agree to practise one school conversation rather than complete three activities. At the end, the therapist asks whether the pacing adjustment helped and what to change next time. The check-in has shaped the session rather than becoming a separate ritual.
If Ash instead raises an urgent concern, the planned activity gives way to an appropriate clinical response. A creative opener is not a reason to defer necessary assessment.
Use check-ins in groups and telehealth
In groups, avoid compulsory public ratings, comparisons or requests for personal histories. Members may select a fictional answer, write privately or pass. Explain who can see written responses; anonymous-looking tools are not necessarily anonymous.
In telehealth, use only agreed communication channels and explain whether chat is retained. Do not require access to private messages or school accounts. Check that there is a workable private follow-up route before inviting sensitive material.
Frequently asked questions
How long should a check-in take? Long enough to identify what needs attention; often a few minutes, but clinical needs take priority over a timer. Should the teen always rate their mood? No. Words, priorities and support requests may be more useful. What if they say “fine”? Offer one concrete choice, then respect the response while following assessment needs.
For broader first-session planning, see activities for a first therapy session. For other communication options, see activities for quiet teens.
Say It Your Way provides optional topic, response-mode, support and control cards with session mats. It is a participation resource, not a mood measure or clinical assessment. The check-ins above can be run with a blank page.
Related educational background: UNICEF’s learning and mood pre-check. These eight original clinical-session examples are not a reproduction or validation of that educational activity.