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Last Name
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What's happening at home with your teen right now? Check all that apply.
They're disrespectful or talk back
They won't talk to me
They're isolating in their room
They're lying or hiding things
We feel disconnected
I'm walking on eggshells
They're dismissive or shut me out
There's constant tension between us
They're struggling emotionally and I don't know how to help
I'm reacting in ways I don't want to
Something Else (explain below)
Explain here
What have you already tried to shift things with your teen?
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Read books or listened to podcasts
Tried different communication approaches on my own
My teen is in therapy
I'm in therapy
Family therapy or counseling
Other parenting programs or courses
Talked it through with friends, family, or my partner
This is the first real step I've taken
When you think about getting support with this, what's true for you?
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I've been looking for the right program and I'm ready to commit when I find the right fit
I know I need help and I'm in a season where I can prioritize this
I want help and I'm figuring out what to do next
I'm gathering information
How ready are you to step into doing something different right now?
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I'm all in, I just need to see the next step
I'm motivated and want to understand what's involved
I'm ready to do the work, I just have a few questions first
I'm ready to start exploring what's possible
What would need to be true for you to feel confident saying yes to this?
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