“boy” therapy

When we talk about therapy for boys and young men, one of the first things we need to do is let go of the idea that there is one "right" way for them to engage.

For some boys, sitting in a quiet room and talking directly about their feelings feels completely natural. For others, it can feel awkward, uncomfortable or even impossible. They might be much more willing to talk while playing a game, kicking a footy, walking, drawing, gaming or simply having something to do with their hands.

This isn't about lowering expectations or avoiding difficult conversations. It is about finding a way into those conversations that actually works.

Boys are not simply "less emotional"

One of the myths we can challenge is that boys and men are naturally less emotional or less interested in talking about what is happening for them.

Boys experience emotions just as deeply as anyone else. What can differ is how comfortable they are recognising, expressing and communicating those experiences.

Many boys grow up receiving messages about what it means to "be a man". Be tough. Don't cry. Don't complain. Sort it out yourself. Don't look weak. Don't let people see that you're struggling.

Over time, these messages can make emotional vulnerability feel unfamiliar or even unsafe.

It is difficult to talk about an internal experience when you don't have the language for it, don't know how to explain it, or have learned that talking about feelings is something you are not supposed to do.

This is one reason seemingly simple tools can be surprisingly useful.

A feelings wheel, for example, might look childish or overly simplistic to some adults. In practice, having a visual list of words can give someone a starting point: Am I angry? Embarrassed? Overwhelmed? Disappointed? Lonely? Frustrated? Ashamed?

Sometimes finding the word is the first step towards understanding what is actually going on.

Therapy doesn't always need to involve sitting and talking

Movement, play and shared activities can be particularly useful ways of building rapport with boys and young men.

A therapy session might involve a board game, cards, drawing, kicking a ball, walking, building something, talking about a favourite game or even using gaming as part of the therapeutic process.

The activity isn't necessarily the therapy. It can provide a comfortable, low-pressure context in which therapy can happen.

For some young people, sitting beside someone rather than directly opposite them reduces the pressure of eye contact and constantly monitoring another person's facial expressions and reactions. Having something to focus on can also give the brain somewhere to put some of that extra energy.

And sometimes, talking about the game is the way we eventually start talking about everything else.

Neurodivergent boys may need something different

Boys are diagnosed with ADHD and autism at higher rates than girls, although the reasons for these differences are complex. For ADHD, Australian population data has found substantially higher rates among boys than girls in childhood.

For autism, researchers increasingly recognise that diagnostic rates do not necessarily tell the whole story. Girls and women may be more likely to camouflage or compensate for autistic differences, potentially contributing to missed or delayed diagnosis. Research also suggests that autistic people of all genders can camouflage, and the extent to which this differs by sex is still being investigated.

This matters when we work with boys too.

Some neurodivergent boys may have fewer opportunities, skills or motivation to hide their differences in environments where they are expected to "just fit in". Their difficulties may therefore be more visible. They may be described as disruptive, lazy, aggressive, immature, defiant or "not trying", when there may be much more happening underneath the behaviour.

That doesn't mean boys are inherently less capable of masking, or that every boy presents in the same way. It means we need to look beyond the behaviour and ask what that behaviour might be communicating.

Development doesn't happen on a single timeline

There can also be enormous pressure on boys to "grow up" quickly.

We sometimes hear about boys being "behind" socially or emotionally compared with their peers. While developmental differences are real, describing a child simply as immature can miss the bigger picture.

Social and emotional development is influenced by many factors, including neurodevelopment, temperament, learning experiences, relationships, environment and opportunities to practise particular skills.

A child who struggles to identify emotions, manage frustration, navigate friendships or cope with losing a game may not simply need to "act his age". He may need explicit opportunities to develop these skills in ways that make sense to him.

Therapy can provide that space without making the young person feel like they are being treated as a problem that needs fixing.

The online world has changed the landscape

Boys and young men are also growing up in a very different environment from previous generations.

The internet can provide incredible opportunities for connection, community, learning and belonging. Gaming communities, YouTube, Twitch, podcasts and social media can connect young people with people who share their interests.

But there is another side to this.

Young men are increasingly exposed to online conversations about masculinity, relationships, status, sex, money, appearance and what it means to be successful. Some of these spaces can provide genuine connection. Others, including parts of the online "manosphere", can promote rigid ideas about masculinity, blame, dominance and relationships.

Simply telling young people to "stay off the internet" isn't particularly realistic.

Instead, therapy can create a space to explore what they are seeing, what they believe, what resonates with them and what doesn't. We can talk about algorithms, influencers, online communities, masculinity, relationships and identity without immediately turning the conversation into a lecture.

Sometimes the most useful question is simply:

"What do you make of that?"

Boys need role models who show that vulnerability is not weakness

There is also reason to be hopeful.

More male athletes, entertainers, creators and public figures are talking openly about mental health. These conversations matter because young people don't only learn about masculinity from parents, teachers and therapists. They learn from the people they watch, listen to and admire.

A particularly powerful recent example in Australia has been AFL player Bailey Smith. Smith has spoken publicly about his mental health on multiple occasions, including revealing in 2025 that he had spent four weeks in a mental health facility during a particularly difficult period following his ACL injury.

His story is important not because professional athletes should become mental health educators, but because young men can see someone they may admire acknowledging that struggling does not make them weak.

And role models don't have to be AFL players.

For some young people, their role models might be YouTubers, streamers, gamers, musicians, actors, creators or characters from the games they play. These interests can actually become useful pathways into therapeutic conversations rather than things that need to be removed from the room.

Risk-taking can be part of the picture

Boys and young men can also be more likely to engage in risk-taking behaviours, although this is influenced by a wide range of individual, social and environmental factors. Australian data shows young males experience higher rates of injury and some forms of risky behaviour than females.

For a neurodivergent young person, impulsivity, sensation-seeking, difficulties with inhibition, emotional regulation or social pressures can add another layer.

Rather than simply saying "Why would you do that?", therapy can explore what the behaviour is doing for the person.

Was it exciting? Did it help them fit in? Did they want to prove something? Were they overwhelmed? Did they act before they had time to think? Did they not recognise the potential consequences?

Understanding the function of a behaviour gives us somewhere much more useful to go than simply telling someone not to do it again.

Sometimes the first goal is simply connection

Therapy with boys and young men doesn't have to begin with:

"So, tell me how you're feeling."

It might begin with:

"What games are you playing at the moment?"

"How's footy going?"

"Want to shoot some hoops while we talk?"

"Show me what you've been working on."

"What's the most annoying thing about school right now?"

"Have you seen that video everyone is talking about?"

These aren't distractions from therapy. They can be the beginning of it.

Once a young person knows that they don't have to perform, pretend or have all the right words, it becomes much easier to build trust.

And once there is trust, we can start having the harder conversations.

Therapy should meet boys where they are

Working with boys and young men isn't about creating a stereotypically "male" version of therapy. It's about recognising that every person engages differently and being willing to adapt.

Some young people will want to talk. Some will want to move. Some will want to game. Some will want to draw. Some will want to sit quietly for a while before saying anything at all.

Our role isn't to force someone into a particular version of therapy.

It is to create enough safety, connection and flexibility that they can gradually become comfortable bringing more of themselves into the room.

Because sometimes the boy who says "I'm fine" isn't refusing to talk.

He might simply not know where to start.