Millennials are coming of age. Broadly classified as those born between 1980 and 2000, by 2020 they will form 50% of the workforce.1 They are a generation that is frequently dismissed as narcissistic ‘snowflakes’ who can’t get to grips with ‘adulting’. But they are also a politically aware, ecologically minded, accepting, compassionate and emotionally literate generation, whose lives have been fundamentally shaped by the digital revolution. As psychotherapist and millennial Sissy Lykou says: ‘We’re not always on our phones, we’re not all obsessed with taking selfies and the reason we can’t buy a house is not because we spend our money on avocados.’

Also known as Generation Y, and sometimes Generation Rent (a third of millennials will never be able to afford their own home)2, in Germany millennials are called Generation Maybe and in Norway Generation Serious. The Chinese call them ken lao zu, or ‘the generation that eats the old’, and in Japan they are known as nagara–zoku, ‘the people who are always doing two things at once’.3

They span an age group from 18 to 30-something, and so include school-leavers and 38-year-olds with their own millennial children. They have grown up in the shadow of terrorism and gun crime, financial crisis and recession, and been fed on neoliberal values of competition and individualism. They have been encouraged to go to university and are more likely than previous generations to come out with a first-class degree, and already in debt. They face a competitive, VUCA (volatile, uncertain, complex and ambiguous) work environment, and many will end up in jobs for which they are over-qualified.4 They invented the term ‘digital nomad’, and think nothing of working globally and in a totally virtual environment. But zero-hour contracts and the gig economy have eroded the securities and rights they can expect from their employer. Even unpaid internships are highly competitive in popular industries. They also report increasing levels of perfectionism,5 and pressure to outperform their peers. It’s no surprise that so many say they feel ‘burnt out’ in their 20s.6

When millennials come to therapy, their therapist is unlikely to be one of their generation – most BACP members, for instance, are baby boomers or, like me, Gen Xers.7 Most of my private clients are millennials and I am careful to check that I don’t view their lives through the lens of my own experience. But lately I have been wondering what else we need to hold in mind when we work with this generation. How can we ensure that they feel understood by us? What are they bringing to therapy and what do they need from us now?

Flexible boundaries

Millennials have been brought up in increasingly non-hierarchical families, where children’s needs are seen as being of at least equal importance to those of adult family members. Their parents tend to spend more time with them than in previous generations,8 and intergenerational closeness generally is on the rise.9 Parental involvement is more likely to continue into adulthood – research has shown that a third of the costs of parenting are spent on children after the age of 18.10 When they come to therapy, even in their 20s and 30s, it may be the parents who are paying, and the therapist may find that those parents expect to have a say in what happens in the therapy room.

So what does this generation expect from their relationship with their (usually) older therapist? I no longer worry if a text from a millennial client to rearrange a session ends in a kiss, which seems to have replaced the full stop. But I wonder at times how they experience my boundaries – the lack of physical contact, for instance, for a generation that seems to greet everyone with a hug, and the lack of self-disclosure, when they are so open to sharing their lives online.

‘Millennial clients bring an enthusiasm for mutuality which is a positive turn towards relationality for both clients and the profession,’ believes Lykou. ‘Some of my personal therapy while training was very rigid, and I remember thinking, when I finished, that I never had a chance to sense the body temperature of my therapist, as we never shook hands. I didn’t know if I was even allowed to ask to shake hands! So there was a hierarchy there.’

But mutuality doesn’t have to mean lack of boundaries, says Lykou. ‘It’s more a way of being. I may sit on the floor with a client, instead of on chairs, if that makes them feel more at ease, but only if I am OK with it – mutuality and equality of relationship mean that I shouldn’t be made uncomfortable either. And a genuine way of being does not have to mean self-disclosing.’ Lykou will only disclose what she chooses, as she would with any client.

Most of us would hold fast to the belief that boundaries are important. As Jane Darougar, a psychotherapist working in a college counselling service and an executive member of BACP’s Universities and Colleges division, believes: ‘When lives are unstable, the reliability and predictability of your therapist being there at the same time every week is very grounding.’

Psychotherapist Aaron Balick agrees: ‘I think that there has been a levelling out of hierarchies between parents and their children, and a diminution in how “authority” is perceived. Unlike in previous generations, younger people may think it’s OK to email or text a therapist between sessions. I think therapists need to be flexible, but I also think they need to maintain boundaries, as negotiating them is so important. The main issue here is avoidance of difficulty or conflict in face-to-face relationships. For example, it may be easier to “ghost” a therapist than to discuss ending therapy. It’s these complex interpersonal relationships that can be avoided by technologies, so it’s really incumbent on therapists to find the best ways of working with difficulty face-to-face.’

Balick is the director of Stillpoint Spaces London, a psychology hub that is finding new and innovative ways of working psychologically. It is experimenting with ‘speed-date a therapist’ open days, when members of the public can meet with several therapists for 10 minutes at a time, for free. ‘While we have been criticised for using a dating model for therapy, I think this is one of those areas where we need to think much more flexibly,’ he says. ‘Therapists talk a lot about how therapy should be more accessible, but then cringe at the idea of changing some potentially outdated models in case they’re breaking a shibboleth. We don’t want to make finding a therapist like Tinder, but we can look to the cultural zeitgeist to get some indications about how we can think about deploying therapy differently.’

Lykou says that we may need to accept an increasingly fragmented approach to therapy from clients of all ages – a ‘dip in, dip out’ approach that sees therapy as something to be accessed only when needed. But she attributes this trend as much to our consumerist culture as to the attitude of millennials. ‘I call it the “Amazon attitude” – you can buy with one click if you decide you want something, but you don’t really care about the product after that because you can send it back. You might not even bother to pick it up from the Amazon Locker.’

Digital awareness

For me, one consequence of working with millennials in my private practice has been a reconsideration of the meaning of the word ‘talk’. I have come to realise that clients who refer to ‘talking’ are as likely to be referring to texting, WhatsApping, Snapchatting or Facebook messaging as they are to verbal conversations. We risk alienating or failing millennial clients by holding a false distinction between real and online life, says Balick. ‘For most younger people, these are just online expressions of real life. I think that many non-millennial therapists are making this faulty distinction, often implicitly or unconsciously, in ways that are not helpful – for example, by dismissing people’s online experiences as “less than”.’

At the same time, an increasing number of millennials are reporting feeling overwhelmed by their digital lives and are seeking new ways to manage the constant onslaught of information. Supporting them is not simply a case of suggesting a ‘digital detox’, says Bridgette Bewick, Associate Professor in Psychological Health and Wellbeing at Leeds University. ‘For the majority of people, not engaging in online life for extended periods of time is just no longer feasible. It’s how we navigate the world, read books, get news, do banking, keep in touch with family and shop for clothes.’

We would be wrong to think of all millennials as engaging with technology in the same way, says Bewick; her own research shows a very varied picture. ‘Some young people have made a conscious decision not to look at their phones at certain times and they feel positive about their phone use. Equally, others have made a conscious decision to be always contactable and to respond quickly, and many seem to be doing OK with that. For millennials, it’s about finding ways to take back control, and one solution doesn’t fit everybody. Young people need space to think about what they want from the digital world and to be supported in how they achieve that.’

The perfection trap

Soon after I started out in private practice, I noticed I was attracting a certain type of client – typically 20- or 30-somethings presenting with anxiety and depression and living with debilitating levels of perfectionism. It’s a trend identified by a 2018 study of 40,000 American, Canadian and British university students aged 18 to 22, from the University of Bath and York St John University.5 The extent to which young people attach an irrational importance to being perfect, hold unrealistic expectations of themselves and are highly self-critical has increased by 10% over the past three decades. Socially prescribed perfectionism, to avoid being judged by others and to secure their approval, has increased most dramatically, by 33%.

‘Socially prescribed perfectionism is the one that is most problematic as it is rooted in the need for others’ validation and approval,’ says study co-author Thomas Curran from the University of Bath’s Centre for Motivation and Behaviour Change. ‘It’s an exhausting existence on a day-to-day basis, an internal dialogue around “I must impress people” or “I must be seen as efficient” – thought processes that create internal conflicts and anxieties. There is a lot of research that suggests that it has a very negative effect on our mental wellbeing.’

Curran emphasises that his study was not looking at causation, but he believes perfectionism is increasing because of broader cultural issues, social media being a major factor. ‘We have shifted our value systems from a New Deal, post-war, consensus-based, collective society to a quite individualistic, consumerist society, and that brings with it fundamental shifts in the way in which people interact and the way they construe a sense of self and identity. There have been changes in education, including more emphasis on testing and competition, as well as other factors outside their control, such as decreased access to employment, high precarity and rising inequality. All of these broader factors we think at some level are having an impact, but social media is the major driver.’

In the therapy room, perfectionism often presents as stress, anxiety, exhaustion and unexplained general unhappiness. Our challenge as therapists, believes Curran, is to shift young people’s mindsets away from thinking of perfectionism as a ‘good thing’. ‘In the young people I come into contact with in my working life, perfectionism is seen as a necessary evil in order for them to get ahead in this competitive world. So raising awareness is important, setting out in clear terms why perfectionism is so damaging, and why there are other ways of going about your academic studies and your relationship with social media that are far healthier. In terms of treatment, what seems to be coming through in the literature is that helping clients to develop self-compassion to silence the inner critic can be very effective, [as can] shifting their focus from outcomes, grades and scores to what they learn as part of the process and how they are developing as a person.’

Expectation hangover

One of the least accurate assumptions about millennials, believes Lykou, is that they have grown up with a sense of entitlement. ‘What is true is that many millennials feel pressure to compete with their peers when they enter the workplace, which is a product of growing up in a post-Thatcher-and-Reagan world, with its emphasis on competition,’ she argues.

Organisational consultant Simon Sinek talks about millennials entering the workplace feeling pressure to make an impact really quickly and feeling like a failure when they don’t:11 ‘Millennials are wonderful, idealistic, hard-working, smart kids who’ve just graduated and are in their entry-level jobs, and when asked “How’s it going?” they say “I think I’m going to quit”. And we’re like “Why?” and they say “I’m not making an impact”. To which we say: “You’ve only been there eight months...” It’s as if they’re standing at the foot of a mountain and they have this abstract concept called ”impact” that they want to have on the world, which is the summit. What they don’t see is the mountain. I don’t care if you go up the mountain quickly or slowly – there’s still a mountain. What this young generation needs to learn is patience.’

The reality for many is an employment landscape defined by increased competition, greater insecurity, higher workloads and lower pay than that of previous generations, says the Chair of BACP Workplace, Nicola Neath. ‘I am about to turn 50 and what was true for me was that hard work got you places, but I don’t think hard work is enough now. In the modern work environment, no matter what people achieve academically, there is no guarantee that they will be rewarded with the job they dreamed of. We therapists need to support them as they experience that huge reality check.’

The current socio-economic situation also challenges the notion of therapy as being about helping the client reach their full potential, believes Lykou: ‘If you have a millennial client who goes for interview after interview and fails to get jobs that are even well below their qualifications, there needs to be an understanding that there is an objective obstacle in moving forward in life. We millennials are the first generation who are unlikely to progress further or even to the same level as our parents, in income, jobs and housing. Many of us are dealing with the depressive state of having to live with our parents at age 35. But not being able to buy a house is not the biggest issue – it’s about not being able to apply our knowledge professionally and being limited in power and not being independent. That is the main issue that comes into the counselling room.’

As well as the challenges of finding a job appropriate to their education and expectations, millennials are facing much greater stress when in work. A 2018 survey by the Mental Health Foundation found that 60% of those aged 18 to 24 and 41% of 25- to 34-year-olds felt under pressure to succeed at work, compared with 17% of those in the 45 to 54 age group.12 More than a quarter of millennials believed tolerating stress went with the territory in the workplace, compared with just 12% of those aged between 53 and 71. This may well reflect the realities of working life today.

‘The virtual workplace is a real phenomenon,’ says Neath. ‘Of course, we have always thought about work when we are away from it, but we have never before been in a world where we can potentially be exposed to work problems at 3am in the morning. We don’t totally understand the effect on our autonomic nervous system of being always contactable. We have to think about how we support young workers in this environment, what their resources are and how they get rest. We need to support millennials to understand what creates stability in themselves and in the workplace in a different sort of way, what brings them their sense of competence, and we need to help them be self-compassionate and patient, so they can work out what they want.’

Lykou agrees: ‘What they need is someone to listen to them rather than mentor them to be better; someone to accept that they have vulnerabilities, rather than saying: “Come on, you will make it one day if you try hard.”’


Millennials are also notably readier to admit to and seek help for mental distress. There has been a well-documented rise in the number of under-30s seeking help for mental health conditions, and millennials have been in the vanguard of breaking down the stigma attached to a mental health diagnosis. They are an emotionally literate generation with an astonishing willingness to articulate and share their vulnerabilities. But there is a downside to this readiness to admit to mental distress, believes Darougar. ‘Notions of privacy and how much access people feel entitled to have to each other’s lives are very different for this generation. It astonishes me when they want to tweet or blog about what happens in their therapy. I work with young clients to consider what they share, and the impact potentially on their lives in the future. I also see an increasing lack of distress tolerance and a growing trend towards the pathologising of normal emotions,’ she says. ‘Labels such as “my anxiety” or “my depression” can become prisms through which they view their whole life. When millennials arrive at the therapy room with a diagnosis of “social anxiety” or a label of “low self-esteem”, we need to acknowledge their difficulties but not collude with them when they are using the label as a form of avoidance, such as missing commitments because of their “social anxiety”.

‘A lot of my work is about normalising – helping clients to consider that feeling nervous about walking into a lecture theatre or breaking into a new friendship group may be normal, rather than a sign that they suffer from anxiety or are “being triggered”. They can profoundly limit their lives because of a perception that they have mental health issues. We need to educate them about the spectrum of normal emotions and experiences.’

So acceptance, understanding, challenge and the time and space to work out what they are really feeling – these are what millennials need from therapists. Perhaps what we are finding is that, while every generation is unique, what each needs from therapy does not differ so very much after all.

Sally Brown is a counsellor and coach in private practice (, a freelance journalist and Chair Elect of BACP Coaching.

Members and subscribers can listen to a panel discussion on working with millennials, produced in conjunction with, on the Therapy Today podcast


5. Curran T, Hill AP. Perfectionism is increasing over time: a meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin 2017.
7. BACP. Members employment research report. Lutterworth: BACP; 2017.
10. Mintz S. The prime of life: a history of modern adulthood. Cambridge, MA: Belknap Press; 2015.
12. Mental Health Foundation. Stress: are we coping? London: Mental Health Foundation.