How Are Mental Health Problems Treated in Kids?
Types of treatment that can work for children
Mental health treatment for kids fits into two broad categories: therapy and medication.
In therapy, a clinician works with the child, and their parents, to reduce the symptoms that are causing them problems — such as anxiety, depression or disruptive behavior. In therapy sessions kids and their parents learn about what might be causing the symptoms (this is called psycho-education). And kids, with the support of parents, learn skills that will enable them to feel better and manage their behavior better.
In medication treatment, a medical doctor or nurse practitioner prescribes medication that will help reduce the child’s symptoms. Once the child has started medication, the doctor will pay close attention to make sure that the medication is working and that the child is taking the right amount. They might adjust the dose to find what works best. Then, the doctor will meet with the child, and parents, every few months to see how the child is doing and whether the medication is still working.
Treatments for mental health disorders are described as “evidence-based” if they have been tested on many children in studies and shown to be successful.
Therapy combined with medication is sometimes the most effective treatment for children, especially those with severe symptoms.
Cognitive Behavioral Therapy
Many evidence-based therapies for mental health issues are a form of cognitive behavioral therapy (CBT). CBT is a skills-based approach in which a therapist teaches the child and their parents how to make changes in their thinking and their behavior in order to reduce the symptoms that are distressing them. That could be anxiety or depression or problem behavior. They learn these skills in therapy sessions and practice them at home.
Therapy sessions usually continue for several months, until the child’s symptoms are under control. That could mean they are feeling better, going back to school, or are able to control behavior problems that were interfering with their life. Sessions may occur less frequently for a period of time before ending, and may start again if a child runs into problems or needs a “booster” session.
CBT is specialized for each kind of mental health problem, from anxiety and depression to trauma and psychosis. The therapist teaches skills in a specific sequence that has been shown to be successful for children with that problem. (For a list of such evidence-based therapies and what they are used for, see our Guide to Behavioral Treatments.) Using the right techniques matters: The right clinician for your child will be one who has experience in the particular therapy your child needs.
Some mental health problems respond well to medication treatment. Or medication may be combined with therapy to help children make the most progress.
There are a number of different types of medication for mental health challenges, including anti-anxiety medications, anti-depressants and anti-psychotics. These categories can be confusing because the medications may actually be useful for several different kinds of problems. For example, the medication that often works best for children with anxiety is a form of anti-depressant. Anti-psychotic medications are sometimes used for severe behavior problems even when there is no psychosis involved. It’s important to make sure that the doctor prescribing medication for your child is experienced in treating children with the problems your child is having.
Success with these medications depends on getting the right dose, which involves starting with a low dose and increasing it gradually to find the most effective level. It’s important to make sure your doctor has enough time to work with you and your child until the medication is successful, and to monitor your child as they grow to make any necessary changes.
If medication that is prescribed for your child isn’t working, one possible reason may be that the diagnosis of your child’s problems is not correct. For example, if your child is having trouble concentrating in school, and is diagnosed with ADHD, they might be prescribed stimulant medication for ADHD. But if the child is actually not paying attention because they have unrecognized anxiety, the stimulant medication may not solve the problem.
A child may also have several different problems, and medication that helps for one may not work for another. Some children are given more than one medication. If your doctor recommends adding a second (or third) medication, here are things you should look out for.