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2017 Children's Mental Health Report

Specialized Psychotherapies

CBT-based behavioral psychotherapy has proved effective for a wide variety of adolescent mental health disorders. This approach is particularly effective when young peple receive specialized therapies developed to treat their specific disorders or symptoms and that are validated through research.¹ In adolescents, more is better: one study found that five or more treatment sessions led to small/moderate effects, while nine or more sessions resulted in moderate/large treatment effects.²

  • Dialectical behavior therapy (DBT) is an evidence-based form of cognitive behavioral therapy for teenagers and adults who experience significant trouble managing their emotions, thoughts and behaviors. Patients participating in DBT learn how to practice mindfulness — being fully in the present moment, focusing on one thing at a time without judgment — along with new problem solving skills. DBT has been successfully adapted for teenagers and young adults dealing with self-injurious and suicidal behaviors, depression and anxiety, eating disordered behaviors, and drug or alcohol abuse.
  • Interpersonal psychotherapy for adolescents (IPT-A) is a time-limited treatment (12-16 sessions) originally developed to treat adult depression that has been adapted for adolescents. IPT-A addresses common issues involving romantic relationships, communicating with parents and effectively interacting with peers. The treatment primarily includes individual therapy sessions, and may also include some sessions with parents to learn about depression, address parent-child relationship difficulties and help support their child’s treatment.
  • Exposure and response prevention (ERP) is a kind of cognitive behavioral therapy for disorders like phobias and OCD, that works by helping children and adolescents face the things that trigger their anxiety in structured, incremental steps, and in a safe environment. This allows them to experience anxiety and distress without resorting to compulsions, with the support of the therapist. Through facing their triggers they learn to tolerate their anxiety and, over time, they discover that their anxiety has actually decreased.
  • Trauma-focused cognitive behavioral therapy (TF-CBT) is a short-term, component-based trauma-specific intervention consisting of psychoeducation and parent training. Together with the therapist and the help of parents, children and adolescents learn relaxation, affective modulation, and cognitive coping skills; work through the trauma narrative; practice processing the trauma; and develop skills for enhancing future safety and development. The components constitute three treatment phases: stabilization and skill building, exposure to and cognitive processing of the trauma, and fostering safety and future development.
  • Cognitive behavioral therapy adapted for psychosis (CBTp). Broadly, CBT works by helping patients examine how they think about a situation, how they act based on their thoughts, and how their thinking and behavior together affect how they feel. In the case of CBTp, the therapist’s goal is not to get the patient to question the reality of delusions or hallucinations, but to reduce the damage they can do. CBTp helps a person experiencing delusions (ideas that are not true) and hallucinations (hearing or seeing things that no one else hears or sees) change the way he thinks about and responds to these experiences, making them less distressing and less impairing.

[1] Reynolds, S., Wilson, C., Austin, J., & Hooper, L. (2012). Effects of psychotherapy for anxiety in children and adolescents. Clinical Psychology Review, 32(4).

[2] Reynolds (2012).