2017 Children’s Mental Health Report

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Treatments That Work

There have been definitive, federally funded clinical trials of medication and psychotherapy treatments for common child and adolescent mental health disorders including anxiety disorders, depression, and ADHD. Summaries of these studies’ findings are below.

Anxiety Disorder Treatment

A trial of treatments for youth with anxiety disorders showed that a combination of cognitive behavioral therapy (CBT) and antidepressant medication (a selective serotonin reuptake inhibitor, or SSRI, called sertraline, or Zoloft) is the most effective acute or short- term treatment.¹

After 12 weeks:

  • Combination therapy was effective in 81% of participants
  • CBT alone was effective in 60% of participants
  • Medication alone was effective in 55% of participants

Depression Treatment

The trial of treatments for adolescents with depression showed that a combination of antidepressant medication (fluoxetine, or Prozac) and cognitive behavioral therapy (CBT) is more effective than either fluoxetine or CBT alone. ²

Rate of improvement after 12 weeks

  • Combination therapy: 71%
  • CBT alone: 43.2%
  • Medication alone: 60.6%

ADHD Treatment

Stimulant medication significantly reduces ADHD symptoms for most young people

  • 70% get a benefit from a single stimulant medication.³
  • 85% get a benefit when more than one stimulant medication is tried.

The best results for adolescents with ADHD come from combined approaches to treatment using medication and behavioral therapy. In a trial of ADHD treatment:

  • 68% of participants receiving combined medication and behavioral therapy had an “excellent response”
  • 56% receiving medication alone had an “excellent response”
  • 34% receiving behavioral treatment alone had an “excellent response”

Psychosis Treatment

Intervention relatively early after a first episode of psychosis with a combination of medication and other services has been shown to reduce the risk of recurring episodes. The treatment that has been shown to be successful, called Coordinated Specialty Care, involves a combination of services coordinated by a group of professionals working with the patient and the family. They include:

  • Lower doses of antipsychotic medication.
  • Cognitive behavioral therapy for psychosis (CBTp)
  • Family education and support
  • Educational and vocational rehabilitation

[1] Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., … Kendall, P. C. (2008). Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety. The New England Journal of Medicine, 359(26), 2753– 2766.

[2] Treatment for Adolescents With Depression Study (TADS) Team. (2004). Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression. JAMA. 292(7), 807-820. doi:10.1001/jama.292.7.807

[3] Spencer, T., Biederman, J., Wilens, T., Harding, M., O’Donnel, D., & Griffin, S. (1996). Pharmacotherapy of Attention-Deficit Hyperactivity Disorder across the Life Cycle. Journal of the American Academy of Child & Adolescent Psychiatry, 35(4), 409-432. doi:10.1097/00004583-199604000-00008

[4] Hinshaw, S. P., & Scheffler, R. M. (2014). The ADHD explosion: Myths, medication, money, and today’s push for performance.

[5] Hinshaw, S. P., & Arnold, L. E. (2015). Attention deficit hyperactivity disorder, multimodal treatment, and longitudinal outcome: Evidence, paradox, and challenge. WIREs Cognitive Science, 6, 39-52.

[6] National Institute of Mental Health. (n.d.). Evidence-based treatments for first episode psychosis: Components of Coordinated Specialty Care. Retrieved from https://www.nimh.nih.gov/health/topics/schizophrenia/raise/evidence-based-treatments-for-first-episode-psychosis-components-of-coordinated-specialty-care.shtml