Treating Children's Mental Health with Therapy

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Key points

  • Getting help for a child's mental health problems early can help children reduce problems at home, in school, and in forming friendships.
  • The first step to treatment is to talk with your child's primary care provider, or a mental health specialist, about getting an evaluation.
  • A mental health professional can develop a therapy plan that works best for the child and family.
Two women talk to a teen on a couch

Overview

Mental, emotional, and behavioral disorders in childhood can cause long-term problems that may affect the health and well-being of children, families, and communities. Treating a child's mental health problems as soon as possible can help children reduce problems at home, in school, and in forming friendships. It can also help with healthy development into adulthood.

The first step is to arrange a comprehensive evaluation of your child's mental health with a mental health provider to figure out a diagnosis and what type of treatments might work best. Psychological therapy is a key component to improving mental health. Depending on the type and severity of the problem, psychological therapy for children may be used in combination with medication.

See Also Mental Health Medications - National Institute of Mental Health (NIMH)

A brief overview of therapy

Psychological therapy is meant to treat a mental health condition or teach a child coping skills to help them manage their symptoms. Therapy can help children learn skills to help them function well at home, in school, and in their community both in the short term and the long term. Engaging parents and other caregivers in treatment is important for children at all ages, but the nature of parent involvement will likely differ depending on the developmental age of the child or adolescent.

When children are young, it is common for therapy to include the parents or caregivers directly.

  • Sometimes therapists work with the parents or caregivers alone.
  • Some types of therapy include working with the whole family or other important adults in the child's life (for example, a teacher).
  • Parent-focused approaches typically mean that parents talk with the therapist about the child's behavior and feelings.
  • Therapists may also observe parents and caregivers and children together and then make suggestions for finding different ways to react.

With older children or adolescents, the therapist can also work directly with the child to teach skills and address mental health needs.

  • Psychological therapy with children can include talking, playing, or other activities to help the child express feelings and thoughts.
  • Even when a therapist works with a child or adolescent directly, it is important for parents or caregivers to be involved and providing support to the therapeutic relationship.

Psychological therapy for children can be done one-on-one or in groups. Sometimes a combination of therapies and treatment approaches is the most effective approach for helping a child.

Evidence-based therapies

Behavior therapy

Behavior therapy teaches children and their families how to strengthen positive child behaviors and eliminate or reduce unwanted or problem behaviors.

One type is parent training in behavior management.

  • The therapist works with parents or caregivers to strengthen the nurturing relationship between parents and children and learn or improve skills to manage their child's behavior.
  • Parents or caregivers are encouraged to practice skills with their child.
  • Teachers can also be trained in behavior management to help the child at their childcare center or school.

Cognitive-behavior therapy

Cognitive-behavior therapy focuses on changing the thoughts and emotions that can affect a child's behavior negatively.

  • The therapist helps the child become aware of their thoughts and feelings.
  • The therapist also helps the child evaluate if feelings or thoughts may be distorted or illogical, and then helps the child through the process of changing the thoughts, as well as the emotional reactions and behaviors that go along with them.
  • Cognitive-behavior therapy can involve working directly with the child, as well as working with caregivers and children together.

Finding the right therapy for your child

Based on the scientific evidence available, different therapies seem to work well for different types of problems.

  • For the most common childhood conditions, (such as behavior disorders, anxiety, or depression) approaches that use behavior therapy and cognitive-behavior therapy are more likely to reduce symptoms than other therapy approaches.
  • Parent training in behavior management works well for disruptive behavior disorders, including oppositional defiant disorder and conduct disorder.
  • Child behavior therapy also works well for disruptive behavior disorders.

Therapy for ADHD

Mother and child doing homework
Behavior therapy is also an effective treatment for attention-deficit/hyperactivity disorder (ADHD). Learn more about behavior therapy, what to look for in a therapist, what to expect, and additional resources.

Cognitive-behavior therapy works well for conditions such as:

  • Disruptive behavior disorders
  • Depression
  • Anxiety disorders
  • Obsessive-compulsive disorder
  • Eating disorders such as anorexia bulimia
  • Post-Traumatic Stress Disorder (PTSD)

Additional types of therapy can be effective for adolescents.

  • Adolescents with disruptive behavior disorders may respond well to family therapy, an approach that includes multiple members of the family and focuses on learning better communication skills and ways to settle conflicts.
  • Adolescents with depression may respond well to interpersonal psychotherapy, an approach in which the therapists help the adolescents learn ways to handle relationship problems.

Other therapy approaches may also be effective but have not been studied enough for researchers to understand if they work well. Information on what works best for which family is also still limited.

See Also Evidence-Based Therapies

Symptom management: Staying healthy

Good physical and mental health is important for all children and can be especially important for children living with mental health conditions. In addition to receiving necessary treatment, practicing healthy lifestyle behaviors may reduce the symptoms your child might experience. Here are some healthy behaviors that may help:

  • Engaging in regular physical activity, including aerobic and vigorous exercise
  • Eating a healthy diet centered on fruits, vegetables, whole grains, legumes (for example, beans, peas, and lentils), lean protein sources, and nuts and seeds
  • Getting the recommended amount of sleep each night based on age
  • Strengthening relationships with family members, friends, and the community

Finding support

Therapy is most effective if it fits the needs of the specific child and family. A helpful first step is for families to think of what questions or problems they are seeking help for. When contacting mental health providers to seek care, many will ask parents or caregivers to briefly explain what they are looking for help to address.

Families can seek out referrals for a mental health provider through multiple avenues, including

  • The child's school
  • A primary care provider
  • Their health insurance
  • Advice from trusted family or friends who may have some experience with providers in the local area

Families may choose to talk to a pediatrician or other healthcare provider as a first step before therapy. Sometimes health problems such as poor sleep, difficulty hearing, or learning problems can cause behavioral or emotional symptoms, or make them worse. A provider or pediatrician may want to find out if your child has any health problems before referring your child for therapy.

To find a pediatrician near you, visit HealthyChildren.org, a service of the American Academy of Pediatrics (AAP) practice organization.

If you need insurance coverage, learn more about enrolling in Medicaid, Children's Health Insurance Program (CHIP), or a Health Insurance Marketplace plan at HealthCare.gov. If your child does not qualify for insurance coverage, you can get low-cost health care at a nearby community health center.

Mental health specialists

Here are additional tools to help find a health care provider familiar with different treatment options:

Resources

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Content Source:
National Center for Injury Prevention & Control
  • Evans, S., Owens, J., & Bunford, N. (2014). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 43(4):527-51.
  • Higa-McMillan, C.K., Francis, S. E., Rith-Najarian, L., & Chopita B. F. (2016). Evidence base update: 50 years of research on treatment for child and adolescent anxiety, Journal of Clinical Child & Adolescent Psychology, 45:2, 91-113.
  • Kaminski, J. & Claussen, A. (2017). Evidence base update for psychosocial treatments for disruptive behaviors in children. Journal of Clinical Child & Adolescent Psychology. 1-23.
  • McCart, M. R., & Sheidow, A. J. (2016). Evidence-based psychosocial treatments for adolescents with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 45, 529-563.
  • Spence, S. H., O’Shea, G., & Donovan, C. L. (2016). Improvements in interpersonal functioning following interpersonal psychotherapy (IPT) with adolescents and their association with change in depression. Behavioural and Cognitive Psychotherapy, 44(3), 257-272.
  • Weersing, V.R., Jeffreys, M. Do, M.T. Schwartz, K.T.G., & Bolano, C. (2016). Evidence base update of psychosocial treatments for child and adolescent depression. Journal of Clinical Child and Adolescent Psychology, 46(1):11-43.