Therapy to Improve Children’s Mental Health
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.
A public health approach to children’s mental health includes promoting mental health for all children, providing preventive intervention to children at risk, and providing treatment for children with identified disorders. Psychological therapy is a key component to improving mental health. Depending on the type and severity of the problems, psychological therapy for children may be used in combination with medication.1
A brief overview of therapy
Psychological therapy is meant to treat a mental health condition or help a child manage their symptoms so that they can function well at home, in school, and in their community.
When children are young, it is common for therapy to include the parent. Sometimes therapists work with the parents alone. Older children may meet with a therapist alone as well. 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. Psychological therapy with children can include talking, playing, or other activities to help the child express feelings and thoughts. Therapists may also observe parents and children together and then make suggestions for finding different ways to react.
Psychological therapy for children can be done one-on-one or in groups. Sometimes, a combination of therapies is the most effective for helping a child.
What types of therapy are most effective for mental disorders in children?
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 to learn or improve skills to manage their child’s behavior. Parents are encouraged to practice the skills with their child, either during the therapy session or at home. Teachers can also be trained in behavior management to help the child at their childcare center or school.
With older children or adolescents, the therapist usually works directly with the child to teach them how to choose positive behaviors. Parents can be involved to support and strengthen the skills their child is learning.
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 often works directly with the child, but can also include parents.
For the most common childhood conditions, like ADHD, behavior disorders, anxiety, or depression, approaches using behavior therapy and cognitive-behavior therapy are more likely to reduce symptoms, but there is limited information about which type of therapy is best for treating each specific childhood mental disorder.
Based on the scientific evidence available, different therapies seem to work well for different types of problems:
Parent training in behavior management works well for
- ADHD; and
- Disruptive behavior disorders.
Child behavior therapy works well for
- ADHD; and
- Disruptive behavior disorders.
Cognitive-behavior therapy works well for
- Disruptive behavior disorder;
- Anxiety; and
Additional types of therapy can be effective for adolescents.
- Adolescents with disruptive behavior disorder 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. Read more about which types of child therapy have been found to work.
Therapy is most effective if it fits the needs of the specific child and family. You can talk to your child’s healthcare provider as a first step. Sometimes, health problems such as poor sleep, trouble breathing, poor vision, difficulty hearing, or learning problems can cause behavioral or emotional symptoms, or make them worse. Your child’s healthcare provider may want to find out if your child has any health problems before referring your child for therapy.
Before starting therapy, a mental health provider typically conducts a comprehensive evaluation of your child’s mental health to figure out what type of therapy might work best.
Here are some tools to help find a healthcare provider familiar with treatment options:
- American Psychological Association Psychologist Locator,
- American Association of Marriage and Family Therapy Locator
- American Board of Professional Psychology Locator
- Child and Adolescent Psychiatrist Finder, a research tool by the American Academy of Child and Adolescent Psychiatry (AACAP).
- Find a Cognitive Behavioral Therapist – A search tool by the Association for Behavioral and Cognitive Therapies
- Hospital and University Related ADHD Centers
- MentalHealth.gov – Information on mental health services and resources
- National Association of Social Workers
- SAHMSA’s Behavioral Health Treatment Services Locator
1 Read about medications used to treat children and adolescents
- FDA: Information on suicidality in children and adolescents treated with anti-depressant medication
- FDA: Information on ADHD medications.
- Evans, S., Owens, J., & Bunford, N. 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.