There are any number of reasons to seek mental health care for your child or teen. Perhaps you see a need for general support with life stressors. Maybe a therapist can help address a specific concern. Or you may receive a medical recommendation for therapy following the diagnosis of a mental health condition. However the need arises, it can be hard to know where to start, as widespread therapies and therapists flood an internet search.
“As a starting point it’s helpful to understand the evidence-based treatments for whatever condition or circumstances your child is going through,” explains Jocelyn R. Lebow, Ph.D., L.P., a pediatric clinical psychologist at Mayo Clinic. “Then you can be sure you’re actually seeking the right kind of therapy from the right kind of therapist.”
School counseling — the first experience of therapy for many kids
Before finding yourself in the position of having to seek out therapy and a therapist, it’s common to have your child or teen visit a school counselor to discuss a scenario where the child or teen is having difficulty. This meeting can sometimes be initiated by the student, but it also can be a referral from school staff or can be requested by a parent. This discussion can be the best form of therapy if a child would benefit from in-the-moment counseling for stressors around social or academic functioning.
“School counseling has a lot of benefits, especially for younger kids,” says Dr. Lebow. “It’s kind of here and now. School counselors have the advantage of having all this data by being on-site, and I do think a lot of times a few visits with a school counselor is all kids need. Having one adult that they can talk to a little bit can help them with a few tweaks, a few interventions. I think it’s good to do everything that can be done to increase low-impact, early interventions for kids. School counseling is a great outlet for that.”
School counselors, depending on their training, may use a range of therapies, including counseling and cognitive behavioral therapy (CBT) tailored for the child’s age. Most school counseling involves talk therapy, with solutions, skills and goals driving the sessions. Sometimes school counseling involves groups in which several students with similar issues work together to process thoughts and emotions. Group counseling can have the added benefit of showing a kid that others are going through things as well.
If school counseling does not lead to an improvement in symptoms — or if semester or summer breaks are disruptive and your child needs added continuity — then it would be prudent to find a therapist outside of school who is matched to your child’s needs.
This search to determine what type of therapy might work best for your child can be very confusing. Your child’s school counselor can help point you in the right direction and may even have referral recommendations. In addition, you can use the simple guide below to help identify which type of therapy will serve your child best.
A simple guide to the 10 most common evidence-based therapies for children and what these treatments might best help with
| Form of therapy | Good for treating | Core style |
| Counseling/school counseling | Everyday challenges, extra support, school-related issues, changes in family circumstances | A child can talk with a trusted neutral confidante to arrive at solutions. |
| Cognitive behavioral therapy (CBT) | General anxiety, social anxiety, panic attacks, depression, obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), chronic pain, post-traumatic stress disorder (PTSD) and trauma, self-harm, drug or alcohol misuse, anger, stress, sleep disturbances, phobias, grief | Aimed at improving thinking and behavior, CBT is a first line therapy for most mental health conditions and can involve working through exercises, completing tasks and keeping a journal between sessions. |
| Exposure therapy | OCD, social anxiety, phobias, generalized anxiety disorder, panic disorder, PTSD | Staggered, gradual exposure to the subject of a child’s anxiety takes place to build resilience and coping strategies. This can be delivered as part of CBT or as a stand-alone therapy. |
| Exposure and response prevention (ERP) | OCD, phobias | The treatment involves deliberate exposure to a feared situation in which a coping ritual would be performed, only this ritual is stopped and the compulsive behavior is unlearned. ERP is similar to exposure therapy but more specialized to OCD and phobias. |
| Dialectical behavioral therapy (DBT) | Self-harm, regulating emotions, substance misuse, suicidal thoughts, binge eating or purging, issues with relationships | Distress management takes place through goal-led therapy centered on tolerance of accepting distressing thoughts or scenarios which can then inspire change. |
| Acceptance and commitment therapy (ACT) | Depression, anxiety, eating disorders, chronic pain, self-harm, panic attacks, psychosis, bullying, substance abuse | Focus is on building psychological flexibility with an emphasis on improving functioning. ACT is driven by cognitive and behavioral strategies. |
| Parent-child interaction training (PCIT) | Behavioral issues in kids up to the age of 7, oppositional defiant disorder, ADHD, behaviors associated with autism spectrum disorder | A therapist coaches parents to manage their child’s behavior using skills and strategies. |
| Family-based treatment (FBT) | Anorexia, bulimia, disordered eating | A clinician guides parents through treating their child’s eating disorder at home |
| Parent management training (PMT) | Oppositional, antisocial or aggressive tendencies | Parents are guided on strategies for improving their child’s social, behavioral and emotional functioning and skills. |
| Interpersonal psychotherapy (IPT) | Depression, grief, life transitions | Short-term therapy focuses on the immediate difficulties a child is experiencing with depression and looks at ways symptoms may be improved by working on daily interpersonal interactions and significant relationships. |
Related articles in the Mayo Clinic Press Series: Navigating therapy for your child
Part 2 How do I find the right therapist for my child?
Part 3 The parents’ role in their child’s therapy
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