4 Troubled Teens Blog

About half the children who have mental problems are not getting treatment for them, according to a new study from the National Institute of Mental Health. The most common untreated problem is anxiety.

• Dr. Kathleen Merikangas and her colleagues used data from 3,042 children ages 8 to 15 years old, whose families participated in the National Health and Nutrition Examination Survey.
  
• Caretakers, parents and children provided information about the children's mental health.
• Dr. Merikangas identified six mental problems: anxiety, panic disorder, eating disorders, depression, Attention Deficit Disorder/Hyperactivity (ADHD), and conduct disorder.
  
• Among those who had such mental problems, about 55 percent had consulted a mental health professional.
  

ADHD was the most common problem, with over 8 percent of the children having that diagnosis. Children from lower socioeconomic backgrounds were more likely to have ADHD, while children from upper income backgrounds were more likely to have anxiety. Only 32 percent of children with anxiety disorder had gotten treatment.

"The earlier you can intervene, the less likely you are to see the consequences of these conditions, such as children developing substance abuse, suicide, dropping out of school, and not being able to function in their social roles," said Dr. Merikangas.

The study appeared in the journal Pediatrics.

Labels: mental_health, treatment_programs, therapy

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The gold standard for treatment of depression is psychotherapy along with drugs.

However, a new study from Thomson Reuters research service finds that half of the American children and teenagers who are taking antidepressants are not in psychotherapy.

The Thomson group analyzed insurance claims that were filed between 2002 and 2006 from a database of 6.8 million people under age 18. They found that of those who made at least one insurance claim for an antidepressant prescription, only 40 percent had also made claims for one or more therapy sessions. The researchers acknowledged that some parents may be paying for therapy out-of-pocket, and some insurance policies do not cover psychotherapy.

"Therapy with antidepressants is the standard of care," said Dr. Sheila Marcus, child and adolescent psychiatry chief at the University of Michigan Medical School. "But is this what's going on in the real world? No."

The Thomson study comes during a congressional investigation into relationships between influential academicians and drug companies. The inquiry has found that some leading researchers at prestigious universities, including Harvard and Stanford, have conflicts of interest - they are performing studies that determine whether drugs are effective, while at the same time receiving large sums of money from drug companies.

For example, the congressional committee recently reviewed the case of Dr. Charles Nemeroff, who failed to report $1.2 million in income to his employer, Emory University, between 2000 and 2007. Dr. Nemeroff received more than $170,000 from GlaxoSmithKline in 2004, even though he agreed to take no more than $10,000 a year from that company in one year.

"After questioning twenty doctors and research institutions, it looks like problems with transparency are everywhere," Sen. Charles Grassley (R-Iowa) said. "The current system for tracking financial relationships is not working."

Labels: antidepressants, medications, therapy

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Alternative therapies do not help children who have been traumatized by violence or abuse, according to a new study in the American Journal of Preventive Medicine. However, the study did find that conventional talk therapy is effective.

A research team from the U.S. Centers for Disease Control and Prevention reviewed a dozen previous studies and found no evidence that alternative therapies provide good outcomes for children who have gone through physical or sexual abuse, domestic violence, or natural disasters.

The therapies reviewed were play and art therapy (in which children use toys or art to express threatening thoughts or feelings) and psychological debriefing (in which a group of children who have witnessed a traumatic event share thoughts and feelings).

Talk therapy involves having the child sit down for several sessions with a trained therapist who helps him explore and change her thoughts and beliefs..

Labels: trauma, therapy, abuse

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A study of young teenagers with bipolar disorder found that those who participated in 21 family-focused therapy sessions recovered more quickly than those who had only three sessions during the same nine-month period. Both groups took medications.

Dr. David Miklowitz and his colleagues at the University of Colorado in Boulder divided 58 teens (average age: 14.5) into two groups. Thirty teens and their families participated in 21 50-minute sessions to improve communication skills, problem solving, and knowledge about bipolar disorder. The other 28 teens had only three 50-minute sessions dealing with relapse prevention.

The group that had more psychotherapy recovered from depression more quickly and spent less time in depressive episodes. There were no differences in recovery rates or elapsed time between depressive episodes.

This study appears in the Archives of General Psychiatry.

Labels: treatment_programs, therapy, bi-polar

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Fewer psychiatrists are offering patients psychotherapy, according to a study from Johns Hopkins University. Instead, they are more likely to prescribe drugs. Patient visits that used to be 45-minute psychotherapy sessions are now more likely to last only 15 minutes.

Dr. Ramin Mojtabai analyzed data from psychiatrists' offices from 1996 to 2005, and found that psychotherapy visits dropped from 44 percent in 1996 to 29 percent in 2005. Other studies have shown that certain patients, including teenagers with depression, have the best chance of recovery if they receive both medication and psychotherapy.

Dr. Eric Plakun, a member of the American Psychiatric Association's Committee on Psychotherapy, said doctors have entered into "the age of the brain," and now focus on the biology of mental illness. He noted that some patients receive therapy from social workers or mental health professionals.

"Either way I'm worried about our patients," he said, because patients should be offered "a range of services," not just medication.

"If all you have is a hammer," he said, "everything looks like a nail."

This study appears in the Archives of General Psychiatry.

Labels: mental_health, psychiatric_illness, therapy

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Executive Director Avital Goel describes Susan's House as a "holistic solution to working with high-risk kids." The project was started six years ago; the realization of a dream for Goes, Eyal Kaplansky and Kaplansky's wife Susan, for whom the project is named.

"[Goel] explains that the teens accepted into this initiative learn the skills they need to complete the various jobs scheduled in the art workshop, enjoy meals prepared by their fellow crew members, earn a salary, and discover how to budget their earnings and save for the future."

The art workshop is the program's heartbeat. Here, the teens learn to create high-end art pieces that are sold at malls and expos. Goel says the creative process helps the teens develop self-esteem and start to believe they can have a better life. Source: Jewish Exponent

Labels: troubled_teenagers, treatment_programs, therapy

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A new study of clinically depressed teens found that while many respond well in the beginning to drug treatments alone, they might need cognitive-behavioral therapy later to sustain their improvements and prevent recurrences.

Dr. Paul Rohde of the Oregon Research Institute studied 242 teens that had been treated for depression. One group had drugs alone, the second group had cognitive therapy alone, and the third group had a combination of the two.

After three months, the combination group had the best result, with a 71% response, compared to 68% of the drug-alone group and 42% of the therapy group. However, six months later, 97% of the teens in the therapy-alone group were maintaining their improvements, compared to 89% in the combination group and 74% of those who only took drugs.

Dr. Rohde and others believe that teens may respond to drugs initially and then hit a plateau, so that after a while, they benefit from psychotherapy.

This study was published in the Archives of General Psychiatry.

Labels: depression, treatment_programs, therapy

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A new study funded by the National Institute of Mental Health found that depressed teenagers who are not responding to medications often improve under cognitive behavioral therapy and a new drug regime.

Researchers led by Dr. David Brent of the University of Pittsburgh School of Medicine studied 334 teens for three months. These teens were suffering from severe clinical depression - some had dropped out of school - and had not responded to a two-month treatment of drug therapy. The researchers divided the teens into groups and noticed improvement in 55 percent of the group that underwent therapy and switched to a new drug.

"These findings should be encouraging for families with a teen who has been struggling with depression for some time," Dr. Brent said. "Even if a first attempt at treatment is unsuccessful, persistence will pay off."

This study appears in the Journal of the American Medical Association.

Teenage depression is a serious and scary condition that many families experience. Learn how you can help your teen at About-Teen-Depression.com.

Labels: depression, treatment_programs, therapy

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A recent study funded by the National Institute of Mental Health found that teens who don't respond to an initial treatment for depression often respond when the treatment is changed. The study was conducted in six clinics with 334 teens, 12 to 18 years old, who had not responded well to a first treatment course.

"About 55 percent of those who switched to either type of medication and added CBT [cognitive behavioral therapy] responded, while 41 percent of those who switched to another medication alone responded."

Results of the study should be encouraging to teens and families of teens who have been struggling with depression without seeing many positive results from treatment. Read more at NIH.gov.

An adolescent residential treatment center, like Aspen Ranch in Utah, offers treatment programs for troubled teens and way to help their families. Learn more at AspenRanch.com.

Labels: depression, treatment_programs, therapy

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Advice columnist Corrie Lynne Player responds to a woman whose 16-year-old stepdaughter is pregnant and wants to keep her baby. In addition to being pregnant, the teen has been in trouble at school and has suffered significant trauma.

"My first point to this stepmom was that the girl is a child and, by definition, needs therapy and parental input in making such important decisions. Teenagers operate on emotion; the logical centers of their brains are disconnected and re-forming, so they have little ability to think abstractly..."

Player emphasizes the importance of helping teens, especially those struggling with issues like substance abuse or pregnancy, to make wise and healthy choices. Read more at TheSpectrum.com.

Youth Care is a residential treatment program that offers pregnant teens a safe, nurturing environment where they can earn school credits, get counseling and therapy, and prepare for the birth of their child.

Labels: pregnancy, trauma, therapy

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In Missouri, the juvenile justice system looks very different than in most states. Here, troubled teens are viewed not as inmates but as works in progress. Rather than being locked away in juvenile jails, young people are place in home-like settings where they attend group therapy, drug rehabilitation if needed and family therapy session.

"The results? About 8.6 percent of teens who complete Missouri's program are incarcerated in adult prisons within three years of release, according to 2006 figures. (In New York, 75 percent are re-arrested as adults, 42 percent for a violent felony.)"

There's no timetable for the program, which means that teens are released only when they make a certain amount of progress. Knowing this pushes the teens to fully engage in the program.

Labels: jails, treatment_programs, therapy

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Depressed teens who take anti-depressants as they undergo "talk therapy" are more likely to recover than those who take drugs or therapy alone. Talk therapy also protects them from having suicidal thoughts.

A federally funded study involved 327 teenagers over a six-month period who were divided into three groups. The first group took fluoxetine (Prozac) by itself, the second had only talk therapy, and the third group had a combination of the two.

Those in the combination group had the best outcomes. The ones who took fluoxetine alone had twice the number of suicidal thought compared to the other two groups.

The study was published in the Archives of General Psychiatry.

Learn how to recognize the risks of teen suicide and how to help your teenager at
BoardingSchoolsInfo.com.

Labels: depression, therapy, medictions

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A juvenile treatment center in St. Paul, Minnesota is trying to teach at-risk young men something about patience and discipline by having them teach those principles to "at-risk" dogs. The dogs, residents of an animal sanctuary called Home for Life, have been deemed unfit for adoption and many have come from abusive or neglectful situations.

"Five students meet with the dogs twice a week for eight weeks, and during the program they'll also take field trips to observe different careers involving animals - from the University of Minnesota veterinary program to doggie hydrotherapy... At the end of the program, the teens run their dogs through the Therapy Dogs International certification test."

Though the program is only in its second season, it's being considered a success. As the teens learn to gently persuade and teach the dogs, they experience success that boosts their confidence and helps them begin to heal from their own abusive or otherwise destructive pasts.

Learn more about SunHawk Academy, a residential drug treatment center, for teens struggling with drug and alcohol abuse.

Labels: treatment_programs, therapy, responsibilty

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A recent study conducted by a team from Duke University shows that treating mildly to severely depressed teens is best done with a combination of medication and cognitive-behavior therapy (CBT). Cognitive-behavior therapy teaches teens how to recognize and appropriately handle the distorted thoughts and feelings that lead to depression.

"After 12 weeks, 73 percent of patients receiving [Prozac] and CBT, 62 percent of those receiving [Prozac] only and 48 percent of those receiving CBT only responded to treatment."

After 36 weeks of treatment, the combination group still had the highest percentage response. Depression currently affects 5 percent of the adolescent population, increasing the stress of family relationships and the risk of suicide.

DrugRehabTreatment offers information and help for parents dealing with adolescent drug treatment.

Labels: depression, treatment_programs, therapy

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"Talk therapy" may not help depressed teens, according to a new study from Cambridge University in Great Britain.

Dr. Ian Goodyer and his colleagues studied 208 children ages 11 to 17 years under treatment for depression. Some only took drugs. Others took drugs but also underwent weekly sessions with a psychologist. Those in the medication-only group actually improved more than those who received therapy as well.

Other studies have found that troubled teens respond better to "experiential therapy" instead of traditional "talk therapy." Experiential therapy may involve working with animals, sharing a wilderness experience with trained counselors, art and drama, etc.

Dr. Goodyer's study appears in the July 20, 2007 issue of BMJ (British Medical Journals).

Equine therapy or animal assisted therapy may be better alternatives for kids who don't respond to traditional therapy. Visit animal-assistedtherapy.com for more information.

Labels: wilderness_therapy, treatment_programs, therapy

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A recent study of over 800 students found that depression and anxiety increase in girls who constantly talk about their problems. The study's lead author, Amanda Rose, said the results may indicate that girls tend to blame themselves when theyre not popular or aren't dating the boy of their dreams.

"The study's findings add a cautionary note to the perennial advice to the young that they should always talk about their problems instead of bottling them up. 'Talking about problems is a good thing, but too much talk is too much of a good thing,' said Rose."

Though boys didn't seem to be affected by how frequently they talked about their problems, girls seemed to find themselves in a vicious cycle. Talking about their problems made them feel more anxious and depressed, which caused them to want to talk more about their problems, which led to greater feelings of depression and anxiety. Read more online.

Learn more about teen depression, including ways to help and treatment options, at About-Teen-Depression.com.

Labels: depression, therapy, anxiety

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The Gulf Coast Community Foundation of Venice (Florida) has given a $100,000 grant to the Jewish Family & Children's Services of Sarasota-Manatee. The additional money will fund an expansion of its Brief Strategic Family Therapy Program to all the schools in southern Sarasota County.

"The program targets middle and high school aged youth exposed to problems including domestic violence, bullying, rebellion, peer pressure and early substance abuse."

The program includes hour-long counseling sessions once a week for 15 weeks. Read more at Sun-Herald.com.

Labels: schools, therapy, family

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A pilot study by the University of Michigan suggests that young people with emotional problems could benefit from "talk therapy" in a school setting.

The researchers provided individual therapy to 45 students, and group therapy to 60 others. The sessions took place at two middle schools and one high school in Ann Arbor and Ypsilanti, Michigan. Using standardized measuring tools, the researchers found that the students who underwent therapy learned to recognize and partly overcome mild depression, anxiety and anger problems. By the end of the study, students reported fewer angry feelings toward their teachers and improvements in problem-solving ability. The depressed students experienced elevated mood levels and better cognitive skills.

"Many studies have shown that cognitive behavioral therapy can help young people with mood and anger issues, but this is the first time that an adapted form of this evidence-based therapy has been shown to work in a school setting," said author David Neal, an assistant professor at the University of Michigan Medical School's Department of Psychiatry.

Other studies found that teenagers will not seek out therapy in community centers, even if their teachers or doctors refer them.

Neal and others presented the findings at April 12, 2007 Conference of the Society for Social Work and Research.

Private boarding schools that combine academics and therapy can help troubled teens who have lost their way. Learn more about therapeutic boarding schools at TeenBoardingSchools.com.

Labels: depression, schools, therapy

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Cognitive behavioral therapy can be an effective treatment for depression, according to a new study from Johannes Gutenberg University Mainz. The study also found that depressive symptoms do not worsen if a patient has to wait months for therapy.

Researchers followed 174 people who completed 18 months of therapy at the University clinic. Most had to wait at least five months or more to enter treatment.

"On completion of therapy, patients reported significantly fewer symptoms than on commencement ," wrote Dr. Amrei Schindler, lead author of the study.

Cognitive behavioral therapy has already proved to be effective in a variety of treatment environments, including residential treatment for eating disorders.

Labels: therapy, depresion, cognitive behavioral therapy

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