Mental health and substance abuse affect teenagers as well as adults. However, the treatment approach targeted at youth aged 13-18 can differ hugely from therapeutic approaches geared toward adults. For adolescents, outgrowing a mental health problem (such as school-based anxiety) is possible – which is why the treatment approach aimed at youth embraces a larger range of options such as specialized schooling. According to the Centers for Disease Control, depression, substance use, and suicide attempts are the leading current concerns in terms of the overall mental health of the nation’s adolescents. The following are seven different types of treatment approaches utilized in providing mental health and substance abuse services to teenagers.
1. Psychotherapy
Individual, group, and family therapy may be recommended for a teenager with mental health and/or substance abuse problem. Adolescence is a developmental state in which the young person typically – and with a still-developing brain – attempts to acquire more independence of thought and action than during childhood. As described in Psychology Today, this normal quest can result in more opposition to adult authority (such as parental or teacher authority).
In psychotherapy (often called “talk” therapy), the adolescent suffering from a mental health problem can have a “safe” place to vent about struggles with authority figures and other problems, as well as perform role-playing to increase awareness of behavior patterns in interpersonal relationships.
Whether receiving mental health treatment as an inpatient or outpatient, psychotherapy is typically a part of that treatment. For example, different types of psychotherapy are offered at Newport Academy in both its residential and outpatient programs (that are located in numerous locations throughout the US). Moreover, this mental health center specializes in providing mental health and substance abuse treatment to adolescents and young adults.
2. Hospitalization (Residential) Treatment
The most common reason that an adolescent is treated on an inpatient basis in a psychiatric hospital is due to being considered at high risk for suicide or homicide. In contrast to outpatient care (such as offered in mental health clinics), inpatient treatment in a psychiatric unit is normally reserved for stabilization during a mental health crisis.
Schizophrenia is the diagnosis in an adolescent that is most likely to result in psychiatric hospitalization where no immediate risk for suicide/homicide exists. According to the nonprofit Mental Health America, short-term residential treatment with family-based aftercare linkage has been found to be more effective for youth than long-term (permanent) residential treatment.
Meanwhile, adolescent substance abusers can need a period of residential treatment in order to separate from friends and schoolmates who abuse alcohol and/or drugs – so interfere with the ability to maintain recovery. Since it is common for teen substance abusers to spend most of their social time with other substance abusers, a residential stay can enable forming a new “peer” social network to support recovery, as well as provide a time period away from alcohol and/or drug access. Upon discharge, entering an outpatient therapeutic program is usually critical to avoid relapse to substance abuse.
3. Therapeutics Aimed at Symptom Control for a Major Mental Illness
The National Institutes of Mental Health (NIMH) reports that nearly 50% of all adolescents experience a mental health disorder at some point in their lives, but only 22% experience severe impairment. Medication is typically prescribed to adolescents exhibiting symptoms of Schizophrenia and Bipolar Disorder. These two major mental illnesses can tremendously impair the ability of adolescents to participate in a classroom setting and form (or maintain) friendships. Schizophrenia is uncommon under the age of 12, but it often begins in adolescence. Due to the impact of major mental illnesses on peer relationships (which are so important in adolescents), treatment often includes psychotherapy as well as medication.
Early signs of Schizophrenia onset in an adolescent can include:
- Hallucinations (as evidenced by talking about seeing, hearing, or feeling things that are not real, such as hearing voices ordering them to do something).
- Distorted perception of reality (difficulty telling dreams from reality).
- Suspiciousness and/or paranoia (such as a groundless fear that someone, or something, is conspiring to murder the afflicted person).
While inpatient treatment may be necessary, many adolescents living with a major mental illness diagnosis are treated through a combination of medication and psychotherapy (including both individual and family therapy) and are able to remain at home and in school.
4. Cognitive Behavior Therapy
Cognitive Behavior Therapy (CBT) is a therapeutic approach that began in the 1960s, and it has been used mainly in trauma survivors suffering from Post-Traumatic Stress Disorder (PTSD). Adolescents with PTSD can include those who experienced childhood physical and/or sexual abuse, and those who have experienced (or witnessed) neighborhood gun violence, as well as any other traumatic events. Whatever the original trauma, people with PTSD typically have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended (per the American Psychiatric Association [APA]).
The APA also describes the following four common PTSD symptoms:
- Persistent intrusive thoughts (such as repeated, involuntary memories and flashbacks of the traumatic event).
- Alterations in arousal and reactivity (such as being easily startled, or having problems concentrating and sleeping).
- Avoiding reminders of the traumatic event (such as avoidance of loud noises).
- Alterations in cognition and mood (such as persistent anxiety and depression, including frequent suicidal thoughts).
Unlike other psychotherapeutic approaches, CBT is a problem-specific, goal-oriented approach that is focused on enabling the adolescent suffering from PTSD to utilize positive thoughts and relaxation techniques to counter the symptoms. One newer form of CBT is Eye Movement Desensitization and Reprocessing (EMDR). CBT is typically time-limited to a maximum of 20 sessions, rather than being of an unlimited duration.
5. Treatment for Autism Spectrum Disorder in Teens
Autism Spectrum Disorder (ASD) is a serious developmental disorder that impacts the Central Nervous System (CNS), and impairs the ability to communicate and interact. People with ASD typically are unable to “read” indirect social cues and body language, so have difficulties in forming social connections. Asperger’s Syndrome was the former term used to describe high-functioning autism, but was changed in 2013 in the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to high-functioning ASD.
Besides communication and social skill impairments, people with ASD often engage in restrictive and repetitive behaviors. Teenagers with ASD are often the victims of bullying in their schools. Therefore, treatment can include behavioral therapy, specialized school accommodations, and anti-anxiety medication.
6. Treatment for Dually-Diagnosed Teens with a Mental Health Disorder and Addiction
Adolescents diagnosed with a mental health disorder and an addiction to alcohol or drugs pose a particular treatment challenge, and most youth-focused outpatient mental health centers or private practices do not treat teen substance abuse. Moreover, these teens are the most likely to enter the juvenile justice system without treatment aimed at their co-disorders. At least 65% of all adolescents in the juvenile justice system have a mental illness, and a substantial rate of substance use has been found in youth who commit crimes resulting in juvenile justice system involvement. Therefore, appropriate treatment for these dually-diagnosed teens – which is seldom provided in juvenile detention centers – is important for their future lives.
7. Treatment for Eating Disorders
The most common eating disorder in teens is Anorexia Nervosa (AN) and it predominantly affects females. An adolescent girl with this condition can be extremely thin but perceives herself as overweight, and this disorder can be fatal without treatment. The prevalence of diagnosed AN in the US in teenage girls (aged 13-18) is 0.3%. Improving nutritional intake is an essential aspect of treatment, as well as psychotherapy and medication.
