Information flows around the world in a manner of seconds–it’s amazing! We all watched last week when peaceful demonstrations, facilitated by social media, helped to topple a corrupt and oppressive government. So, what does this have to do with children and treatment?

Like many mental health professionals, the internet has given us opportunities to keep up with a variety of current issues, research studies, and trends in our field. Instead of trying to keep up with 3 or 4 journals a month, we have access to just about any published article, sometimes before it is even published.

When I started college many years ago, a literature search involved long hours combing through guides to periodic literature. Today a literature review involves going to an online library and reading about topics of interest from peer reviewed journals not just in English, but translated text from all over the world.

There have recently been a slew of articles about evidence-based treatments. Many of these review research (meta-analyses) and try to find patterns not just from one university, hospital, or treatment center, but from multiple trials and projects. Here are some of the findings that we believe parents, mental health therapists, and primary medical providers should be aware of as they relate to treatment of children and adolescents.

  1. When children are given medication for depression or anxiety, they often discontinue because of side effects such as stomach aches, trouble sleeping, agitation, diarrhea, sedation, irritability, fatigue, and in rare cases, thoughts of self-harm.
  2. Many studies find that when children are given sugar pills (aka placebo) they do almost as well as when they receive “real” medication.
  3. Cognitive behavioral therapy (CBT) alone works as well in the short term, and is better at preventing relapse.
  4. Like medication, CBT can change the way the brain works. Unlike medication, there are few side-effects and many spill over benefits to the child and the whole family who learn new ways to handle difficult feelings.

Another consideration when treating children is context. If you treat a boy who is legitimately depressed or anxious because he is the victim of bullying with medication, you’re not really addressing the issue. Or is a girl is quite anxious because her parents are getting divorced, medication hardly seems an appropriate response.

We like to view most emotional and behavioral problems in children as normal responses to abnormal events, environments, biological challenges, or genetics. Providing a short time fix (medication) for a problem that may continue to plague a child, does not give the child the tools necessary to adjust to future demands.

In the short haul, many (including health care professionals and insurance companies) look to medication as a quick fix. However, when viewed over time, putting the effort into changing patterns of thinking and behaving can have life time benefits.