Mental Health Treatment for Kids & Teens: Creating Safe Spaces for Children in Crisis
The COVID-19 pandemic robbed kids of many typical childhood and teenage experiences, from mundane activities to milestones. The losses were great, and while society may be ready to put the pandemic in the rearview mirror, the reality is that our kids are still feeling the aftershocks and need support.
“Social isolation, leading to increased use of social media, accompanied by limited access to youth sports and other activities, resulted in short- and long-term psychosocial and mental health implications for children and adolescents,” says Elizabeth Easton, PsyD, CEDS (she/her/hers), national director of psychotherapy at Eating Recovery Center and Pathlight Mood & Anxiety Center (ERC Pathlight). “Furthermore, due to school closures, children and adolescents were not afforded the same in-person learning opportunities, and those with medical vulnerabilities experienced even greater adjustment issues or mental health concerns.”
Mental Health Statistics
For many kids, the pandemic may have also been the first time they lost a loved one and experienced grief—another trigger for mental illness. According to a 2021 meta-analysis, depression among kids and teens doubled during the first year of the pandemic, rising to nearly 25%. The same was true for anxiety, with rates climbing to about 20%.1 The prevalence of eating disorders also increased. One study from a pediatric hospital in Michigan showed that eating disorder admissions more than doubled compared to pre-pandemic levels.2
“The lack of control over what was going on in the world proved to be a trigger for young people at risk for eating disorders,” notes Delia Aldridge, MD, FAPA, CEDS-S (she/her/hers), medical director at ERC Pathlight. “Kids saw family members lose their jobs, and there was limited access to resources. With everyone in lockdown, isolation was acute, and young people experienced a pervading sense of fear and anxiety. Eating disorders thrive under these conditions.”
Just as each generation was impacted by the pandemic in different ways, we are healing at different speeds, and kids and teens need more support than ever.
The Right Mental Health Treatment at the Right Time
When a mental health disorder becomes so acute that outside help is needed, parents and caregivers play an important role in treatment and recovery.
Katie Kittredge (she/her/hers), ERC alumnus, knows this from firsthand experience. When she developed an eating disorder at the beginning of high school, her parents were her lifeline. “They saw the signs and sought help from a friend, who recommended ERC,” says Kittredge. “During my recovery, my parents were making many medical decisions for me, which was hard. I wanted to be in control. My eating disorder was driven by that desire. Over time, I realized that I had goals outside my eating disorder and wanted to think about college and other things, not just about food. As I moved away from my disorder, I regained control of my life.”
Mental Health Assessment for Kids and Teens
The earlier a mental health disorder is recognized, the more effective treatment can be, increasing the likelihood of lasting recovery. Research suggests that outcomes are better if treatment is started within the first three years of the onset of the illness.3
For teens like Katie Kittredge, ERC Pathlight provides individualized treatment plans that meet them where they are. Here is an example of what that might look like:
- When a patient comes to ERC Pathlight for treatment, the first step is determining the level of support needed.
- A master’s-level clinician conducts a comprehensive assessment and makes a recommendation about what level of care they need.
- A multidisciplinary team, including a primary care physician, a psychiatrist, an individual and family therapist, and a dietitian (for eating disorder patients), then determines an individualized treatment plan using a variety of evidence-based treatment approaches.
- Throughout treatment, parents and caregivers are involved and supported at every step. Family-based treatment, used in conjunction with emotion-focused family therapy, empowers parents, caregivers, and children and teens to learn tools to lean into the feelings that are arising and create behavior changes.
- Depending on the diagnosis, other modalities are used. For example, if the patient has an anxiety or mood disorder, the treatment may involve cognitive behavioral therapy (CBT). CBT focuses on how thoughts and beliefs can contribute to anxiety and depression; similarly, behaviors and reactions can also trigger those feelings. CBT works on both sides simultaneously and is a highly effective form of therapy.
Reducing the Risk of Relapse
These therapeutic approaches have proven to be long-lasting over time, especially with ongoing
parental support. Kittredge’s experience is a case in point. She was a senior in high school when the pandemic hit, but by then she had the tools to deal with this stressful time. As a result, she didn’t relapse during this period. “It changed a lot about my senior year,” recalls Kittredge. “Prom and graduation were both canceled, but I had my parents, friends and a supportive community in place. We were still able to have fun.”
For all children and adolescents, it is essential to have coping strategies and tools to help get through the ups and downs of life, especially during challenging times. The people most likely to provide young people with these tools are parents and caregivers. Communication is key, but knowing what to say and how to say it can be challenging.
Protective Mental Health Factors for Kids and Teens
Dr. Easton of ERC Pathlight has the following tips you can apply yourself or share with parents:
- Establish consistency. Create a routine with your child or teen that they can count on.
- Create a safe space. Have open conversations about their feelings and concerns and validate those emotions without jumping to solutions.
- Build connection. Show interest in their world and what excites them (i.e., hobbies or music).
“Supporting kids on a daily basis and when they’re in crisis is a family affair,” says Dr. Aldridge. “This means helping them have positive interactions and develop coping skills, both of which build resilience and confidence. Ultimately, that’s the outcome we’re looking for.”
ERC Only: Reframing the Conversation: Talking with a Child About Their Eating Disorder
When parents are dealing with their child’s eating disorder, they are willing to do anything to help their child overcome it. But when a child is malnourished, their brains are not functioning properly, and having constructive conversations about better nutrition and weight improvement is not always easy.
That’s where a concept called “brain rescue” may be helpful. Developed by Ovidio Bermudez, MD, FAAP, FSAHM, FAED, F.iaedp, CEDS (he/him/his), senior medical advisor at ERC Pathlight, brain rescue supports parents and clinicians to convey a sense of urgency when discussing the young person’s eating disorder and nutritional needs.
“The conversation is not about weight gain but about protecting the brain,” says Dr. Bermudez. “It is in the patient’s best interest to protect their brain, especially in adolescence, a time of much neurobiological development. Patients need to know that the nutritional insult could be significant enough to cause the brain to malfunction and derail brain development.”
The power behind this concept is that even young kids struggling with weight acceptance may not want to jeopardize their brains. Once they realize the potential consequences of their behaviors, they are more likely to become motivated to change it. “Brain rescue becomes a rationale and a justification to see treatment through,” says Dr. Bermudez. “Once they commit to treatment and their nutrition improves, other interventions like therapy and medications will work better, and they will become more capable of identifying and utilizing coping skills.”
Families Ask, We Answer
At our monthly virtual open house, parents and caregivers learn more about mental health treatment for their kids and teens in crisis. Read more here and share with your patient’s loved ones so they can get their questions answered.
Get Started with a Free Assessment
Please contact us to make a referral or schedule a free assessment with a master’s-level clinician at 1-877-825-8584.
- Slomski, A. (2021). Pediatric depression and anxiety doubled during the pandemic. Journal of the American Medical Association, 326(13), 1246
- Otto, A.K., Jary, J.M., Sturza, J., Miller, C.A., Prohaska, N., Bravender, T., & Van Huysse, J.L. (2021). Medical admissions among adolescents with eating disorders during the COVID-19 pandemic. Pediatrics, 148(4), e2021052201
- Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: Theoretical exploration of maintaining factors. British Journal of Psychiatry, 199(1), 5-7
This article first appeared in Luminary, A Magazine for Mental Health Professionals. Find more articles for additional tips, resources and insights from leading experts in the field.