By Alexandra Wilson (AMHSW; CSW; MAASW; BSW Usyd)
Raising teenagers is difficult at the best of times, but even more so if your teen is struggling with mental health or behavioural issues. Unfortunately navigating mental health services can be far from simple. Mental health treatment is not a ‘one–size–fits–all’ approach.
There are some key factors to consider when getting help for your teen. These are the factors that can help you make informed decisions and find the best treatment fit for your teen.
Severity
How much are your teen’s symptoms affecting their life and yours? What counts as severe?
Factors such as:
- Suicidal thoughts or actions
- Self harm
- Eating behaviours that are having a significant impact on health
- Hallucinations, delusions or other signs that someone is losing touch with reality
- Symptoms that are stopping someone from doing what they usually would (e.g., Attending school, work or other enjoyable activities)
If you identify severe symptoms in your teen, the most appropriate mental health support may come from a public mental health services (such as the local Child and Adolescent Mental Health Service), or a specialised private service such as a private hospital or a private service that specialises in higher levels of support.
Treatment History
Has your teen tried other mental health treatment in the past? Are things still not improving?
If previous treatment attempts have failed, it may be your teen needs a different approach.
Look for the following:
- Services that specialise in medium to long–term support programs, rather than brief interventions
- Services that have experience and knowledge managing complex and long–term mental health needs
- Services able to offer a different kind of approach than your teen has tried before (e.g., Tried CBT with no success? Try DBT, EMDR or ACT instead – see table for more info)
Specialty Knowledge
What specific problems is your teen struggling with? It’s important to match the right treatment with the right person. Think about it like this: if you are having chest pains you don’t want to see a podiatrist! It’s the same with mental health – there are many different specialities that take different approaches. It’s the fit that matters.
Try the following:
- Look up reputable information about your teens symptoms and see what type of treatment is recommended (see attached table as a guide)
- Look for specialist practices that target those symptoms. For example, if your teen is struggling with anxiety, look for a service that specialises in anxiety and works with teens. If your teen is struggling with self harm, look for a dialectical behavioural therapy service that targets those specific problems.
A Final Consideration
Don’t ever think your teen is just too ‘difficult’ or ‘complex’ for treatment to work – they just haven’t found the right treatment yet! Keep looking and asking for help – it’s out there!
Treatment Options
Type of Treatment | Symptoms Targeted | Overview | Pros & Cons |
Cognitive Behavioural Therapy (CBT) | Anxiety/ Depression Adjustment disorders NFD (neurological functional disorder) | Skills focused Targets distorted and unhelpful thought patterns 6–10 session treatment duration | Pros: Widely practiced Strong evidence–base Cons: Limited efficacy for complex symptoms |
Dialectical Behavioural Therapy (DBT) | Emotion dysregulation Self harm/ suicidal Difficulties w/ engagement (eg. teens) Disordered eating Complex PTSD Borderline Personality Disorder | Skills focus and therapeutic relationship focus Medium to long term treatment Groups, 1:1 sessions and support between sessions | Pros: Strong evidence–base Designed for more complex and ‘treatment–resistant conditions Cons: Not widely practiced (in full) 12–months plus for full program Higher cost due to intensity and duration of treatment |
Trauma Therapy | PTSD | Focuses on talking about recalling traumatic memories | Pros: Treats underlying cause of symptoms Cons: Not safe for those with Complex – PTSD; risky behaviours or suicidality |
Eye Movement Desensitisation Reprocessing (EMDR) | PTSD | Uses eye movement exercises to process past trauma | Pros: May relieve symptoms quickly for ‘simple’ trauma (eg. 1x traumatic event) Cons: May not be safe for those with Complex – PTSD risky behaviours or suicidality |
Acceptance and Commitment Therapy (ACT) | Anxiety/ Depression Emotion dysregulation Adjustment disorders | Based on concepts of acceptance and commitment to identified goals and values Uses metaphors and other cognitive concepts to illustrate ideas | Pros: Fair research base May benefit those who tend towards control themes Cons: Not many practical /body–based skills Requires cognitive processing skills May not be suitable for risky behaviours |
Mental Health Access Line (Central Coast): 1800 011 511
Lifeline: 13 11 14
Mindful Recovery Services: (02) 4660 0100 mindfulrecovery.com.au
Alex Wilson is an Accredited Mental Health Social Worker and Director of Mindful Recovery Services and the Central Coast DBT Centre, providing psychological treatment and support for adolescents and adults. Alex is passionate about dispelling myths about mental illness, and is highly skilled in dialectical behavioural therapy. She is an experienced public speaker and provides consultation to other professionals on managing difficult behaviours in teens. Alex lives on the NSW Central Coast with her partner, 2 young boys, 2 goats, a bunch of chickens and a cheeky puppy named Axel.