Child and Adolescent Mental Health

Teaching Young People the Skills They Need To Succeed

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Overview

At McLean Hospital, we are committed to supporting young people and their families while they learn the skills they need to manage their mental health. From comprehensive treatment programs to robust support and education, we are here to help.

As the brain and body develop from infancy through adulthood, kids and teens may encounter an array of challenges. Some issues may be easy to solve, while others may result in crisis. Some young people have the ability to deal with these challenges, while others may need assistance to navigate their way through these problems. Child and adolescent care focuses on mental health symptoms and diagnoses as they apply to youth development and is focused on supporting young people and their parents and families on the path to recovery.

While children and teens can suffer from most any mental health condition, there are a few conditions that are more often present in younger individuals. Depression, anxiety and OCD, ADD/ADHD, autism, bipolar disorder, addiction, and personality disorders are common among youths.

Learn more about treatment programs at McLean, definitions of common mental health conditions, and resources like helpful links and books.

Child and Adolescent Mental Health Treatment at McLean

McLean treats children ages 3-19 for an array of diagnoses including depression, anxiety, ADD/ADHD, bipolar disorder, and addiction, and we also provide specialty treatment programs focusing on OCD and personality disorders and their accompanying symptoms. Our full complement of inpatient, outpatient, residential, and partial hospital services helps young people and their families cope with psychiatric illness and the challenges it often brings.

State-of-the-art diagnosis and treatment is tailored to each child’s needs and focuses on symptom reduction and skills development. Patients and their families benefit from our range of treatment programs as well as access to consultation services from specialties throughout the hospital.

McLean’s Programs for Children and Adolescents

3East – Intensive programs for adolescents ages 13 to 20 who require treatment for depression, anxiety, post-traumatic stress disorder, and borderline personality disorder.

Child and Adolescent OCD Institute – A treatment program for children and adolescents ages 10 to 18 with obsessive compulsive disorder (OCD), specific phobias, panic attacks, and anxiety disorders.

Treatment at McLeanMcLean Anxiety Mastery Program – A comprehensive outpatient program for children and adolescents ages 7 to 19 with social anxiety, phobias, panic attacks, separation anxiety, and obsessive compulsive disorder.

McLean-Franciscan Child and Adolescent Inpatient Program – Stabilization and treatment for children and adolescents ages 3 to 19 who are in psychiatric crisis.

Adolescent Acute Residential Treatment (ART) Program – Short-term treatment for adolescents ages 13 to 19 with emotional and behavioral difficulties including those with substance use disorders.

Child and Adolescent Outpatient Services – Outpatient treatment for children and teens with conditions such as depression, anxiety, phobias, and bipolar disorder.

Academics

Arlington School – A nationally recognized, private senior high school providing specialized educational services to adolescents with substantial psychiatric needs.

Pathways Academy – A private school developed to meet the psychological, social, and academic needs of children and adolescents ages 6 to 22 with autism spectrum and related disorders.

McLean School Nurse Liaison Project – Offering pediatric psychiatric consultation and education services for school nurses and other education professionals in public, private, and parochial schools.

What Is Unique About Child and Adolescent Mental Health?

While the brain is still developing, mental health care can be a challenge. The therapies and treatments that work for adults might not fully address the same issues in a child. The treatment concepts might be confusing to a young mind. Child and adolescent care focuses on using methods that help kids and teens to develop skills to manage their illnesses in a way that they can understand and can build upon as they get older.

According to the National Alliance on Mental Illness, 1 in 5 teens and young adults live with a mental health condition—half develop the condition by age 14 and three quarters by age 24. The Child Mind Institute’s 2017 Children’s Mental Health Report notes that half of teens diagnosed with major mood disorders don’t adhere to treatment, but studies show 81% of teens with anxiety, 71% of teens with depression, and 85% of teens with ADHD get better with treatment.

Family involvement is a key component to child and adolescent care. Parents and guardians are often taught the same skills their kids are learning so that they can help the child to practice the skills outside of treatment and use the skills to manage challenging thoughts and behaviors. Parent education is also important, so that parents fully understand the mental health conditions and the steps clinicians are suggesting to best help their child.

Youths may be diagnosed with most any mental health condition, but these are a few of the most common mental illnesses affecting children and adolescents.

Anxiety is chronic, excessive worry and fear that seems to have no real cause. Children or adolescents with anxiety disorders often worry a lot about a variety of things. These include future events, past behaviors, social acceptance, family matters, their personal abilities, and/or school performance. Obsessive compulsive disorder is an anxiety disorder in which people have obsessive thoughts that are unwanted and related to fears (such as a fear of touching dirty objects) and use compulsive rituals to control the fears (such as excessive hand-washing). When OCD is present, obsessive thoughts and compulsive rituals can become so frequent or intense that they interfere with activities of daily living and normal developmental activities.

Addiction is a recognized medical brain disorder. It refers to the abuse of illegal or legal substances including alcohol, opioids, and other drugs. Teens are especially at risk for substance abuse since the part of the brain that controls risk taking is not fully developed and impaired thinking can lead to high-risk behaviors.

Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are behavior disorders, usually first diagnosed in childhood, that are characterized by inattention, impulsivity, and, in some cases, hyperactivity. The symptoms of hyperactivity, when present, are almost always apparent by the age of 7 and may be present in very young preschoolers. Inattention or attention-deficit may not be evident until a child faces the expectations of elementary school.

Autism spectrum disorder is a neurological and developmental disorder that usually appears during the first three years of life. A child with autism appears to live in his or her own world, showing little interest in others, and a lack of social awareness. The focus of an autistic child is a consistent routine and includes an interest in repeating particular behaviors. Autistic children often have problems in communication, avoid eye contact, and show limited attachment to others. Autism can prevent a child from forming relationships with others, in part, because of an inability to interpret facial expressions or emotions. A child with autism may resist cuddling, play alone, be resistant to change, and have delayed speech development. People with autism tend to exhibit repeated body movements, such as flapping hands or rocking, and have unusual attachments to objects. However, many people with autism excel consistently on certain mental tasks, such as counting, measuring, art, music, or memory.

Bipolar disorder, previously referred to as manic depression, goes beyond ordinary highs and lows of mood changes, and is a serious medical condition. The disorder is characterized by periodic episodes of extreme elation, happiness, elevated mood, or irritability (also called mania) countered by periodic, classic major depressive symptoms. The median age of onset is 25. When symptoms are present before the age of 12, they are often confused with ADD/ADHD.

Eating disorders often begin in youth. Anorexia, a form of self-starvation, is characterized by a distorted body image that leads to restricted eating and other behaviors that prevent a person from gaining weight. Bulimia is defined as uncontrolled episodes of overeating (bingeing) usually followed by purging (often self-induced vomiting). Adolescents who develop eating disorders are more likely to come from families with a history of eating disorders or weight problems, physical illness, and other mental health problems. Teens may also be dependent, immature in their emotional development, and are likely to isolate themselves from others. Other mental health problems such as depression, anxiety, and substance abuse are commonly found in teens with eating disorders.

Non-suicidal self-injury (NSSI), or self-harm, by definition is the deliberate, intentional damage to one’s body tissue without the intention of dying. There is no intention of suicide, however, there can be a high correlation with suicide if self-injurious behavior goes untreated. In the US, approximately 14 to 18 percent of high school students and between 12 to 35 percent of college students engage in some form of self-injurious behavior at least once. The age of onset often occurs in early adolescence, between the ages of 11 and 14. While self-harm is of serious concern for parents, families, and teachers, it’s important to know that when the right approach and treatment is provided in a timely manner, this behavior is highly treatable. But kids who self-harm need treatment right away. Giving in to pleas for more time and delaying treatment can lead to further, more serious injury. While we often hear about the number of teens who engage in this behavior, the majority who are treated appropriately can go on to lead happy, healthy lives.

Suicidal behavior is defined as a preoccupation or act that is focused on causing one’s own death voluntarily. Suicidal ideation refers to thoughts of suicide or wanting to take one’s own life. Suicidal behavior refers to actions taken by one who is considering or preparing to cause his or her own death. Suicide attempt usually refers to an act focused on causing one’s own death that is unsuccessful in causing death. Suicide refers to having intentionally caused one’s own death. Talking about suicide is the best way to prevent it. Although it is not possible to predict suicide with any certainty, our best tool is recognition of the signs that many people exhibit when contemplating suicide. These three behaviors should prompt you to seek immediate help for you or a loved one: talking about wanting to die or to kill oneself; looking for a way to kill oneself, such as searching online or obtaining a gun; talking about feeling hopeless or having no reason to live. See the Resources section below for actions to take if you or someone you know needs help.

Child and Adolescent Mental Health Resources

You may find these organizations and their websites useful to learn more about child and adolescent mental health.

General Mental Health

ADD/ADHD

Autism Spectrum

Suicide Prevention

If you or someone you know needs help:

These organizations also offer suicide prevention resources:

Books About Child and Adolescent Mental Health

McLean Hospital faculty have penned more than 50 books in recent years, including these books about child and adolescent mental health.

Fighting BackFighting Back: What an Olympic Champion’s Story Can Teach Us About Recognizing and Preventing Child Sexual Abuse—and Helping Kids Recover
Kayla Harrison, Cynthia S. Kaplan, and Blaise Aguirre
(Guilford Press, 2018)


5 Things You Need to Know about Social Skills Coaching5 Things You Need to Know About Social Skills Coaching: Your Guide to Better Communication Skills in the Modern World
by Roya Ostovar, PhD, and Krista DiVittore, PsyD
(Future Horizons, Inc., 2017)


Parenting Your Child with AutismParenting Your Child With Autism: Practical Solutions, Strategies, and Advice for Helping Your Family
by Anjali Sastry and Blaise Aguirre, MD
(New Harbinger, 2012)


Becoming a SuperheroBecoming a Superhero: A Book for Children Who Have Been Exposed to Terrorist Attacks (Hebrew version)
by Miri Bar-Halpern
(Family Care Publications, 2012)


Textbook of Autism Spectrum DisordersTextbook of Autism Spectrum Disorders
by Eric Hollander, MD, Alexander Kolevzon, MD, and Joseph T. Coyle, MD, eds.
(American Psychiatric Publishing, Inc., 2011)


Ultimate Guide to Sensory Processing DisorderThe Ultimate Guide to Sensory Processing Disorder
by Roya Ostovar, PhD
(Sensory World, 2010)


The Joy of ParentingThe Joy of Parenting: An Acceptance and Commitment Therapy Guide to Effective Parenting in the Early Years
by Lisa Coyne, Amy R. Murrell
(New Harbinger Publications, 2009)


Helping Teens Who CutHelping Teens Who Cut: Understanding and Ending Self-Injury
by Michael Hollander, PhD
(Guilford Press, 2008)


Helping Your Troubled TeenHelping Your Troubled Teen: Learn to Recognize, Understand, and Address the Destructive Behavior of Today’s Teens and Preteens
by Cynthia Kaplan, PhD, Blaise Aguirre, MD, and Michael Rater, MD
(Fair Winds Press, 2007)


Learn More

Looking for information on another mental health condition? Visit one of these pages to find out more.