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Mother Jones
What Works for Troubled Teens?
News: When kids have behavioral
problems—but not severe disabilities—experts say the best treatment
is not boot camp, but plain old family therapy.
August 20, 2007
By Maia Szalavitz
The most effective treatments for
troubled teenagers have these things in common: They use
family-based therapies; they treat adolescents with empathy,
dignity, and respect; and, except for very short periods of
emergency stabilization, they keep teens at home.
Research has proven the
effectiveness of a number of methods for treating youth with
behavioral and other problems—including functional family therapy,
cognitive-behavioral family therapy, and multisystemic family
therapy (the latter, ironically, is available almost exclusively to
kids in the juvenile justice system). All of them focus on improving
communication between children and parents, setting clear
boundaries, and ensuring that teenagers' developmental needs for
increased freedom, social connection, and responsibility are
recognized and met in safe and healthy ways. Inpatient treatment
happens only on a short-term basis when a child is a threat to
himself or others.
Since most problems involve
fractured family relationships, recovery requires repairing those
bonds—connections that can be harder to rebuild if a child spends
years away from home. "Youth will modify their dangerous behavior in
response to practical, problem-solving, behavioral therapies—if they
feel respected and cared for by the therapist," explains Charles
Huffine, a child and adolescent psychiatrist in private practice in
Seattle.
Effective therapies also recognize
that different problems require different approaches. What helps a
kid with autism or Asperger's is different from what is needed for a
child with conduct disorder or depression or drug addiction.
Appropriate medication and talk therapies tailored to these
conditions can make all the difference. Residential programs, on the
other hand, are generally one size fits all, even while they claim
to offer individualized care.
Huffine notes that getting youths
to change their behavior often takes longer than parents realize (or
hope for). He recommends avoiding programs that promise too much, as
well as those that exaggerate the danger of problematic but common
teen troubles such as poor grades, bad attitudes, and
experimentation with drugs. "Such programs," says Huffine, "exploit
parents who feel desperate."
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