Family Therapy Can Help Teens

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When kids or teens face conduct disorders, substance abuse, depression, anxiety, and eating disorders, family therapy may help.

That's the conclusion of Allan Josephson, MD, and colleagues. They studied a decade of research on family therapy.

In family therapy, one or both parents attend therapy with the troubled child. Other kids in the family don't have to attend.

"Most parents want the best for their kids," Josephson said in a media conference call. He says there is "abundant evidence" that family therapy can often make a big difference in six areas: conduct disorders, substance abuse, depression, anxiety, eating disorders, and understanding attention problems.

The report appears in the Journal of the American Academy of Child and Adolescent Psychiatry.

Conduct Disorders

Conduct disorders are serious violations of age-appropriate behavior that often involve physical aggression, property destruction, and truancy, says Josephson. He works in the child and adolescent psychiatry division of the University of Louisville's medical school.

"There's no question that in this spectrum of family influence, conduct disorders clearly need family intervention and it's one of the more successful things when it's consistently applied," says Josephson.

Parents Step Up, Kid Takes Note

"It's very difficult to set limits without a child feeling secure," says Josephson. "Most clinicians that work very intensively with these problems will have a situation where a parent says, 'Fix the kid,' and the kid says, 'Well, why should I come in on time? Why should I stop using drugs? He or she has never done a damn thing for me.' I've had that quoted to me directly."

When the parent signs on for family therapy, that's a strong signal to the child, he notes. "The parent demonstrates their commitment to the child and the kid finally thinks, "Maybe I should go along with this,'" says Josephson.

Engaging parents in the treatment process and reducing the toxicity of the negative family environment can contribute to better treatment engagement, retention, compliance, effectiveness, and maintenance of goals, write the researchers.

Breaking Bad Cycles

Family therapy can sometimes show parents how to stop a vicious cycle with their kids.

Josephson recalls a father who admitted being "furious" when his 8- or 9-year-old son pestered him and acted out when he came home from work.

The dad "sat down with the paper, he took his beer, and he wanted to watch TV, tired from work. And guess what the kid did. He didn't disappear. He kind of badgered his father. He stood in front of the TV. And then guess what the father did? He yelled at him, he rejected him. The child then had nothing else to do but kind of act out a little more," says Josephson.