Diagnosis and treatment plans for teenage mental health conditions

Diagnosis and assessment
Getting your child’s symptoms of mental illness assessed and diagnosed will you help you and your child choose the right mental health treatment.

A mental health assessment should help you understand your child’s current symptoms and spot any possible triggers that might make his condition worse or obstacles that might stop him from getting better.

If you’re concerned that your child might have mental health issues, your GP is a good place to start for a mental health assessment. The GP can refer your child to an adolescent psychiatrist or another mental health professional like a psychologist for further advice.

Treatment plans
Your child’s teenage mental health assessment should result in a treatment plan that aims to improve her wellbeing and reduce her symptoms. The plan should focus on things that make your child stressed and trigger her symptoms or make them worse.

As part of the treatment plan, the mental health professional might say your child needs a particular type of treatment or therapy. You can understand what a treatment or therapy can do for your child by asking questions and writing things down when you’re with your child’s mental health professional. It’s also OK to phone afterwards if you want more information.

Types of teenage mental health treatments and therapies

Here are some common teenage mental health treatments and therapies.

Counselling is a ‘talking therapy’.

If your child sees a counsellor, your child will talk about his situation with the counsellor. Counsellors don’t offer advice. Instead they help your child make his own decisions and find his own solutions.

Counselling is usually a one-on-one therapy.

Psychotherapy is based on talking with a trained therapist.

Psychotherapy aims to help your child to understand her problems better. This is usually achieved by talking about her thoughts and feelings and by helping her change the way she thinks about things so she can manage problems in different ways.

Psychotherapy is usually a one-on-one therapy, but can also happen in groups or with family members.

Cognitive behaviour therapy
Cognitive behaviour therapy (CBT) is a structured psychological treatment that recognises that the way we think (cognition) and feel affects the way we behave.

CBT helps your child recognise unhelpful or unhealthy thinking and behaviour habits. Your child  then learns to consciously and deliberately change his thinking as a step towards changing the way he feels and behaves.

CBT can be used to treat problems including anxiety, depression, low self-esteem, uncontrollable anger, substance abuse, eating disorders and other problems. Your child can have CBT one on one with a professional, in groups or online.

Behaviour therapy
Behaviour therapy is a major component of CBT, but it’s also a separate therapy.

Behaviour therapy focuses on your child’s behaviour. The therapist will plan activities that help your child develop skills to deal with difficult situations. The therapist will also use a step-by-step approach to help your child conquer her fears.

Interpersonal therapy
Interpersonal therapy (IPT) is a type of psychotherapy based on the idea that how people communicate and interact with others can affect their mental health.

The goal of interpersonal therapy is to help your child understand how his experiences of social interactions and issues – for example, at school or in relationships – are affecting his mental health. The therapist will help your child improve his communication skills and manage his emotions.

E-therapies are also known as online therapies or computer-aided psychological therapy. Some therapies – for example, CBT and behaviour therapy – work well as e-therapies.

Most e-therapies teach your child how to identify and change patterns of thinking and behaviour that might be stopping her from overcoming anxiety and stress.

E-therapies can work just as well as face-to-face services for some teenagers with mild to moderate anxiety and/or depression. But they’re not for teenagers in crisis or who are seriously unwell.

Some teenage mental health conditions can be treated with medication. Medications  can help control and improve symptoms.

If a medical professional prescribes medication for your child, the professional will usually combine the medication with other therapy and support to help your child get better.

Different mental health medications can have different side effects. For example, some cause weight gain. For this reason, mental health professionals will also say that your child should stay active and eat a healthy diet throughout his treatment. Staying fit and healthy can have a big impact on your child’s mental health.

If your child has a mental health condition and her mental health professional prescribes medication, you and your child usually have the right to decide whether to take the medication.

The exception to this is if your child has been detained under the Mental Health Act. To be detained or ‘committed’ under the Act people must have serious mental illness, be in need of immediate treatment and be either a likely risk to themselves and/or others.

The Therapeutic Goods Administration (TGA) and manufacturers of antidepressants do not recommend antidepressant use for depression in young people under the age of 18 years. But guidelines published in 2011 indicate that fluoxetine can be considered for children under 18 years with moderate to severe depression.

Anger and stress management
Anger is a natural and powerful emotion. Getting angry is normal. Anger can range from mild annoyance to violent rage. When anger turns into violence or uncontrollable rage, it can become a problem that needs treatment.

If your child has a problem with anger, anger management can help him get control over his temper. Talking treatments like CBT, behaviour therapy or counselling can work with anger management. Therapists can also teach your child practical skills to use when he feels angry.

Stress management and relaxation training can also help young people learn to manage anger.

Self-esteem training
Young people with low self-esteem can have a lot of negative thoughts about themselves, which are linked to negative emotions including sadness, anxiety, guilt and anger. This can lead to mental health problems like depression.

Low self-esteem can also affect a young person’s social relationships and schoolwork.

If your child suffers from low self-esteem, you could look into online therapy or books that explain how to boost self-esteem. Talking about therapy options with your GP is always a good idea too.

Family therapy
Family therapists work with your child and the people who are important to your child, especially family members. This can be really useful because close relationships are often the way to help someone recover from difficulties and improve life.

During a family therapy session, a family therapist encourages family members to think about each other’s viewpoints, experiences and beliefs, find constructive ways of supporting each other and solve problems together.

Creative therapies
Art, music and dance/movement therapy are all forms of psychotherapy that can help your child cope with emotional, relationship or behaviour problems.

Mental health professionals use these therapies to help your child understand, communicate or express herself in new and more positive ways.

Other therapies
There’s clear evidence that, for adults, practising mindfulness can have health benefits.

For example, studies suggest that mindfulness-based stress reduction (MBSR) can reduce stress and have some positive effect on other mental health issues, and that mindfulness-based cognitive therapy (MBCT) can maintain treatment gains made for depression, prevent relapses and be as effective as an antidepressant.

There’s growing evidence that mindfulness is also effective with children and teenagers.

During and after treatment

As your child progresses with a course of treatment, you might need to go back to your GP for a review. This is especially the case if your child has a GP Mental Health Care Plan under Medicare. Along with other mental health professionals working with your child, the GP will watch and review your child’s progress to make sure the treatment is working.

Depending on your child’s progress, the GP or your mental health professional might suggest alternative approaches or that your child keeps going with the current treatment.

At the end of treatment it can be good to review your child’s progress and celebrate his achievements.