Academic journal article International Journal of Child and Adolescent Health

Psychotherapy and Pharmacotherapy in Adolescence

Academic journal article International Journal of Child and Adolescent Health

Psychotherapy and Pharmacotherapy in Adolescence

Article excerpt

Introduction

Psychotherapy alone or in conjunction with pharmacotherapy can be a powerful tool in helping youth manage or eliminate negative outcomes of mental and behavioral disorders. Determining which treatments qualify as evidenced based treatments is controversial. Behavioral and cognitive-behavioral therapies are most often identified as well- established treatments for specific mental and behavioral disorders in children and adolescents. Therapists should have training with youth and for treating their specific problems.

Definition

Psychotherapy is the umbrella term used to describe a variety of treatment interventions that therapists use to help their clients/patients address personal problems that impede their function. Cultural beliefs guide theories of mental and physical health, which then impact problem identification, cause, types of treatment (see table 1) and determine how psychotherapy is delivered (1).

In the humanistic model, problems are not seen as pathological but rather as a part of the human condition. This approach also addresses personal problems that impede an individual's function. Humanistic models in the United States are closely aligned with the medical model. In recent years blended treatments have emerged in response to increased published works that embrace Western and non-Western views of heath and treatment. All therapists work to help their clients/patients live healthy lifestyles. Clinicians can be psychiatrists, psychologists, or social workers. These clinicians obtain special training/experience to develop skills and competence in the delivery of specific treatment techniques based on their cultural beliefs and theoretical orientation. Clinicians generally assess the patient's needs, select treatment goals, determine appropriate treatment interventions, deliver a specific treatment and monitor outcomes.

Psychotherapy is most effective with individuals who are of average to above average intelligence and who have well-developed abstract thinking and communication skills (see table 2). Young children, school-age children, pre adolescents, and youth who are in the early stage (11-13 years of age) respond best to play therapy, modeling (visual examples) and art therapy (2).

Epidemiology

It is difficult to identify how many different types of psychotherapy interventions are used with adolescents. Researchers who have conducted metaanalyses have identified more than 200 studies that meet their inclusion criteria for empirical research (2,3).

Controversy surrounding the use of evidence - based treatment approaches

An evidenced-based approach to healthcare is fueled by the need to protect patients from harm by requiring providers to deliver treatments that are a) designed for specific populations and b) have demonstrated time and cost effectiveness. Identifying treatments for specific patients is often difficult because the published research is plagued with problems in methodology, subject selection, and measures used to evaluate subjects (2,4). Advances in psychotherapy outcome research with youth do not eliminate problems with translation to clinical practice. Findings are limited because the results were designed to answer specific questions about carefully selected individuals and results are derived from carefully selected, regulated, and controlled treatment conditions as well as from asking very specific questions. Generalization of results is often difficult because therapists in the "real world" cannot replicate those conditions (5,6).

The use of evidenced-based treatments that are based on empirically supported treatments and controlled experimental studies is important to the field and the development of efficient and effective treatments. But therapists should consider that there may be many effective treatments that do not have empirical support as researchers continue to research work that helps us to understand which treatments work with whom (3,6-9). …

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