Last spring while providing a behavioral health workshop to a group of pediatric medical providers, a pediatrician lamented to me how hard it can be to tell if a child is receiving quality psychotherapy. This concern is warranted. In the field of behavioral health, there are few psychological therapies that have survived the gauntlet of scientific scrutiny. In contrast, there are many therapies for a variety of psychosocial concerns that possess little to no research support. The demand for pediatric behavioral health services has sharply increased over the past decade. Even if parents are able to find a therapist for their child, how do they know whether their child is receiving quality therapy? In the spirit of provide parentings with a road map of effective therapies, I created a “cheat sheet” enumerating the scientifically well-established therapies for common pediatric behavioral health conditions.
Anxiety Disorders
- Exposure-Based Cognitive Behavioral Therapy
Author note(s): It is important to find a provider who includes the parents in the treatment process and is competent in providing parents/caregivers with guidance on how to respond to anxious symptoms in their child.
Depressive Disorders
- Cognitive Behavioral Therapy (CBT)
- Interpersonal Therapy (IPT)
Author note(s): IPT has more research support for adolescents and less so for younger children. CBT is effective for both children and adolescents, though more effective for the latter.
Obsessive Compulsive Disorder
- Exposure and Response Prevention (ERP)
Author note(s): If symptoms are more severe, it is wise to see someone who truly specializes in treating OCD and uses ERP.
Autism Spectrum Disorder
- Applied Behavioral Analysis (ABA)
- Cognitive Behavioral Therapy (CBT)
Author note(s): ABA is best for younger children, especially those with low functioning autism. Similar with other treatments, ABA is best delivered by someone who specializes in the treatment of Autism and who is competent in providing ABA in a safe and effective manner.
Eating Disorders
- Family Based Treatment (FBT)
- Cognitive Behavioral Therapy (CBT)
Author note(s): FBT is best for Anorexia whereas CBT is usually indicated for Bulimia.
Trauma Related Disorders
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
- Prolonged Exposure (PE)
- Cognitive Processing Therapy (CPT)
Author note(s): PE and CPT have more research support for adolescents presenting with trauma disorders while TF-CBT is efficacious for both younger children and adolescents.
ADHD
- Behavioral Management Training (BMT)
- Executive Functioning Coaching
Author note(s): BMT involves the parents/caregivers receiving guidance on how to manage their child’s behavior through limit setting and reinforcing specific positive behaviors. It should also be noted that executive functioning coaching has a mixed evidence based and the efficacy is highly dependent on the provider. I always recommend families seek an executive functioning coach who has a strong behavioral health background.
Disruptive Behavioral Disorders (e.g., oppositional defiant disorder)
- Parent-Child Interaction Therapy (PCIT)
- Behavioral Management Training
- Functional Family therapy
Author note(s): PCIT is recommended for children ages 2-7. For older children and adolescents, a combination of behavioral management training and family therapy is best.
For more information on effective child therapies, feel free to visit effectivechildtherapy.org. It is managed by Division 53 of the American Psychological Association and maintains a log of efficacious therapies based on level of research support.
*This is a modified version of an article Dr. Sam published in the Fall 2024 quarterly newsletter of the American Academy of Pediatrics Minnesota Chapter
