When Therapy Fails

Meanwhile, down under in Australia, researchers decided to run an experiment about therapy. They chose groups of students and subjected them to therapy, as in what is called dialectical behavioral therapy. For the record, DBT has a good track record, especially with suicidal teens. 

Another control group did not receive therapy.

They were responding to the fact that more and more teenagers, even in Australia, are suffering from depression and anxiety. So, the do-good brigade tried to help them. How many times have we heard that the answer to children’s mental health problems lay in therapy.

The results shocked everyone, especially those who do not read my blog or Substack. The treatments did not work. Not only did they not work, they aggravated the children’s mental health.

Olga Khazan reports for the Atlantic.

The therapy seemed to make the kids worse. Immediately after the intervention, the therapy group had worse relationships with their parents and increases in depression and anxiety. They were also less emotionally regulated and had less awareness of their emotions, and they reported a lower quality of life, compared with the control group.

Most of these negative effects dissipated after a few months, but six months later, the therapy group was still reporting poorer relationships with their parents.

These results echo those obtained in Great Britain where children were subjected to a mindfulness mediation program-- one that, studies tell us, has proved itself to be effective:

Last year, a study of thousands of British kids who were put through a mindfulness program found that, in the end, they had the same depression and well-being outcomes as the control group. 

As for cognitive-behavioral therapy-- a treatment that also seems to have a good track record--, the results were the same:

A cognitive-behavioral-therapy program for teens had similarly disappointing results—it proved no better than regular classwork.

I will underscore the point. Regular classwork works fairly well. It organizes a child’s life, gives him purpose, and provides him with social activities. Without his having to do therapy. Fancy that.

Other efforts produced the same disappointing results:

D.A.R.E., which from the ’90s to early 2000s taught legions of elementary-school students 10 different street names for heroin, similarly had little to show for its efforts. (The curriculum has since been revamped.) The self-esteem-boosting craze of the ’80s also didn’t amount to much—and later research questioned whether having high self-esteem is even beneficial. Anti-bullying programs for high schoolers seem to increase bullying.

That’s quite a track record. Perhaps the hidden motivation of it all is to keep therapists in business. 

And yet, Kazan points out, the problem is dire:

From 2007 to 2016, pediatric emergency-room visits for mental-health disorders rose 60 percent. Most teen girls—57 percent—felt “persistently sad or hopeless” in 2021, up from 36 percent in 2011. That figure is a still-not-great 29 percent among teen boys. Nearly a third of teen girls have considered suicide, according to the CDC. (Although school closures probably didn’t help things, these numbers were rising even before the coronavirus pandemic began.) The kids are not all right, and frustratingly, we don’t really know how to help them. It feels like we should be able to just sit the teens down and tell them how to be happier. But that doesn’t seem to work, and sometimes it even backfires.

As for what might help children, why not begin with two-parent households? Why not begin with regular family dinners? And, why not add a good dose of patriotism, of love of country or pride in the nation’s achievements. And let’s not forget the madness of shutting down the school system for two years, unnecessarily, in order supposedly to combat a virus. 

By now everyone knows that American teachers’ unions damaged children, perhaps irrevocably. Doing therapy will not bring them up to grade in math and language. Did you need me to explain that one?

Admittedly, such is the case in America. I cannot immediately vouch for Australia or Great Britain, but surely, when you watch British television shows you see them saturated with woke ideology.

Do you not see that indoctrinating children with an oppression narrative tends to make them crazy. If not craze, then at least depressed and anxious?

Oh, and let’s not forget the contribution that feminism has made to our culture. If girls are brought up to be self-sufficient and self-defining, not needing to connect with anything resembling a boy, well then, this might produce confusion. If it leads, in older girls, to hooking up, this might make participants less than sane. 

Anyway, the researchers have come up with their own explanations for the failures of their favorite treatment modalities.

In many cases, they posit that the children did not accept that they were psychologically defective and did not choose treatment.

Worse yet, these treatments, especially those that derive from cognitive therapy, require homework exercises. And children do not like to have extra homework, or some such.

Kazan explains:

In the case of the Australian study, the teens didn’t opt in to the intervention; they were signed up for it, class by class. But teens don’t like being told by adults how to think or what to do, even if it’s something that could benefit them, experts told me. The Australian kids were instructed to practice the DBT exercises at home, and those who did so had better outcomes, but only about a third practiced at least weekly. This could be considered low, but does anyone really enjoy doing their “therapy homework”? Especially when they have, you know, regular homework? “It’s just another thing they are required and asked to do without any input from them,” as Jessica Schleider, a psychologist at Northwestern University, puts it.

Then again, in some cases the children in the study might not have had emotional problems. Perhaps being chosen for the treatment induced them to believe that they really did have problems, only they did not know it:

Many therapists use DBT to help people struggling with suicidal ideation and self-injury, through months of intensive individual treatment. But the teens in this study weren’t, on average, clinically depressed or anxious to begin with. Many of them were just normal, happy kids. It’s possible that by teaching kids to notice their negative thoughts, the program inadvertently reinforced those thoughts.

So, therapy tends to manufacture distress. It is more the problem than the solution:

“Maybe everybody thinking about how anxious or hurt they are might not be the best idea,” says Jean M. Twenge, a professor of psychology at San Diego State University and the author of Generations. “We might be taking people who are doing just fine and trying to teach them these techniques, which may actually call attention to their distress.”

One solution might be to offer therapy only to children who really want it:

Schleider said that rather than subject entire classrooms of kids to therapeutic information, mental-health treatment should be available to kids when they feel that they need it, not just when it happens to be fifth period. 

And naturally, in the therapy world, the problem always boils down to a line from the Spice Girls-- they do not really, really want to change.

The upshot of all of these failed experiments, from the cheesy D.A.R.E. to the trendy mindfulness, is the old chestnut that you can’t change people who aren’t ready to change. Teens can make poor choices, but they are smart and, on some level, know themselves. Alleviating the teen-mental-health crisis may require something that is not altogether comfortable for adults: trusting that teenagers will know when they need help. We may need to make treatment available but not obligatory. Teens have plenty of obligations as it is.

So, forget about curing cultural toxins by forcing children to undergo treatment that is more a cultural toxin than a panacea.

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