The adolescent attitude can be challenging. Often it’s a case of “make me.” They may see treatment as something their parents or other authority figures want. But if there’s a therapeutic alliance, that is, a bond between clinician and patient, and they agree on the goals, it can be a stimulus that leads patients to identify and enact positive change.
Although it’s an understudied subject, “treatment expectancy” can be a valuable predictor of treatment outcome and a powerful tool in shaping the process. Helping kids with depression and anxiety anticipate feeling better isn’t easy, but techniques designed to encourage them to feel positively about treatment and to see it as relevant to their own goals can boost adherence. A pretreatment intervention with motivational interviewing, for instance, significantly improved attendance in group therapy sessions, and led to more adolescents starting treatment.
Ultimately, teens who expect to see improvement are more likely to. Expectations of treatment effectiveness accounted for up to 31% of symptom improvement in a trial of CBT. In another study, participants who thought medication would be very effective had a 90% response rate—compared with 33% of those who thought it would be only somewhat effective.
Adolescence is a time when reward is powerful. Finding compelling ways to help kids want to feel better, to want to take steps toward that goal, can help keep depression and anxiety from taking root in young lives.
The Gender Gap
Source: CMHR, Barcaccia