Holiday Blues and Your Teen

Holiday depression is an issue that effects many families. A survey by the National Women’s Health Resource Center found that two-thirds of women experience depression during the holidays. High expectations, and increased stress and anxiety are often cited as prime reasons for increased levels of depression during the holidays.

Many parents ask me, “At what point do we consider a residential placement option or special school for our child?” If the holiday depression pushes your family to breaking point, it might be time to consider a fresh start for the next semester. If your child is already in outpatient therapy and has made little or no progress, it may be time to consider a higher level of intervention. If your child refuses to participate in outpatient therapy, you have already crossed that threshold.  For lower level concerns, perhaps a therapeutic summer camp will be the best option so school is not disrupted.

For many years I ran an outpatient therapy clinic before moving into educational consulting. I see the effectiveness of outpatient therapy but am also aware of the limitations. A child diagnosed with Oppositional Defiant Disorder is unlikely to benefit from outpatient therapy at a satisfactory rate. If you add ADHD to the diagnostic profile, you are almost certainly better off looking at residential placement.

Here are the most common reasons why outpatient therapy can be ineffective:

  1. Lack of a comprehensive treatment team. To accurately assess, develop a treatment plan, and implement the most effective treatment possible- a comprehensive treatment team is more likely to provide superior results than one individual outpatient clinician.
  2. Not enough time. Generally outpatient therapists follow traditional therapy guidelines of one or two sessions per week of approximately 50 minutes in length.
  3. The therapist's training. Peer-reviewed scientific research into effective strategies for residential treatment centers has demonstrated that multi-modal treatment, or providing multiple strategies and opportunity's for learning, is by far the most effective approach.
  4. Environmental stress. If the child is living in a stressful chaotic situation, perhaps the most immediate way to provide emotional relief is to change environments. Holiday gatherings can add to this stress level, as well as summer vacation when the child is left unsupervised during the work week.
  5. Wrong focus. A typical outpatient therapy session will involve the therapist asking the patient about events of the past week, which can be vastly different from reality. A structured residential setting with good staff communication eliminates this issue.

Next Steps

If the holiday blues has your teen down this year, perhaps it is time to consider a higher level approach. If you have additional questions please don’t hesitate to call me directly at 813-454-1050.

You can also learn more about depression here: http://bit.ly/cc0m2o.