The Role of Therapy in Youth

"It's hard to live in a body and mind that you don't like."

With depression so common among adolescents, these heart-wrenching words of a 14-year-old could very well represent the feelings of countless other youth. This is one of several quotes written on a wall at SGA Youth Services in Chicago, an organization which works in conjunction with the Chicago Public School system to provide school-based counseling services for thousands of elementary and high school students per year.

Children are referred to the SGA program, which is approaching its 95^th year of operation, by teachers and school counselors, often for "acting out" in schools. Pamela Brown, School Based Counseling Supervisor for SGA, says that depression often isn't reflected in children the same way it is in adults, and that "sometimes acting out is masking the feelings of depression that are really kind of manifesting themselves as irritability and anger."

SGA counselors primarily work with at-risk youth, and recognize that environmental factors such as where they live, not having certain resources or seeing hope for opportunity contributes to the problems these children are having, as well poor relationships at home.

Therapists have a variety of methods for working with the children, but the most important factor seems to be that they have someone who they can turn to with the pressures they are facing. Brown said she definitely thinks there is a chemical component in some cases of depression, but believes that even if there are chemical issues, therapy is still important.

"I think a lot of kids have really good experiences and establish really good relationships with the counselors that work with them." She says that a lot of times these children may just need someone to talk to. "I think the relationships that they build with counselors are one of the most important factors, because it's a place where they can come and talk to someone safely and not feel judged, and they have this person that is pulling for them, that is supporting them in a sense."

This is echoed by another one of the youth quotes on the wall which said, "It's nice to have a safe place to go so that I can talk about my not-so-safe life." Brown says that the organization tries to get the youth involved in positive things, and help them to find job opportunities as well. They also have juvenile justice services, programs for homeless youth and several counseling programs for teen parents. They sometimes provide additional referrals to outside services as well.

Therapy can be used alone or in conjunction with medication to treat depression. This may include cognitive behavioral therapy and interpersonal therapy. The first is described as a form of psychotherapy that emphasizes the important role of thinking in how we feel and what we do. According to the National Association of Cognitive-Behavioral Therapists, this form of therapy teaches that "when our brains are healthy, it is our thinking that causes us to feel and act the way we do." The therapy is said to work by identifying "the thinking that is causing the feelings / behaviors and to learn how to replace this thinking with thoughts that lead to more desirable reactions."

Interpersonal therapy is a short-term supportive psychotherapy that focuses on the connection between interactions between people and the development of a person's psychiatric symptoms. It was initially developed to treat adult depression, but is now used to treat adolescents as well. According to the Encyclopedia of Mental Disorders, this type of therapy has the following goals in the treatment of depression: to diagnose depression explicitly; to educate the client about depression, its causes, and the various treatments available for it; to identify the interpersonal context of depression as it relates to symptom development; and to develop strategies for the client to follow in coping with the depression. This type of therapy is designed as a short term approach to treatment.

According to an article in the February 2005 edition of Neuropsychiatry Reviews, a monthly magazine that covers new research and emerging trends in neuropsychiatry and neuroscience, "both cognitive behavior therapy and interpersonal psychotherapy have demonstrated positive results in a handful of trials, their long-term benefits still need to be assessed."

SGA says that at least 90 percent of the students that receive services stay in school and continue to the next grade level. In addition to the wall of student quotes, they also have a booklet that includes snippets of stories of several young people who say the program has helped them. From the powerful statements that some of the children make, it shows that children are dealing with truly painful issues and leaves the impression that having counseling and therapy services, as least for some adolescents, makes a big difference in their lives.