Successful cognitive behavioral therapy for kids could lead to fewer suicidal thoughts

Highly anxious people who underwent successful psychotherapy as children have fewer suicidal thoughts as adults, found a new study from the Journal of the American Academy of Child and Adolescent Psychiatry this month.

The results suggest that early detection and effective treatment for child anxiety disorders may protect against suicidality in the long-term.

In the study, a group of anxious youth who took part in very (very) well-designed psychotherapy studies as children were contacted an average of 16 years later and interviewed about their current mental health. Those who had responded well to the psychotherapy reported fewer thoughts about suicide – both within the last two weeks and over their lifetimes – than the nonresponders.

But the children didn't receive just any old psychotherapy – it was a specific form known as cognitive behavioral therapy (CBT). In CBT, anxiety sufferers are helped to identify error-prone, catastrophic thinking – "ALL DOGS WILL BITE! NO MATTER WHAT I DO, PEOPLE WON'T LIKE ME. IF I AM FEELING ANXIOUS, THAT MEANS I CAN'T GO TO SCHOOL."

They are then taught to challenge those thoughts and – most importantly – use more realistic thinking and other helpful coping techniques to confront feelings and situations they have been avoiding.

As with any emerging skill, practice makes perfect: Children in CBT are guided at first in these new behaviors by their therapists, but become more independent with each session. By the time they are ready to say goodbye to their cognitive-behavioral therapists, the children have ideally mastered healthy coping strategies that they can use for the rest of their lives.

The study inspires respect. It has long been known that an anxiety disorder in childhood is a risk factor for depression in adolescence. It's an established fact that depression is a risk factor for suicide. So it makes sense that treating child anxiety might be a way to prevent the kind of misery that leads to suicidality later in life. But this study is among the first to establish the link by following one group of treated children through to adulthood.

The study should inspire some hometown pride, too: It was completed by local researchers from the University of Pennsylvania and Temple University.

"It is important to identify anxiety disorders in kids as they emerge and to improve access to evidence-based treatments, like cognitive behavioral therapy, in the community," said Courtney Benjamin Wolk, PhD, the lead investigator of the study and a postdoctoral researcher at the Center for Mental Health Policy and Services Research at the University of Pennsylvania. Evidence-based treatments are those that have been demonstrated through rigorous scientific studies to be effective.

In previous research with the same individuals, Benjamin Wolk and her colleagues found that those who had responded well to the CBT also showed lower rates of panic disorder, alcohol dependence, and drug abuse in adulthood.  "Our work suggests that children who are successfully treated for an anxiety disorder may experience important long term benefits."

A good and trustworthy source for parents to learn which child therapies have scientific backing? Check the not-for-profit website effectivechildtherapy.com.

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