Virginia Commission on Youth - Reference Chart of Disorders and Evidence-based Treatments

Evidence-Based Children’s Mental Health
Findings by Treatment Type^[1]

Disorders/Behavior	Support for Treatment	Positive Effects -- Consistent Evidence	Inconsistent Evidence –Unproven	Comments
ADHD	Evidence-based treatments	Psychosocial Parent Management Clinical behavior therapy Pharmacological Treatments Methylphenidate (MPH)	Dietary replacement, exclusion; various vitamin, mineral, or herbal regimens; biofeedback; and perceptual stimulation	Not necessary to select one treatment at the expense of the other.
Adjustment Disorders	Promising treatments	Psychosocial Cognitive Behavioral Therapy Stress Management Family Therapy Group Therapy		Medication is seldom used as a singular treatment for adjustment disorders due to the fact that child requires assistance in coping with the stressor that is causing the maladaptive behavior.
Anorexia Nervosa	Evidence-based treatments	Psychosocial Nutritional rehabilitation – Considerable evidence suggests that nutritional monitoring is effective in Family psychotherapy Inpatient behavioral programs Pharmacological Treatments SSRIs	Individual Psychotherapy Group therapy 12 Step Programs Somatic treatments	It is important to note that many patients display a limited response to treatment and will require long-term monitoring and intervention.
Anxiety Disorders	Evidence-based treatments	Psychosocial Cognitive Behavioral Therapy Modeling CBT and Family Component CBT and Group Component Systemic Desensitization Pharmacological Treatments SSRIs	Herbal Supplements which may impede diagnosis	Phobias may be treated through systematic desensitization. Parenting strategies and behavior management strategies are also effective. Medication should not be utilized as the sole intervention.
Binge Eating Disorder	None Available			The treatment goals and strategies for binge eating disorder are similar to those for bulimia nervosa except patients with binge eating disorder present difficulties associated with being overweight rather than being malnourished.
Bipolar Disorders	Evidence-based treatments	Psychosocial No consistent studies on psychosocial treatments with children Pharmacological Treatments Lithium	Electroconvulsive therapy (no research with children)	Some evidence supporting the use of lithium in the acute phase, no evidence for or against the use of electroconvulsive therapy.
Bulimia Nervosa	Evidence-based treatments	Psychosocial Cognitive Behavioral Therapy Combined Treatments Group Therapy Pharmacological Treatments SSRIs	Bupropion Monoamine oxidase inhibitors (MAOIs)	Treatment includes treatment of co-occurring disorders the establishment of regular, non-binge meals and improvement of attitudes related to the disorder.
Fire Setting	Promising treatments	Psychosocial Cognitive Behavioral Therapy Fire Safety Education		Leaving the child untreated is not beneficial as children usually do not outgrow this behavior.
Major Depressive Disorder and Dysthymia	Evidence-based treatments	Psychosocial Cognitive Behavioral Therapy Family Systemic Therapy Interpersonal therapy Combined Treatments Group Therapy Pharmacological Treatments SSRIs	Dietary supplements such as Omega-3, St. John’s Wort, SAM-e which may have harmful side effects	Most studies fail to accommodate developmental differences in children, lack of culturally sensitive perspective, little attention paid to cultural relevance of materials used.
Mental Retardation	Evidence-based treatments	Psychosocial Individual therapy Family therapy Social skills training Cognitive therapy		Treatment is tailored for co-occurring disorders and is based on two guiding principles: normalization and community-based care.
Oppositional Defiant & Conduct Disorder	Evidence-based Treatments	Psychosocial Parent Training Based on Living w/Children Videotape Modeling Parent Training Multisystemic Therapy Anger Coping Therapy Assertiveness Training Delinquency Prevention Program Rational Emotive Therapy Pharmacological Treatments Stimulants Mood Stabilizers	Boot camps, psychiatric hospitalization, medication trials, brief courses of cognitive-behavioral therapy	Interventions usually performed in school or home Various treatment modalities are utilized for treating these disorders as well as the comorbid disorders which accompany ODD and CD Medications must only be prescribed in conjunction with psychological interventions such as parent training.
Pervasive Developmental Disorders (Autism & Asperger’s disorders)	Promising treatments	Behavior Interventions Educational and Communication Focused Interventions Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) approach Natural Language Methods Picture Exchange Communication System Behavior Intervention Pharmacological Treatments Antipsychotics Psychostimulants		(TEACCH) Treatment and Education of Autistic and Related Communication Handicapped Children Home Based Behavior Therapy a good option Low Prevalence of autism, approaches to treatment are 2 types: 1. Focus on specific symptoms or learning needs, 2. Focus on reversing the level of impairment Home based behavior.
Schizophrenia	Evidence-based treatments	Psychosocial Psychoeducational Therapy for the child and for the family Family Intervention Programs Pharmacological Treatments Antipyschotics		Few well conducted trials in Psychopharmacology and children the superiority of atypical over neuroleptic medication. Concerns with side effects. Best Practice guidelines based on extrapolation from adult studies or consensus of child clinicians.
Self Injury	Promising Treatments	Psychosocial Cognitive Behavioral Therapy Behavior Modification Addictions Model Pharmacological Treatments SSRIs		Research continuing on psychosocial interventions and medications. Hospitalization used as last resort.
Sex Offending	Promising Treatments	Multisystemic Therapy Residential Sex Offender Treatment		Promising sex offender treatment programs often combine an intensive, multi-modal approach with early intervention. Comprehensive cognitive-behavior programs often focus on taking responsibility for one's sexual behavior, developing victim empathy, and developing skills to prevent future offending. Approaches to the treatment of juvenile sex offenders can vary.
Substance Abuse	Evidence-based treatments	Psychosocial Cognitive Behavioral Therapy Group Therapy Behavioral Therapies Skills Development Family Therapy Multisystemic Therapy Individual Psychotherapy Medical detoxification		The use of medication should only be pursued as a last resort in the dually-diagnosed population, as there is potential for misuse and overdose.
Suicide Prevention	Evidence-based Treatments	Psychosocial Training of Emergency Room professionals for follow up and treatment Pharmacological Treatments Lithium Clozapine SSRIs (comorbid disorders)	Tricyclic antidepressants Closely monitor medications that may increase disinhibition or impulsivity	All medications prescribed to the suicidal child or must be carefully monitored by a third party and any change of behavior or side-effects immediately reported. Education regarding benefits of follow-up treatment to reduce the reoccurrence of attempted suicide should be emphasized.
Tourette’s Disorder	Evidence-based treatments	Psychosocial Habit Covariance Habit Reversal Pharmacological Treatments Neuroleptics	Plasma exchange or intravenous immunoglobulin (IVIG)	When tics interfere with functioning and/or there are other disorders also present, medication may be helpful.

[1] The information contained in herein is strictly for informational purposes and is not intended to replace the advice and counsel of a medical professional.