Playground psychology


The introduction of talk therapy into schools in the UK, has been lauded by some, but Philippa White notes its downfalls


The UK government recently introduced a new initiative in the area of the young people’s mental health. Its implementation means that in the future, adolescents and children who are displaying signs of depression or anxiety will be offered talk therapy to deal with the issue. The whole point of the exercise is to prevent these youngsters from developing mental illnesses as they progress into adulthood.

However, it must be questioned whether or not early intervention can succeed in preventing mental illness from persisting as the child graduates into adulthood. Furthermore, it is imperative that the dangers of offering psychotherapy to primary school children are explored.

Only a small minority of adolescents can say they have never been depressed. However, as over half of mental illnesses are said to manifest themselves by the age of 14, it is during these formative years that it becomes clear who has more than a bad dose of the blues and who actually has an intelligible case of mental illness. Nonetheless, is early intervention a worthwhile pursuit?

Offering teenagers therapy if they are depressed appears to be a smart as well as compassionate move for any policy maker. The National Institute of Mental Health in America estimates that problems associated with poor mental health cost the US economy up to $148 billion every year – more than cancer and heart disease combined – due to the cost of treatment, support and lost earnings. Those proposing the British initiative cite similar findings. Therefore, giving teenagers talk therapy could save the British economy millions.

For more altruistic reasons, the initiative again seems like an effective measure. In many studies, it has been found that the effects of psychotherapy on clinically depressed teenagers have the same effect as it has on adults with the same condition – anxiety levels abate and the patient gains insight into how to control the symptoms. A decline in incidence of adolescent depression could lead to a drop in the number of ancillary problems associated with depression, such as youth suicides and alcohol abuse. Thus the benefits of the measure, in this respect, are difficult to refute.

On the other hand, offering the same type of therapy to children is a matter that deserves a more thorough assessment. Firstly, there is something odd and unnatural about offering talk therapy to children. For anyone who is unaware, talk therapy does not entail role-play, art, puzzles and games like ‘play therapy’ and other more conventional forms of child therapy.

Think more along the lines of Freudian psychoanalysis, chaises longues and a stoic-faced therapist asking nine-year-old Jimmy if he gets on with his father. It is inappropriate to say the very least. A child would not have the necessary level of maturity to benefit from this kind of intimate tête-à-tête with a stranger.

Talk therapy is only effective if the patient can gain insight into their illness and wish to resolve the problem. Most children in primary school, let alone the children experiencing bouts of anxiety, would not have this kind self-awareness that would allow them to benefit from talk therapy. This is probably why Freud himself never intended psychoanalysis to be for children.

Another possible danger that could result from talk therapy, due to the lack of subtlety in the method, is that a child might start to identify himself as ‘different’ from his peers. This could shatter his self-esteem, thus confounding his feelings of anxiety.

It seems conveniently self-serving for psychologists and other mental health professionals to advocate for more therapy, even among young children, but the alternatives must be explored. If a child is showing signs of depression or anxiety and the cause is not apparent to a teacher or healthcare professional, it is likely that the explanation can be found at home.

Therefore, counselling which includes one or both parents would seem more beneficial. Another approach that is strikingly less contrived than talk therapy would be integrating group therapy into the classroom during school time. Not only is this approach more cost-effective, as the teachers are already paid to do their job, but one does not run the risk of singling an individual child out as being troubled and abnormal.

Psychotherapy and indeed pharmacotherapy are not recent creations. Nevertheless there is something repugnantly modernised about offering talk therapy to children, even if they show signs of depression. It may sound old-fashioned, but the best cure for most childhood stints of depression is distraction. For a child, no therapy method is any match for chasing, snakes and ladders or a good old game of Monopoly. Therefore, the British government should consider the wise words of Homer Simpson and simply allow children to “run wild and free”.