The Next Big Thing in Child and Adolescent Psychiatry: Interventions to Prevent and Intervene Early in Psychiatric Illnesses

Abstract

The last two decades have marked tremendous progress in our ability to prevent and intervene early in psychiatric illnesses. The interventions described in this article range from established, empirically-supported treatments to creative interventions early in their development and deployment. Some of these interventions are low-technology programs delivered in social settings (such as schools), and some rely on sophisticated emerging technologies such as neuroimaging. This article reviews 4 preventative interventions: 1) The use of structural brain imaging to identify children at risk for familial depression who are most likely to benefit from preventative cognitive behavioral therapy 2) The Good Behavior Game, a school based program that, when implemented in 1st grade classrooms, cut the incidence of substance use disorders in students in half when those students were 19 years old, 3) The SPARX video game, which has the potential to be an accessible, appealing, and cost-effective treatment for the thousands of teens affected by mild to moderate depressive disorders, and 4) Intensive psychosocial treatments which can reduce the progression of from the ultra high risk state to the first episode psychosis by 50% over 12 months. All of these interventions have tremendous potential to reduce the suffering and disability caused by psychiatric illness to both children and adults.

Keywords: Adolescent depression; Familial depression; Health promotion; Maternal depression; Prevention; Substance abuse; Ultra high risk for psychosis.