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6 March 2024

The case against therapy in schools

A provocative new book argues that the therapy industry is exacerbating our children’s mental health crisis.

By Hannah Barnes

More than a million children in England were referred to NHS mental health specialists last year. The number had doubled between 2017 and 2022. Young people today, we’re told, are the loneliest and most anxious cohort on record, yet mental health is more talked about and less stigmatised than ever. So why are our children in crisis?

In her new book, the American journalist Abigail Shrier suggests an answer: not just the bad therapy referred to in the title, but also bad therapists, self-styled parenting gurus and amateur counsellors in schools. Central to the thesis is the idea of iatrogenesis: unintentionally causing harm in the course of treatment. Put simply, Shrier explains, having therapy to discuss a problem you didn’t already have might be sufficient to induce it.

In punchy, persuasive prose, Shrier paints an almost dystopian picture of 21st-century America. Less than half of Gen Z (those born between 1997 and 2012) believe their mental health is good, writes Shrier; 42 per cent have a mental health diagnosis; 10 per cent of American children have an ADHD diagnosis; and one in six children aged between two and eight has a diagnosed disorder. Some figures cited are far more reliable than others: the last two come from the Centers for Disease Control and Prevention (CDC) – the US’s national public health agency – but the first two are from surveys, one conducted by a health-data management company.

Shrier is scathing about therapists, who she says have “presided over a disaster”. They are too quick to diagnose disorders, to dispense drugs and to take parents’ money. “It’s in therapists’ interest to treat the least sick for the longest period of time,” Shrier argues. Scepticism has veered into cynicism here. Friends who are mental health professionals acknowledge that there are some – too many – poor practitioners. But not all therapists are ineffective and generally, they say, a client who doesn’t feel they are getting better won’t continue paying for help. 

Meanwhile, a wave of new mental health apps, helped by AI, are being rolled out to children. Talkspace, one such app, has the motto and mission “Therapy for all”. The poor mental health of young people, Shrier writes, “spells unimaginable business opportunity” for these companies.

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Even more frightening are the accounts of what is taking place in America’s schools, where most have a “full team” dedicated to mental health, and children take part in daily “emotion check-ins”. “What is something that is making you really sad right now?” a teacher asks a group of ten- and 11-year-olds. “I think that my dad hates me. And he yells at me all the time,” one boy replies, as he bursts into tears. “Within minutes,” a mum of one in the class tells Shrier, “half of the kids were sobbing.” It’s difficult to see how these children are helped by the activity. Then there are the questions asked in school surveys, the contents of which have been extracted by parents through Freedom of Information requests. Eleven-year-olds in Florida are asked: “Have you ever seriously thought about killing yourself?”

Blanket, school-based mental health interventions will be nothing new for many British parents, and the view that some measures might be harming some children is being explored by psychologists in the UK. But while Shrier is right to sound a note of caution about these schemes, she does not appear to acknowledge the uncertainty and lack of evidence on both sides of the debate: the Oxford psychologist Lucy Foulkes wrote recently that, “The backlash against mental health awareness has begun before we are even close to understanding how to support anyone who needs help.”

Shrier saves some of her fiercest criticism for parenting “experts” who dispense advice in books and podcasts, especially those who encourage the pursuit of “gentle parenting”: “a therapy-infused model that requires parents to give choices instead of orders”.

But much as Shrier despises these self-styled gurus, in some ways Bad Therapy is itself – inadvertently – a parenting manual. Its message? Take back control: no one loves your children more than you do, or knows them better. “There is no good reason to believe that most kids are traumatised,” she writes. “They thrive with independence, a certain level of responsibility and autonomy and, yes, failure.” In other words, children are amazing, if we give them the chance to be. It’s a message that parents, teachers, mental health professionals and policymakers need to hear.

Bad Therapy: Why the Kids Aren’t Growing Up
Abigail Shrier
Swift Press, 288pp, £20

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[See also: The wisest investment in your child is not giving them a smartphone]

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This article appears in the 06 Mar 2024 issue of the New Statesman, Bust Britain