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Is there such a thing as good therapy? Not for kids, argues Abigail Shrier. Sure, “play therapy” for the littlest tykes probably does no more harm (and no more good) than a very expensive babysitter. But when the talk therapy developed for adults is administered to children and teenagers, “no harm” is the best case. Iatrogenic effects include demoralization, rumination, alienation, overdiagnosis, hypochondriasis, and overmedication. All this, for just a “fifty-minute hour” per week.

Shrier argues that therapy is to blame for America’s youth mental health crisis, by which she means the large and expanding cohort of “the worriers; the fearful; the lonely, lost, and sad.” The trends are bad and long-running. Between 1950 and 1988, the rate of adolescent suicides quadrupled. Between 1990 and 2007, the number of mentally ill kids rose 3,500 percent. In the past decade or so, one is tempted to say that mental illness has become fashionable. Diagnoses proliferate, some venerable, some novel, some evidently severe, some seemingly fanciful. Ever more teens present anxiety, depression, dissociation, gender dysphoria (the subject of Shrier’s previous book), eating disorders, self-harm behaviors, hair-pulling compulsions, and tics. To make her thesis go, Shrier relies on an expansive definition of “therapy”: the practice itself, the application of therapeutic concepts to parenting and school discipline, and the suffusion of therapeutic concepts throughout American culture. It’s a salutary polemic, if not airtight.

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