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American kids are the freest, most privileged kids in all of history. They are also the saddest, most anxious, depressed, and medicated generation on record. Nearly a third of teen girls say they have seriously considered suicide. For boys, that number is an also alarming 14 percent. 

Whatu2019s even stranger is that all of these worsening mental health outcomes for kids have coincided with a generation of parents hyper-fixated on the mental health and well-being of their children.

Whatu2019s going on?

That mystery is the subject of Abigail Shrieru2019s fascinating, urgent new book:

Most American kids today are not in therapy. But the vast majority are in school, where therapists and non-therapists diagnose kids liberally, and offer in-school counseling and mental health and wellness instruction. By 2022, 96 percent of public schools offered mental health services to students. Many of these interventions constitute what I call u201Cbad therapyu201D: they target the healthy, inadvertently exacerbating kidsu2019 worry, sadness, and feelings of incapacity.

Since a childu2019s first mental or behavioral diagnosis often comes from school, the Child Mind Instituteu2014one of the premier nonprofits devoted to adolescent mental healthu2014provides an online u201Csymptom checkeru201D specifically to help parents or teachers inform themselves about u201Cpossible diagnoses.u201D

I began to wonder what schools were doing in the name of improving kidsu2019 mental health. I was in luck. Each year, the state of California sponsors a three-day public school teachersu2019 conference to showcase its vast array of emotional and behavioral services. Immediately, I registered. That is how, in July of 2022, I came to join more than 2,000 public school teachers at the Anaheim Convention Center, right next to Disneyland.

At the convention, ankle tattoos winked over fresh pedicures, Anne Taylor cardigans abounded, and the occasional mohawk sliced indoor air cool enough to crisp celery. We talked about u201Cbrain scienceu201D based on a YouTube video many of us had seen. It explained that the brain is like a hand, with the thumb folded into the palm. u201COur amygdala is really important in serious situations,u201D said the voice-over. This sounded right. We felt like neuroscientists. 

We lamented the burdens placed upon school counselors, now part of an expanded psychology staff, which oversees every public school the way diversity officers dominate a university. We were leery of these new bosses, but we had to admit, they had a big job to do. Our kiddos were bonkers. (The word we were careful to use was dysregulated.) Counselors now routinely monitored the social-emotional quality of our teaching, sniffed out emotional disturbance in our students, and decided what assignments to nix or grades to adjust upward.

We talked about the need to give kids u201Cbrain breaks,u201D the salvific power of u201CMindfulness Minutes,u201D and the importance of ending each day with an u201Coptimistic closure.u201D Our purview was the u201Cwhole child,u201D meaning we needed to evaluate and track kidsu2019 u201Csocial and emotionalu201D abilities in addition to academic ones. Our mandate: u201Ctrauma-informed education.u201D We pledged to treat all kids as if they had experienced some debilitating trauma.

Subsequent interviews with dozens of teachers, school counselors, and parents across the country banished all doubt: therapists werenu2019t the only ones practicing bad therapy on kids. Often traveling under the name u201Csocial-emotional learning,u201D bad therapy had gone airborne. 

When I first heard the term social-emotional learning, I assumed a hokey but necessary call for kids to get a grip. Or maybe it was the new name for what they used to call character education: treat people kindly, disagree respectfully, donu2019t be a jackass. Proponents insist it arrives at those things, albeit through the somewhat circuitous route of mental health. Sometimes described by enthusiasts as u201Ca way of life,u201D social-emotional learning is the curricular juggernaut that devours billions in education spending each year and more than eight percent of teacher time. (Many teachers say they try to ensure that social-emotional learning happens all day long.) Through a series of prompts and exercises, SEL pushes kids toward a series of personal reflections, aimed at teaching them u201Cself-awareness,u201D u201Csocial awareness,u201D u201Crelationship skills,u201D u201Cself-management,u201D and u201Cresponsible decision-making.u201D 

Morning Emotions Check-in

Forget the Pledge of Allegiance. Todayu2019s teachers are more likely to inaugurate the school day with an u201Cemotions check-in.u201D

School counselor Natalie Sedano advised our assembled conference room of teachers to ask kids: u201CHow are you feeling today? Are you daisy-bright, happy and friendly? Or am I a ladybug? Will I fly away if we get too close?u201D

This prompted great excitement in the audience, and teachers jumped up to share their own u201Cemotions check-ins.u201D One teacher said every day, she asks her kids if they feel itu2019s a u201Cbonesu201D or u201Cno bonesu201D kind of a day, borrowing the verbiage from a viral TikTok video in which a pug owner shares the mood of his 13-year-old pug, Noodle. If Noodle sits upright, itu2019s a bones day! If he collapses, itu2019s a no-bones day. 

u201CThat is so fun!u201D Sedano enthused. u201CLove it! Thank you!u201D

I asked Leif Kennair, a world-renowned expert in the treatment of anxiety, and Michael Linden, a professor of psychiatry at the Charitu00E9 University Hospital in Berlin, what they thought of practice. Both said this unceasing attention to feelings was likely to make kids more dysregulated.

If we want to help kids with emotional regulation, what should we communicate instead?

u201CIu2019d say: worry less. Ruminate less,u201D Kennair told me. u201CTry to verbalize everything you feel less. Try to self-monitor and be mindful of everything you dou2014less.u201D

Thereu2019s another problem posed by emotions check-ins: they tend to induce a state orientation at school, potentially sabotaging kidsu2019 abilities to complete the tasks in front of them.

Many psychological studies back this up. An individual is more likely to meet a challenge if she focuses on the task ahead, rather than her own emotional state. If sheu2019s thinking about herself, sheu2019s less likely to meet any challenge.

u201CIf you want to, letu2019s say, climb a mountain, if you start asking yourself after two steps, u2018How do I feel?u2019 youu2019ll stay at the bottom,u201D Dr. Linden said.

Ethical Violations 

In 2022, California announced a plan to hire an additional ten thousand counselors in order to address young peopleu2019s poor mental health. A new law encourages California school districts to bill federal Medicaid for mental health services allocated to kids in school. Meaning, however much in-school therapy kids have already received, they likely will soon be getting much more. California school psychologist Michael Giambona provides individual therapy sessions to his middle school students during the school day. 

Giambona also routinely runs interference with kidsu2019 teachers on kidsu2019 behalf. u201CMy teachers have special training in working with individuals with behavior needs and mental health needs,u201D he told me. u201CAnd we meet weekly, and we talk about whatu2019s going on with each student and how we can approach them and support them when they need it.u201D

Thereu2019s a problem with in-school therapy, an ethical compromise, which arguably corrupts its very heart. In a remarkably underregulated profession, therapists still have a few ethical bright lines. And among the clearest isu2014or wasu2014the prohibition on u201Cdual relationships.u201D

u201CThe relationship in the therapy room needs to be its own, distinct and apart,u201D psychologist and author Lori Gottlieb explains in her book, Maybe You Should Talk to Someone. u201CTo avoid an ethical breach known as a dual relationship, I canu2019t treat or receive treatment from any person in my orbitu2014not a parent of a kid in my sonu2019s class, not the sister of coworkers, not a friendu2019s mom, not my neighbor.u201D This ethical guardrail exists to protect a patient from exploitation. A patient may reveal her deepest secrets and vulnerabilities to her therapist, who could then rule over her like a czarina does her kulaks. Anyone possessing this much knowledge of a patientu2019s private life may be tempted to exert undue power. And so the profession makes u201Cdual relationshipsu201D off limits.

Except that school counselors, school psychologists, and social workers enjoy a dual relationship with every kid who comes to see them. They know all of a kidu2019s best friends; they may even treat a few of them with therapy. They know a kidu2019s parents and their friendsu2019 parents. They know the boy a girl has a crush on, what romantically transpired between them, and how the relationship ended. They know a kidu2019s teammates and coaches and the teacher whou2019s giving him a hard time. And they report, not to a kidu2019s parents, but to the school administration. Itu2019s a wonder we allow these in-school relationships at all.

The American Counseling Association appears to have noticed the obvious problem. In 2006, it revised the ACA Code of Ethics. While still prohibiting sexual relationships with current clients, it decided that u201Cnonsexualu201D dual relationships were no longer prohibitedu2014especially those that u201Ccould be beneficial to the client.u201D

As school counselors and psychologists came to see themselves as studentsu2019 u201Cadvocates,u201D they slipped into a dual relationship with their students: part therapist; part academic intermediary; part parenting coach. Today, school counselors and psychologists commonly evaluate, diagnose, and treat students with individual therapy; meet with their friends; intervene with their teachers; and pass them in the lunchroom. A teen who has just spent a tear-soaked hour telling the school counselor her deepest secrets might reasonably be fearful of upsetting anyone with that much power over her life.

But are school counselors and social workers exerting undue influence over kids?

Over the past two years, I have been so inundated with parentsu2019 stories of school counselors encouraging a child to try on a variant gender identity, even changing the childu2019s name without telling the parents, that Iu2019ve almost wondered if there are any good school counselors. One parent I interviewed told me that her sonu2019s high school counselor had given him the address of a local LGBTQ youth shelter where he might seek asylum and attempt to legally liberate himself from loving parents.

There are good school counselors; I have interviewed several. But the power structureu2019s all wrong. Grant a leader the powers of a monarch, and he may gift his subjects freedomu2014but whatu2019s to tether him to his promises? Thatu2019s placing a whole lot of trust in an individual counseloru2019s conscience. 

You might respond at this point: fortunately, my child has never been to see the school counselor. But more likely, you donu2019t know. In California, Illinois, Washington, Colorado, Florida, and Maryland, minors twelve or thirteen and up are statutorily entitled to access mental health care without parental permission. Schools are not only under no obligation to inform parents that their kids are meeting regularly with a school counselor, they may even be barred from doing so.

As long as a parent has not specifically forbidden it, a school counselor may be able to conduct a therapy session with a minor child without parental consent. School counselors are encouraged to make u201Cjudgment callsu201D about what information, gleaned in sessions with minor children, they may keep secret from the childrenu2019s parents.

School Staff Who Play Therapist 

Ever since her school adopted social-emotional learning in 2021, Ms. Julie routinely began the day by directing her Salt Lake City fifth graders to sit in one of the plastic chairs sheu2019d arranged in a circle. u201CHow is each of you feeling this morning?u201D she would ask, performing a more intensive version of the u201Cemotions check-in.u201D One day, she cut to the chase: u201CWhat is something that is making you really sad right now?u201D

When it was his turn to speak, one boy began mumbling about his fatheru2019s new girlfriend. Then things fell apart. u201CAll of a sudden, he just started bawling. And he was like, u2018I think that my dad hates me. And he yells at me all the time,u2019u2009u201D said Laura, a mom of one of the other students.

Another girl announced that her parents had divorced and burst into tears. Another said she was worried about the man her mother was dating. Within minutes, half of the kids were sobbing. It was time for the math lesson, but no one wanted to do it. It was just so sad, thinking that the boyu2019s dad hated him. What if their dads hated them, too?

u201CIt just kind of set the tone for the rest of the day,u201D Laura said. u201CEveryone just was feeling really sad and down for a really long time. It was hard for them to kind of come out of that.u201D

A second mom at the school confirmed to me that word spread throughout the school about the AA meetingu2013style breakdown. Except this AA meeting featured elementary school kids who then ran to tell their friends what everyone else had shared.

Thanks to social-emotional learning, scenes of emotional melee have become increasingly common in American classrooms. In 2013, The New York Times reported on a near identical scene that took place after a California teacher conducted a similar social-emotional learning session with his kindergarteners. u201CWith children especially, whatever you focus on is what will grow,u201D Laura said. u201CAnd I feel like with [social-emotional learning], theyu2019re watering the weeds, instead of watering the flowers.u201D

Advocates of social-emotional learning claim that nearly all kids today have suffered serious traumatic experiences that leave them unable to learn. They also insist that having an educator host a class-wide trauma swap before lunch will help such kids heal. Neither claim is well-founded.

But the predictable result is precisely what Ms. Julie saw: otherwise happy kids are brought low and a child seriously struggling has his private pain publicly exposed by someone in no position to remedy it.

Sometimes when a kid plunks himself down on the rug for morning circle, he is in no mood to exhibit a painful experience no matter how much it might expand the classu2019s emotional horizons. This leaves teacher-therapists with a problem: How to get kids to dish about their emotional lives when they really donu2019t want to?

One presenter at the conference, Amelia Azzam, a regional mental health coordinator for Orange County Public Schools, told a story that seemed to answer this quandary. She knew of a teaching assistant who trailed a seventh grader to lunch. She u201Cgoes out to lunch where this young student sits, and she always says u2018hiu2019 to him. And she has casual interactions with him.u201D And one day, he told her that his dad was getting out of jail. 

u201CNobody else knew that,u201D Azzam said.

Good therapists know that it may be counterproductive to push a kid to share his trauma at school. Good therapists are trained specifically to avoid encouraging rumination, a thought process typified by dwelling on past pain and negative emotions. Rumination is a well-established risk factor for depression. But school staff who play therapist rarely seem aware that they might be encouraging rumination as they stalk a kid at lunch, waiting to see if heu2019ll open up about his fatheru2019s incarceration minutes before a history test.

Injecting Anxiety into Math Class

Social-emotional learning enthusiasts happily disrupt math or English or history because, to the true believers, education is merely a vehicle for their social-emotional lessonsu2014the corn chip that carries the guac straight to a kidu2019s mouth. u201CI canu2019t think of a content area that needs more social-emotional learning than mathematics,u201D educational consultant Ricky Robertson told our assembled conference room.

But how would a teacher manage to make social-emotional learning the goal of a math class? To discover the answer, I sat through a presentation titled u201CEmbedding SEL in Math.u201D

Our mock lesson commenced withu2014you guessed itu2014discussion of our feelings about math. u201CAnxiety!u201D more than one teacher volunteered. The presenters showed us a series of kindergarten-level u201Cmath problemsu201D that asked us to look at a bunch of shapes and asked: u201CWhich one doesnu2019t belong?u201D 

At the end, they revealed the correct answer: they all belong. No wrong answers! Everyone wins! See, that wasnu2019t hard.

I turned to the high school math teacher next to me and asked her how she could possibly incorporate this sort of approach into Algebra II. She stared back at me, a frozen rictus pinned to the corners of her mouth. She seemed to think Big Brother was watching us.

The only feeling apparently never affirmed in social-emotional learning is mistrust of emotional conversation in place of learning. A decent number of kids actually show up hoping to learn some geometry and not burn their limited instructional time on conversations about their mental health. But from every angle, such children could only be made to feel errant and alone.

In the minds of social-emotional learning advocates, healthy kids are those who share their pain during geometry. That is how a teacher knows they are emotionally regulated. They are willing to cry for the benefit of the class.

Excerpted from Bad Therapy: Why the Kids Arenu2019t Growing Up, by Abigail Shrier, in agreement with Sentinel, an imprint of Penguin Publishing Group, a division of Penguin Random House LLC. Copyright u00A9 Abigail Shrier, 2024.

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