Can mental health treatments ever be harmful for children? What’s Bad Therapy by Abigail Shrier about?
In Bad Therapy, Abigail Shrier lays out her argument for why mental health treatments aren’t helping young people. She also discusses how well-intentioned interventions by parents, schools, and mental health professionals can damage youth mental health.
Read more in our brief overview of Bad Therapy.
Overview of Bad Therapy
Bad Therapy by Abigail Shrier argues that we’re too quick to medicalize youth mental health in today’s society. She says that while some children genuinely suffer from mental illnesses that require professional treatment, parents, teachers, and mental health experts often view normal struggles of growing up as problems that need to be treated with therapy or medication. This overtreatment prevents young people from developing the skills they need for adulthood. Shrier suggests that instead of rushing to therapy, parents should give their kids more independence and opportunities to develop resilience.
Shrier is a journalist and former opinion columnist for The Wall Street Journal. She holds a bachelor’s degree in philosophy from Columbia University and the University of Oxford, and she attended Yale Law School as a Coker Fellow. She’s also the author of Irreversible Damage, which discusses gender dysphoria among adolescent girls and the rise in cases of teenage girls identifying as transgender. Bad Therapy was published in 2024.
Gen Z’s Mental Health Crisis
To understand why overtreating mental health can be damaging, we must first understand how young people’s mental health today differs from that of older generations. According to Shrier, Generation Z children (those born 1995-2012) struggle with mental health more than previous generations. They experience unprecedented levels of loneliness, anxiety, and depression. She specifies that nearly half of this generation think their mental health is poor: 40% have sought professional care and 42% have a formal diagnosis. Let’s look at the reasons behind Gen Z’s poor mental health.
Myths About Gen Z’s Poor Mental Health
Many mental health experts argue that Gen Z simply faces greater challenges than previous generations. These experts cite three challenges that make this generation uniquely stressed:
- Smartphones and social media: Experts argue these technologies harm mental health by causing depression and anxiety, and preventing healthy in-person relationships.
- Covid-19 lockdowns: The pandemic forced young people into isolation, cutting them off from friends, normal school life, and social activities during their crucial developmental years.
- Climate change: Many experts say that young people feel hopeless and anxious about environmental disasters, rising temperatures, and fears about the planet’s future.
However, Shrier argues that these are insufficient explanations for Gen Z’s poor mental health. She acknowledges that smartphones and lockdowns deprive children of in-person interactions, but she argues that mental health problems among young people were increasing well before lockdowns and smartphones. She also doubts that climate change is a major cause of youth mental health problems—past generations also faced existential threats like nuclear warfare without having widespread mental health problems.
The Real Cause of Gen Z’s Poor Mental Health
So, what’s actually causing Gen Z’s poor mental health? According to Shrier, the real cause is the way parents raise their children—an approach that relies too heavily on mental health experts, therapies, and medications. They rush to have their kids tested and diagnosed at the smallest sign of a problem, treating normal childhood challenges as problems that require professional help. For example, parents might seek therapy when their child experiences common growing pains like anxiety about schoolwork or sadness after a breakup.
Shrier points out that youth mental health is poorer than ever despite therapy, medication, and mental health accommodations becoming more available—a trend she refers to as the treatment-prevalence paradox. This paradox suggests that mental health treatments aren’t helping and are even making things worse.
Why Mental Health Treatments Can Be Harmful
Shrier argues that while mental health treatments aim to help children, treating them when it isn’t necessary can cause unintended harm. In this section, we’ll discuss five ways therapy can damage young people.
1) Children Might Accept Unhelpful Ideas Without Question
First, young people lack the life experience and self-awareness to challenge a therapist’s ideas like adults can. Because of this, they might accept inaccurate or unhelpful interpretations without question, leading to confusion about their feelings or experiences. For example, if a therapist tells a teen that their parents’ strict rule about chores is overly controlling, the teenager might start viewing their parents as unfair or oppressive.
2) Family Relationships Can Suffer
Second, Shrier says that therapists often suggest that many issues stem from childhood trauma, leading patients to view their parents in an overly negative light. She argues that this can cause young people to cut ties with family members when they become adults, depriving them of relationships that could provide connection, support, and guidance.
3) Unproven Treatments Can Backfire
Third, Shrier contends that many therapies used on kids haven’t been proven to work and can backfire. For instance, group sessions for trauma survivors often worsen symptoms rather than improve them—when children repeatedly talk about the trauma with other victims, they may feel their negative feelings intensify rather than heal from them and move on.
4) Children Might Obsess Over Emotions
In therapy, children often reflect on and share their emotions, and parents and educators regularly check on how kids feel. However, Shrier argues that constantly asking children how they feel teaches them to see their emotions as overly important. This is harmful in three ways:
First, young people learn to use their emotions as the basis for decisions. This can lead to poor decisions because our emotions are constantly changing and don’t always match reality. Shrier explains that many external factors can influence our emotional state, and feeling something doesn’t automatically justify acting on it. For example, if a teen is upset with their friend due to a misunderstanding, they might end the friendship in anger without trying to uncover the full story.
Second, when children frequently reflect on their emotions, they feel more negative emotions like anxiety or sadness. This is because happiness isn’t a common feeling—most of the time we feel neutral at best. So, if you ask kids how they feel every day, you’ll often just remind them of something negative, such as worries or stresses they have about the day.
Third, fixating too much on emotions can make it hard for young people to manage them—to acknowledge their emotions, put them into perspective, and move on. Shrier says that when young people share their mental health problems, they often get sympathy and attention, which encourages them to exaggerate or prolong their issues instead of trying to resolve them.
5) Children Might Feel Inherently Fragile
Shrier writes that overtreatment not only teaches children to fixate on their emotions, but it also causes them to view themselves as inherently damaged and fragile. She argues that today’s society has become obsessed with finding trauma in everyone’s past. While severe trauma exists, the tendency to see trauma everywhere convinces people that common childhood difficulties permanently damage them.
Shrier adds that when we rush to diagnose and medicate children, we damage their self-image and create a self-fulfilling prophecy: Children think they can’t change or improve without professional help and expect less from themselves. As a result, instead of learning to handle life challenges by themselves, they struggle to make decisions or take action without medication or guidance.
The Overemphasis on Mental Health in Schools
Now that we’ve discussed how unnecessary mental health treatment can harm children, let’s look more specifically at how schools can contribute to these issues. According to Shrier, schools focus too much on student mental health. Despite lacking proper training or guidelines, teachers and staff routinely encourage students to share personal feelings in class, suggest mental health diagnoses like ADHD, and provide excessive accommodations. In the following sections, we’ll discuss the effects of these interventions in school on student mental health.
Mental Health Programs and Surveys
Shrier writes that many schools have implemented mental health programs like social-emotional learning (SEL), which have students share feelings and personal experiences in class. While schools intend for these to teach students emotional awareness and empathy, they disrupt learning by having students repeatedly discuss their anxieties and personal problems during academic time. Listening to and talking about negative emotions can leave students feeling distressed and make it harder for them to concentrate on their academic subjects.
Many schools also administer surveys that ask questions about mental health, family life, drug use, sexual activity, and other sensitive topics. Shrier argues these surveys are intrusive, inappropriate for children, and may actually introduce or normalize risky behaviors by asking about them. Additionally, in many states, schools aren’t required to inform parents when students receive counseling services. This means children may be discussing personal issues with school staff without parents’ knowledge.
Excessive Accommodations
Schools have long provided special accommodations to help struggling students succeed. But Shrier argues that schools now bend over backward to accommodate nearly every student request, a practice that undermines independence and academic performance. Shrier discusses three accommodations that she considers damaging:
1) Academic accommodations: Teachers liberally make modifications to academic standards, even for students without formal diagnoses, by accepting late work, giving extra time on tests, and allowing students to leave class if anxious. While some students face genuine trauma, schools now label common challenges like having divorced parents as traumatic. This leads educators to treat typical students as psychologically damaged and unable to meet basic expectations. Shrier contends that this mindset particularly harms disadvantaged students who need high standards and accountability to succeed.
2) Student aides: Schools increasingly assign aides to follow and help individual students throughout the day. While these helpers originally supported students with severe disabilities, schools now assign them to students for minor behavioral issues. Having a constantly monitoring shadow can make students more dependent on adults and deprive them of opportunities to learn to deal with situations independently.
3) Restorative justice: Many schools have replaced traditional discipline with restorative justice, where students who misbehave participate in group discussions about their feelings rather than face punishment. Shrier argues that this approach fails to prevent violence and actually hurts victims by forcing them to confront their attackers. By treating all misbehavior as a mental health issue requiring therapy instead of discipline, schools have lost the ability to maintain order. According to the teachers Shrier interviewed, restorative justice has led to more behavioral problems and school violence.
How Parents Can Nurture Resilient Children
To raise more resilient children, Shrier encourages parents to trust their instincts instead of relying on expert opinions. She says modern parenting has become too dependent on experts and interventions, with parents turning to therapy and medication to handle their child’s behavioral issues instead of using parenting strategies like setting boundaries and consequences. Depending so heavily on outside help prevents children from developing life skills and forming strong relationships with their parents.
Instead of relying on mental health treatments, Shrier recommends parents be more authoritative instead of coddling their children and let their children be more independent.
Be a More Authoritative Parent
Shrier encourages parents to adopt a more authoritative parenting style—an approach that combines love with clear rules, high standards, and consistent discipline. She explains that modern parenting has become overly permissive and therapeutic. Parents often treat their children like therapy clients who need constant validation and emotional support. For example, where previous generations might have told a misbehaving child to stop and go to their room, today’s parents engage in lengthy discussions about emotions and offer multiple choices for the child to choose from.
The shift toward this more permissive style of parenting happened as Generation X parents rejected their own upbringing, wanting to avoid the emotional detachment and discipline methods they experienced as kids. However, this gentler parenting style hasn’t produced better outcomes. Shrier argues that despite parents being more present in their children’s lives and accommodating more of their needs, young people are more anxious, depressed, and struggling to launch into adulthood. Children naturally need and want parental authority—when parents fail to provide it, kids look for it elsewhere, so they may even distance themselves from their parents and seek authority from extreme political movements or cults.
For these reasons, Shrier advocates a return to clearer boundaries, consistent consequences, and the understanding that temporary discomfort from discipline helps children develop into capable adults. She cites studies showing that children raised with firm but loving guidance become more successful and emotionally stable than those raised with permissive parenting.
Encourage Independence
Shrier writes that children need time away from adult supervision to develop properly. In the past, kids were given more independence and expected to entertain themselves. Today, parents intervene excessively in their children’s schooling, social lives, and daily activities. For example, they might pick up their child immediately after school, supervise all homework, and plan enriching activities at home. This constant adult supervision actually increases stress and anxiety in children, Shrier argues.
Shrier cites countries like Japan and Israel, which allow young children to regularly navigate public transportation alone and handle responsibilities that American parents would consider dangerous. This independence, she argues, leads to greater emotional stability and fewer mental health issues compared to American youth.
Ultimately, Shrier argues parents should reduce their involvement in children’s lives rather than constantly intervening. She encourages them to step back and allow children to face natural consequences. For instance, instead of emailing teachers about homework, let your children face the natural outcomes of forgetting assignments. Allowing kids to have responsibilities and explore their environment without adult supervision—even if it involves small risks—teaches them to negotiate relationships, solve problems on their own, and build confidence.
