Practice Guidelines for Pediatric Mental Health

Recommendations are evidence strength A (strong evidence) or B (moderate evidence).¹ 

Tier 1 – Universal

Socialization

• Provide whole-school programs to improve social and emotional skills.
• Create and support after-school programs that incorporate social skills-based goals.
• Address bullying and victimization with prevention programs.
• Educate on problem-solving skills to improve coping with mental health symptoms associated with socialization.
• Educate on problem-solving skills to improve peer interactions.
• Collaborate with and educate parents to improve child compliance.
• Partner with parents to prevent aggressive behaviors using a multi-component school program.

Health Management

• Provide school-based stress management programs to improve self-efficacy.
• Use mental health literacy programs for adolescents to improve knowledge and attitudes about mental illness, e.g., stigma.
• Reduce physical stress from carrying backpacks and lifting heavy objects with programs for elementary school children.
• Incorporate yoga to improve physical fitness and cardiopulmonary health.

Play and Leisure

• Use skill-based activity groups to improve mental health behavioral outcomes.
• Use performing arts programs to improve social interaction and skills.
• Use recreational after-school programs that promote physical activity
• incorporate team-building activities to improve self-concept.
• Teach cooperation and reduce competitive behaviors in elementary school children.

Tier II

Socialization

• Provide social skills training for at-risk children and adolescents to improve social interaction, peer acceptance, and social standing.
• Provide social skills programming for at-risk, aggressive, or antisocial children and adolescents to improve task attention, peer interaction, prosocial behaviors, and reduce aggression and undesired social behaviors.
• Provide social skills programming for clients with learning disabilities and ADHD to improve communication, functioning, and reduce problem behaviors.
• Provide social and life skills programs for clients with intellectual impairments and developmental delays to improve behaviors and skills (e.g., life skills, conversational turn-taking, initiation of social interactions).
• Partner with parents and parenting programs for teenage mothers to improve mother-infant interactions.
• Address teenage mothers and their children’s interactions, attitudes, knowledge, communication, confidence, and identity.

Health Management

• Incorporate yoga for adolescents with physical symptoms from other conditions.
• Program in yoga, massage, and relaxation for clients with behavioral difficulties to improve self-confidence and communication.
• Use a guided imagery program in combination with coping strategies to withdrawn first-graders to increase socialization.
• Utilize a multicomponent program that trains clients with asthma to realize their internal locus of control.
• Educate and use programs to decrease days missed from school due to physical symptoms.

Play and Leisure

• Utilize playgroups for abused or neglected children to improve their play skills and self-image and to reduce problem behaviors.
• Use play and music for clients with intellectual and language impairments to improve social skills.
• Use recreation, leisure, and physical education programs for clients with intellectual disabilities to improve social interactions.
• Provide structures programs for children with shyness to increase extraversion.

Tier III

Socialization

• Incorporate self-management strategies to reduce challenging behaviors.
• Use social skills training for clients with ASD to improve their social behavior and self-management.
• Utilize social skills interventions for clients diagnosed with mental illness and behavioral disorders to improve social behaviors.
• Use of friendship skills group for children with ASD may improve their socialization skills.
• CBT may help children with ASD have decreased symptoms of anxiety.
• Use interventions that include joint attention for preschoolers with autism to improve their language and adaptive behaviors.

Play and Leisure

• Use play for school-aged children with ASD to increase play participation and promote cooperation.
• Use music-related activities for children with ASD to improve their communication skills and reduce problem behaviors.

1. American Occupational Therapy Association. (2013). Occupational therapy practice guidelines for mental health promotion, prevention, and intervention for children and youth. Retrieved from https://www.guidelinecentral.com/summaries/occupational-therapy-practice-guidelines-for-mental-health-promotion-prevention-and-intervention-for-children-and-youth/#section-424[↩]