Bullying | Diagnosis & Treatment

What can a pediatrician do to determine if a child is being bullied?

Asking children specifically about problems with bullying during routine office visits—“Is anyone being mean to you?”— is the first and most important step. Pediatricians should also be on the lookout for signs of stress, such as:

  • a sudden decline in grades
  • school refusal
  • an abrupt change in sleep patterns
  • unexplained weight loss or weight gain
  • frequent visits to the school nurse’s office

What are the treatment options for bullying?

Treatment related depression and anxiety

Knowing that your child is struggling with her thoughts and feelings is an upsetting experience for any parent—but you can rest assured that at Boston Children’s Hospital , your child and your family are in good hands.

Our team of psychiatrists, psychologists and social workers can help you, your child and your family by:

  • tailoring therapy plans according to your child’s age, specific symptoms, family and school situation and overall medical history
  • using psychotherapy (such as Cognitive Behavioral Therapy), or a combination of medication and therapy, to help your child feel and function better

Boston Children’s Department of Psychiatry has a team of expert psychiatrists, psychologists and social workers ready to help your child cope with bullying and mental health issues related to bullying. We’ll work closely with her—and with you and your family—to:

  • devise a plan for stopping the abuse.
  • help your child rebuild her self-esteem.
  • teach her new, constructive thought patterns to help her succeed in the present and plan for the future.

In addition, our Boston Children’s Hospital Neighborhood Partnerships provides a range of services to children in seven Boston-area schools and four community health centers, tackling bullying directly in the schools.

Psychotherapy

Psychotherapy is designed to help your child identify, express and manage her feelings about being bullied. It will also teach her important new skills for overcoming those feelings, rebuilding her self-esteem and feeling optimistic and confident about the future.

Your child may receive individual therapy, or may participate in group sessions with other kids working through similar issues. We also offer family counseling, which allows parents, siblings and other family members to take part in a child's therapy sessions and learn new strategies as a team.

Medication

If your child’s depression, anxiety or stress do not adequately respond to psychotherapy, your clinician may recommend adding an anti-anxiety or antidepressant medication to his treatment plan. These medications can help your child feel more relaxed and comfortable while he is working on learning and practicing coping skills in therapy.

Here at Boston Children’s, we never prescribe mental health medication as a standalone treatment. Instead, we always consider medication as part of a two-pronged approach, with psychotherapy as a necessary component. Our Psychopharmacology Clinic can help determine whether medication might be a useful addition to your child's therapy.

Help at schools and in the community

Boston Children’s Hospital Neighborhood Partnerships (BCHNP) is the community mental health program in the Department of Psychiatry at Boston Children’s Hospital. Established in 2002, BCHNP places Boston Children’s Hospital clinicians in 7 Boston-area schools and 4 community health centers to provide a comprehensive array of mental health services to children and adolescents where they live and learn. 

Consistent with Community Systems of Care principles, Boston Children’s Hospital embraces community settings for mental health service delivery. By offering high-quality services in environments that are convenient and familiar to children and their families, CHNP plays an important role in improving the health and well-being of children in Boston’s most underserved communities.

Preventing depression and suicide

The Swensrud Prevention Initiative includes the prevention and promotion components of the CHNP School-Based Program. The Initiative also fosters the development, implementation and evaluation of innovative prevention strategies having the potential for far-reaching public health impact, such as raising awareness of depression and suicide among teens through the Break Free From Depression program. 

This program is a specially designed depression awareness program for use in schools. It applies an innovative and engaging format and proven cognitive behavioral techniques to teach young people how to effectively cope with difficult life circumstances, how to identify signs of depression in themselves and their peers and how to seek help.

A groundbreaking collaborative: BACPAC (Bullying And Cyberbullying Prevention & Advocacy Collaborative) is a multidisciplinary anti-bullying collaborative based at Boston Children’s Hospital — the first hospital-based program of its kind anywhere in the U.S. BACPAC:

  • serves as a source of expert information on bullying for schools, families and other healthcare providers
  • operates a clinic that performs comprehensive evaluations of children with neurodevelopmental disorders (like ADHD, Tourette’s disorder, intellectual disabilities, Asperger’s syndrome and autism) who are affected by bullying, either as victims or perpetrators
  • provides customized guidance and recommendations to meet the needs of the individual child
  • works in partnership with each child’s family, school and primary care provider to resolve the issue

How can I prevent bullying?

While there is no way to guarantee that your child will never be bullied (or be a bully), some measures have proven very effective in reducing bullying on a broader scale:

  • Parents should start talking to their children about bullying — including why it is wrong and hurtful, and what to do if they see someone else being bullied — at a very early age.
  • Parents should strive to create an atmosphere of tolerance, respect and compassion at home.
  • Schools should increase adult supervision (especially on the playground, on the bus and in the hallways between classes).
  • Schools should get parents involved in bullying prevention discussions and initiatives.
  • Schools, school districts and legislators should work together to create — and enforce — clear, strict anti-bullying policies. For example, Massachusetts now has a law that requires all school employees, from teachers to support staff, to report any incident of bullying to the school principal. Principals are also required to report any potentially criminal behavior to law enforcement officials.

What is the long-term outlook for a child who is bullied?

Bullying can have long-lasting social, psychological and health effects on victims. Children who experience bullying continuously are at greater risk for:

  • depression and suicidal thoughts during adulthood.
  • anxiety disorders including panic disorders and agoraphobia (fear of public places) during adulthood.
  • problems with physical activities like walking, running or participating in sports.
  • poorer physical health (sometimes as a result of harmful activities like disordered eating or using drugs).
  • dropping out of school, which is likely to have long-lasting negative effects on their education and career.
  • lower wages later in life.
  • future unemployment or reduced work participation

The good news is that supportive relationships with families, peers and mentors can make a difference and mitigate the negative effects of bullying (American Psychological Association).