Ask a Therapist: What Is a Day at Residential Treatment Like?

“We are considering a residential treatment center for our child who needs a mental health treatment plan that gives more in-depth, consistent care. I’m nervous because I’m unsure what to expect. What’s a typical day like? What will they do? What kind of treatment is offered for their mental health disorder?”

Sending teens to residential treatment centers for youth is one of the most difficult decisions a parent will make. In order to come to the right decision about adolescent treatment, you deserve to know what this level of care will be like for your child — and for you.

To answer these questions, we talked with Josh Nordean, M.S., LPC, clinical director of Embark at The Forge.

Why Are Days in Residential Treatment Programs So Structured?

“Structure and schedule create consistency and predictability. When things are consistent and predictable, they’re physically and emotionally safe,” Nordean explained.

“Kids aren’t having to wonder what’s around the corner. The daily structure provides the foundation for everything else that happens during their stay at the residential treatment facility. They know when school starts, when group therapy meets, and what times they’ll have their meals.

“From a human perspective, the unknown is the scariest thing. If we know something challenging is coming, we can prepare. If we don’t know what’s coming, that’s really hard.”

What would a typical day in a residential treatment program look like for my teen?

Here are a couple weekday schedules from two of Embark Behavioral Health’s residential programs as an example.

Embark at The Forge (for teen boys)
Embark at The Forge challenges teen boys physically and mentally. Functional physical fitness is worked into each day, and the school is academically rigorous. At the end of each day, boys feel like they’ve accomplished something, and those accomplishments add up throughout the treatment period.

Weekday schedule:

Embark at The Poconos (for teen girls)
Embark at The Poconos gives plenty of opportunities for group and individual therapy along with its solid academic program. The program also works on improving a teen’s social/emotional functioning and life skills, enhancing their relationships with their family and peers.

Weekday schedule:

What about family therapy and activities?

Embark works from a developmental lens that is founded upon attachment theory and a family systems approach for mental health issues, substance abuse, eating disorders, attention deficit hyperactivity disorder, personality disorders, and dual diagnosis issues. The most important part of treatment for your teen is making sure their family relationships are strengthened and supported.

“Each teen has weekly Zoom meetings for their family therapy,” Nordean explained. “If we have families that are close enough to come on campus to do family sessions, we’ll do those sessions in person. Families can spend several hours doing a mini-intensive.”

When parents visit their teens, the goal isn’t to just sit around in an office talking to each other. Experiential therapies like going fishing together, hiking, or other activities give parents and teens time together so they can strengthen the bonds between them.

Embark at The Forge also has quarterly parent events that feature speakers and parent support groups. These events give parents the opportunity to share experiences and support each other.

In addition, teens call their parents on weekends just to talk with their families — to share about their week and reconnect with parents and siblings.

What Should Parents Do While a Teen Is in Residential Treatment?

“We encourage parents to do their own work. We give them reading lists and homework assignments from week to week,” Nordean said. “We recommend parents be in therapy with a mental health professional while their teen is in residential treatment.”

When one family member is working hard on their behavioral issues and coping skills, the other family members change too. Those changes need to be supported throughout the entire family.

If your teen is the only one working on their specific needs, when they complete treatment, they’re returning back to the same environment. Parents need to do their own work on behavioral health and emotional issues so they can figure out how to best support their teens when they return home.

Nordean gave a few additional reasons why you should be in therapy with your own provider while your teen is in residential treatment:

1. You have your own emotions about all that’s been happening: anger, grief, fear, worry, sadness. When you work through these in your own therapy in an environment where you’re supported, you’re able to let family therapy be about your family.
2. It’s hard to see your teen struggle, and it’s easy to blame yourself as a parent. Therapy lets you work through that guilt and establish good emotional boundaries. Nordean emphasized that you’re not a bad parent just because your teen struggles. If you can recognize that through your own mental health care, you’re more prepared to share in your teen’s struggles and have a much better chance of real connection with your teen.
3. Your teen may feel like they’re being sent to treatment to be fixed instead of supported. When you also embrace therapy so you can change together, you’re erasing that stigma and letting them know that mental health care is important, and everyone needs to look after their mental health. You’re emphasizing how your family is in this together.

What if my teen refuses to do what they’re supposed to during teen residential treatment?

“We typically have some refusal on the front end,“ Nordean said. “‘I don’t want to go to school … I’m not going to.’ So we focus on keeping students safe. For example, the schedule provides safety. With that, there’s a positive impact from the peer group. When we have boys that are further along in treatment, they’re used to the schedule and doing their thing.

“There’s a little bit of that herd mentality that a kid will buy into. ‘OK, we’re going to go to school now because we know that if we don’t go to school, we may not get to go on this outing later.’ And so there’s that positive peer environment.

“But they also recognize that the longer they continue to refuse to participate, the longer they’re probably going to be here. And that’s something that helps them get motivated, when they realize their behavior has consequences.”

Daily shift changes in staff also work well for gaining teens’ cooperation. It’s hard to dig in their heels for any length of time when each staff change represents a different person to resist — someone who is friendly, direct, and wants to help. It’s easier to start following the routine.

“The people that are part of our robust treatment team — from residential staff to the clinical team of therapists and nurses — encourage that engagement,” Nordean explained.

If you’re interested in exploring residential treatment for your child, you can find a program near you through the National Association of Therapeutic Schools and Programs member directory. Learn more.