It’s easy to be overwhelmed by the many decisions and jargon that goes along with learning about treatment.

With that in mind, we hope this information provides insight into the various options available to you and your loved one.

A ‘continuum of care’ provides different levels of service and programming based on an individual’s changing needs. The continuum is meant to be used to ‘step up’ or ‘step down’ services, and treatment intensity. Stepping up means moving to a more restrictive and intensive service level (i.e., going from PHP to Residential Treatment); whereas stepping down means moving toward a less restrictive environment (i.e., going from PHP to IOP).

“For a family looking for best-in-class care, ensuring the treating organization has a robust continuum of care is key.”

The coordinated effort and integrated service levels mean better outcomes and experience for the client. Effective treatment over the continuum of care requires attention to many moving parts. Not only does the treatment and therapy need to be coordinated between a variety of providers, the billing, and treatment planning but also must be efficient and accessible.

Here are the most common levels of care along with some therapeutic treatments and program types for you to consider:

The least intensive of therapies, outpatient therapy is where many families begin their journey. If school-based counseling services are ineffective, then meeting with an outpatient therapist may be an effective intervention to support growth and/or prevent things from getting worse. Outpatient therapy can be anywhere between multiple times a week to monthly at a therapist’s office, or at an outpatient clinic.

Mental Health Therapists can go by many names, titles, and licensures such as  Psychologist (a Doctorate level degree), Social Worker, Licensed Professional Counselor, or Marriage and Family Therapist (all Master’s level degrees).

Sessions are usually 50 minutes and can also be offered virtually. Depending on the needs, weekly individual therapy can be paired with family therapy, and medication management, in which a psychiatrist will prescribe medicine to supplement therapy.  Outpatient therapy can be used for preventative care, early intervention, or maintenance from a continuing care perspective.

Many of the typical outpatient clinic services can also be offered virtually or online. Oftentimes these virtual services also include web and chat messaging. Services can include:

Parent Coaching

Teen Mentoring

Counseling & Therapy

Intensive Outpatient Programming (IOP)

Psychiatric Med Management

These sessions occur in the community, rather than in an office. Clinicians or therapists meet clients at school, at home, or at their favorite spot in town.

Parent Coaches and Mentors support clients in managing real-world challenges and solutions.

In addition to weekly scheduled sessions, clinicians show up for families in real-time, when they need support and guidance the most.

Family Intensives

Another form of intervention that can be effective is called a Family Intensive. This type of program provides hope for your family in a retreat environment where you all go together for several days. This level of intervention allows you and your family to examine your unique dynamics, challenges and address core issues in an intensive and systemic way. This approach combines family systems therapy techniques with experience-based learning, so you and your family will experience vulnerability, deepen understanding and relationships, and have a truly transformational experience.

Intensive Outpatient Program (IOP)

Intensive outpatient programs (IOP) are a great option for those who need help with emotional or behavioral issues but need more than traditional outpatient therapy. This type of program is also good for those stepping down from a therapeutic day program / partial hospitalization program (PHP. In this model, young people are relatively engaged in the treatment process and willing to comply with the expectations of the program.

An intensive outpatient program (IOP) meets anywhere between 3 to 6 times per week for around 3 hours a day.

The IOP is offered at an Outpatient Clinic and typically in the afternoon, so the participant cannot only continue to live at home but also attend work or school during the treatment process.

Partial Hospital Program (PHP)

A partial hospital program (PHP) is more intensive than an IOP, but the young person still lives at home. PHP is 5 days a week for around 5 hours a day, and if combined with a clinical day school can create an intensive treatment for up to 8 hours per day. Young people who can cope while at home but need a significant amount of clinical intervention to avoid higher levels of care are good candidates for a partial hospital program. A PHP is a good option for someone coming home after being away at a higher level of care outside the home (i.e. wilderness therapy and residential treatment). Depending on where you live in the country, this can also be called Day Treatment Program (DTP).

Although programs vary by specialty, all of them include intensive therapy, accredited academics, and a wide range of recreation and residential services. Staff are highly trained and include psychiatrists, therapists, recreation therapists, teachers, and nurses. Individual, family, and group therapy sessions that foster emotional regulation and promote healing are core to residential treatment. Residential treatment programs create safety and can achieve long-lasting healing that may not be possible in traditional outpatient therapeutic settings. Studies suggest that teens who successfully complete a residential treatment program are less likely to relapse to what led them to treatment in the first place. Long-Term Residential treatment can be indicated if the individual is more treatment resistant or has a difficult time staying engaged in their healing journey.

Young people who need significant support and can no longer safely live at home due to continual emotional, behavioral, or psychiatric issues may benefit from residential treatment.

Residential treatment is offered on a short-term and long-term. A Short-Term Residential Treatment program typically ranges between 30 and 90 days.

Long-term residential treatment centers are more of a boarding school basis. Long-Term Residential Treatment is typically 9 to 12 months and includes a comprehensive approach to treatment.

Short Term Residential Treatment (STR)

If you choose a short-term residential treatment program to address a behavioral health or substance abuse issue, young people undergo intensive treatment for a period of 30 to 90 days; enough time to provide robust stabilization, assessment, and treatment. During that time, the participant lives at the treatment facility and takes part in a schedule of treatment programming. Schedules include individual and group therapy sessions in which staff therapists utilize a wide range of therapeutic techniques to create an individualized treatment plan. Additionally, life and coping skills training, family therapy, holistic and alternative therapies, and recreational therapy and activities are included. To allow for continuing care, clients typically transition to a day treatment (PHP/IOP) program after leaving a STR program.

Therapeutic boarding schools offer educational programs that are integrated with the therapeutic program and include specialized supervision for students with behavioral and emotional problems, as well as substance abuse issues and learning difficulties. Often teens transition to a therapeutic boarding school following successful wilderness therapy or residential treatment. This can help them maintain the gains they received in treatment. Teens who are compliant in the treatment process and do not require intensive treatment are good candidates for a therapeutic boarding school.

A therapeutic boarding school is a school-based treatment facility that combines therapy and education for students with psychological, behavioral, and emotional challenges.

There, the teen would receive therapy while getting an individualized education and participating in recreational activities or service opportunities.

Typically, a therapeutic boarding school is highly structured to help students build emotional and personal skills while continuing their education. Many schools have college prep academics and/or special education services.

The difference between residential treatment and therapeutic boarding school can sometimes be difficult to ascertain, but generally, students in a therapeutic school have completed other intensive treatment that has resulted in a degree of personal insight and cooperation that was not there previously.

Inpatient Hospitalization

Short-term inpatient hospitalization may be the right choice to help your loved one in an emergency. Short-term inpatient hospitalization is best for clients who are at immediate risk of harming themselves, or others or who are experiencing a threat to their own or someone else’s safety.

Short-term inpatient hospitalization is designed to keep your loved one safe and to stabilize the situation, but not necessarily to get to the root of the problem. The staff will focus on making a diagnosis and forming a longer-term treatment plan so they can provide you with some recommendations.

Staff will also administer medical care, support, and supervision during the client’s stay.

Sometimes young adults (typically ages 18-24) need extra support as they transition into independent living and adulthood. There are many types of programs that can help these young adults as they transition. Often, these programs include the features of long-term treatment, but with the goal of preparing young adults for independence.

At-risk teens and young adults dealing with wide-ranging emotional and behavioral issues may benefit from a wilderness therapy treatment program.

Typically, two to three months length of stay, wilderness therapy uses Mother Nature as the setting for stabilization, assessment, and therapeutic healing. Wilderness therapy programs are transformational and an effective way to help stabilize a young person and give the family some respite. Wilderness 

Wilderness therapy programs provide nurturing, compassionate, and sophisticated therapeutic interventions in an experiential, safe environment. During a wilderness therapy expedition, participants learn new ways of thinking and coping that can help them end a pattern of poor choices or negative behaviors.

Teens and young adults who enroll in wilderness therapy typically do not thrive in or have already not had success with, traditional residential or outpatient therapy, while others are simply resistant to treatment. In these cases, wilderness therapy can be an alternative to traditional treatment settings.