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Is Your Teen Depressed or Anxious? When To Get Intensive Intervention

Julie’s daughter Isabelle experienced an intense bout of depression the summer before junior year of high school. Since the fall, Isabelle had been going to therapy and Julie was hopeful things would turn around. But it was not getting any better. Isabelle’s grades were falling. She was often too anxious to go to school. She began isolating herself from even her closest friends.

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When Isabelle seemed to lose interest in graphic art—which had always been her passion and the one thing that soothed her during difficult times—Julie started to wonder if Isabelle needed something more than the weekly therapy sessions she’d been attending.

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Symptoms such as Isabelle’s can sometimes be remedied on the outpatient level, says Elise Guthmann, a licensed marriage and family therapist, and clinical program director at Evolve Treatment Centers in California. But if your child’s symptoms seem to be getting worse, if they are not able to function in their day-to-day lives, or if they are exhibiting signs of suicide ideation or self-destructive behaviors, it’s time to consider intensive intervention.

Mental Health Treatment Options

But what does that look like? Essentially, says Guthmann, there are three modes of intensive intervention:

1. Intensive Outpatient

The first level is IOP, or Intensive Outpatient treatment. This is for teens who attend school during the day but go to a treatment center several days a week. Typically, treatment would be 3-4 hours a night, 3-5 days a week. What’s great about an option like this, says Guthmann, is that it’s often a package deal. This means psychiatric care and individual, family, and group therapy are all included.

2. Partial Hospitalization

The next level of treatment is PHP, or Partial Hospitalization. This is similar to IOP but takes place between 5-8 hours per day, typically five days a week. This would be a good option if your child’s issue is significant enough that they are unable to function at school but are still able to live at home.

3. Residential Treatment Center

RTC, or Residential Treatment Center, is one of the most intensive treatment options. With RTC your child lives onsite, and the stay generally lasts between 30 and 60 days depending upon the need. Teens typically have programming 16 hours a day, including exercise, recreation, socializing, and meals—in addition to daily therapy regimens.

Determining What’s Best For Your Child

If you suspect your teen might need intensive treatment, it can be overwhelming to know where to start. After all, you are already extremely worried about your child; how are you supposed to have the headspace to look into all of the available options and know which one is best for your child?

The best place to start, says Guthmann, is to consult with a clinician or someone familiar with mental health treatment resources. If your teen is seeing a therapist, start with them. If not, you can always reach out directly to a treatment center and request to speak to the admissions department. You will be put in contact with someone who can help make recommendations about the level of care your child needs.

Before making any recommendations, a good treatment center will conduct a thorough assessment.

This will include your teen’s symptoms, previous treatment, any substance use, family dynamics, and other important factors.

Says Guthmann, “If your insurance and financial means are the first thing they ask about, hang up and call another center.”

If intense intervention seems like too extreme an option, you might instead consider increasing your child’s outpatient therapy, trying a new therapist, or changing the type of outpatient therapy your child is receiving.

However, you might discover that your child needs more intensive treatment than a residential center can offer. The highest level of care, inpatient hospitalization, would be appropriate for a child who is a danger to themselves or others, acts out aggressively, or refuses to take their medication. If you feel your teen is in imminent danger of self-harm or is a danger to others, you should call 911 or take them to the nearest emergency room.

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Parenting a teen who is dealing with mental illness is never easy. But remember there are many options for treatment and caring professionals who are ready to help your child on the road to recovery. Researching and understanding the available options is an important first step.

Wendy Wisner’s work has appeared in The Washington Post, Huffington Post, Scary Mommy, and elsewhere. She is a frequent contributor to

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