Evolve Therapy is Evidence-Based, Solution-Focused, Data-Driven, Results-Oriented
All our modes of therapy are goal-directed and focus on solutions instead of problems. We look for the strengths in our teenagers and design a therapeutic program that fits each teen’s unique needs. In each level of care, we find what works best for each individual. We engage in a continuous process of evaluation and assessment to make sure what worked yesterday still works today, and what works today prepares our teenagers and families for success tomorrow and the rest of their lives.
Dialectical Behavioral Therapy (DBT)
Dialectical Behavior Therapy treats issues such as impulsivity and overwhelming emotion, which are recurring themes among adolescents with mental health and substance abuse disorders. A structured, skills-based therapy, there are four core modules of DBT: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These four practical, actionable skills-sets help teens change ineffective behavior patterns into effective ones. DBT’s ultimate aim is to create a life worth living, free of any obstacles that could be blocking this goal. DBT therapists discourage all-or-nothing thinking; instead they encourage adolescents to engage in radical acceptance of themselves at the same time as improvement.
Applied Behavioral Analysis (ABA)
ABA focuses on the application of effective learning principles. Decades of research proves punishment does not teach—positive reinforcement does. When a reward follows a behavior, the behavior is more likely to be repeated. We integrate such principles of behaviorism into our programs. We don’t blame teens for what they do; we uncover the cause, understand the reward, then change both the behavior and reward to those that are positive, healthy and life-affirming. Considering what may be reinforcing unhealthy behaviors is the first step to improving them. In this way, our behavioral approach reduces maladaptive behaviors.
Cognitive Behavioral Therapy (CBT)
CBT focuses on making connections between thoughts, feelings, and actions. It’s based on the belief that when negative thought patterns are identified and adjusted, positive changes in feelings and behavior can take place. When people think of therapy in general, CBT is what comes to mind: talk, think, talk more, then apply the concepts from discussion to daily behavior. At Evolve, we always focus on changing behavior. If the talk doesn’t lead to positive change, then we find something that does.
Mindfulness-Based Dialectical/Cognitive Therapy (MBD/CT)
We integrate mindfulness practice into our dialectical and cognitive therapies. We understand mindfulness as something simple and practical: it means paying attention to what’s happening in the here and now, i.e. reality. If our teens are not aware of what’s happening in the moment, then all the therapy in the world is not going to work. For example, we see the impulsivity in teens as a form of mindlessness. Mindfulness practices help replace mindlessness with awareness. We teach our teens the first step toward positive change is acceptance of the moment without attachment or judgment. When they learn to see their behavior through clear eyes, they can then learn to enhance their quality of life.
Behavioral Activation (BA)
Behavioral Activation is a component in behavioral therapies (like CBT, DBT, and ABA) as well as a standalone treatment in itself. BA is based on the idea that experience and behavior affect one’s mood. As such, it encourages teens to participate in activities that bring them pleasure and to accomplish small, meaningful tasks on a regular basis. Research shows that engaging in these actions increases positive emotions and reduces the sadness associated with depression. Our role at Evolve is to coach our teens in making these life choices.
Relapse Prevention Therapy is a type of cognitive-behavioral therapy that primarily treats addiction and substance abuse. Research shows that relapse is very common after recovery. Among other factors, negative emotions (e.g. being lonely, depressed or angry) and environmental triggers (e.g. witnessing friends using drugs) can trigger a relapse. At Evolve, we use Relapse Prevention to help our teens limit relapses by teaching them how to anticipate, identify, and cope with these high-risk scenarios.
Trauma and substance abuse often go hand-in-hand. After a traumatic experience, many people choose unhealthy coping mechanisms, such as addictive substances, to escape their pain. Seeking Safety, a relatively modern evidence-based treatment model that treats co-occurring posttraumatic stress disorder and substance abuse, helps our teens recover from their traumatic past so they can regain the footing they need to move forward in life. Each of the 25 skills helps patients attain safety in their relationships, thinking, behavior, and emotions.
Teens are often very unsure of themselves. The goal of Motivational Interviewing is to explore and resolve any ambivalent feelings teens could be experiencing. The therapist (“interviewer”) leads the teen on a path of self-discovery and questions them about their goals in life. In the process, the teen finds their own internal motivation to make healthy, positive choices. It is very difficult to make big life changes when there is no personal motivation to do so.
Structural Family Therapy
Individual / Family Therapy
We believe our teens cannot be completely understood in isolation from their families. When possible and practical, we require family members or caregivers to participate in family therapy sessions at least once a week. While we prefer families to attend sessions in person, we can also accommodate sessions by telephone or remote conferencing. This is particularly beneficial for families who live out of state.
We believe parents need to learn recovery skills right alongside their kids. Many of our therapists are parents themselves, and we all agree that giving parenting advice was easy—before we had kids. We understand, empathize, and know from experience that what when we’re parenting, all our weaknesses are revealed, and that’s okay. It’s not about giving stock advice and canned answers. We want our parents to learn as their kids learn, and our goal is for everyone involved to get on the same page and move forward together.
Multi-Family Support Group
In addition to the family therapy sessions, families in our Intensive Outpatient and Partial Hospitalization programs participate in multi-family parent support groups every week. These group sessions allow for families, teens, and therapists to meet all together in a large group (and at times in small, intimate groups) to collaborate and share their treatment experiences. In these sessions, families can learn from one another, recognize they are not alone, and get support from others going through similar experiences. We conduct group sessions in a variety of formats, depending on specific family needs and circumstances. Times for these groups vary from facility to facility.
Parents need support, too. And sometimes, they need to talk to other parents without kids around. We offer support groups designed to teach parents a new set of skills to help them cope with their new normal. These groups help during and after treatment. We address questions such as:
How can I support my child during treatment?
How can I support myself while my child is in treatment?
What do I do when my child comes home from treatment?
We understand that taking your child home from treatment is like taking them home from the birth hospital (if that’s how you did it) for the second time. No one plans for that. We connect you with knowledge and information to make this transition as easy as possible. In these groups, our therapists also educate parents about strategies and tools they can use to better their relationships with their teens. Parents learn how to improve their communication skills, demonstrate empathy and validation, regulate their emotions, and learn how to set healthy boundaries. These skills are beneficial for all parents, everywhere.
Group Therapy is a powerful therapeutic tool at all levels of treatment. Peer approval and acceptance means everything to teens. During group sessions, therapists help adolescents develop and explore interpersonal relationships and work on specific treatment goals.
At Evolve, we use group therapy in a variety of ways. Our teens participate in recreational groups, daily process groups, and 12-Step meetings when appropriate. They’re involved in several group sessions per day, which may include:
Group Dialectical Behavioral Therapy
DBT Group Therapy is a highly effective treatment for individuals with intense emotions, disrupted relationships, and impulsive behaviors. We meet our teens—as individuals and as groups—where they are in the moment, while maintaining a keen awareness of the necessity for change. We use DBT to help them understand and transform unhealthy patterns of behavior into healthy, effective ones. DBT group therapy teaches teens to tolerate distress without making situations worse, be in the moment without judgment, observe and change strong emotions, and ask for what they want and need in an effective and productive way.
Teenagers often feel lonely and misunderstood. We use process groups to establish a sense of community, support, and camaraderie on the path to health and recovery. The goal of a process group is for teens to find out more about who they are and the different ways they relate to others. In these groups, teens learn how they come across to other people, gain awareness of how they’re perceived, and understand the effect of their words and actions on others. For a teen, peers can give the most effective feedback and offer therapeutic pearls of wisdom. For a therapist, the group process setting offers a glimpse into how a teenager functions in the world.
We want our teens to believe in themselves. Commitment groups teach our teenagers to set the kind of reasonable, achievable goals that lead to self-efficacy and self-mastery. During each group, the therapist introduces and discuss a specific recovery topic. Then, everyone makes a personal commitment to explore the topic over a certain time period. We don’t ask for miracles over the course of a day, but rather a simple promise to observe, reflect, and become more diligent in one area of behavior. In these groups, teenagers, their peers, and their therapists meet as equals, create mutually respectful relationships, and participate in a positive and productive give-and-take of ideas and insights. The sense of community works to dispel hopelessness and instill self-confidence.
Mindfulness-Based Stress Reduction (MBSR)
Mindfulness is something simple and practical: it means paying attention to what’s happening in the here and now, i.e. reality.
For example, we see the impulsivity in teens as a form of mindlessness. Teens often have highly emotional reactions when they are not focusing in the present moment. Mindfulness helps replace mindlessness with awareness. We teach our teens that the first step toward positive change is acceptance of the moment, without attachment or judgment. When they learn to see their behavior through clear eyes, they can then learn to enhance their quality of life. Cultivating a mindful awareness gets our teens out of a reactive space and into a more neutral space, where they can calmly approach a situation by taking the facts of reality into account.
Informed by the principles of MBSR, we integrate the following mindfulness-based activities and exercises into every program. These all aim to increase one’s awareness of reality in order to reduce intensely emotional reactions and promote a more balanced perspective of life. MBSR exercises also have been proven to increase self‐compassion and decrease anger, anxiety, and emotion dysregulation.
Adolescence is a time of radical physical, emotional, and social change. Hormones flood the body, while the brain struggles to keep up as the urge to seek novelty and carve out an identity outpaces the ability to regulate thoughts and control impulses. Teens riding this emotionally charged roller coaster need help learning how to slow down their thoughts, regulate their emotions, and make positive, objective choices. Yoga and meditation groups help adolescents achieve this.
Experienced instructors lead yoga and meditation groups for our teens as part of our regular exercise program. Teenagers often have difficulty simply being alone, and many teens come to Evolve because they’ve learned to fill empty time and space with self-destructive, counter-productive behaviors. Yoga and meditation teach our teenagers to find a calm, centered, compassionate, and peaceful place inside themselves. They also learn the ability to seek validation internally, instead of through other unhealthy sources. It takes time, repetition, and practice—like the entire recovery process.
We teach simple breathing exercises, relaxation techniques, and focusing strategies to ground and center the chaotic jumble of thoughts and emotions that adolescents have. From simple belly-breathing to full-body progressive muscular relaxation, a calm mind helps give our teens the freedom to see their behaviors clearly and make healthy choices.
The purpose of walking meditation—sometimes called mindful walking or mindful hiking—is the same as in all types of meditation: to quiet the mind, focus on the breath, and fully appreciate the present moment. A simple mindful walk teaches our teens to open their eyes to the world around them, open their minds to and hearts to their thoughts and emotions, and improve concentration and self-regulation.
Other activities we include across all levels of care that might fall under the category of mindfulness are journaling, cooking, and gardening.
Our surfing program is all about taking therapy into nature. The National Surf School and Instructors Association accredits our surf instructors, who specialize in using surfing as a therapeutic tool and transformative experience. Surfing helps teens practice social skills, learn stress management techniques, develop executive functioning skills, improve muscle tone, and develop spatial awareness, all while having fun and learning a new skill. Surfing also releases endorphins that increase positive emotions and wellbeing.
Horses have a unique sensitivity to human emotions, which makes equine therapy an effective and widely accepted therapeutic tool, especially for adolescents. Teens can address and break down barriers and resistance toward the therapeutic process through their connection with these majestic, powerful, nonjudgmental and loving animals. Through their interactions with the horses, adolescents develop caring and nurturing behaviors. They also uncover aspects of themselves previously inaccessible in their relationships with peers, family, and society. Teens are required to be fully present, watch for and respond to subtle signals on multiple levels, and solve problems in the moment in ways that trigger deep learning and emotional maturation. Equine therapists use horses in this context to guide and support positive change.
Our equine specialists hold certifications in the use of horses in therapeutic setting and specialize in working with teenagers with substance abuse and mental health issues. Equine therapists are present during the therapeutic process and work collaboratively with our clinical team in the development and implementation of the individual treatment plan.
Studies have shown that nature lifts one’s mood and significantly lowers symptoms of depression, anxiety and stress. In fact, many teens become instantly calmer as soon as they’re outside in the fresh air. How does this work? One theory is that spending too much time in an urban environment causes our minds to work hard to overcome our stimulation-heavy surroundings. This hard work results in “mental fatigue.” When you gaze at nature—trees, lakes, flowers, or any other sort of greenspace—you let your mind relax from its never-ending stimuli. This is one reason why all of our residential treatment centers feature large backyards with ample greenspace.
This is also the reason why many of Evolve’s residential treatment are located in scenic areas—near forests, state parks, creeks, the beach, and more—and why we offer hiking as a weekly activity. Our therapeutic hiking groups provide our teens a unique opportunity to connect with the natural beauty around them. Nature hikes offer opportunities to develop a new self-image, a new way of relating to others and the environment, and new ways to respond to the challenges of daily life.
The study of the sweet science of pugilism goes back centuries. On the surface, it’s easy to understand why putting on a pair of gloves and getting a great workout hitting a heavy bag can relieve a measure of stress, anxiety and frustration. What many don’t realize, though, is that boxing actually requires a great deal of mindfulness. You need to ensure you’re focusing on the proper stance, footwork, and punching combinations. You need to learn how to read your own emotions and those of your opponent’s. Boxing helps teens learn to strategize, apply tactics, work hard, and recognize the proper time and place for this type of interaction.
We want to show adolescents that living a healthy and well-balanced life can be fun. Every Evolve residential treatment center is equipped with gym facilities that our teens can use when they have down-time or free time, and physical activity is built into the schedule every day. Our goal is to offer our teens the option of making healthy, life-sustaining choices, and teach them that regular exercise is an important part of stress management and emotional stability. Through exercise, teens can develop coping skills and find healthy outlets in their lives that are productive, too. In treatment, this leads to more enhanced recovery and limits the rates of relapse.
Exercise has a huge effect on a teen’s emotional wellbeing and mood, and even improves cognition. It also has a host of physical benefits: it increases heart rate, reduces stress, improves sleep, lowers blood pressure, and increases energy. In many instances, exercise has been shown to reduce depression as effectively as traditional approaches like CBT or medicine.
We take weekly trips to the beach, movies, special hiking trails, museums, miniature golf courses, and more. If we think an activity is appropriate and beneficial, we’ll include it as a special bonus for hard work and achievement. We use outings to model how to experience the world without the use of addictive substances, how to interact with society in enriching and sustaining ways, to glean the benefits of nature, and for the same reason everyone else in the world does—to get out and about, have fun, and shake up the regular routine.
Research has found that traumatic memories are stored in the right hemisphere of the brain, while speech is located in the left. Because art and music are right-brain activities, it is often easier for those suffering from trauma to draw or paint about their experience rather than verbally talk about it. For all teens, though, creating art improves self-awareness, reduces stress, and is a peaceful, relaxing activity that many of our teens truly end up enjoying.
In our therapeutic creative writing groups, teens have the chance to write fictional short stories or poems, or respond to imaginative prompts that ask about their personal dreams or experiences. When writing, many find that they end up drawing from their personal struggles or general life experiences to tell a story. What you create on paper – or any other type of medium – often reflects much of what’s going on internally. This is one reason why writing often has a healing, cathartic effect on the author. The outpouring of words from pen to paper has been linked to reduced stress levels and improved mood and wellbeing.
Music and Dance
It’s no secret that teens respond well to music and dancing. Expressive therapies like these improve self-understanding and teach productive ways to cope with uncomfortable feelings. Singing along with a song provides a healthy context to release painful or difficult emotions, and discussing song lyrics often helps an angry adolescent articulate the tangled knot of angst they feel inside. Our therapists aren’t afraid of delving into pop genres like rock, punk, rap, or metal to meet teens where they are and on ground they feel comfortable. Playing music has a magical way of simultaneously soothing and releasing emotions. Teens benefit from all the therapeutic positives of music therapy, learn to transform their experiences into art, and feel the satisfaction and sense of accomplishment that comes with creating something from beginning to end.
Dance, like music, has an amazing capacity to unite mind, body, and soul in a single moment of pure joy and self-expression. Dance/ movement therapy helps our teens express feelings and tell stories while boosting self-esteem and increasing self-awareness and understanding. Dance therapy has also been shown to successfully increase general wellbeing, positive mood, and body image.
In drama therapy, teens participate in improv, storytelling, theater games, group dynamic games, or role-play exercises that help them learn empathy, self-confidence, and relationship/communication skills. The process of acting out a specific role during drama therapy can be cathartic and trigger real change in a teen. It can help adolescents solve problems and explore their personal feelings about a specific issue.