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 the 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 Behavior Therapy (DBT)
Dialectical behavior therapy (DBT) 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 might block 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 recognizing there’s room for 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 the 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. Identifying what may be reinforcing unhealthy behaviors is the first step toward improving them. In this way, our behavioral approach reduces maladaptive behaviors.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (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.
Behavioral Activation (BA)
Behavioral activation (BA) is based on the idea that experience and behavior affect mood. It encourages teens to participate in activities that bring pleasure and to accomplish small, meaningful tasks on a regular basis. Research shows that engaging in pleasant and mastery-building activities increases positive emotions and reduces the sadness associated with depression. Our role at Evolve is to coach our teens in making these life choices.
Mindfulness-Based Cognitive Behavior Therapy
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 isn’t going to work. For example, we see the impulsivity in teens as a form of mindlessness. Mindfulness practices like mindfulness-based cognitive behavior therapy 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. At Evolve, we integrate mindfulness practice into our dialectical and cognitive therapies.
Motivational Interviewing (MI)
Teens are often very unsure of themselves. The goal of Motivational Interviewing (MI) is to explore and resolve any ambivalent feelings teens might experience. The therapist leads the teen on a path of self-discovery and questions them about their goals in life. In the process, the teen finds the internal motivation to make healthy, positive choices. It’s difficult to make big life changes when there is no personal motivation to do so.
Prolonged Exposure (PE) Therapy
Exposure therapy involves exposing an individual with post-traumatic stress disorder (PTSD) – in a controlled, clinician-controlled setting – to the thoughts, feelings, emotions, and images they work to avoid. Therapists help patients regain power over these images and emotions, and gradually teach them to experience them without emotional pain or distress. PE includes imaginal exposures, which involve recounting the traumatic memory and processing the revisiting experience, as well as in-vivo exposures, in which the client repeatedly confronts trauma-related stimuli that were safe but previously avoided.
Interpersonal Psychotherapy (IPT)
Interpersonal psychotherapy decreases symptoms of depression by helping teens improve their interpersonal functioning through fostering autonomy and a sense of self, managing peer pressure, developing appropriate and responsible romantic relationships, and when applicable, coping successfully with initial experiences of death and loss.
Social Skills Training (SST)
Social skills training teaches prosocial concepts teens need to function successfully in multiple social environments. SST uses the principles of behavior therapy to teach communication skills, assertiveness skills, and other skills related to social interaction. It is particularly effective for teens with social anxiety disorder.
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’re 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. Weekly 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 smooth as possible. In these groups, our therapists also educate parents about strategies and tools they can use to improve their relationships with their teens. Parents learn how to enhance 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
Group DBT is an 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 group DBT to help them understand and transform unhealthy patterns of behavior into healthy, effective ones. DBT groups teach 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.
Trauma and substance use often go hand-in-hand. After a traumatic experience, many people choose unhealthy coping mechanisms, such as substance use, to escape their pain. Seeking Safety, a relatively recent evidence-based treatment model that treats co-occurring post-traumatic stress disorder and substance use disorder, 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 seeking safety skills helps teens attain safety in their relationships, thinking, behavior, and emotions.
Relapse prevention therapy is a type of cognitive behavior therapy that treats alcohol and substance use disorder. Research shows that relapse is 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 high-risk scenarios that can lead to relapse.
Increased anger is common during adolescence. For some teens, anger can result in verbal or physical aggression as well as constant conflict with family and peers. In anger management groups, teens learn how to control their temper without resorting to yelling, aggression, temper tantrums, and violence. They learn productive and healthy ways to process their frustration and techniques to calm down when they feel the first signs of anger.
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 often give the most effective feedback and can offer therapeutic pearls of wisdom. For a therapist, the group process setting offers a glimpse into how a teenager functions in the world.
Mindfulness-Based Stress Reduction (MBSR)
Mindfulness is something simple and practical: it means paying attention to what’s happening in the here and now. It means seeing the world as it is.
For example, we see the impulsivity in teens as a form of mindlessness. Teens often have highly emotional reactions when they’re not focused on the present. 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 mindful awareness gets our teens out of a reactive space and into a neutral space, where they can approach a situation by taking facts and reality into account.
Informed by the principles of MBSR, we integrate the following mindfulness-based activities and exercises into every schedule. These exercises all aim to increase awareness of reality in order to reduce intensely emotional reactions and promote a balanced perspective. Evidence shows MBSR exercises 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 external, 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 experience. 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 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 use 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 show nature improves mood and decreases symptoms of depression, anxiety, and stress. In fact, many teens become calm down 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 stimulus-rich surroundings. This hard work results in mental fatigue. When you gaze at nature – trees, lakes, flowers, or any other sort of greenspace – your mind gets a break from constant, intrusive stimuli. This is one reason why our residential treatment centers feature large backyards with ample greenspace.
This is also the reason why many of our residential treatment centers are located in scenic areas – near forests, state parks, creeks, and the ocean – 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 stress, anxiety, and frustration. What many don’t realize, though, is that boxing requires a great deal of mindfulness. You focus on the proper stance, footwork, and punching combinations. You learn to read your own emotions and predict what your opponent might do. Boxing helps teens learn to strategize, apply tactics, work hard, and recognize the proper time and place for this type of interaction.
We 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. 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. In treatment, this enhances 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 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 enjoy 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 shows 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’s often easier for those with past trauma to draw or paint about their experience rather than talk about it. For all teens, though, art therapy improves self-awareness, reduces stress, and is a peaceful, relaxing activity they enjoy.
In our therapeutic creative writing groups, teens have the chance to write fictional short stories, poems, and 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 what’s going on internally. This is one reason why writing often has a healing, cathartic effect on the writer. Evidence shows putting words to paper has been linked to reduced stress levels and improved mood and wellbeing.
Music and Dance
It’s no secret that most teens love 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. Discussing song lyrics can help an angry adolescent articulate the tangled knot of angst they feel inside. Our therapists aren’t afraid of delving into 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 and movement therapy helps our teens express feelings and tell stories while boosting self-esteem and increasing self-awareness and understanding. Research shows dance therapy can 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 that’s bothering them.