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A Day in the Life: Residential Treatment at Evolve

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT Meet The Team >

If you’re the parent of a teenager with a serious mental health, substance use, or behavioral disorder, you know they need professional treatment. If their situation is serious enough, they may have received a referral for immersive treatment at a residential treatment center (RTC).

A teen residential treatment center is an appropriate therapeutic option for adolescents with a high level of acuity, severe symptoms, and/or teens who engage in extreme, risky behavior.

High acuity means they need immediate, immersive support. Severe symptoms means their symptoms are so disruptive they interfere with their ability to engage in typical daily activities at school or at home. Teens with high acuity and severe symptoms – such as teens who engage in self-harm, suicidal ideation, or other dangerous behavior – often require immersive, 24-hour support and supervision.

That’s why your teen may have received a referral for residential treatment. To stay safe, find stability, and begin their journey to recovery, they need a level of support and care that goes beyond what’s possible in an outpatient, intensive outpatient, or partial hospitalization program.

If your teen needs the immersive level of support offered by a residential treatment program, we’re sure you want to know what residential treatment is really like.

This article can help.

We’ll describe a typical day at one of our adolescent residential treatment centers.

A Typical Day in Residential Treatment at Evolve

What we share below is based on the dynamic schedules in use every day at our teen residential treatment centers throughout California.

Note: Real times and schedules vary by location, client population, and variables such as weather, holidays, and other events.

6:30 a.m. Wake-up

Good morning!

Our teens wake up bright and early to make the most of the day.

Teens, in general, rarely sleep the 8-10 hours recommended by sleep experts. Lack of sleep can contribute to mental health issues such as depression and anxiety. It can also lead to moodiness, irritability, and impulsive behavior. In residential treatment, we address this issue making sure our teens get plenty of sleep every night. This means they wake up feeling fresh and rested, ready for a full day of treatment and therapeutic activities.

7:00 a.m. Breakfast

Our teens and counselors sit down together to eat a nutritious, filling breakfast. Residential treatment does not mean bland, boring meals. Our in-house chefs prepare three delicious and healthy meals a day for our teens: think fresh fruit, eggs, pancakes, cheese, and of course, cereal and milk. Studies show that eating a balanced and nutritious breakfast every morning promotes positive mental health. After breakfast, our teens do chores. Daily duties may include clearing the dishes, wiping down the table and counters, or sweeping the floor. In residential treatment, chores teach our teens the importance of cooperation, cleaning up after themselves, and maintaining an orderly home.

7:30 a.m. Gym/Fitness

We incorporate physical activity into our schedule every single day. Each of our residential treatment centers has a gym on-site, equipped with free weights, treadmills, elliptical trainers, weight machines, and yoga accessories. Many of our homes also have tennis, basketball, or volleyball courts. Our teens participate in aerobic or anaerobic fitness activities every day, which may include basketball, tennis, weightlifting, hiking, soccer, or swimming. Each of our residential treatment centers has an outdoor pool, which is a refreshing treat in the summer months. Decades of research show that regular exercise improves mental health, boosts self-esteem, enhances cognition, and reduces impulsivity.

8:30 a.m. Hygiene

After gym, it’s time for personal hygiene. A teen with a mental health issue such as depression often lacks the energy or motivation for personal grooming. In residential treatment, teens learn the importance of hygiene because it’s part of their schedule. They’re required to shower and dress appropriately every morning. Evidence shows that making an effort to look presentable correlates with positive mood, positive mental health, and increased productivity.

9:30 a.m. DBT Diary Cards

Each of our teen residential treatment centers incorporates dialectical behavior therapy (DBT) techniques during the treatment day. DBT diary cards require teens to record their emotions and behavior twice a day. These cards help measure progress towards specific treatment goals. On a standard diary card, teens rate, on a scale of 0-10, the current intensity of emotions such as sadness, anger, anxiety, and loneliness. Teens also record the coping skills they used that day (or the night before) to deal with unwanted emotions and urges. There are dozens of DBT coping skills on each card, and teens circle the ones they used. Research shows that the simple act of self-monitoring negative behaviors can help reduce those behaviors. During individual therapy, a primary therapist reviews diary cards with each teen.

10 a.m. Group Therapy

Licensed therapists lead our teens in five (5) group therapy sessions per day. Teens actively participate in these treatment sessions, which include cognitive behavior therapy (CBT), relapse prevention,  Seeking Safety, behavioral activation, and other evidence-based therapies. Our clinicians also facilitate educational workshops, commonly called psychoeducation classes. Teens sit in a circle in a comfortable room and participate in groups sessions with names like Healthy Relationships, Communication Skills, Self-Esteem Building, Exploring Self-Identity, and more. Groups such as Health & Wellness and Independent Living help teens learn important life skills that prepare them to navigate day-to-day living when they return home. The group therapy setting creates a unique, nonjudgmental environment where teens feel accepted and supported in their efforts to learn, grow, and change.

11 a.m. Experiential Therapy

Every day, our teens participate in a fun experiential therapy, such as art therapy, music therapy, cooking lab (led by our chef), drama, yoga, dance, knitting, or creative writing. Once a week, our teens travel to a nearby horse ranch to participate in equine therapy, led by certified and trained equine therapists. The clients who attend our residential treatment centers in Southern California also participate in surf therapy on the beautiful California coast. Experiential activities provide enjoyable outlets for teens, expose them to new ways of expressing themselves, and help them discover what a “life worth living” looks like for them. Additionally, these activities offer teens concrete examples of how to engage in practical, healthy coping skills. The goal is for teens to implement one or more of these coping skills in their lives when they return home.

12:00 Lunch

Time to eat! Again!

After a full morning, our teens and staff enjoy a filling, delicious, gourmet lunch prepared by our chef. Every lunch includes a protein, a carbohydrate, and a vegetable dish. Honey-mustard salmon, tomato soup, homemade pizza, grilled vegetables…our chefs make it all. Our residential chefs account for food allergies, dietary restrictions, and client preferences to make meals that our teens enjoy safely and eat with gusto.

1:00 p.m. DBT Group Therapy

After lunch, our teens head back to the therapy room for a dialectical behavior therapy (DBT) session. Four days a week, teens focus on one of the four core modules of DBT: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. These sessions are facilitated by a Primary Therapist or Clinical Program Director. In these sessions, our teens learn how to manage stress, improve relationships, regulate emotions, and practice mindfulness. DBT is proven effective for a wide variety of mental health disorders, including depression, anxiety, PTSD, borderline personality disorder, substance use, self-harming issues, and suicidal ideation. At Evolve, we don’t just teach DBT, we live it. Our clinicians model DBT coping skills during meals, downtime, experiential therapy sessions, and supervised outings.

2:00 p.m. Academics

Each of our residential treatment centers has a dedicated school area complete with computers, printers, desks, books, and school supplies. We do everything we can to help teens stay on track with homework, exams, and/or future college plans. The staff at our teen residential treatment centers work with teachers to proctor tests and stay as current as possible with all academic work. When teens have no school assignments to complete, they work on treatment assignments, known as treatment homework.

On weekends, in place of school hours, our teens go on supervised community outings to a nearby park, museum, art gallery, or appropriate cultural or recreational activity. In addition, on the weekends, teens may have supervised family visits with parents, siblings, or other family members.

4:00 p.m. Recreation

Teens in treatment – just like any teens, anywhere – need the right amount of free time. That’s what happens after schoolwork at an Evolve RTC. Our teens use the rec room, pool, or quiet common area for personal time. They can read, talk, play board games, create art, complete puzzles, write letters, write in their journal, or call their parents. During recreation hour, residential counselors keep teens within line-of-sight and line-of-hearing, with no exceptions.

5:00 p.m. Experiential Therapy, Dinner, Evening Activity

After another hour of experiential therapy, it’s dinner time. After dinner, depending on the evening, our teens and staff attend a 12-Step or SMART Recovery meeting. These 12-Step meetings occur twice weekly. Depending on their specific clinical needs, our teens can attend Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or Codependents Anonymous (CoDA) groups. These community support groups help teens feel connected during recovery. Meetings operate by guidelines that encourage humility, honesty, and faith in the recovery process. Evidence shows that teens who participate in AA and NA are more likely to achieve long-term recovery from alcohol or drug addiction.

On weekends, evening activities include therapeutic games or everyone’s favorite: Movie Night.

9:30 p.m. Lights Out

Goodnight!

After attending to personal hygiene, our teens go to bed. We’re strict about our lights out policy. As we mentioned earlier, our teens go to sleep early so they can get the sleep they need. This mitigates emotional issues such as moodiness and irritability. Proper sleep hygiene is important, and one of the things we encourage our teens to continue practicing when they return home.

After bedtime, our overnight counselors conduct bed checks every 15 minutes. If problems arise, our staff is on-hand to handle them immediately. In addition, each location has a licensed therapist or psychiatrist on call to respond to crises as needed.

Individual and Family Therapy

Our teens attend individual psychiatry sessions once a week, family therapy twice a week, and individual counseling three times a week. Psychiatry sessions happen one-on-one with our board-certified specialist, trained in child and adolescent psychiatry. Family therapy occurs twice a week, in sessions led by our certified counselors and therapists. Out-of-state families participate in family therapy via HIPAA-compliant video conferencing. Individual counseling occurs throughout each day, at different times for each teen. Our teens receive an hour of individual therapy with a licensed and trained therapist three days a week.

Does Your Teen Need Residential Treatment?

Our structured, immersive residential treatment centers are appropriate for families seeking treatment for teens with high-acuity mental health, substance use, and/or behavioral issues. If your teenager needs the immersive support available in a residential treatment program, we encourage you to get them the support they need as soon as possible. If the schedule we present above looks like exactly what your teen needs, we’re here to help. Please contact us today for a free clinical assessment.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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