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Does My Teen Need Drug Rehab? Part One: Getting Started – Know the Levels of Care

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
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Drug rehab – known these days as treatment for substance use disorders – comes in many shapes and forms.

If you’re worried your teen has a problem with drugs and needs treatment, don’t panic. Your first step should be to seek the help of a qualified mental health professional. You can find a reputable professional in your area with this psychiatrist finder provided by the American Academy of Child and Adolescent Psychiatry. It’s important to understand that licensed and certified mental health professionals are the only people qualified to diagnose your teen with a substance use disorder. As a parent, you might know it in your bones, but you still need a second opinion. Preferably from someone trained to identify and work with adolescents who need treatment. Neither you nor this article can diagnose your teen: we’re here to help by offering information that can serve as a guide for your decision-making process.

With all that said, how do you get started?

After consulting with a psychiatrist or therapist, the next thing to understand is that there are several options available. These options are known as different levels of care. Generally speaking, there are three levels of care in the world of drug rehab. That’s not including detoxification, which is a category of treatment by itself. Detox is often a precursor to treatment, but detox is not treatment per se.

Now, with that said, we’ll move on to the levels of care you’re likely to find when you begin looking for treatment for your teen.

Teen Drug Rehab: Levels of Care

Outpatient Treatment

The first level of care is Outpatient Treatment. At this level, teens typically see a qualified professional therapist in an office at least once a week and participate in 12-step community support programs such as Narcotics Anonymous (NA) or Marijuana Anonymous (MA). Teens at this level of care live at home, go to school, and carry on with most of their regular daily activities.

Intensive Outpatient Treatment

The next level of care is Intensive Outpatient Treatment. At this level, teens typically receive a half day – around three hours – of treatment per day but continue to live at home and go to school as usual. Teens at the intensive outpatient level need more support than weekly office visits and 12-step meetings. Teens in intensive outpatient programs have typically tried outpatient programs without success, or are transitioning down from a more intensive level of care.

Partial Hospitalization Treatment

The next level of treatment is Partial Hospitalization. At this level, teens continue to live at home, but receive a full day – typically six to eight hours – of treatment. Teens in partial hospitalization programs need more structure than the half-day offered by intensive outpatient programs, but don’t require the 24/7 supervision offered at a more intensive level of care.

Residential Treatment

The next – and for all practical purposes, the highest – level of care is Residential Treatment. At the residential level, teens live on-site at a rehab center. They receive support and supervision twenty-four hours a day, seven days a week. With some exceptions, this is not an entry level of care. Most teens in residential treatment have been unsuccessful at the lower levels of care. For them, outpatient, intensive outpatient, and partial hospitalization were not enough. These teens need  full immersion in the treatment experience. Residential treatment is for teens whose lives have become unmanageable whose behavior has spiraled out-of-control due to their substance use.

Choosing Rehab for Your Teen

It’s important to take a methodical, rational, step-wise approach to substance treatment for your teen. Evidence shows that the sooner a teen gets into treatment, and the longer they stay in treatment, the better the outcomes. Don’t misunderstand this. We don’t mean throw your kid in residential treatment right this second and tell the staff to keep them as long as it takes.

Two keys to treatment for teens are trust and engagement. If your first move is the nuclear option – i.e. residential treatment – you may erode trust and undermine any chances of full engagement.

A teen can be in treatment and fully engaged at the outpatient level of care. Treatment that happens once a week (twice or more if you count 12-step meetings) is as valid as 24/7 treatment. What matters is that your teen receives the level of care appropriate to their level of need . And the best person to decide that is the mental health professional you consult as soon as you suspect your teen needs help.

Be sure to read part 2: Does My Teen Need Drug Rehab: Five Signs

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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