A Checklist for Parents Seeking Residential Treatment for Teens
When your child crossed the threshold from pre-teen to full-fledged teenager, you probably braced yourself for the changes you knew were coming. You expected a range of physical, emotional, social, and psychological growth known as differentiation. The experts told you your teen would develop their own personal identity and their own sexual identity. They told you to expect changes in appearance, changes in their peer group, and changes in the way they spend their spare time.
Your teen might trade their trumpet for an electric guitar. They may quit the drama club and go all-in on the school newspaper or yearbook staff. They may put down their electronic devices and discover a new love for sports or outdoor recreation. With regards to their peers, they may stop hanging around with their friends from elementary or middle school and form an entirely new group of friends. You may love some of the new faces. Others, perhaps not so much. And with regards to sexuality and gender identity, your teen may come out as a member of the LGBTQI+ community. Or they may begin their first romantic relationship: in any case, it’s new territory.
Bu you’re ready. You’re a responsible parent and you read about what to expect during adolescence.
There’s something you may not have realized, though. Adolescence is also the time when many mental health, behavioral, or addiction disorders first appear. That’s why it may come as a shock when and if your teen develops one or more of these types of disorders. As a responsible parent, you know you need to seek professional support for your teen, and they receive a diagnosis for a mental health disorder and a referral for residential treatment.
You may not have prepared for that. But that’s okay.
We can help.
Residential Treatment for Your Teen: The Checklist
Residential treatment comes in various forms. They all have one thing in common, implied by the name. When your teen enters residential treatment, they live at the treatment center full time and receive intensive, immersive mental health and/or addiction treatment and support. When a mental health professional refers your teen for this level of care, it means their mental health or addiction issue is severe. They need support beyond what they can receive in less immersive levels of care, such as outpatient, intensive outpatient, or partial hospitalization programs.
For details on these levels of care, as well as a type of residential treatment that’s typically only appropriate during mental health emergencies called inpatient psychiatric hospitalization, please click here.
Item one on our checklist is a type of pre-check. You need to make sure – big-picture-wise – that residential treatment is the appropriate match for your teen’s diagnosis. Therefore, before we discuss how to find the best residential treatment center for your teen, we’ll give you a quick review of what types of diagnoses may require residential treatment, according the latest guidance from the mental health treatment community.
Residential Treatment: Diagnoses and Disorders
The Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that residential treatment may be an appropriate option for teens diagnosed with the following:
- Mood disorders
- Depressive disorders
- Bipolar disorder
- Co-occurring disorders (mental health/behavioral disorder + substance use disorder)
- Anxiety disorders:
- Generalized anxiety disorder
- Social anxiety disorder (social phobia)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Behavioral disorders:
- Non-suicidal self-injury
- Suicidal ideation
If your teenager receives a diagnosis for any of these disorders and they receive a referral for residential treatment, then it’s time to start seeking a treatment center that’s the right fit for your teen and your family.
The Top Residential Treatment Programs for Teens: Three Must-Haves
Must Have #1: Biopsychosocial Assessment
Successful treatment and recovery for any of the disorders on the list above begins with an accurate diagnosis. The evaluation administered by the referring professional is a typically thorough, and a good start. However, any residential treatment center you consider must begin the admissions process with a full biopsychosocial evaluation.
During a complete biopsychosocial evaluation, a licensed and experience clinician collects information in the following domains:
Biological
The assessing clinician collects detailed information on your teen’s personal medical history, alcohol/drug use history, and current state of physical and mental health. They’ll also collect information on family medical and alcohol or drug use history.
Psychological
The assessing clinician collects detailed information on your teen’s present mental health symptoms, past mental health symptoms, present or past mental health diagnoses, present or past medication and/or treatment for mental health/substance use, and any additional current circumstances relevant to their emotional or mental health. They’ll also collect detailed information on their family mental health history.
Social
The assessing clinician collects detailed information on your teen’s present level of social function/ability, family, social, school, and peer circumstances, gender and sexual identity, past trauma, risk factors, and protective factors.
Those are the bio, psych, and social components of their evaluation. Recently, clinicians began expanding biopsychosocial evaluations to enhance their sensitivity to the diverse spiritual and cultural circumstances that may be a major factor in a teenager’s life. In addition to the information above, here’s the spiritual and cultural information many clinicians now collect.
Spiritual
Assessing clinicians may collect information on your teen’s spiritual and religious traditions, their level of participation in those traditions, and information on the protective and supportive resources related to their spiritual and religious practices.
Cultural
Assessing clinicians may collect information on your teen’s personal and family cultural traditions, their level of identification with those traditions, norms related to medical treatment or healing related to their cultural heritage, and any protective and supportive practices related to their cultural traditions.
As a whole, this information helps your teen’s assessing clinician form a full picture of your teen’s entire life – the full person, not just any potential disorder they may have – at the time they receive the assessment.
If the residential treatment center you’re considering does not administer a full biopsychosocial (add spiritual and cultural) evaluation, then check them off your list, and move to the next one.
Must Have #2: The Medical Model of Mental Illness/Addiction
For decades, treatment for mental health or addiction issues was stigmatized by archaic notions leftover from the 20th century, which had their roots in 19th century thinking. In the 21st century, the accepted best practice for treatment of mental health and/or addiction issues is the medical model of treatment.
Here’s a brief description of the medical model of treatment:
The medical model of treatment operates from the evidence-based premise that a mental health, behavioral, or addiction disorder should be treated like any physical illness or disorder. This premise implies that first, anyone can develop a mental health disorder, just as anyone can develop a physical illness or disorder. Next, it implies that a mental health disorder responds well to evidence-based treatment, just like a physical disorder does. Finally – and perhaps most importantly – the medical model treats a mental health, behavioral, or addiction disorder as a medical issue, rather than a moral failing, a lack of character, or the consequence of poor personal decision-making.
To learn more about the medical model of treatment, click here.
Must Have #3: The Ten Components of Highly Regarded Treatment Centers
Beginning in 2003, researchers conducted a series of analyses on the elements common to the most highly regarded adolescent treatment centers in the United States. You can read the original publications here and here. You can also read our summary of those publications here.
1. Full Evaluation
Top adolescent residential treatment centers begin with comprehensive assessments to build a full profile of the adolescent’s life and circumstances. For more details, see biopsychosocial assessment above.
2. Custom Plan
The top adolescent residential treatment centers use their initial assessments to collaborate with you and your teen to create an individualized plan that meets your teen’s unique therapeutic needs.
3. Integrated Care
Top adolescent treatment centers deliver care that addresses all the mental, behavioral, or substance use disorders indicated in your teen’s assessment. A plan to treat only one aspect of your teen’s needs is incomplete, and a sign that the center may not be able to offer your teen the best available support.
4. Family Involvement
Top adolescent treatment centers include the family participation. This may include caregivers, aunts, uncles, siblings, or other loved ones or people that may offer valuable support to your teen. Evidence shows family participation in treatment improves outcomes.
5. Age-Appropriate Programming
Top adolescent treatment centers address needs and issues unique to the teen population. These centers modify therapeutic approaches and create innovative programs that offer your teen the best chance of complete healing and recovery.
6. Commitment to Treatment
Top adolescent treatment centers seek to secure full commitment to the treatment process from your teen. To do this, they must gain their trust. This is crucial, because the longer your teen stays in treatment – and the more they believe in the process – the greater their chance of success.
7. Licensed and Qualified Teen Experts
The staff at a top adolescent treatment center should be specialists in working with the teen population. They should be trained in adolescent development, adolescent issues, and have extensive clinical experience supporting teens with mental health, behavioral, and/or addiction issues.
8. Cultural, Spiritual, and Gender/Sexuality Awareness
The staff at a top adolescent treatment center should understand and serve the needs of their entire population. All clinicians should be trained in treatment practices specific to females, males, and teens from gender/sexual and cultural/ethnic minorities.
9. Ongoing Support
Top adolescent treatment centers provide aftercare plans and long-term strategies that help your teen manage the symptoms when they return home. The best ongoing support plans include family participation, continuing therapeutic support, access to peer groups, and access to any relevant 12-step programs, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) for teens in recovery from alcohol or drug addiction.
10. Self-Assessment and Continuous Improvement
Top adolescent treatment centers engage in an ongoing process of self-assessment, evaluation, and review of their treatment programs and therapeutic approaches. The best centers formalize this process and keep current with best practices. This self-review process ensures your teen always receives the latest, most effective treatment appropriate for their individual needs.
Those are the three things any treatment center you consider absolutely must have. If a treatment center on your list lacks any of those three components, check it off your list. Then move on to find a center that does.
What to Do Once You Find a Potential Adolescent Treatment Facility
When you find a treatment center that meets the criteria we list above, it’s time to talk to them. You can get on the phone, or you can go visit the facility yourself. In both cases, we advise you to ask questions about the following things. The top treatment centers also have highly qualified first-contact staff answering their phones.
Important tip: an unprepared and under-informed first-line representative probably indicates a unprepared and under-informed treatment center.
When you make contact – either on the phone or in-person – ask questions on the following topics:
Staff and Center Qualifications
Any treatment center you consider must be fully licensed and accredited. All staff and clinicians have appropriate education and training, and hold current licensure and accreditation.
Staff-to-Patient Ratio
The best staff to patient ratio is a high ratio, which increases your teen’s chance of treatment success.
Emergency Procedures
A top adolescent treatment center should have qualified medical staff available all day and night, every day of the year, with no exceptions. Emergencies don’t check the calendar before they happen. A treatment center that does not have licensed staff on call 24/7 is not a top treatment center.
Monitoring Procedures
Top treatment centers have what are known as line-of-sight and line-of hearing policies in place. This means the staff keeps your teen within eyesight and earshot at all times, with no exceptions.
Locked Facility? Unlocked Facility?
The rules governing locked and unlocked facilities vary by state. If you choose an unlocked facility for your teen, it should have clear policies in place designed to protect your teen if they choose to leave the facility before they complete their treatment program.
Harmful Objects
While your teen is in residential treatment, access to potentially dangerous objects should be restricted. Things like scissors, razors, or kitchen utensils should be locked when not in use, only used under close supervision, and fully accounted for after use.
Behavioral Modification
You should know about and approve of the various behavior modification strategies treatment staff may implement during your teen’s treatment. This includes consequences for breaking rules as well as incentives – such as a level structure – for full participation in and progress the treatment process.
Outside Contact
During a residential treatment program, your teen’s attention should be the treatment and recovery process. Supportive contact, in the form of letters, phone calls, and emails, should be closely monitored by treatment center staff. Contact should be restricted to a specific set of family members, friends, or loved ones. Everyone on the list should be approved in advance by you, your teen, and the treatment team.
If you find a treatment center with first-contact admissions staff that can give you full and reasonable answers to all the questions above, that’s a very good sign. As we mention above, top treatment centers have high-quality staff across the board. This means everyone. From their phone representatives to their clinical staff to their administrative staff to their cooks and overnight monitors, the best centers hire the best people. Any person you talk to on the phone or in person should put you at ease, rather than put you on edge. If you’re not happy with what you hear, move on to the next potential facility on your list.
The First Step in A Lifetime of Healing
As the parent of a teen with a mental health, behavioral, or addiction issue, we want you to know that you’re not alone. Every year, millions of teens are diagnosed with these types of clinical disorders. And every year, millions seek and receive evidence-based treatment that helps them on the road to healing and recovery. In some cases, treatment is lifesaving. In all cases, the right treatment, at the right time and place, delivered by the right people, can be life-changing.
Your teen can learn to manage a mental health disorder, recover from addiction, and modify problematic behavior. To get there, however, they need your help. They need you to find the support and care that will get them on the road to healing and recovery. That’s why we advise putting in the time and effort to follow the steps above. In the long run, it will be well worth it, for the health and wellbeing of your teen and your entire family.
Treatment works – the sooner, the better.