When your teenager receives a diagnosis for depression, their psychiatrist or therapist typically recommends a course of treatment. Some teens with depression may respond to once-a-week with their therapist. For those teens, the process is simple: you schedule appointments, take your teen to therapy, and monitor progress by keeping an eye on your teen and talking to their therapist.
If their therapist recommends a more immersive level of care, then you have more work to do. You start the process by finding a treatment center that specializes in adolescent mental health issues. For help finding an appropriate facility that specializes in rehab for teen depression, please have a look at our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.
When you find a treatment center that meets the specific needs of your teen and your family, you’ll decide on a date for your teen to begin the rehab process. This article gives you an overview of how the process works. There are hundreds of details related to the rehab process that are beyond the scope of this article, and many details will differ from center to center. However, once you choose a location and arrive on your teenager’s admission date, the overall process follows a common, predictable pattern.
Here’s how it works:
- Your teen will receive a full biopsychosocial assessment.
- You, your teen, and the treatment center staff will decide on an appropriate level of care for your teenager.
- You, your teen, and treatment center clinicians will design a treatment plan for your teen’s depression.
- Your teen begins treatment.
We’ll explain each of these items in detail now, beginning with item #1: the biopsychosocial assessment.
What is a Biopsychosocial Assessment?
The textbook “Biopsychosocial Assessment in Clinical Health Psychology” offers this description of a biopsychosocial profile:
“…the biopsychosocial approach to psychological assessment presumes that there are varying levels of physical, cognitive, emotional, behavioral, and environmental factors that contribute to the overall clinical assessment and conceptualization of every individual case. Rather than trying to determine whether an individual case is more “psychological” or “physical,” multiple domains are seen as contributing varying amounts of influence to the overall biopsychosocial conceptualization of an individual case.”
Here are the types of information a clinician will ask for during a full biopsychosocial evaluation:
- Complete medical history
- Family history of medical and mental illness
- Substance use/misuse history
- Developmental history
- Current level of physical function and abilities
- Current psychiatric symptoms or diagnoses
- Past psychiatric symptoms or diagnoses
- Current mental/psychological status
- Family history of mental illness
- Current psychiatric medication/treatment
- Past psychiatric medication/treatment
- Current psychological stressors
- History of trauma or traumatic experiences
- Current level of social function
- Current home situation
- Status of family, peer, and other relationships
- Gender identity and sexuality
- Family history
- History of adverse/traumatic events
- Educational background
- Legal history
- Work history
- Current risk factors
- Current strengths and available resources
In addition, some treatment centers collect information on the spiritual and cultural factors that may be relevant.
- Spiritual tradition and belief
- Engagement in spiritual activities
- Engagement in organized religion
- Helpful resources related to religion or spirituality
- Cultural tradition
- Level of engagement or connection to cultural traditions
- Cultural norms related to health, mental health, medicine, and receiving treatment
- Relevant cultural practices and helpful cultural resources
Once the biopsychosocial assessment is complete and the clinician confirms a diagnosis of depression, the next step is to determine the appropriate level of care.
We’ll explain what level of care means now.
What Are the Levels of Care?
At the most basic level, level of care refers to the amount of treatment your teen receives and the intensity/degree of immersion of that treatment.
Clinicians determine which level of care your teen needs by three criteria:
- Level of acuity. This refers to the immediate seriousness of their symptoms or disorder.
- Level of disruption. The more disruptive the symptoms, the more immersive the level of care should be.
- Treatment history. A teen who has tried outpatient therapy, and shown little progress, will probably receive a referral for a more immersive level of care.
A teen who receives outpatient care meets with a licensed therapist once or twice a week in an office setting. This is the least immersive level of care, typically recommended for teens with mild or moderate depressive symptoms. Teens with depressive symptoms that do not impair participation in family life, in social activities with friends, or in school often start their treatment journey in an outpatient program.
Intensive Outpatient Treatment (IOP Rehab for Teenage Depression)
A teen who participates in an intensive outpatient program needs a more immersive level of treatment than a teen in outpatient care. This is the next step up the treatment continuum after outpatient treatment. Clinicians typically recommend intensive outpatient programs for teens with moderate depressive symptoms that are disruptive, but do not significantly prevent their participation in family, social, or school life. Teenagers in IOP programs receive treatment for half a day, 3-5 days a week. Teens in IOP programs most often live at home, rather than at the treatment facility.
Partial Hospitalization (PHP Rehab for Teenage Depression)
A teen who participates in a partial hospitalization program needs a more immersive level of treatment than a teen in outpatient care or a teen in an intensive outpatient program. This is the next step up the treatment continuum after outpatient treatment and intensive outpatient programs. Clinicians typically recommend partial hospitalization programs for teens with severe depressive symptoms that prevent participation in activities and responsibilities associated with family, school, and social life. Teenagers in PHP programs receive a full day of treatment, five days a week. Teens in PHP programs most often live at home, rather than at the treatment facility.
Residential Treatment (RTC Rehab for Teenage Depression)
A teen who participates in a residential treatment program needs a more immersive level of treatment than a teen in outpatient, an intensive outpatient program, or a partial hospitalization program. This is the next step up the treatment continuum after outpatient treatment, intensive outpatient, and partial hospitalization programs. With the exception of inpatient hospitalization in a psychiatric hospital, this is the most immersive level of rehab available for teenage depression.
Clinicians recommend residential treatment programs for teens with severe depressive symptoms that prevent participation in family, school, or social life. Teenagers in RTC programs receive a full day of treatment, seven days a week, with a slightly modified weekend schedule. Evenings in RTC programs include community self-help meetings and assignments known as treatment homework. Teenagers in RTC programs live at the treatment facility and receive 24/7 psychological/medical support/monitoring. RTC programs give teens time and support to focus completely on recovery, without the distractions of the outside world.
The Treatment Plan: Integrated Treatment for Teenage Depression
An integrated treatment plan includes a combination of individual therapy, group therapy, community support, lifestyle modifications, experiential therapies, and medication, if needed. Many high-quality treatment centers also provide expressive therapies, as well.
One way to look at the treatment plan is that it’s the practical application of the findings in the biopsychosocial assessment. Clinicians at high-quality treatment centers address everything in the assessment that’s relevant to the life of the teenager. For instance, if a teenager has depression and another mental health disorder, such as anxiety, the plan includes treatment for anxiety as well as treatment for depression.
To learn more about the elements common to highly regarded treatment programs, please read our article here. To learn more about co-occurring disorders – i.e. when an individual has more than one mental health disorder – please visit our Parent Guide for dual diagnosis/co-occurring disorders.
Evidence shows the integrated treatment model increases the likelihood of treatment success, promotes genuine recovery, and gives teenagers with depression the skills they need to manage their depressive symptoms over both the short- and long-term. Here are the different types of therapies and treatment common to each of these categories:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Motivational interviewing (MI)
- Multi-family groups
- Parenting groups
Mindfulness-Based Stress Reduction
- Relaxation techniques
- Exercise/working out
- Equine therapy (horses)
- Visual art
- Group meetings for people with major depressive disorder
- Group meetings for family members of people with severe mental health disorders
- Upon discharge, a teen will have a plan in hand that helps them stay on their recovery path, called an aftercare plan.
- The aftercare plan typically includes a schedule for ongoing outpatient treatment, relapse prevention strategies, a list of effective coping techniques developed while in treatment, and resources for local community support groups.
Since each teenager is unique, each treatment plan for a teenager in rehab for depression will contain a combination of the treatment approaches above. The plans should address all the clinical needs identified in the biopsychosocial assessment. In addition, treatment plans should be adaptable. With the input of the teen in treatment and their clinical staff, a good plan can change along with treatment progress and a recognition of what works and does not work for each teen.
Now, to the last topic in this article: how does all this help?
How Rehab for Teenage Depression Helps
From a clinician’s perspective, rehab for teenage depression has three goals:
Safety means a teenager with severe depression is not in crisis or at risk of harming themselves or others. Stability means a teenager with any level of depression can live at home and participate in most typical daily activities without significant disruption. Recovery means a teen with any level of depression has the skills and personal tools required to manage their symptoms and participate fully in all aspects of daily life, including family, school, social activities, and extracurricular activities related to school, culture, spirituality, or any other interests the teen may have.
From a family perspective – which includes the teen in treatment and any involved and concerned adults – what this means is that the teenager will develop skills that allow them to live a life they choose, rather than a life dictated by the symptoms of their depressive disorder.
Rehab Skills: Depression Treatment for Teens
During rehab, a teen with a depressive disorder can learn to:
- Identify, discuss, and manage their emotions in a productive way that supports an independent life.
- Validate their personal journey, experiences, and emotions.
- Recognize the direct relationship between their emotions and their patterns of thought.
- Realize how those emotions and patterns of thought influence their behavior.
- Apply knowledge about the dynamic relationships between emotions, patterns of thought, and patterns of behavior in order to manage those emotions, thoughts, and behaviors in a way that minimizes disruption and promotes full participation in all the elements of typical teenage life, including family, friends, school, work, and activities.
- Believe in themselves and access or develop the internal strength and resilience required to manage their depressive disorder.
One way to think about rehab for teen depression is that it allows teens to get back to the business of being a teenager. Depression often prevents teens from doing what they want, when they want, and how they want. Their symptoms disrupt their lives. Treatment helps them manage those symptoms and eventually rediscover the life they remember – and create a life they want to lead on their own terms.
In closing, it’s important for parents and teens to understand two things.
First, untreated clinical depression rarely resolves on its own, but rather, typically becomes more disruptive over time. Second, evidence shows that the sooner a teen diagnosed with depression receives treatment for depression, the better their chances at making a full recovery.
That’s why we always remind our families this:
Treatment works – the sooner, the better.
Finding Help: Resources
If you’re seeking treatment for your teen, please navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.
In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting for you right now.