Integrated Treatment for Teens With Depression
When your teenager is diagnosed with clinical depression – known as major depressive disorder (MDD) – you have practical decisions to make. For the purposes of this article, we assume your teen received a full evaluation from a licensed mental health professional. We further assume you arranged a consultation for a second opinion, which confirmed the diagnosis: major depressive disorder. That means your next step is to review the treatment recommendations you received – which assessing professionals should have provided – and decide two things:
- Where your teen receives treatment. There are many treatment centers that specialize in teen mental health. The teen depression center you choose needs to be a good match for your teen and your family.
- Which level of care meets their needs. There are several levels of care available at a typical teen depression center. They range from immersive, meaning your teen lives on-site, to non-immersive, meaning your teen goes to treatment once or twice a week, to everything in between.
Let’s back up for a moment. We understand a diagnosis of MDD for your teen also means you have internal issues to address and resolve. The emotions you feel when your teen receives a diagnosis for a mental health condition probably run the gamut. They may include denial, shock, confusion, worry, sadness, fear, and even anger. Those are all things you have to handle, too, because what your teen needs most from you, in this moment, revolves around one emotion and one type of behavior. The emotion is love, and the behavior – phrased as a verb – is to support.
Teen Depression Treatment: Finding the Right Fit
We remind you of these two things because dealing with the details of seeking high-quality treatment for your teen can be stressful, frustrating, and colored by anxiety about everything but their wellbeing. It’s best to shield them from those emotions, though. They have plenty on their plate – and you don’t want them to get the idea you’re frustrated with them.
With all that said, how you find the right teen depression center?
You start by reading articles like this one.
At the same time, we advise talking to friends and/or family members with experience finding mental health treatment. If you know someone whose teen is in treatment for depression – and they’re willing to share their knowledge – start there. They can give you a personal reference for a trusted therapist or teen depression center. Personal references can be gold. Friends give you unscripted, uncensored advice you never hear from a referring professional or read in articles written for the public. However, it helps to take personal references with a grain of salt, because there’s always a subjective element that can skew their point of view.
What an article like this can do is help you understand what to look for in a teen depression center and explain – in plain language – the meaning of mental health and depression-specific terms and phrases you’re likely to encounter on your search. The good news is there are objective criteria, established by mental health professionals and vetted through a rigorous peer-review process, that define the necessary constituent elements of a high-quality teen depression treatment center. And there are also clear, objective definitions of the levels of care available at most teen depression treatment centers.
We’ll cover those two topics, starting with the core components experts identify as the benchmark for high-quality mental health treatment for teens.
The Elements of Highly Regarded Teen Depression Centers
Almost twenty years ago, the Journal of the American Medical Association: Pediatrics published an influential study on the treatment of adolescents with alcohol and/or substance use disorders (AUD/SUD). Over twenty experts in adolescent mental health – including researchers, clinicians, policy-makers – identified nine components common to the most highly regarded treatment programs available. Since publication in 2004, this seminal meta-analysis has provided a template for adolescent mental health treatment in general – not just for teens with AUD/SUD.
In 2017, the article “Treating Mental Health and Substance Use Disorders in Adolescents: What Is on the Menu?” confirmed the relevance of the nine components identified in 2004. It also verified their value and effectiveness for treatment for mental health disorders such as depression and anxiety. Then, in 2020, the Substance Abuse and Health Services Administration (SAMHSA) published a comprehensive review in their Evidence-Based Resource Guide Series called “Treatment Considerations for Youth and Young Adults with Serious Emotional Disturbances and Serious Mental Illnesses and Co-occurring Substance Use” that both updates and reaffirms the nine components identified in the original paper.
Based on the two follow-up publications, we expanded the nine components to ten, which we list and explain below. When you begin your search for a depression treatment center for your teen, we recommend excluding from consideration any treatment center that does not include all ten elements we list below.
In short, this list includes everything you should expect from a teen depression center that’s up-to-date on the best and latest techniques and therapies to treat teen mental health issues, including teens diagnosed with major depressive disorder.
Here they are:
The Ten Elements of High-Quality Teen Treatment Centers
1. Complete Assessment
Teen treatment centers should administer comprehensive assessments and evaluations to create a full biopsychosocial profile of your teen’s life. Assessments should identify and address any relevant psychiatric, psychological, medical, family, and academic issues.
2. Custom-Designed Treatment Plan
Teen treatment centers should create an individualized treatment plan based on their comprehensive assessment. The treatment plan should collaborate with you and any involved family members to address all elements identified in the assessment.
3. Integrated Treatment
Teen treatment centers should design a plan to treat all the mental, behavioral, or substance use disorders the teen faces. Experts consider plans that treat one disorder and not others as insufficient and incomplete.
4. Family Engagement
Evidence shows that when the family is involved in treatment, outcomes improve. Treatment plans for teens should include the family members, caregivers, and other people involved in your teen’s life. Non-family members who play a significant role in your teen’s life may participate. Their level of involvement is determined by you, your teen, and the treatment team.
5. Teen-Specific Programming
Your teen’s treatment plan should include therapies and treatment modalities that are developmentally appropriate, and recognize the specific needs of adolescents. Treatment center staff should modify their approach for teens to offer the best chance of healing and recovery.
6. Time-in-Treatment/Commitment
To ensure more time-in-treatment and improve engagement in treatment, teen treatment centers should prioritize building an atmosphere of trust and respect between their therapists and your teen. Committed and engaged teens stay in treatment longer, which improves treatment outcomes and increases the chance of sustained recovery.
7. Qualified Clinicians
All staff at a teen treatment center should have experience working with adolescents. They should be trained in adolescent development, adolescent issues, and have clinical experience supporting teens with co-occurring disorders.
8. Gender and Cultural Competence
Treatment center staff should be aware of and understand the specific needs of each individual. Clinicians and programs should understand and know how to tailor treatment to meet the needs of females, males, LGBTQI individuals, and cultural/ethnic minorities.
9. Continuing Care
Teen treatment centers should design custom aftercare plans that include long-term recovery strategies. An effective continuing care program should include family involvement, outpatient therapy as needed, peer support, and information on relevant community-oriented 12-step-type programs.
10. Evaluation and Improvement
Teen treatment centers should commit to ongoing self-evaluation. Programs with a codified internal review process can stay current with the latest tools and techniques that increase the likelihood of treatment progress and sustained recovery.
We recommend you keep this list at hand when seeking treatment for your teen. If the teen depression center you’re considering does not include all ten components, we advise crossing that center off your list and moving on to the next one.
Now we’re ready to explain the different levels of care your teen’s therapist may recommend.
Teen Depression Centers: Levels of Care
The level of care appropriate for your teen depends on several factors. First, a teen with depression who engages in suicidal ideation or suicidal behavior is considered in crisis.
If your teen is in crisis, and poses an imminent danger to themselves or others, call 911 or take them to an emergency room now. Do not wait.
That warning represents the first criterion clinicians use to determine which level of care your teen needs: their level of acuity or the immediate seriousness of their symptoms or disorder. Second, clinicians look at how disruptive their symptoms are. The more disruptive the symptoms, the more immersive the level of care should be. Finally, they look at whether your teen has attempted treatment before, either successfully or unsuccessfully. A teen who has tried outpatient therapy, and shown little progress, will probably receive a referral for a more immersive level of care.
Here are the four most common levels of care recommended for teen depression. We list them in order from least to most immersive:
Outpatient Programs (OP Programs for Teen Depression)
Outpatient treatment involves office visits with a psychiatrist, therapist, or counselor one or two times per week. This is typically the entry level of treatment for depression. Teens diagnosed with MDD, but whose symptoms do not disrupt their ability to function in school or impair their family or peer relationships often begin with outpatient treatment.
Intensive Outpatient Programs (IOP Programs for Teen Depression)
Intensive outpatient treatment is one step up from outpatient treatment. If you admit your teen to an IOP program, they participate in treatment for a half-day, three to five days a week. Teens with depressive symptoms that are disruptive but do not impair ability to live at home or go to school may be a good fit for an IOP program.
Partial Hospitalization (PHP Programs for Teen Depression)
Partial hospitalization programs are one step up from intensive outpatient programs. If you admit your teen in a PHP program, they participate in treatment for a full day, five days a week. When your teen’s depressive symptoms disrupt day-to-day living, prevent them from functioning in school, a PHP program may be appropriate. In most cases, teens in a PHP program live at home, and not on-site at the treatment center.
Residential Treatment Programs (RTC Programs for Teen Depression)
Residential treatment is the most immersive level of treatment we discuss in this article. If your teen experiences depressive symptoms so severe they cannot participate in family life or go to school and need 24/7 support and monitoring to manage their depressive symptoms, then an RTC program may be appropriate. When you admit your teen to a residential behavioral treatment center, they will live full-time, on-site at the treatment center. In an RTC program, your teen will the time and support they need to focus on recovery, without the distractions of home, school, or peers.
Depression Treatment for Teens: Goals and Objectives
The goal of depression treatment for teens is to give them the tools to manage the symptoms of their disorder and live a life based on their vision of happiness, rather than a life dictated by the frequency and severity of their symptoms.
An integrated treatment plan at a teen depression center should include the following:
- Individual Therapy
- Group Therapy
- Family Therapy
- Mindfulness Practices
- Experiential Activities
- Expressive Therapies
- Community Support (i.e. Alcoholics Anonymous)
- Medication (as needed)
All these elements of treatment serve the goal we just mentioned. They empower teens to manage their depression and live life on their own terms. At a treatment center for teens with depression, a well-crafted plan will include the elements above in various combinations across the different levels of care. The treatment center should tailor techniques to meet your teen’s specific needs. During treatment, your teen will learn skills they can use every day. Treatment helps them reach a psychological and emotional place where they can return to and function at home, at school, and during extracurricular activities. Treatment, in a phrase, helps them get back to the work of being a teenager. They’ll use their recovery skills to navigate adolescence and move forward toward a productive and fulfilling adulthood.
Finding Help: Resources
If you’re seeking depression 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.