Teen Treatment: Outpatient, Inpatient, Psychiatric Hospitalization, and Partial Hospitalization

What Kind of Teen Treatment Facility Does Your Teen Need?

If your teen develops a mental health disorder, it’s important to know everything you can about their treatment options. The first thing you should know is you can find effective, evidence-based teen treatment options for:

• Mood Disorders:
  • Depressive disorder (MDE)
  • Bipolar disorder (BD)
  • Mood disorder + substance use disorder/alcohol use disorder (AUD/SUD)
    • This is known as dual diagnosis treatment for co-occurring disorders
  • Anxiety Disorders:
    • Generalized anxiety disorder (GAD)
    • Social anxiety disorder (Social Phobia)
    • Panic disorder (PD)
    • Post-traumatic stress disorder (PTSD)
  • Behavioral Disorders:
    • Oppositional defiant disorder (ODD)
    • Disruptive mood dysregulation disorder (DMDD)
    • Conduct disorder (CD)
  • Non-Suicidal Self-Injury
    • Self-harming behaviors such as cutting, branding, scratching, burning
  • Suicidal Ideation and Suicidality*

*Please Note: If your teen talks about suicide, and/or you think your teen presents an imminent danger to themselves or others, call 911 or take them to an emergency room immediately. Act now. Do not ignore talk of suicide.*

If your teen receives a diagnosis for any of the mental health disorders listed above, you can find the support and care they need at a teen treatment facility that specializes in working with the adolescent population.

This article will give you information about four possible types of treatment for your teen:

1. Outpatient
2. Inpatient
3. Psychiatric Hospitalization
4. Partial Hospitalization

You have the best chance of choosing the most appropriate option for your teen when you collaborate with their therapist or psychiatrist – meaning the person who administered a full assessment and evaluation and determined a diagnosis – and your family, including your teen, to find a teen treatment facility that meets your specific needs.

We’ll address the list above in order, starting with outpatient treatment.

Teen Treatment: What Are Your Choices?

We’ll start with a disclaimer: this article cannot diagnose your child or recommend a course of treatment for their mental health disorder. Only a qualified, licensed, mental health professional can do that. This is a know your options article. Everything you read here should align with what you hear from your teen’s therapist. If there are minor discrepancies in vocabulary or terminology that create confusion, talk to your provider.

Now let’s get right to it, beginning with Outpatient treatment.

What is Outpatient treatment?

Outpatient treatment is the entry level of care for most teens who need mental health or addiction treatment and support. It’s the least immersive, least intensive option among the four we discuss in this article.

However, least immersive and least intensive does not mean least effective. When your teen receives a referral for outpatient treatment, it means:

• They received a diagnosis for a mental health or addiction disorder
• The symptoms, emotions, and behavior associated with their disorder are uncomfortable and disruptive.
• Despite being disruptive, uncomfortable, and difficult to deal with on their own, the symptoms/emotions/behaviors associated with their disorder do not prevent them from participating in the activities of day-to-day life.
  • Daily activities include home life, school life, social life, extracurriculars, and employment.
• They will develop the skills they need to manage the symptoms of their disorder and live life on their terms, not those dictated by their symptoms.

Do not think of outpatient treatment as treatment lite or easy treatment. It’s real treatment that can challenge your teen to learn and grow on many levels. It’s treatment that matches the level of disruption caused by the symptoms related to their disorder.

Here’s how outpatient treatment works:

1. After you receive a referral for treatment, you find a licensed, qualified therapist or psychiatrist with experience working with the adolescent population. This may or may not be the same person who administered their assessment.
2. The choice between a therapist, counselor, or psychiatrist depends on the specific details of the diagnosis. In cases that require medication, your teen will likely need a psychiatrist to write prescriptions and manage medication. However, they may spend more therapy time with a therapist or counselor, and only check in with their psychiatrist on a predetermined schedule, or if medication issues arise.
3. Your teen attends therapy once or twice a week, most often in an office setting. Some teens begin with twice a week. If they make progress, they may step down to once a week. If they continue to make progress, they may step down to every other week.
4. Many teens who step down to every other week will step back up to once a week during times of stress. They may also step back up if symptoms escalate or they relapse, in cases of AUD/SUD.
5. If a teen does not make progress during outpatient treatment, their therapist may recommend and more immersive level of care.

What is Inpatient Treatment?

In the big picture of medical treatment – not just mental health treatment – inpatient treatment means the person in treatment lives at the treatment facility and receives around the clock support and monitoring.

In teen mental health treatment, inpatient treatment means almost the same thing. Teens do live on-site and receive full-time treatment and monitoring, but that’s where the definitions for mental health treatment diverge in some ways from what’s considered inpatient treatment for non-mental health disorders.

The first type of inpatient treatment we’ll discuss is treatment at a residential treatment center (RTC) for teens. When your teen receives a referral for an RTC program, it means:

• They received a diagnosis for a mental health or addiction disorder
• The symptoms, emotions, and behavior associated with their disorder are extremely uncomfortable and very disruptive.
• The symptoms/emotions/behaviors associated with their disorder prevent them from participating in the activities of day-to-day life.
  • Daily activities include home life, school life, social life, extracurriculars, and employment.
• They will leave their typical daily life to focus on developing the skills they need to manage the symptoms of their disorder and live life on their terms, not those dictated by their symptoms.

Teens with disruptive symptoms that impair their ability to function in daily life will likely receive a referral for residential treatment. Time spent in a teen residential treatment facility gives your teen a distraction-free environment that allows them to focus on healing and recovery, without the pressures or concerns associated with family, friends, school, or work.

Here’s how treatment in an RTC program works:

1. After your teen receives a referral for treatment, you find a licensed, qualified teen treatment facility with clinicians and staff with experience working with adolescents.
2. You admit your teen to the teen treatment facility. Clinicians develop a full biopsychosocial profile for your teen. Then, they collaborate with you and your teen on a treatment plan that’s designed to meet your teen’s specific therapeutic needs.
3. Your teen lives at the RTC and receives 24/7 support and monitoring. They receive treatment for a full day, with breaks for meals and recharge time. Evenings typically involve group meetings or therapy homework. Weekends are treatment days, too, but most RTCs modify the schedule with fun excursions or activities that are designed to be therapeutic, but a change from the approach that happens during the week. Treatment plans typically include:
   1. Individual therapy
   2. Group therapy
   3. Family therapy
   4. Experiential therapies yoga, mindfulness, meditation, outdoor recreation, exercise)
   5. Expressive therapies (music, visual art, drama, dance, journaling/writing)
4. A typical stay in an RTC is anywhere from three to six weeks, with most teens staying around a month. Discharge, or stepping down to a less immersive level of care, is determined by your teen’s treatment team. In most cases, teens step down to a less immersive level of care such as a partial hospitalization program, which we discuss later in this article, or an intensive outpatient program, which we discuss in articles like this one.

What is Psychiatric Hospitalization?

Psychiatric hospitalization is the most immersive level of care for teens who need mental health or addiction treatment and support. It’s the most intensive option among the four we discuss in this article. It’s considered a type of inpatient treatment, but it’s not the same as a teen treatment facility that operates an RTC as described above.

When your teen receives a referral for psychiatric hospitalization, it means:

• They received a diagnosis for a mental health or addiction disorder
• The symptoms, emotions, and behavior associated with their disorder put your teen in imminent danger and expose your teen, your family to immediate danger.
• The symptoms/emotions/behaviors associated with their disorder place their immediate physical safety at risk, as well as being disruptive and preventing them from participating in the activities of day-to-day life.
• They need time under strict medical supervision to prevent harm.

Psychiatric hospitalization is for teens in immediate crisis, such as teens who are actively suicidal, display violence or aggression, or engage in excessively risky or dangerous behavior. The goal of psychiatric hospitalization is safety and stability, rather than therapy. Therapy starts when your teen is safe and capable of participating in individual and group therapy.

Here’s how psychiatric hospitalization works:

1. This level of care most often begins with a crisis: a suicide threat, a suicide attempt, escalating self-harming behavior, violent outbursts or aggressive behavior associated with some mental health disorders, or escalating risky behavior associated with severe alcohol or substance use/addiction.
2. If you take your teen to an emergency room in a crisis, the on-call psychiatrist may refer them to inpatient psychiatric hospitalization for their safety. Your teen’s psychiatrist may also make this referral after an office visit, an emergency room visit followed by consultation with them, or an emergency call. In some cases, a referral for psychiatric hospitalization is involuntary and mandatory.
3. Your teen lives in the teen treatment facility or psychiatric hospital and receives intensive, round-the-clock support and monitoring until the crisis passes. These facilities are often locked and have hands-on policies with regards to managing your teen if their crisis or behavior escalates. For details on locked facilities and hands-off or hands-on policies, please read this article.
4. When a physician determines your teen is safe and stable, they will discharge them to a less immersive level of care, such as residential treatment at a teen treatment facility that operates an adolescent RTC. The goal of inpatient psychiatric hospitalization is safety and stability. Clinicians work with your teen until they’re ready to engage in therapy. The length of stay in a psychiatric hospital is typically three days minimum and a week to ten days maximum. In rare cases, psychiatric hospitalization may last longer than ten days.

What is a Partial Hospitalization Program?

One way to think of a partial hospitalization program like this:

If you look at teen treatment facilities and teen mental health treatment programs as a continuum of care – a phrase which many medical professionals do use – and put psychiatric hospitalization at one end as the most intensive/immersive level of care, and put outpatient treatment at the other end as the least immersive/intensive level of care, a partial hospitalization program lands around the middle, perhaps a shade toward the intensive/immersive end of the continuum.

When your teen receives a referral for treatment at the PHP level of care, it means:

• They received a diagnosis for a mental health or addiction disorder
• The symptoms, emotions, and behavior associated with their disorder are extremely uncomfortable and very disruptive.
• The symptoms/emotions/behaviors associated with their disorder prevent them from participating in most of the activities of day-to-day life.
  • Daily activities, in this case, include school life, social life, extracurriculars, and employment.
  • In most cases, teens in treatment at the PHP level of care live at home during treatment. That means they’re stable enough, and can manage their symptoms well enough, to eat dinner at home with their family and manage a small amount of unstructured free time at home in the evenings and on weekends, without incident or emergency.
• They spend a significant amount of their weekdays in treatment, focusing on developing the skills they need to manage the symptoms of their disorder so they can return to school and begin reconnecting to their peers and extracurricular activities.

Teens with disruptive symptoms that impair their ability to function in daily life but are stable enough to spend evenings and weekends at home may receive a referral for treatment in a partial hospitalization program. Support and care in a PHP gives your teen time every day to learn, grow, and focus on recovery, without the stress and pressure often related to school, peers, or work.

Here’s how a teen PHP works:

1. After your teen receives a referral for treatment, you find a licensed, qualified teen treatment facility that offers a PHP program staffed with clinicians experienced in working with adolescents.
2. Your teen goes through an admission process like what they’d experience at the beginning of an RTC program. Treatment facility clinicians meet your teen and create a full biopsychosocial profile, then collaborate with you and your teen on a treatment plan that meets their specific needs.
3. Your teen participates in treatment five to six hours a day, three to five days a week. Most programs are six hours a day, five days a week. Your teen will most likely eat lunch at the treatment facility with their treatment peers. Most top-rated treatment facilities provide excellent, nutritious lunches. With the exception of lunchtime, PHP days are programmed from beginning to end. Teens receive a combination of therapies similar to teens in RTC. Individual therapy, group therapy, and family therapy are the core elements of treatment. Experiential and expressive therapies are an important part of most partial hospitalization programs, but they typically happen less frequently in PHP, as compared to RTC.
4. Teens in PHP go home for evenings and weekends. They typically have treatment homework and receive advice to attend community support groups in the evenings and on weekends.
5. The average length of a PHP program is two to four weeks. Most adolescents spend about three weeks in PHP. Teen treatment facility clinicians review and assess your teen’s condition at the end of each week. They make recommendations for continued care or discharge based on therapeutic progress. Teens discharged from a PHP program typically go back to school. In addition, they step down to a less immersive level of care.

How to Learn More

If you have additional questions about levels of care, specific elements of teen treatment at teen mental health treatment facilities, or more details about treatment for various mental health disorders, please read these articles:

A general article on levels of care here.

An article on treatment for teens with obsessive-compulsive disorder here.

An article on treatment for teens who engage in self-harming behavior here.

Our article on teens diagnosed with psychosis here.

An article on treatment for teens with addiction here.

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.