Level of Care Definitions

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Types of Care & Services

Finding the treatment option that best meets the needs of your child and your family can be challenging. The following information aims to reduce confusion about the types of treatment available and offers a list of considerations to keep in mind when choosing the best program for your child.

Understanding Placement Options

Day Treatment

Virtual Outpatient

Virtual outpatient programs are the same level of care as outpatient programs. The difference is that they occur via videoconference app, such as Skype, Zoom, FaceTime, or Google Hangouts, rather than in person. Teletherapy typically occurs once or twice a week, with the frequency determined after consultations between the family and therapist.

Outpatient

In outpatient treatment, parents take teens to an office visit once or twice a week. This is a typical entry level of treatment for a teen who needs help with psychological or emotional issues, but whose issues do not significantly disrupt their ability to function in school and do not significantly impair their family or peer relationships.

Intensive Outpatient

These programs are called Intensive Outpatient Programs – IOP for short. In IOP programs, adolescents attend treatment for a half-day, three to five days a week. This level of mental health treatment is appropriate for teens with mental health and/or substance use issues that are significant enough to disrupt day-to-day living but who can still live at home and/or go to school.

Partial Hospitalization

These programs are called Partial Hospitalization Programs – PHP for short. In PHP programs, adolescents attend treatment for a full day, five days a week. This level of treatment is appropriate for teens with mental health issues that are significant enough to disrupt day-to-day living. Teens in PHP programs typically do not go to school while receiving this level of care although most PHP programs have an academic component. Participants in PHP programs live at home, and do not live on-site.

Overnight Treatment

Detox

Detoxification refers to the process of allowing substances of misuse and related toxins to clear the body so a teen diagnosed with an alcohol or substance use disorder can begin treatment with a clean slate. In some cases, detox must be medically monitored, and in others, detox must be both medically monitored and medication-assisted. If a professional assessment indicates a medical detox is a necessary first step before treatment begins – typically in cases involving opioid, benzodiazepine, or alcohol addiction – then it’s critical to select a program that offers medical detox in an appropriate setting with qualified staff. That’s the first step before participation in any program we describe below. During medically monitored and medication-assisted detox, medical staff are on-hand to address any emergencies that may occur, and to ensure the administration of appropriate medication to mitigate the physical symptoms of withdrawal.

Psychiatric Hospitalization

Psychiatric hospitalization is appropriate for adolescents in crisis or whose symptoms are more acute than teens in residential treatment centers. Their risk of self-harm is the highest. Teens recommended for psychiatric hospitalization may have attempted suicide or experienced a drug overdose. Psychiatric hospitalization occurs in psychiatric units within general hospitals or in private psychiatric hospitals. Intake can be voluntary or involuntary, with care supervised by psychiatrists and delivered by group therapists and/or psychiatric nurses.

In general, psychiatric hospitalization involves the highest degree of monitoring of all levels of care. Movement and activity within the facility is tightly controlled, and doors to living quarters and other areas may be locked during predetermined times. While most residential treatment centers have “hands off” policies, the regulations in psychiatric hospitals typically allow staff to put “hands on” patients in crisis situations. In addition, psychiatric hospitalizations typically occur on recommendation of mental health professionals after a crisis situation. These voluntary or involuntary stays last 3-10 days, depending on the reason for admission and the acuity (immediate seriousness) of the issue. Upon discharge from psychiatric hospitalization, the level of care most often recommended by clinicians is residential treatment.

Therapeutic Boarding Schools

Therapeutic boarding schools are boarding schools where teens live on-site and receive treatment for a mental health, substance use, or behavioral disorder while simultaneously pursuing an appropriate academic program. These programs typically work for teens who have attempted less intensive programs, such as outpatient, partial hospitalization, or residential, but need the additional support and time in treatment offered by half-year or year-long programs common to a TBS. While TBSs always have licensing and accreditation as academic institutions, parents interested in these school for their teens should ensure the school offers evidence-based mental health or substance use treatment provided by counselors or therapists trained to support adolescents.

Residential Treatment

These programs occur at Residential Treatment Centers – RTC for short. This level of treatment is appropriate for teens with mental health or substance use issues that are so severe they need 24/7 support and monitoring. Teens who attend an adolescent residential treatment center do not live at home and need an immersive level of care to manage their mental health or substance use issues.

In a residential program, teens receive more intensive therapy and psychiatric care than in IOP or PHP programs. These teens need time away from their current environment to concentrate on recovery and healing. Residential treatment allows for more time for one-on-one therapy, family therapy, and group therapy and peer support. Teens learn and practice coping skills, distress tolerance techniques, and relapse prevention strategies. They have time to practice what they learn and hone their skills with feedback from therapists, counselors, and peers. This prepares them for success when they finish treatment or step down to a less immersive level of care.

The length of stay in a residential treatment program – typically 30-60 days – is often covered by insurance plans that include behavioral health benefits. Insurance plans that include behavioral health benefits often do not cover programs of greater length than residential treatment programs, such as the long-term treatment programs, wilderness programs, and therapeutic boarding schools we discuss below.

Long-Term Treatment

Long-term treatment programs occur at residential treatment centers and often involve a higher level of monitoring than a teen receives in a typical residential program. While residential treatment often lasts 30-60 days, long-term treatment may last three to six months or more. Long-term treatment units can have increased ability to contain a treatment-resistant teen. This level and length of care is appropriate for teens who have tried shorter term residential programs without success and need long-term intervention due to elopement risk, physical aggression that may require physical intervention, or profound mental health issues that require long-term medication stabilization.

Wilderness Programs

Wilderness programs occur in the outdoors and use challenge-type experiences in a wilderness setting to support teens who struggle with maladaptive behaviors. These programs typically last six weeks to two months. They combine individual and group therapy with wilderness-based adventure activities to treat teens with significant behavioral issues that remain unresolved after intensive outpatient or residential treatment programs. Licensing and accreditation for wilderness programs vary from state to state. Parents interested in these programs should look for evidence-based mental health or substance use treatment provided by counselors or therapists trained to support adolescents. Completion of a wilderness program is often a requirement before admission to an emotional growth or therapeutic boarding school.

Questions to Ask

Below are various topics we cover on our Questions Page around questions to ask the admissions counselor of any treatment center you consider for your adolescent.

Clinical Questions >

What are your therapists’ credentials? How long is each session?

Safety Questions >

It’s vital to ask about these safety policies and protocols.

Wilderness Programs >

Wilderness programs operate under a different set of guidelines than most adolescent treatment centers. Read more.

Boarding Schools >

Therapeutic boarding schools operate under a different set of guidelines than most adolescent treatment centers. Learn more.

Questions to Ask Admissions

Considerations To Make

When doing your research, it’s vital to ensure any treatment center you consider has strong safety protocols in place to protect your child. Do your due diligence and ask as many questions as you can about the program

Level of Care Definitions

Level of Care Definitions

Types of Care & Services

Understanding Placement Options

Day Treatment

Overnight Treatment

Questions to Ask

Clinical Questions >

Safety Questions >

Wilderness Programs >

Boarding Schools >

Considerations To Make

Licensing & Accreditation

Staff-to-Client
Ratio

Staff
Qualifications

Emergency
Policies

Monitoring
Methods

Behavior Modification

Access to Dangerous Objects

Contact With
Others

Your Family,
Your Choice

More Questions? Reach Out Now.

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Level of Care Definitions

Types of Care & Services

Understanding Placement Options

Day Treatment

Overnight Treatment

Questions to Ask

Considerations To Make

StaffQualifications

More Questions? Reach Out Now.

Staff
Qualifications