When Teens Need More Than Outpatient Therapy

By: Pine Rest Staff

Many teenagers with anxiety, depression or other behavioral health diagnoses can recover with outpatient therapy. However, teens with significant mental and/or emotional health problems need to receive a more intensive program of treatment but not an inpatient stay. 

Pine Rest’s Adolescent Partial Hospitalization Program (PHP)

Our Adolescent PHP is a short-term, intensive treatment program designed specifically for adolescents (ages 13-17) with significant mental health and/or emotional issues that don’t require inpatient care. With our program, teens receive expert, intensive and structured daily care a teen would experience in the hospital while still being able to return home each evening.

When should an adolescent partial program be considered?

Teens who come here don’t display a significant need for inpatient care, but they need more support than seeing an outpatient therapist once a week. The defining factor is safety – they are able to safely be at home in the evenings while seeking treatment.

Teens with the following symptoms may be appropriate for partial hospitalization:

  • Disturbance in sleep, appetite, mood and/or functioning in daily activities because of severe anxiety or depression
  • Suicidal ideation without a specific plan or intent to harm self
  • Increased difficulty in sustaining relationships with family/friends, thoughts of hurting others
  • Decreased functioning at work and school that may have long term impact
  • Unable to stabilize while receiving outpatient behavioral health services
  • Refusal to participate in outpatient services while symptoms are intensifying

Partial is also used as a step down from Inpatient care when a period of transition is needed to sustain the impact of inpatient treatment but 24-hour monitoring to maintain safety is no longer needed. This is particularly important when an individual has an insufficient external support system or increased exposure to factors identified as triggers for increased risk of harm to self and others.

Teens who need to work on practicing healthy mental health skills really benefit, because they’re able to go home and practice what they’re learning, and then return the next day to process how things went.

What diagnoses do you treat?

Teens dealing with any type of a mental health diagnosis can benefit from partial. We treat most mental health disorders, but most commonly we treat…

  • Anxiety disorders
  • Depression and other mood disorders
  • Eating disorders
  • Attention deficit hyperactivity disorder (ADHD)
  • Post traumatic stress disorder (PTSD)

What treatment do teens receive?

Adolescent PHP is a group and class-based program. Patients meet with a case manager/therapist daily, a psychiatry provider at least two to three times per week for ongoing care and evaluation and are encouraged to attend a family meeting.

90-minute group therapy session each day. Adolescents work on processing emotions and feelings with peers, and they receive support from peers in a safe environment. They also receive individual care in group therapy.

Our structured groups are activity and topic-focused. We work on meeting kids where they are and form our content around what kids are dealing with, like family dynamics, LGBTQ identity, bullying, substance use, school avoidance, self-harm and suicidal thoughts.

Group Topics Include
  • Communication Skills
  • Community Involvement
  • Coping Skills
  • Creative Expression
  • Distress Tolerance
  • Emotions Management (anger, depression, anxiety)
  • Family Dynamics
  • Friendship/Peer Relationships
  • LGBTQ+
  • Problem Solving
  • School Stress
  • Self-Care/Healthy Habits
  • Self-Esteem/Self-Compassion
  • Substance Use
  • Support Systems

45-minute group with the case managers each day. At this morning check in, we review goals and talk about growth and how we can help them accomplish their goals. Students rate how they’re doing with depression, anxiety, suicidal thoughts, and things like sleeping and eating. This helps us determine their safety, and their progress towards discharge.

Journaling and reflection time. We want kids to recognize the importance of how their eating, sleeping, and exercising contribute to their mental health.

Exercise and nutrition. We support these healthy habits by providing gym time (basketball, volleyball, badminton, soccer, walking, using chalk outside) and providing nutritious lunch and snacks.

What feedback do you receive?

Parents are thankful their child is back on the right path. They like to hear that we work from a strengths-based perspective, meaning that we get to know each kid and use their individual strengths and assets to help them grow and to promote healing.

Teens tell us they don’t feel so isolated and alone anymore. They like that they can relate to others. Often we hear from teens…

  • “I never learned these skills before!”
  • “The first day is the hardest, and then it gets better.”
  • “I feel like it’s going to be OK.”
  • “I feel like I have a plan to return to school and have the tools to cope with it.”

How does the program support parents?

We offer two parent classes each week and ask parents to attend one of those sessions. Parents learn about the specifics about the program, what to expect, how to prepare for discharge and generally how to support their teen. Outside of this class, we support parents as their teens stabilize and return home.

How does the program work with physicians and therapists?

Call our Health Information Management department at 616.281.6349 for information about the care of a patient in Adolescent PHP. Primary care physicians, therapists, and psychiatrists receive hospital courtesy calls, provided a release of information has been signed by the patient’s parents. Pine Rest staff will notify you that your patient has been admitted and let you know who to call for information.

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