In seeking mental health services for your child, you have several options available regarding the philosophy, frequency, intensity and duration of the treatment you choose. Listed in this section are the different levels of treatment in order of intensity (lowest to highest) and typical progression of care. If your child is not a danger to himself or others, I recommend individual outpatient therapy as your starting point. Individual outpatient therapy is the easiest treatment to access and it provides the most personalized care and least restrictive environment. It is important to note that if your child starts with individual outpatient therapy, the treatment provider, upon completing an assessment of your child’s difficulties, may refer you to a more intensive level of care if deemed necessary.
Mental health services can be provided by a variety of different professionals including psychiatrists (Medical Doctor, MD), nurse practitioners, psychologists, social workers, family therapists, alcohol and substance abuse counselors and/or a combination of all of the above. Psychiatrists are the only mental health professionals who can prescribe medication. Throughout the remainder of this handbook, the professionals mentioned above will be referred to as “treatment providers”.
Outpatient Treatment: Your child attends the treatment session and then returns home.
Individual Outpatient Therapy: Provided by a licensed treatment provider (psychologist, social worker or professional counselor). Approximate duration of treatment varies according to patient’s diagnosis and treatment needs. Typical treatment structure is one-on-one counseling, one session per week, one hour per session. I categorize individual outpatient therapy into two subtypes:Individual Talk Therapy – primary focus is the patient, primary treatment strategy is to have the patient talk out his/her problems and emotions, gain insight, problem solve and implement identified solutions. Multi-Strategy Therapy – focus of therapy includes the patient and his/her family members, treatment strategies may include individual talk therapy, group therapy, patient/family education, parent training, behavior modification, and skills training. Session structure often varies with regard to number of sessions per week, length of sessions, strategies for change and who is involved in the treatment along with the patient.
Intensive Outpatient Therapy: Provided by a community or privately operated mental health/substance abuse agency or hospital. Approximate duration and structure of treatment is 2-4 months, 4 days per week, 3-4 hours per day (after-school hours, 4-9 PM). Treatment typically includes a combination of individual, group and family counseling.
Partial Hospitalization: Provided by a community or privately operated mental health/substance abuse agency or hospital. Approximate duration and structure of treatment is 2-4 weeks, 4-5 days per week, 5-8 hours per day (8 AM – 4 PM). Treatment typically includes a combination of medical/psychiatric evaluations and monitoring, individual, group and family counseling andapproximately 2-3 hours of academic education (coordinated with the patient’s school district).
Inpatient Treatment: Your child stays overnight in the hospital or treatment facility.
Emergency Hospitalization: Provided by a public or private hospital. Length of stay may vary from 2-10 days. Usually occurs following a psychiatric or substance abuse emergency during which an individual is at risk for harming himself/herself or others. The primary goal of hospitalization is to ensure the individual’s safety, stabilize acute physical and/or psychiatric symptoms and educate the patient and his/her family about the nature of the diagnosed condition. Treatment primarily includes medication, medical evaluations/monitoring, psychiatric evaluations/monitoring and patient and family education.
Intensive Inpatient Treatment: Provided by a publicly funded or privately operated inpatient treatment program. Approximate length of stay may be from 5-28 days depending on the treatment program. Usually occurs as a result of failed attempts at less intensive treatments (individual outpatient, intensive outpatient, partial hospitalization) or following an emergency psychiatric hospitalization. The primary goal is to educate and assist the individual in developing a long term plan and strategies for effectively coping with the diagnosed condition. Treatment primarily includes supervised living, academic education (coordinated with patient’s school district), medical evaluations/monitoring, psychiatric evaluations/monitoring, behavior modification and individual, group and family counseling.
Extended/Long-Term Treatment: Provided by a publicly funded or privately operated extended/long-term care program. Approximate length of stay may be from 2-18 months. Usually occurs as a result of failed attempt(s) at intensive inpatient treatment and/or when the nature and severity of the psychiatric disorder requires longer treatment. Treatment primarily includes supervised living, academic education (coordinated with patient’s school district), medical evaluations/monitoring, psychiatric evaluations/monitoring, behavior modification and one-on-one, group and family therapy.