Female psychologist noting down while her patient is talking about her problems
Published On: February 17, 2016|Categories: Clinician’s Corner|

Last week, we took a look at how to begin treatment for your teen at High Focus Centers. Now, we take a look at the available levels of care and provide some context to help you determine how to best help your loved one.

For more information about High Focus Centers outpatient programs, click here. For help, call (800) 877-3628 or fill out our online contact form to have a member of the High Focus Centers admissions team contact you.

Outpatient Programs

If you think of the movies you have seen, with the therapist sitting across from an individual patient (who is either sitting across from them or laying down), this is a depiction of individual sessions with outpatient therapists.

An outpatient therapist provides treatment for mild to moderate symptoms of depression or anxiety; some experimentation with drugs or alcohol; attentional issues; acting out behaviors; and family conflict. Usually, these sessions happen once per week, but the frequency can vary depending on the availability of the therapist and the severity of the client’s symptoms.

There are many different degrees that allow someone to be a therapist, which often confuses the picture when you are trying to figure out which professional to see. Common degrees include:

  • Licensed social worker (LSW or LSCW)
  • Licensed family counselor (LMFT)
  • Licensed associate or professional counselor (LAC, LPC)
  • Psychologist (PhD or PsyD)

From a practical viewpoint, it does not matter which degree or letters? the therapist has; they are all trained to provide clinical care and talk therapy. Focus instead on how comfortable you and your family member feel with the individual.

Outpatient therapists may also provide specific groups designed to allow individuals of similar ages and problems to be treated within a group setting. Many of these themed groups occur for 1-1.5 hours a week. Some of the most common groups for adolescents include social skills groups, as well as groups aimed to assist teenagers with attentional difficulties. If your concerns for your child include that they struggle socially, then group therapy offers an appropriate therapeutic setting to assist them with developing these skills.

Psychiatry

Psychiatrists can provide assessments or recommendations regarding medications. Often the psychiatrist sees individuals for an initial evaluation, and then follows up with them monthly for medication management sessions. Some psychiatrists will see patients weekly and provide both individual talk therapy sessions and medication management sessions. However, this varies from doctor to doctor.

Many people seeking help for the first time will try to get their initial appointment with a psychiatrist. In general, psychiatrists often do not take insurance and usually have longer waits than therapists. Therefore, if you are concerned about a family member, it can be easier and quicker to get an appointment with an outpatient clinician first. Then, they can begin therapy and receive a referral to a psychiatrist from the clinician if the clinician believes that medication is necessary or should be considered.

Intensive Outpatient Programs (IOP)

Intensive outpatient programs offer a higher level of care designed to treat individuals experiencing moderate to severe symptoms. IOPs usually meet for multiple hours, multiple days per week. Most run from three-five times per week for about three-four hours per treatment day. This schedule generally lasts between two and three months.

All IOPs are designed with a strong emphasis on group work to assist the individual with developing specific skills that improve their level of functioning.  If your child uses drugs or alcohol on a semi-regular to regular basis, then this is most likely the appropriate level of care for them. Similarly, many individuals who struggle with eating disorder symptoms often receive a referral to this level of care. IOPs typically have specific groups that they work with including substance abuse, eating disorder or psychiatric disorders (such as mood, anxiety and psychotic disorders.)

If you have a child who has received therapy from an outpatient clinician but has not made the progress you were hoping for, then this may be the next step. Conversely, if your family member has not been in treatment before, but their symptoms are raising some safety concerns (i.e., you have recently discovered that they are harming themselves through cutting or burning), or if they are struggling with suicidal thoughts, then this may be a more appropriate level of care for them.

Partial Care/Partial Hospitalization Programs (PCP/PHP)

This level of care is the step between an IOP and an inpatient hospitalization program.  This program is designed for individuals who experience significant symptoms that make it difficult for them to function in their daily lives. Individuals who benefit most from these programs are not at immediate risk of harming themselves, but may struggle to function.

PCPs, group-based programs that also provide family work, individual work, and medication management sessions with a therapist, usually run five days a week for five to six hours at a time. At this level of care, the patient usually attends the program with this intensity from anywhere from two to four weeks, with specific goals of getting their medications adjusted, improving their level of functioning, addressing any safety concerns, and creating an appropriate aftercare plan. Many partial patients will step down directly into an IOP.

If your child is not attending school, not functioning well, showing severe depressive symptoms, self-injuring, or expressing suicidal thoughts with regularity, then this may be the appropriate level of care for them.

Inpatient Hospitalization

Just like if your child broke their arm or leg, if your child is in immediate danger, the best thing to do is take them to the emergency room for an evaluation. Any suicidal gesture or attempt should be taken seriously, so if your child tells you or someone else that they want to die or have a plan to harm themselves, they need the inpatient level of care.

When you take your child to the emergency room, they will first be medically cleared, and will then evaluated by a therapist to determine the appropriate next step. Many times, the therapist will recommend an approximately weeklong stay at the hospital. Although this recommendation may sound scary, it is the best course of action for someone in crisis.

Inpatient treatment often includes therapy groups and family sessions, as well as regular medication management by the psychiatrist. Once patients are more stable and no longer at high risk to harm themselves, the clinician at the hospital will assist you with determining what level of care is appropriate for them in the future.

Again, please call (800) 877-3628 for to talk with a member of the High Focus Centers team or fill out an online contact form to learn more about our program offerings.

Contributed by Dara Gasior, Psy.D.

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