When is it time to take the plunge?
There are no strict guidelines as to when parents should choose residential treatment as a placement option for their teen. Generally speaking, teens enter residential treatment when their needs are too intense to be managed with outpatient treatment.
When we receive referrals from an outpatient counselor, usually one or more of the following issues is taking place:
- Outpatient treatment has failed to contain the symptoms and increasing the intensity and/or the frequency of counseling contacts has not stemmed the tide of distress and dysfunction.
- Available emotional resources for support from friends and family have become depleted or drained, leaving the teen with a lack of support during periods of heightened symptomatology.
- There is no clear indication for acute inpatient hospitalization.
- There is considerable diagnostic ambiguity that may be clarified or eliminated by regular or round-the-clock observations in a safe environment—for example, to determine whether a behavioral disturbance is the result of a rapid-cycling mood disorder or concealed substance abuse.
- There are safety issues, such as escalating levels of substance abuse, disordered eating or purging behaviors, or self-injurious behaviors, that may be reduced in a controlled (but not necessarily locked) treatment milieu that features round-the-clock behavioral observations.
Therapeutic boarding schools fill a gap between outpatient treatment and inpatient hospitalization. But often the medical environment is simply not an effective intervention for most adolescent development issues. A hospital can feel impersonal, short, detached, expensive, and create a label for your teen that will be difficult for them to move past. Outpatient counseling can also feel impersonal to your teen as they tolerate it in an effort to simply get by each week. Unless your teen is motivated to change, outpatient counseling does not have sufficient structure and oversight to require a teen to ‘try change.’ The mere attendance in a weekly session can lull you as a parent into believing something is happening even though no real progress is being made.
Many teens confess when they arrive at Shelterwood that they are desperate for this kind of inpatient therapeutic help. While they might not admit it to their parents, most students realize that without a firm intervention that removes them from their environment, they had no ability to ‘self heal.’ As long as it was possible to avoid change, they were committed to avoiding it. But once they felt the warmth, support, and duration of a therapeutic boarding school, they let their guard down and tried on new ways to live.
Families will normally be the first ones to notice changes in the teen’s behavior.
Signs of teenagers in crisis include the following:
- becoming increasingly rebellious
- withdrawing from family and friends
- seeking new friends who exhibit questionable behavior
- becoming violent
- taking on compulsive obsessions
- becoming sneaky
- starting to lie about whereabouts
- sudden drop in school performance
- extreme mood swings
- disappearance of items including money.
On noticing negative changes, parents and caregivers should take immediate steps to resolve the issue. Non-confrontational means of communicating with the teen should be implemented by parents and caregivers. If in doubt, seek professional help with the teen.
Read the list of 30 questions below to determine if your teen needs help. This teen assessment is designed to be a first step and it might be critical for you to discuss the results with a therapist. Please refer to the scoring guide below to see which options are most suitable for your child, based upon the total number of questions that you checked as positive.
1. Does your teen struggle with basic family rules and expectations?
2. Has your teen ever been suspended, expelled, truant or had a drop in school grades?
3. Has your teen ever been verbally abusive?
4. In your opinion, does your teen associate with a bad peer group?
5. Has your teen lost interest in former productive activities, such as hobbies and sports?
6. Do you have difficulty getting your teen to do simple household chores or homework without a major fight?
7. Has your teen had problems with the law?
8. Do you find yourself picking your words carefully when speaking to your teen so as not to elicit a verbal attack or rage from them?
9. Are you worried that your teen may not finish high school?
10. Does your teen, at times, seem depressed and/or withdrawn?
11. Is your teen’s appearance or personal hygiene outside your family standards?
12. Has your teen ever displayed violent behavior?
13. Is your teen manipulative or deceitful?
14. Does your teen seem to lack motivation?
15. Do you suspect that your teen is telling lies or has been dishonest with you?
16. Are you concerned that your teen may be sexually promiscuous?
17. Have you seen any evidence of suicidal thoughts, such as statements that your teen wanted to be dead, etc?
18. Do you suspect that you have had money or other valuables missing from your home?
19. Are you concerned that your teen’s behavior is a threat to his safety and well-being?
20. Does your teen seem to lack self-esteem and self-worth?
21. Do you have a lack of trust with your teen?
22. Is your teen angry or displaying temper outbursts?
23. Does your teen have problems with authority?
24. Does your teen engage in activities you don’t approve of?
25. Do you think your teen is using or experimenting with drugs and/or alcohol?
26. Are you concerned about your teen’s well-being and future?
27. Does your teen seem to be in constant opposition to your family values?
28. No matter what rules and consequences are established, does your teen defy them?
29. Are you exhausted and worn out from your teen’s defiant or destructive behaviors and choices?
30. When dealing with your teen, do you often feel that you are powerless?
Your Total Score is: _______
18+ Checks = HIGH RISK!
– Get help! – Find a residential facility that you feel comfortable with.
9-17 Checks = BORDERLINE RISK
– The problems may be resolved by tightening up the Family Rules and Structure. However, a residential treatment facility may need to be considered if things don’t improve or if the situation worsens.
Up to 8 Checks = MODERATE RISK
– Tighten up family rules and be consistent with your monitoring. It is critical that you follow through. When you say something will happen, your teen must see it happen!
Please call if you have any questions regarding this teen assessment. We would love to visit with you and discuss these questions in greater depth if you have concerns. (800) 584 5005
Teen placement is always a difficult question. It can be very difficult to determine when and where to place your child in treatment. A good place to start this evaluation is to simply make a subjective assessment of their general emotional health. Mental or emotional health refers to ones overall psychological well-being. It includes the way one feels about oneself, the quality of their relationships, and their ability to manage feelings and deal with difficulties. Good emotional health isn’t just the absence of mental health problems. Being mentally or emotionally healthy is much more than being free of depression, anxiety, or other psychological issues. Rather than the absence of mental illness, mental and emotional health refers to the presence of positive characteristics. Sometimes when considering outpatient treatment parents ask themselves, “is my teen ‘bad’ enough to warrant treatment”. But maybe we should be asking, is our teen healthy enough to stay at home and deal with life as a young adult. Here are some of the abilities that a teen needs to live a productive life.
People who are emotionally healthy have:
- A sense of contentment.
- A zest for living and the ability to laugh and have fun.
- The ability to deal with stress and bounce back from adversity.
- A sense of meaning and purpose, in both their activities and their relationships.
- The flexibility to learn new things and adapt to change.
- A balance between work and play, rest and activity, etc.
- The ability to build and maintain fulfilling relationships.
- Self-confidence and high self-esteem.
These positive characteristics of mental and emotional health allow you to participate in life to the fullest extent possible through productive, meaningful activities and strong relationships. These positive characteristics also help you cope when faced with life’s challenges and stresses.