Lessons Learned From Implementing a Transdiagnostic, Stepped-Care, Day Treatment Program for Adolescents

Mental health disorders are common in adolescents, yet most do not receive appropriate treatment. Some at-risk adolescents need more than traditional outpatient mental health services for stabilization and prevention of inpatient hospitalization. These adolescents may benefit from day treatment programs, which include intensive outpatient (IOP) and partial hospitalization programs (PHP).

There are few transdiagnostic day treatment programs for adolescents that span across both IOP and PHP levels of care. Therefore, lessons learned from the implementation of a novel transdiagnostic, stepped-care, day treatment program for adolescents are presented.

The current day treatment program serves adolescents ages 14-17 and their parents/guardians. Adolescents enrolled have a range of diagnoses and complete both PHP and IOP levels of care for a total of about 6-8 weeks. Adolescents attend the program 3-5 days each week for about 6 hours each day. Adolescents receive therapeutic content adapted from empirically supported treatments; they receive individual therapy, family therapy, group therapies, milieu therapies, medication management, and case management/care coordination from an interdisciplinary treatment team. Qualitative data from adolescents, parents/guardians, and staff were used to generate the lessons learned.

Ten lessons learned were generated. Lessons were identified related to preparing adolescents/families for the program, varying program content, encouraging skill practice, intervening on the family system, managing peer relationships, coordinating with schools, structuring mealtimes, monitoring risky behaviors, assessing safety, and fostering team relationships.

Many adolescents would benefit from greater access to day treatment programs, and these lessons may help practitioners who want to develop and/or iterate upon existing programs.