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Enhanced Outpatient Services
for Teens and Young Adults

Why AND How we are ready to support your family!

Coronavirus disease 2019 (COVID-19) has emerged as a global public health crisis with adverse physical and psychological health implications for millions of people worldwide. COVID-19 and efforts to quell its spread have resulted in significant disruptions to daily life, the education system, and health service delivery. Preliminary research suggest that these disturbances may have especially negative effects on the mental health of children and adolescents, as well as their parents and caregivers and we want to help!

According to Andrea Hussong, Licensed Clinical Psychologist, UNC professor and associate director of clinical psychology in the department of psychology and neuroscience, “our youth is in trouble”. Dr. Hussong has been studying the impact of COVID-19 on adolescents’ mental health for the last few years. According to Dr. Hussong’s research, deteriorating mental health in youth emerged in studies after the first few months of the pandemic’s onset, although youth vary greatly in their experiences of and responses to the pandemic. Studies that followed youth from before the pandemic to sometime in the first six months of the pandemic report increases in adolescent depression and negative effects but also little change or even decreases in anxiety, irritability and self-injury. As the pandemic has worn on, however, youth show more consistent elevations in anxiety, depression and stress. (Read more here.)

The WHY:

Depression has become increasingly common among American teenagers, especially teen girls, who are now almost three times as likely as teen boys to have had recent experiences with depression. In 2017, 13% of U.S. teens ages 12 to 17 (or 3.2 million) said they had experienced at least one major depressive episode in the past year, up from 8% (or 2 million) in 2007, according to a Pew Research Center analysis of data from the 2017 National Survey on Drug Use and Health. Teens express concern about anxiety and depression among peers, feel day-to-day pressures mounting, resulting in, seven-in-ten U.S. teens reporting anxiety and depression is a major problem among people their age in the community where they live, according to a Pew Research Center survey of teenagers ages 13 to 17 conducted in fall 2018. An additional 26% cited anxiety and depression as a minor problem. (Read more here.)

Children had more than 6,500 emergency department behavioral health visits in 2021, said the hospital in a recent news release, calling it “just the tip of the iceberg.” (Read more here.)

According to the American Academy of Child and Adolescent Psychiatry (AACP), here are some of the signs of depression to look out for in your child or teen:

  • Loss of energy
  • Feelings of guilt
  • Changes in sleep habits
  • Increased sadness and irritability
  • Changes in eating habits and weight
  • Lack of concentration
  • Feeling lethargic
  • Presence of suicidal thoughts or thoughts of death
  • No longer interested in things that used to bring joy
  • Low self-esteem
  • No longer wanting to participate in school activities
  • A decline in interest in school or friendships
  • Substance abuse (especially with teens)
  • Stomach aches or headaches (especially in children)

The AACP also states that the cause of depression is not always known. Sometimes depression can run in families. Sometimes it can be the result of bullying or spending too much time on social media, which can often result in feelings of inadequacy. Other issues such as learning disabilities, behavior problems, attention problems, or anxiety disorders can put a child at high risk for depression. It is very important for parents to look out for any signs of depression in their child due to possible thoughts of suicide or self-harm. According to the AACAP, children and teens are at an increased risk for suicide. We need to take teens seriously and seek professional help. The best treatment is an individualized combination of counseling, leaning new coping skills, understanding one’s unique body chemistry and family history of mental health concerns, and making improvements in self-care. Self-care includes decent nutrition, hydration, movement, a sense of belongingness and feeling understood and possibly medication.

In addition to the alarming statistics, just ask any therapist and you will find that the need for mental health care for children, teens and young adults has never been greater. The call to support teens and young adults in the Triangle area of North Carolina has implored the dynamic therapists at Lifeologie Counseling to meet the need. Many therapist also agree that working within our current levels of psychiatric and mental health care that are available for teens and young adults with private insurance (not Medicaid/Medicare/Tricare), is lacking. Below is the array of available services that may meet the treatment needs of teens and young adults. Hospitalization is the highest level of care and is available to anyone in emergent need.

  • Hospitalization – patients may be hospitalized for 1 – 10 days in a hospital facility for stabilization and psychiatric monitoring.
  • Psychiatric Residential Treatment Facility (PRFT) – is a residential treatment program, where patients are admitted for 30-120 days or more depending on insurance coverage and medical necessity.
  • Group Residential (group home) is treatment at home/community-like facility where patients can live for months to years.
  • Partial Hospitalization Program (PHP) provides 30 hours of group treatment at facility per week, 2-3 months maximum depending on insurance coverage and medical necessity.
  • Intensive Outpatient Program (IOP) provides 6 hours of group treatment at facility for adolescents, 9 hours for adults at the facility, usually offered 2 – 3 days per week.
  • Our service – Enhanced Outpatient Therapy (OPT+) – 1-3 sessions/week with a Licensed Professional (LP) and 1-3 sessions per week with an in-home skills coach/Qualified Professional (QP) who works with the individual and family.
  • Outpatient Therapy (OPT) – one 53-minute session usually once per week, usually in-office or via tele-health with Licensed Professional (LP) therapist.
  • Psychiatry – one to two visits with Psychiatrist or Psychiatric Nurse Practitioner or Physician’s Assistant per month or per quarter.

Enhanced Outpatient services includes traditional therapy and additional skill building, much like an in-home academic tutor works one on one with a student after school. Often, Outpatient therapy is offered 1-2 times per week in-office or via tele-health. For many people, this frequency meets the needs and goals. However, adding the in-home skills coaching and pairing that with regular family sessions helps the entire family system, allowing everyone to benefit from mindfulness, emotional regulation, distress tolerance and interpersonal skills.

The HOW:

Lifeolgie Counseling in Raleigh and Durham is offering a new service called Enhanced Out-Patient Therapy (E-OPT), which provides 1-3 sessions/week with a Licensed Professional (LP) and 1-3 sessions per week with an in-home skills coach/Qualified Professional (QP), using an informed Dialectical Behavior Therapy approach. This service offers structured, one-on-one, strength-based support services for adolescents and young adults for the purpose of improving emotional regulation, mindfulness skills, interpersonal skills, and distress tolerance.

We offer three levels of Enhanced Outpatient Services at Lifeologie Counseling:

High – therapy and skills coaching offered 6+ sessions/week for minimum of 6 months.

Moderate – therapy and skills coaching 4 sessions/week for minimum of 4 months.

Low – therapy session 1/week and skills coaching session 1/week as agreed upon with the team.

The number of weekly sessions and hours will vary depending on the level the client’s guardian chooses AND is clinically appropriate. Our Licensed Professionals and Qualified Professional skills coaches use an informed Dialectical Behavior Therapy approach. Each professional successfully completes training in delivering DBT skills training. DBT is an effective treatment for people who have difficulty controlling their emotions and behaviors. DBT aims to replace problem behaviors with skillful behaviors. DBT skills help people experience a range of emotions without necessarily acting on those emotions. DBT skills help teens navigate relationships in their environment (family/school/ peers). DBT helps people create a life worth living.

Our professionals teach skills in 5 areas to teens, young adults, and their caregivers:

  1. Mindfulness Skills – Teens are not always aware of what they are feeling, why they get upset, or what their goals are. They also have trouble staying focused and mindfulness skills training can help.
  2. Emotional Regulation Skills – teens sometimes experience fast, intense mood changes and report having little control over their emotional state. Some teens experience mood-dependent behaviors, which can be impulsive and not well thought out in terms of the potential consequences.
  3. Distress Tolerance Skills – teens often report that they act without thinking it all through, even escaping or avoiding emotional experiences to try to help themselves.
  4. Interpersonal Skills – Some teens experience a pattern of difficulty keeping relationships steady, getting what they want while keeping their self-respect. This can lead to loneliness and isolation which in turn feeds depressed thoughts and resulting negative beliefs.
  5. Walking the Middle Path – teens are well…teenagers! They sometimes have extreme thinking, feeling, and acting like the world is all or nothing. They sometimes approach their world absence of flexibility; have difficulty navigating family conflict without going to extremes. Walking the middle path helps teens to better understand the nuances of life, stressors and emotional states.

Dialectical Behavior Therapy has a large body of evidence that demonstrates effectiveness and is a highly recommended treatment for mood disorders, anxiety and much more. Studies included in this evidence review demonstrated that use of DBT for youth with suicidal thoughts and behaviors was associated with reductions in one or more of the following outcomes: Suicidal ideation, Self-harm (non-suicidal), Self-harm (intent unknown), Suicide attempts. DBT has shown efficacy when delivered to individuals, families and groups. DBT has been used with promising results in a wide range of settings, including intensive outpatient programs, regular outpatient care, and psychiatric inpatient units. (Read more here.)

Teen depression, anxiety and other psychiatric diagnoses affects how a teenager thinks, feels and behaves, and it can cause emotional, functional and physical problems. Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings; they’re a symptom of clinical depression and hopelessness. Teen depression isn’t a weakness or something that can be overcome with willpower, it can have serious consequences and requires treatment. (Read more here.)

We want to provide the care you are seeking! We want to support your teen and family to feel better and move toward health and wellness. Please give us a call to find out more. Contact Lakiyah “Ky” Gillard, Enhanced Outpatient Program Coordinator, for a free consultation. Ky can answer any questions you may have about the services, fees and get you connected with a team right away!

Request an appointment here.