Understanding Levels of Care: The Difference Between Outpatient vs. Inpatient vs. Residential Treatment

Treatment for teenage mental health, depression, teen anxiety, and other challenges takes time and care. Different stages of the healing process may require different levels of care. Therefore, it’s helpful to understand the difference between inpatient vs. residential treatment, as well as inpatient therapy vs. outpatient care.

Optimal treatment takes into account an adolescent’s individual needs and history, as well as their severity of their diagnosis. Following an in-depth assessment, experts can recommend the best approach for each phase of treatment. Hence, teens might receive treatment first in an inpatient mental health unit of a hospital, transfer to a residential setting, step down to an outpatient program, and then receive weekly therapy and/or attend support groups at a community teen mental health center.

Given all these options, it can be hard for parents to distinguish the difference, let alone understand what their child needs to recover. Let’s look more closely at the various levels of care.

Levels of Care: Outpatient vs. Inpatient vs. Residential

About one in five teens has a diagnosable mental health disorder, such as depression or anxiety. Treatment for these issues is much more likely to be successful when a teen is placed in the right level of care. The main levels of care include:

• Weekly therapy, online or in person; which may include medication prescribed by a psychiatrist or physician
• Outpatient programming—at an outpatient clinic or community mental health center.
• Inpatient care—in a psychiatric hospital or the psychiatric unit of a hospital, usually for no more than 30 days
• Residential care—in a homelike setting, preferably for 90 or more days.

Within those categories are more subtle differences. Let’s take a look at the difference between inpatient and residential treatment, as well as inpatient vs. outpatient mental health programs.

Download our chart detailing the different levels of care, the typical length of stay for each, and what they each provide.

Teen Residential Treatment Programs

Residential programs typically provide an educational component in addition to a structured schedule of clinical and experiential therapy. Teens attend individual, family, and group therapy, as well as Adventure Therapy, art and music therapy, yoga, and other approaches. Many of these modalities are typically not available in a hospital-based program.

Residential treatment programs are live-in healthcare facilities that provide a structured environment. A residential schedule for teens includes clinical care, experiential activities, and academics. While in residential treatment, clients live in a comfortable, homelike setting and are supervised by trained staff. Staff members include psychiatrists, therapists, counselors, nurses, dietitians, and experiential therapy practitioners.

As we have seen, residential care is usually the next step in a teen’s healing journey after inpatient care in a hospital. However, residential care is also appropriate for teens who are in outpatient care or weekly therapy but need more support than these options provide. Research shows that residential programs are an effective approach to treating teen depression, anxiety, substance abuse, and eating disorders. Furthermore, experts recommend at least 90 days of residential treatment for the most successful outcomes.

Integrated Residential Care

According to research, residential treatment is most effective when it takes an integrated approach—addressing all aspects of an adolescent’s well-being, including:

• Relational
• Social
• Educational
• Physical
• Psychological.

A review study of 10 years of research examined the outcomes of residential treatment for children and teens. The researchers found that the best residential treatment provides multiple modalities—for example, Cognitive Behavioral Therapy; Dialectical Behavioral Therapy; family therapy, such as Attachment-Based Family Therapy; and EMDR. In addition, most teen residential programs include academics. Teen treatment at Newport Academy includes a minimum of 30 hours of clinical and experiential therapy each week and about 20 hours weekly in academic study and tutoring.

Why Travel for Care?

Making the decision to enroll your teen in residential treatment can be difficult. It’s hard for parents to send their child away from home. However, the long-term benefits of this choice can be life changing. Research shows that the structure and ongoing support of a residential program is the most effective way to achieve long-term recovery from depression, anxiety, trauma, and co-occurring behavioral issues like substance abuse and self-harm.

Here are the top benefits of residential treatment and the reasons why this level of care provides the most impactful and sustainable healing for adolescents.

A fresh start in a new environment

Research shows that changing your environment entirely can be significantly beneficial for your mental health. Creating a geographical distance between their past and their future can help young people resolve old wounds, break habits that aren’t serving them, and make a new start. Equally important, stepping out of an unhealthy environment minimizes exposure to old trauma and anxiety triggers, as well as access to alcohol and substances. Without the distractions, difficulties, and responsibilities of everyday life—whether that’s school, family conflict, or peer relationships—teens can focus entirely on healing and growth, supported by a caring community of peers and mentors.

Access to the highest-quality treatment options

When researching mental health options, it’s natural to begin the search close to home. However, the best mental health treatment for an individual’s specific diagnosis and needs may not be available locally. In fact, as a result of the current shortage of mental health providers and treatment programs, the likelihood is that the right program won’t be in your immediate area. Making the choice to travel for care means that you have access to a broad range of options, including programs specifically designed to address teen mental health concerns. Learn the five top indicators of quality mental healthcare.

Authentic connections

For teens struggling with mental health issues, difficult relationships with peers are a major factor in depression, anxiety, and other mental health issues. Whether they’re experiencing bullying, mean girl behaviors, or struggles with siblings, relationship issues can have a tremendous negative effect on young people. In a residential program away from home, clients have the opportunity to build trusting relationships with peers who truly understand what they’re going through, in an environment that values honesty, openness, and mutual support. Young people experience—sometimes for the first time—what it’s like to be their full, authentic self.

Structure and self-care

There’s a difference between learning healthy behaviors and actually doing them on a daily basis in order to build a habit. In a residential treatment program, teen have a built-in structure that supports the development of new, positive habits. At Newport Academy, each client has a tailored treatment plan, with daily schedules that include ongoing individual, group, and family therapy; individualized academic instruction and tutoring; experiential activities; and time for self-reflection, creative expression, and connection with self and others.

New experiences

Treatment can be challenging—and healthy, supported challenge is a powerful path to growth and change. Experiential activities in particular build young people’s self-esteem, skills, and ability to navigate change and take healthy risks. The benefit comes from stepping outside the box within a safe, supported container that allows teens to push themselves in positive ways. Experiential activities at our teen residential locations nationwide range from sledding, zip lining, and snowboarding at our Minnesota locations to kayaking, surfing, and paddle boarding as part of our California programs.

A springboard to the next stage of growth

Teens and parents sometimes worry that taking time off school will create problems when they return from treatment. However, the best residential programs help clients close the gaps they may be experiencing in their education. At Newport, we help teens to build motivation and engagement with learning. When they go back to their home school, our alumni are better equipped to succeed, both emotionally and practically—with new organizational tools, stronger executive functioning, and enhanced resilience.

An investment in a bright future

Traveling for care results in better success rates, as long-term residential treatment (30–45 days minimum) is proven to yield higher rates of sustainable recovery. While the distance, time, and financial investment may seem daunting at first, there is nothing more important than your teen’s well-being. Don’t wait for symptoms to resolve themselves—the likelihood is that, without treatment, mental health and behavioral issues will get worse, not better. When it comes to mental health conditions and treatment, taking the steps to move from awareness to action can literally save a teen’s life.

“Results showed that children and adolescents with severe emotional and behavior disorders can benefit and sustain positive outcomes from residential treatment that is multi-modal, holistic, and ecological in its approach.”

—Journal of Child and Family Studies 

What’s the Difference Between Inpatient and Outpatient Treatment?

The main difference with inpatient vs. outpatient mental healthcare is that teens live at home while receiving outpatient vs. inpatient treatment that takes place while they are living at a hospital or a teen treatment center. However, outpatient treatment provides clients with many of the same clinical and experiential modalities they receive at a residential or inpatient facility.

Outpatient treatment for mental health conditions and substance use disorders varies in the level of structure and the number of hours of programming. Depending on the level of outpatient care, teens may attend their home school and go to outpatient are in the afternoon. Or they may spend the full day in outpatient care that includes an educational component. Let’s look at the various options for outpatient treatment.

Partial Hospitalization Programs

Teens in a Partial Hospitalization Program (PHP) live at home and receive treatment all day, five days a week, in an outpatient clinic or in a psychiatric hospital or the psychiatric unit of a hospital. PHP schedules are designed to help teens transitioning from residential treatment continue their recovery in a structured and secure environment.

A PHP typically includes:

• Group therapy
• Individual therapy
• Psycho-educational sessions
• Parent support groups
• Experiential activities, such as art, music, and Adventure therapy.

Intensive Outpatient Programs

Teen Intensive Outpatient Programs (IOPs) are similar to PHPs. But clients attend for fewer hours—three to four hours a day, up to five days a week. An adolescent IOP may be part of a hospital’s services or an extension of a residential program.

An Intensive Outpatient Program for teens includes:

• Individual therapy sessions
• Experiential therapies
• Group sessions
• Psychiatric and medical management
• Therapeutic activities such as yoga, meditation, creative arts, hiking, kayaking, and more.

Studies show that intensive outpatient treatment is effective for the underlying issues catalyzing depression, anxiety, substance abuse, and other mental health and co-occurring disorders. A teen can gradually decrease their IOP hours as they regain lost ground in terms of mental health, social-emotional development, and overall well-being. After completing a youth outpatient program, teens move from the IOP to a lower level of care, such as weekly therapy in a therapist’s office.

Continuing Care after Treatment

Whether a teen is in residential, inpatient, or outpatient treatment, continuing care after discharge is essential. Once an adolescent is on the path of healing, ongoing support and therapy help maintain health and well-being. Below are some options for continuing care.

Community Mental Health Centers: Many towns and cities have centers that provide therapeutic groups and educational sessions to help people stay in recovery. In addition, some mental health centers offer yoga and meditation classes, as well as other experiential approaches to maintaining mental health.

Private Practitioners: After residential and/or outpatient treatment, teens may work with a private mental health clinician. Regular individual sessions help adolescents to firmly establish new, healthy behaviors. Furthermore, family therapy sessions support families to build on new ways of connecting and communicating.

Support Groups: Parent support groups and teen support groups offer encouragement and the wisdom of peers. Some community mental health centers and other community centers offer ongoing support groups.

Alumni Support: Many residential and outpatient teen mental health treatment programs offer alumni programming after discharge. Special events, group activities, and get-togethers keep former clients connected so they can support each other on the journey of recovery.

Find the Right Level of Care: Outpatient vs. Inpatient vs. Residential

In summary, there are a number of important differences between what is inpatient and outpatient treatment, as well as inpatient vs. outpatient mental healthcare. Teens benefit from these various levels of care—inpatient, residential, and outpatient—as they progress through the recovery process. Ultimately, the right level of care can support young people to find sustainable healing, so they can successfully take the next steps into young adulthood and beyond.

To find the right level of care, the first step is an in-depth assessment by a mental health expert. Newport Academy’s experts offer confidential mental health assessments at no charge. One we understand what your family is going through, we can recommend the level of care that has the best chance of helping your teen heal. Contact us today to schedule an assessment.

Sources:

US Dept. of Health & Human Services

Psychiatr Serv. 2014 Jun 1; 65(6):718–726.

J Child and Family Studies. 2005 Dec;14(4):551–575.