Types of Treatment
There are many types of mental health treatment and the types of treatment and supports your child and family will receive and who you receive it from will be based on your child and family’s individual needs, the type of insurance you have, and other important factors.
Treatments take place in a variety of settings including out patient settings such as clinics or hospitals, community-based services such as treatment provided in your home school or the community; and inpatient settings such as hospitals, and residential treatment centers. Services should be provided in the ‘least restrictive environment’ which means your child will receive treatment within their normal daily environment such as home school and community when ever possible.
Listed below if a brief explanation of some of the many types of mental health services and treatment programs that may be available. The list is not inclusive of all mental health treatments but includes many that are widely used with children and youth.
No matter what treatments are being used; Treatment should:
- Have a specific goal and measurable outcomes so you know when it is or is not working
- Be evidence based, which means that research has shown that a particular treatment has proven to a positive effect for the children or young people who participate in it.
- Include you! You as a parent have the right to thoroughly understand what the purpose of the treatment is, how you will know if it is effective, and any potential adverse effects of treatment. You should also be given information about how you can best be involved in and support your child while receiving the treatment.
As a parent you have the right and responsibility to ask questions and let your child and family’s treatment team know when you feel a particular treatment/approach will or will not work for your child and family.
Types of Mental Health Treatment & Services
Assessments: Children’s mental health assessments may involve a variety of testing including: an overall health assessment, psychiatric evaluation and neurological, psychological, psychiatric, vocational or other types of testing or assessments that look at your child’s functioning across all environments such as the Child and Adolescent Functioning Scale or CAFAS.
Behavior Therapy – Behavior therapy is a broad term for treatment that focuses on children’s behaviors and the thoughts and feelings that affect it. Behavior therapists also look at how the environment might have an impact on those behaviors. The basic goal of behavior therapy is to reinforce the behaviors you want to see and to eliminate the behaviors you don’t want to see. Behavioral therapy uses rewards and consequences to help children change their behavior and has been found to be effective in improving behaviors at home, school and the community. During treatment, a therapist will work with your child and family to set behavioral goals for your child. In addition to helping with to create behavioral goals, family members also help by implementing the reward and consequence system. Rewards are usually small incentives or objects used to reward the wanted or positive behavior. Your child might also lose privileges for not meeting expectations, but the primary focus should be on reinforcing positive behaviors.
Case Management Services: A service available for children with serious mental health challenges where a case manager works to ensure that the family or person-centered planning process occurs and that a individualized plan of services and supports fits the needs of the child and family.
Child Psychiatry Services: Children and youth are referred to child psychiatrists for evaluation, consultation and, if needed, psychotropic medication.
Child Therapy: A broad term used to describe a variety of therapy methods provided by a child mental health professional used to help a child maintain or improve their mental and/or emotional functioning.
Cognitive Therapy: A type of therapy that can help your child to correct negative or distorted thinking that may lead to troublesome feelings and behaviors. It is often combined with behavioral therapy (described below).
Cognitive Behavior Therapy (CBT): A type of behavioral therapy that focuses on helping children and youth understand the thoughts and feelings that influence their behaviors. It is commonly used to treat a wide range of disorders including depression, anxiety and phobias. CBT teaches kids a different way of thinking, behaving and reacting to situations and can help them feel less irritable, anxious or fearful. CBT can also help young people recognize negative or unrealistic thoughts and turn them into more positive and realistic ones. CBT has been demonstrated to be one of the most effective treatments for youth with depression. It can teach a young person how to change their thoughts and behaviors so they can change the way they feel which can lead to a decrease in their depression. If your child is in CBT they will most likely be given homework to work on outside of their therapy sessions. You as a parent are critical to the success of CBT as you will be directly involved by helping your child to: practice their new way of thinking, use the techniques and strategies they have learned and by reinforcing those more positive and realistic thoughts outside of their therapy sessions.
Community Living Support: Are services and supports designed to support children and youth with significant mental health challenges to increase independence in the community through direct teaching, assisting, and training.
Counseling: Individual and group counseling sessions are provided by a trained counselor that can help children to cope with challenges in their lives, learn self-confidence and social skills, manage anger and emotions, and develop other positive life skills.
Crisis Residential Services: Short term, out of home placements intended to provide an alternative to inpatient psychiatric services for children who experience a sudden mental health crisis. Intensive Crisis Stabilization Services are used when the crisis lasts longer than 14 days. The residential crisis service provider will have to partner with you and education services to ensure your child receives school services while receiving crisis services.
Day Program and Activity Services: (often referred to as day treatment programs) are a combination of treatment and educational services that give children several hours a day of special activities that help them to deal with their emotional or behavioral problems. Day treatment may also include special education, counseling, parent training, vocational training, skill building, crisis intervention, and recreational therapy. The program lasts at least 4 hours a day.
Dialectical Behavioral Therapy (DBT): A therapy designed to help young people change patterns of behavior that are not effective, such as self-harm, suicidal thinking and substance abuse. DBT involves balancing acceptance and change and believes that acceptance is necessary for change and treatment focuses on the present moment and acceptance of the child in that moment. DBT assumes that young people are doing the best that they can, but are either lacking the skills they need to be successful or are being influenced by factors that reinforce their current behavior and interfere with their functioning. DBT focuses on mindfulness, awareness and improving social interactions to help avoid problematic behavior. The goal of DBT is to replace ineffective behaviors with skilled and practiced responses.
Emergency and Crisis Services: A group of services that are available 24 hours a day, 7 days a week, to help your child and family during a mental health emergency. Examples of crisis or emergency services might include a mobile crisis team (who could come and assist during a crisis in your home), telephone crisis hotlines, suicide hotlines, crisis counseling, crisis respite care and crisis residential treatment services. These services exist for times when you need help quickly, such as, when your child can’t calm down, is uncontrollable, or may be in sudden danger of hurting themselves or others. As parents, we can’t always plan for these situations but if we know there is a possibility that a mental health crisis may develop it is a good idea to create a crisis plan as a part of your treatment plan. A crisis plan will help you by listing the steps to take and people to contact if things do get out of control.
Exposure therapy: Is a type of therapy often used to treat anxiety disorders and phobias. It helps young people with strategies to manage their fears and worries in an effort to lower their level of distress when they encounter them. During exposure therapy the therapist will work with your child and gradually expose them to the thoughts, feelings, memories, things or situations that make them excessively anxious or worried. As their anxiety increases the therapist talks with your child about their fear and provides them with support, as well as, strategies (for example deep breathing exercises) to deal with their fear and help them to calm down. The hope is that eventually the fear will be reduced or eliminated and your child will have developed coping strategies to deal with whatever level of anxiety they may experience.
Family Therapy: is a type of psychological counseling designed to help improve the way a family functions together. During treatment, a therapist will work with your family to improve your communication, relationships and help you to reduce and resolve conflicts within your home. Family therapy is usually provided by a psychologist, clinical social worker or licensed therapist. The therapist or counselor will look at your family’s strengths and interactions and then help you to reduce conflicts and address issues through a variety of strategies including: building conflict resolution skills, providing parent coaching and guidance, and helping you to improve family interactions as a way to reduce problem behavior. Your specific treatment plan and the things you work on with the therapist will depend on your family’s situation. Family therapy sessions can teach you skills that can help you create strong supportive family connections which will help you to get through stressful times together, even after you’re done going to therapy sessions.
Group Therapy– Group therapy is a form of treatment where a small group of people with similar challenges meets regularly to talk, and discuss issues with each other and the group leader (usually a therapist). The general purpose of Group Therapy is to create a safe and comfortable place where participants can work out problems and emotional issues, gain insight into their own thoughts and behavior, and offer suggestions and support to others. Young people who have difficulty with friendships or other relationships can often benefit from the social interactions that are a basic part of group therapy.
Home Based Services: are intensive services provided in a familiy’s home and are considered an effective and essential service for children and youth with severe mental health challenges. The services provided in your home will be individually designed for your child and family and will focus on helping you and your child deal with specific behaviors or problems. Examples of the types of services that may be provided include: mental health therapy, crisis intervention and other support services needed by the family. The goal of home-based services is to prevent your child from being placed outside of the home.
Independent Living Services: Support for a young person living on his or her own.
These services include therapeutic group homes, supervised apartment living, and job placement. Support services are provided to teach youth how to handle financial, medical, housing, transportation, and other daily living needs, as well as providing assistance to the young people as they learn how to live and get along with others.
Individual Therapy: Also sometimes called psychotherapy or counseling. During individual therapy children and youth work one-on-one with a trained therapist to explore their feelings, behaviors and memories in a safe and caring, environment where they work to better understand themselves and others, set personal goals, and work toward the changes they would like to see in themselves.
In-Home Family Services: Mental health treatment and support services offered to
children and adolescents with severe mental health challenges and their family members in their own homes.
Inpatient-Mental Health Treatment: Treatment provided in a hospital setting where the child stays 24 hours a day. Inpatient hospitalization is sometimes necessary for children because of the severity of their mental illness or symptoms and is often used as an option for short-term treatment in cases where a child is in crisis or a danger to his/herself or others. It is also sometimes used for diagnosis and treatment and during medication changes or adjustments, to monitor worsening behaviors and symptoms and when a doctor feels a child cannot be evaluated or treated appropriately and safely in an outpatient setting. Before children are hospitalized, every effort should be made to provide crisis or outpatient services that meet their needs while they continue to live at home. There are times, however, when it may be in a child’s best interest to have hospital care. Stays are usually short, lasting from a few days to a few weeks.
Interpersonal Therapy: (IPT) is a short-term treatment for depression that helps the young person regain control of their moods and improve their daily functioning. To do this, the therapist works to engage the young person by showing empathy and helping them to feel supported and understood while helping them to address interpersonal issues. IPT was originally developed to treat depression in adults, but it has been shown to be effective in treating adolescent depression and is commonly recommended as a treatment for depression in children as well.
Medication Administration & Review: Services where a child is given a doctor-prescribed medicine or injection and is then monitored to watch for side effects and monitor dosage levels. Children and youth with mental health disorders are often treated with Psychotropic Medications, which are medication capable of affecting the mind, emotions, and behavior, many of which need to be monitored closely.
Multi-Dimensional Treatment Foster Care: (MTFC) The goal of MTFC is to decrease problem behavior and increase developmentally appropriate, pro-social behavior in children and youth who are in need of out-of-home placement. Youth come into MFTC through referrals from juvenile justice, foster care, or mental health and are placed in a treatment foster care home where treatment goals are reached by providing close supervision, fair and consistent limits, predictable consequences for rule breaking, a supportive relationship with at least one mentoring adult and reduced exposure to peers with similar problems. The program also provides behavioral parent training and support for MTFC foster parents, family therapy for biological parents, skills training for youth, supportive therapy for youth, school-based behavioral interventions and academic support and psychiatric consultation and medication management, when needed. The program uses the help of parents, teachers, individual and family therapists, a program supervisor, and others to help accomplish the goals. During the treatment process, youth are expected to progress through a three-level system of supervision, rules, privileges and rewards. This program is not readily available in all counties.
Multi-Systematic Therapy (MST): Is an intensive family and community-based treatment program available to youth with serious behavioral issues involved in multiple systems including the juvenile justice system. MST focuses on promoting behavioral changes in the youth’s natural environments by addressing the factor’s that affect them within their home, family school, neighborhoods, and social networks. MST understands that parents and other family members are valuable resources even when they may have multiple needs of their own and works to empower them by identifying family strengths, natural supports and by working with families to address the barriers they face. The team uses evidence-based therapies including cognitive behavioral therapy and other strategies during the treatment process. Families take the lead in setting their family’s treatment goals and the therapist provides support to help them to reach them. Common goals include reducing family conflicts, providing parenting resources and support, decreasing the youth’s involvement with negative peers and increasing association with peers who have a positive influence; improving coordination between family, schools, and other community agencies, as well as, increased assertiveness and problem solving skills for the youth and family. MST therapists also help the family implement strategies to set and enforce rules and curfews, improving school attendance and performance, and reduce substance abuse and the need for contact with law enforcement. Research has proven that MST is an effective alternative to incarceration for young people involved in the juvenile justice system and has been proven to be effective with the toughest youth offenders ages 12 through 17 even those with very a long history of arrests. Families who have received MST report increased family warmth and cohesion and decreased youth aggression with peers.
Mentoring Programs: Programs where an adult works with a young person intensively to increase healthy activity and involvement in school or the community.
Outpatient Services Outpatient services are the most commonly used services provided to children. They can be provided in community agencies, schools, homes, clinics or therapists and doctors offices located in the community. Outpatient treatment is usually the first treatment prescribed for children with mental health problems.
Outpatient Therapy: Individual or group counseling which usually takes place in an office setting.
Parent-Child Interaction Therapy: A type of therapy where a trained therapist works with you and your young child aged 2-8 in joint sessions to help improve your child’s behavior and create positive parent-child relationships. The therapist can help you to learn new and effective parenting and communication skills, positive discipline and other child behavior management strategies to support your child.
Parent Management Training: (PMT) is an addition to other treatments that involves educating and coaching you as a parent to manage your child’s problem behaviors at home and school by using the principles of learning theory and behavior modification. PMT helps parents develop the special skills needed to successfully support and maintain their children at home and in the community. These skills are sometimes described as ‘advanced child behavior management skills.’ The techniques taught are based on social learning and assist families in understanding how positive and negative behaviors are developed and maintained by their consequences.
Parent-to-Parent Support: Is not a type of therapy but rather a peer support service where parents with lived experience who have navigated public mental health and other service systems with their children are trained to support other parents as they work to navigate systems and meet their child and family’s needs.
Psychiatric Hospitalization: Short term, acute psychiatric care available when children and youth can no longer be managed in their home safely or those who are in need of 24-hour supervision.
Play Therapy: A form of therapy, typically used with young children, where the child plays in a protected and structured environment with games and toys provided by the therapist who observes the child’s behavior and conversation to gain insight into their thoughts and feelings. The therapist then works with the child to understand and work through any issues that come up through play.
Problem Solving Therapy: Is a therapy where the child or youth meets with their therapist to identify problems and strategize possible solutions. Once they choose a solution and try it out they look back and see if it actually solved the problem.
Psycho-education: Involves providing information to the youth and their family about their mental health disorder and the treatments and strategies used to manage its effect on their life. Being informed helps empower children, youth and their families and helps them to effectively manage their condition.
Recreational Therapy: A treatment/service designed to restore a young person’s level of functioning and independence in life activities they enjoy by promoting health and wellness and by supporting them by reducing obstacles to their participation in those activities.
Relaxation Therapy: A broad term used to describe a number of techniques used to reduce stress, eliminate tension throughout the body and help to create a peaceful state of mind. Relaxation Therapy has been shown to be effective for young people with anxiety and other disorders. Relaxation training can help a young person learn how to relax their mind and body by relaxing specific groups of muscles or by thinking of relaxing places or situations.
Respite Care: Is a type of family support provided by trained workers that allow families a temporary break from the day-to-day responsibilities of caring for a child with severe mental health challenges or other special needs. Respite care may be provided for a few hours or a few days, in or out of the home, depending on the need and availability of services in your community. Respite Care allows the family of a child with intensive needs, including mental illness a break from the responsibility of caring for their child for a brief time and can help to reduce stress and prevent out of home placements for youth with intense mental health issues & treatment needs.
Residential Treatment: An out of home placement in a residential treatment center that houses children and youth with significant psychiatric, psychological, behavioral, or substance abuse problems who have been unsuccessful in home and community based treatment and cannot be housed in treatment foster care, day treatment programs, and other non-secure environments but do not currently qualify for a stay in a psychiatric hospital or secure correctional facility. Residential treatment centers frequently offer a combination of treatment, therapy, and medication management, along with 24-hour supervision in a highly structured-environment. These facilities typically are less restrictive than an inpatient psychiatric unit, and are not licensed as hospitals.
Residential Treatment Centers: Facilities that provide treatment 24 hours a day and can usually serve more than 12 young people at a time. Children with serious emotional disturbances receive constant supervision and care. Treatment may include individual, group, and family therapy; behavior therapy; special education; recreation therapy; and medical services. Residential treatment is usually more long-term than inpatient hospitalization. Some are also known as therapeutic group homes.
Skill Building Assistance and Community Activities: These are activities that promote the integration of your child into the community. The therapist will assist your child to learn the skills they need to successfully be involved and engage in meaningful activities in their home, school and community.
Substance Abuse Treatment: Provides medical or therapeutic treatment to help your child if they are dependent on psychoactive substances such as prescription drugs, alcohol and street drugs like marijuana, cocaine, heroin or amphetamines.
Treatment Foster Care: Is a placement outside of a family home for youth with serious mental health treatment needs and difficult behaviors. Trained ‘treatment parents’ work with the youth in a treatment home to provide a structured and therapeutic environment while still allowing the child to live in a family-like setting. Treatment foster care parents are provided with training and regular supervision in their home to help support the youth in their care. TFC allows youth to get intensive treatment in the community with ongoing contact with their biological parents. Treatment Foster Care is the least restrictive out of home placement.
Therapeutic Foster Care: A home where a child with serious emotional disturbance lives with trained foster parents with access to other support services. These foster parents receive social support from organizations that provide crisis intervention, psychiatric, psychological, and social work services.
Therapeutic Group Home: Community-based, home-like settings that provide intensive treatment services to a small number of young people who require 24-hour-per-day supervision and support. The home should have many connections within an interagency system of care. Psychiatric services offered in this setting try to avoid hospital placements and help the young person move toward a less restrictive living situation.
Transition Services: Services that support young people as they leave the child and family serving systems and move into adulthood and the adult service systems. Help includes mental health care, independent living services, supported housing, vocational services, and a range of other support services.
Trauma-Focused Cognitive Behavioral Therapy: Is a specialty treatment designed for children who have experienced trauma. During TF-CBT, children and their families learn new skills to help process thoughts and feelings related to traumatic life events; manage distressing thoughts, feelings, and behaviors related to those events; and enhance safety, growth, parenting skills, and communication. TF-CBT has proven successful with children and adolescents who have significant emotional problems and symptoms of posttraumatic stress disorder, including fear, anxiety, or depression that are related to traumatic life events. Children or adolescents experiencing traumatic grief can also benefit from this treatment.
Wraparound: A process where community-based services “wrap around” children and families in their own home, school or community, to help meet their needs and help them live the life they have hoped and dreamed for. Wraparound is individualized to each child and family and the supports and services used will be based on the family’s strengths, needs, goals and desires and build upon their values, culture and beliefs. If you and your family are involved in Wraparound, a team approach will be used to develop a plan of services and supports to help you. You and the people you choose to be a part of your team will guide the group’s work. The planning process used to create your family’s Wraparound plan will be comprehensive which means it will look at all areas of your family’s life. The treatment you receive will be community based, which means it will be provided right in your home, school or community. The Wraparound process provides an unconditional commitment to your family’s success. If the plan or the support and services being provided are not improving the life of your family, the plan is changed. You and your team keep working together trying new ideas until you find what works. Wraparound may look a little different in communities across Michigan, but it must contain the basic components, values and principles listed above or it is not Wraparound.