How to Choose the Right Residential Treatment Center for Your Teen

Knowing how to choose a residential treatment center for teens can be challenging, especially for parents of adolescents who have been in and out of multiple programs with no success. However, some residential programs are truly committed to providing a compassionate treatment approach—you just have to know what to look for.

How to Choose the Right Residential Treatment Center for Teens: FAQs

When choosing a residential treatment center for teens, many parents, especially those who have been through other residential programs with their child with unsuccessful outcomes, often have questions regarding the effectiveness of different programs and therapies.

Below, we answer some of the most frequently asked questions about residential treatment centers for teens and also provide specifics about the residential treatment program at Compass Behavioral Health.

Program Policies

#1: Are teens with substance abuse issues combined into the same programs as teens with mood disorders who don’t have substance abuse issues?

Depressed and anxious teens are in a lot of emotional pain and can be highly influenced by their peers, which is why it’s important to ensure that teens with mood disorders aren’t exposed to conversations surrounding mood-altering substances such as marijuana or fentanyl.

While a profit-driven company will mainly care about getting “heads in beds,” regardless of whether certain clinical populations should be in the same program, a purpose-driven company will prioritize a therapeutic program environment, even if it means having a lower census at times.

Compass focuses on adolescents with mood disorders only—teens with substance abuse issues are referred to a separate substance abuse program.

#2: How do you guarantee that my child will not learn new maladaptive behaviors from their peers while in your program?

Contagion behaviors are a real issue in teen residential treatment. Many teens requiring residential treatment have significant identity dysregulation and are highly influenceable. A quality program should be able to describe its policies and procedures used to keep a program pro-recovery and should prevent teens from bonding around maladaptive behaviors and diagnostic labels.

As a DBT-LBC Certified Program™, Compass draws upon DBT-informed milieu management protocols. At intake, teens are oriented to STAT (stop talking about that) topics like self-harm, suicide, eating disorder behaviors, substance abuse, and more. They are coached to use language such as, “I am struggling with urges to engage in my target behavior,” and reinforced to ask for coaching. Compass has a high enough staffing ratio that we can provide one-on-one support for teens who need assistance with refraining from STAT talk and help with developing pro-skills communication. This protocol is vital in blocking the historical reinforcement our teens have received in the form of care and concern when emphasizing target behaviors.

#3: Do you track your treatment outcomes? If so, can I have access to that information?

It is now considered a standard of care to provide objective evidence of a program’s efficacy using standardized and validated research measures. Most programs provide these at intake and at discharge (before and after). Programs comply with this industry expectation by utilizing one or two measures that are easy to capture some gains on. While this practice glides over the benchmark, it’s inadequate for several reasons. A generalized measure of anxiety or depression will not tell you if trauma symptoms have remitted, if a child’s BPD symptoms have decreased, if emotion regulation skills have objectively improved, or if OCD symptoms have decreased. The larger the battery of assessments used, the easier it is to show the lack of gain in treatment.

Compass has utilized a comprehensive assessment battery, tracking treatment outcomes since 2015. This data has shown both our treatment strengths and the symptoms and diagnosis we have needed to do a better job treating, helping to inform our training institute curriculum. Two of the most important measures we utilize are the DERS, a measure of emotion regulation skillfulness, and the BIDS, a measure of identity dysregulation.

Clinical Qualifications

#1: Will my child be treated by a licensed therapist?

Residential programs have long controlled costs by utilizing unlicensed clinicians, resulting in the treatment of some of the most complex psychiatric conditions by some of the most inexperienced clinicians.

Compass utilizes licensed psychologists, clinical social workers, and marriage and family therapists for clinical services.

#2: Can I confirm that the licensed therapist assigned to treat my child is certified in DBT?

Because dialectical behavioral therapy (DBT) has gotten a lot of celebrity press and has strong research outcomes, most residential programs advertise that they provide DBT. However, a weekend seminar in adolescent psychiatry isn’t enough training to make a psychiatrist competent in adolescent psychiatry—to show competency, they actually need to complete a two-year fellowship and then pass Child and Adolescent Psychiatry board exams. Similarly, a DBT-Linehan Board Certified Therapist™ has an intensive two-year training process that culminates with passing board certification as proof of competency.

Compass is the only DBT-LBC Certified Program™ in Southern California and employs the largest number of individually-certified clinicians.

#3: Can I confirm that the licensed clinician assigned to treat my child has had training and experience in treating my child’s diagnosis?

Residential treatment is often needed for complex psychiatric disorders that call for specialized training and certification beyond a graduate degree.

Below, we detail the specific disorders that Compass treats along with the specialized training our licensed clinicians receive to ensure your child receives the most compassionate and effective treatment.

Specialized Training and Experience of Licensed Clinicians at Compass Behavioral Health
Psychiatric Disorder	Specialized Training
Obsessive Compulsive Disorder (OCD)	Exposure and Response Prevention
Purely Obsessional OCD Subtype	Mindfulness-Based Cognitive Behavioral Therapy
Anorexia Nervosa	Management of Eating Disorders – Dialectical Behavioral Therapy (MED-DBT) Family-Based Therapy for Anorexia Nervosa supplemented by Radically Open-Dialectical Behavioral Therapy
Borderline Personality Disorder (BPD)	Dialectical Behavioral Therapy
Post-Traumatic Stress Disorder (PTSD)	Prolonged Exposure DBT
Treatment-Resistant Depression	Behavioral Activation, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Radically Open-Dialectical Behavioral Therapy
Anxiety	Cognitive Behavioral Therapy and Mastering Anxiety and Panic for Adolescents

Compass has a training arm, the Compass Research & Training Institute, that provides an average of 30 hours of continuing education to its clinical team annually. Training is provided by our in-house experts as well as internationally recognized subject matter experts. See individual clinician bios for a complete list of evidenced-based trainings your child’s therapist has been trained in.

#4: Do you provide families with the training backgrounds of your clinicians?

Both the Board of Psychology and the Board of Behavioral Sciences require clinicians to disclose their background and training to you prior to consenting to services—this is part of informed consent.

Compass clinicians provide a complete disclosure of all intensive trainings and certifications in their biographies on our website.

#5: Can you describe the average education and training of your floor staff? Do you have biographies online that I can read? Are you willing to share the average length of employment of your floor staff?

If you take away the floor staff, what you have left is a Partial Hospitalization Program (PHP). program. The floor staff members ARE the residential program. What makes residential so effective is the 24-hour availability of well-trained skills coaches who can effectively catch a teen in a skills breakdown and mentor them through to skills mastery.

Often, you won’t see the biographies of floor staff on a company’s website—this is largely because the average length of employment for a floor staff member is 6-12 months industry-wide. This is caused by poor pay, poor training, and understaffing due to high turnover. It is impossible to have a high-quality residential program with high floor staff turnover.

Understanding this central issue in residential programs, Compass opened with a radically different model. Not only are our floor staff required to have a bachelor’s degree, but they’re also required to commit to a 24-month training externship in DBT. Most of our Guides are currently in graduate school studying to be therapists. Our Guides complete a training curriculum, with intensives in DBT, CBT (Cognitive Behavioral Therapy), ACT (Acceptance and Commitment Therapy), and Mindful Self-Compassion. They have assigned weekly readings and weekly clinical supervision, and they participate in a Guide DBT Skills Training Group for their own skill development.

Program Components

#1: How many individual therapy sessions will my child receive per week?

Due to the acuity at a residential level of care, your child should have a minimum of two hours of individual therapy per week.

However, Compass provides three hours of individual therapy per week to create traction and make the most of your child’s time in the program.

#2: How many family therapy sessions per week does your program support?

At a minimum, a program should offer one family session per week.

Compass has built in three hours of family therapy per week in the form of two 90-minute sessions, allowing the entire family to obtain skills and improve communication and increasing the likelihood of retaining treatment gains after discharge.

#3: Does your program offer DBT skills training in a multi-family format so parents can learn skills too?

All adolescent DBT research is based on this model. If a program does not provide a DBT Multi-Family Skills Training group, they ethically cannot say they are providing DBT.

Core to our program at Compass is our Saturday Family Day programming, which starts with a group session that teaches essential DBT skills to parents and other family members.

#4: Does your program have a parent-only group to support parent effectiveness training?

Parents of highly acute teens who are suicidal, self-harming, or have eating disorders need support and specialized training in how to best help their child.

In evaluation feedback of our program at Compass, parents of teens who have graduated from our program have shared that the 90-minute weekly Parent Effectiveness Training was by far the most helpful treatment component, as it offered a critical level of support and training they needed in previous teen residential programs and never had access to.

#5 What evidence-based treatments does your program provide in its group programming components?

Acceptance and Commitment Therapy Group

#Adulting (Chores) Group

Art Therapy

Cognitive Behavior Therapy Group

Community Group

Dialectical Behavior Therapy Skills Group

Executive Functioning Coaching

Family Therapy

Attachment-Focused Multi-Family Group

Horticulture Therapy

Interpersonal Effectiveness Group

Individual Skills Coaching

Individual Therapy

Love Mapping

Mindful Cooking & Culinary Lab

Multi-Family Dialectical Behavior Therapy Skills Group

Mindfulness & Mindful Self-Compassion

Parent Effectiveness Training

Physical Fitness & Yoga

Sleep Hygiene Group

An effective program should be able to give you a schedule, clinical rationale, and research evidence for every group and activity built into that program.

In our program schedule at Compass, 25 years of research and experience specializing in suicidal teens can be found in each group and activity. Our brochure and website detail the research and clinical rationale for every component of our programming.

Proven Treatment Outcomes at Compass Behavioral Health

Many of the largest teen residential programs are owned by billion-dollar venture capitalist firms. That’s where we differ. Compass Behavioral Health is an employee-owned organization that fosters the mastery of DBT material in every one of our dedicated team members.

At Compass Behavioral Health, we treat depressed and anxious children and young adults with gold-standard, evidence-based treatments that create mastery, a sense of belonging, and a purposeful life. Our residential program is overseen by clinicians certified by the DBT-Linehan Board of Certification™, meaning only the most experienced therapists and medical staff will provide your child with individualized treatment at our employee-owned facility.

Cherie Mills

Executive Director at Compass. Licensed Marriage & Family Therapist (LMFT #40443) DBT-Linehan Board of Certification, Certified DBT Clinician™

Cherie has spent three decades working with adolescents struggling with depression, suicidal ideation, and other disorders. Her pursuit of strong treatment outcomes for suicidal youth led her to found Compass Behavioral Health. As Executive Director, Cherie oversees the implementation of Compass’ Mission Statement and adherence to its driving principles. Cherie is a DBT-Linehan Board of Certification, Certified DBT Clinician™ and has taught DBT at UCI Medical School since 2004. She served as the Director of the Advisory Board for Orange County Parenting Magazine and was a contributing writer. Cherie is proud to have been a 1999 nominee for the Mental Health Care Professional of the Year Award for Orange County. An avid mountaineer and globe-trotter, Cherie is on a continuing mission to carry a Compass summit flag to the highest peak on every continent on Earth. Three down, four to go.