No. 42; Updated May 2015
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Communities provide different types of treatment programs and services for children and adolescents with mental illnesses. The complete range of programs and services is referred to as the continuum of care. Not every community has every type of service or program on the continuum. Some psychiatric hospitals and other organized systems of care now provide many of the services on the continuum. When several of the services are provided, the organization may be called a health care system.
The beginning point for parents concerned about their child's behavior or emotions should be an evaluation by a qualified mental health professional such as a child and adolescent psychiatrist. At the end of the evaluation, the professional may recommend treatment and a service to help your child. Which treatments and programs the professional recommends may be influenced by what services are available in your community. The professional or you may be required to obtain approval from your health insurance company. For publi9cly funded programs, a specific state agency would authorize the recommended program(s) or service(s). If the program or service is not authorized, the cost of the program or service will be the responsibility of the child's parents. Parents can appeal the decisions of the insurance company but there is no guarantee an appeal will be successful.
Many of the programs on the continuum of care offer a variety of different treatments, such as individual psychotherapy, family therapy, group therapy, and medications. Types of programs in the continuum of care may include:
Office or outpatient clinic
Visits are usually 20-60 minutes. The number of visits per month depends on the child's needs. Visits may be focused on medication, psychotherapy, or both.
Intensive case management
Specially trained individuals coordinate or provide psychiatric, financial, legal, and medical services to help the child or adolescent live successfully at home and in the community.
Home-based treatment services
A team of specially trained staff go into a home and develop a treatment program to help the child and family.
Family support services
Services to help families care for their child such as parent training or a parent support group
Day treatment program
This intensive treatment program provides psychiatric treatment with special education. The child usually attends five days per week.
Partial hospitalization (day hospital)
This provides many of the treatment services of a psychiatric hospital, but the patients go home each evening.
24-hour-per-day services for emergencies (for example, hospital emergency rooms and mobile crisis teams).
Respite care services
A patient stays briefly away from home with specially trained individuals.
Therapeutic group home or community residence
This therapeutic program may be linked with a day treatment program or specialized educational program.
Crisis residence (acute residential)
This setting provides short-term (usually no more than 15 days) crisis intervention and treatment. Patients receive 24-hour-per-day supervision.
Residential treatment facility
Patients receive intensive and comprehensive psychiatric treatment in a campus-like setting on a longer-term basis.
Patients receive comprehensive psychiatric treatment in a hospital. Treatment programs should be specifically designed for either children or adolescents. Length of treatment depends on different variables.
Parents should always ask questions when a professional recommends psychiatric treatment for their child or adolescent. Questions to ask include:
- Which types of treatment are provided, and by whom?
- Over what length of time?
- What is the cost? How much of the cost is covered by insurance or public funding?
- What are the advantages and disadvantages of the recommended service or program?
Choosing psychiatric treatment along the continuum of care can be challenging because there are many factors involved. Parents should always feel free to obtain a second opinion about the best type of program for their child or adolescent and to ask why specific treatments are being recommended over others.
For additional information see Facts for Families:
#25 Where to Find Help for Your Child
#26 Understanding Your Mental Health Insurance
#32 11 Questions to Ask Before Psychiatric Hospital Treatment of Children and Adolescents
#41 Making Decisions About Substance Abuse Treatment
See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins)
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