Diagnosing Struggling Teens
Misdiagnosed behavioral and emotional issues are common among adolescents and young adults. Mental health diagnoses are relatively subjective and the data used to make them—behavioral observations in various settings, psychometric assessments, and self-reported symptoms—are often unreliable or incomplete.
“Our therapist chalked up Marnie’s dramatic outbursts to normal adolescent acting out. But they never got better, only worse. It wasn’t until she was 19 that we got an accurate diagnosis of borderline personality disorder. But it was too little too late. She’s non-compliant with treatment, so we’ve effectively missed our window to intervene as parents. We feel like we’ve lost our daughter.” ~Mark L.
Teen mental-health diagnostics are further complicated by the fact that adolescent neurology is in flux. Developmental changes can mimic, or sometimes obscure, the symptoms of actual psychological disorders. Teens are, therefore, particularly vulnerable to misdiagnosis.
Misdiagnosis, in turn, can lead to treatment approaches that are too aggressive, not aggressive enough, or wrong altogether.
For teens or young adults whose emotional or behavioral problems have been chronically misdiagnosed, a residential setting can provide ideal circumstances for diagnostic observation and assessment.
Residential treatment programs offer a controlled setting in which external factors are less likely to interfere with clinical observations. As a result, clinicians are better equipped to understand the young person’s baseline state of functioning, which is critical for accurate diagnostics.
In this controlled setting, the treatment team (teachers, activities staff, therapists, nurse, et cetera) have a 360 degree, 24 hour a day view of each student’s behavior. This allows clinicians to construct a complete diagnostic picture from the puzzle pieces of peer relationships, medication compliance, school behavior, sleep patterns, dietary habits, and affective patterns.
“After six months of erratic behavior—including two hospitalizations—our new psychiatrist took our daughter off of Prozac. The change was immediate and miraculous. Our Katie is back.” ~Susan P.
Finally, quality residential treatment programs have a consistent treatment team whose efforts are coordinated by a single clinical case manager. This case manager—whether the clinical director or team leader—is responsible for putting all the pieces together and applying a forensic approach to diagnosis, using information from all stakeholders as diagnostic data points.
A case management approach means that past assessments, parental insights, psychiatric analysis, and current observations from teachers, therapists, and other team members are integrated for a complete diagnostic picture.