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Dealing with Teen Depression in a Residential Treatment Setting

Upon entering a residential treatment center, about 80% of adolescent girls have some form of anxiety or depression. Many of the behaviors we see in residential treatment mirror the behaviors at home upon admission: school avoidance, isolation, struggles with peer relationships, activity refusal, self-harm, suicidal ideation and disconnect from family.

I have encountered all of these behaviors and many more in my five years of working in residential treatment. The most effective tool, I have found, in treating teens with depression is relationship-based therapy. When a student enters treatment, it is important to build a relationship, show care, love and understanding for the student, and to build trust. During times when the student shows any of the above behaviors, relationships between the staff and student will allow the student to be emotionally supported and help them move past their destructive behaviors. Residential staff will have more influence with the student in asking them to participate in activities, group therapy sessions and school when they can show the student they care and understand.

Often times when students are self-harming or talking about suicidal ideation, it is more important to give attention to the emotions behind the behaviors. Students are more likely to be honest about what’s going on for them when staff members react with love and understanding. We want to keep the student safe and intervene as needed, but keep in mind the goal of allowing the student to heal by talking about what they are dealing with in the moment.

We find that many of the students that are admitted into our program stopped doing the things they loved months and sometimes years before beginning treatment. Residentially, it is important to provide opportunities to participate in old and new activities. Take all students on recreational activities, such as hiking, horseback riding, bowling, ice-skating, etc. Allow students to participate in team sports, such as soccer or softball. Provide opportunities for private lessons, such as singing, guitar, tennis, painting, etc.

Providing students with activities they can continue to do at home helps them to be successful by finding new, healthier peer groups and filling their time with healthy alternatives to past activities. Students will also need to find ways to reconnect with their families. Residentially it is important for the students to make weekly phone calls to their family, as well as writing and receiving letters from family members. The family should connect through family weekend and home passes. The residential staff also model positive relationships for the girls and their families.

In conclusion, the most important aspect of the depressed teen’s treatment will be positive relationships with the residential staff. The residential staff are on the front lines with the students. They are with them more than their therapist. They watch the student as they struggle and provide support throughout the process. They watch the student as they triumph and cheer them on. When a student feels genuine love from the residential staff, it brings about the greatest healing.

By, Lacey Collingsworth.  Lacey is a Residential Program Director at the Susan B. Anthony House