Who’s on the Team: Adolescent Treatment Professionals
This is a partial overview of the types of mental health professionals typically found in a private adolescent-treatment setting. There are other professionals—such as social workers, specially trained teachers, life coaches, and etcetera— who may also provide services in a treatment setting, but this is a description of those professionals most commonly participating directly in the adolescent treatment process.
Functions: The therapist’s role in treatment is to foster a therapeutic relationship based on safe boundaries, rapport, confidentiality, trust, and to deliver psychotherapy within the context of that relationship. Forms of psychotherapy may vary widely from a pathology-oriented approach to a more strengths-based approach and from in-office talk therapy to experiential equine-assisted therapy that takes place outdoors. Therapists may provide individual, group, and/or family therapy, and can offer assessment, treatment, and monitoring services as well. Often the therapist is the main contact between parents and the adolescent treatment program, and keeps the parents apprised of their child’s therapeutic process.
Types: Therapist credentials typically include a master’s degree plus a state and, less frequently, a national form of licensure. In some states, a psychotherapist may practice without a license.
Functions: Educational consultants help families select an appropriate treatment program for their child based on a combination of interview, review of academic materials, and psychological tests. In addition to placement, some consultants also provide mentoring, advocacy, and even therapy.
Types: The two main types of educational consultants are traditional consultants, who focus on academic placements, and special needs consultants, who focus on therapeutic placements. Consultants have diverse educational backgrounds, including special education, psychology, and others.
Functions: Addictions counselors are a highly specialized professionals. They may provide intervention services to get someone struggling with drug or alcohol (or another) addiction into treatment. They also provide specialized counseling, mentoring, and support.
Types: Traditional addictions counselors are versed in a 12-step approach and are in recovery themselves. Many are certified to provide this kind of treatment. More recently, however, professionals who are not in recovery are providing these services and many offer alternatives to the traditional 12-step approach.
While a psychologist may deliver a wide range of services from organizational change to psychotherapy, their typical roles within a treatment setting include supervision of clinical staff, patient assessment and treatment planning, clinical training, and delivery of psychotherapy. The clinical psychologist is often seen as the psychologically oriented counterpart of the medically oriented psychiatrist—and the two often work closely together on cases.
Types: There are many different types of psychologists, but the most relevant to a treatment setting is a licensed clinical psychologist. These professionals are trained to address the therapeutic needs of clients and to work in a clinical setting, such as a hospital, treatment center, or private practice. They possess both a license and a Ph.D.
The psychiatrist approaches behavioral, emotional, and neurobiological issues primarily from a medical perspective. While some also practice psychotherapy, their primary role is typically to provide medical assessment and medical treatment—including the prescription and monitoring of psychotropic medications. While a licensed, board-certified physician (and nurse practitioner) can prescribe drug-based psychotherapeutic treatment, it is recommended that this kind of treatment be provided by a practitioner who specializes in emotional or mental disorders, such as a psychiatrist.
Psychiatrists are MD’s who have specialized training in psychological, emotional, and neurobiological disorders.
Functions: In a treatment setting, nurses may serve a broad range of medical functions, including medication dispensing and monitoring, body weight assessments for eating disorders, and of course taking care of aches, pains, and medical emergencies. Some may monitor the detox process in addictions programs. Nurse practitioners may also prescribe certain medication (including anti-depressants) and/or monitor other current prescriptions.
Types: Nurse training and certification levels vary widely from LVN to RN to MSN to Nurse Practitioner. Some nurses have bachelor’s degrees and others have doctorates. Increased certification and training carries with it specific permissions to administer increased levels of care. Specialization varies widely too, from psychiatric to pediatric to surgical. Depending upon what other resources are available in a treatment setting, many programs hire a registered nurse for their wide range of general nursing capabilities.
Functions: Direct-care staff are generally responsible for 24/7 supervision of those in treatment. This supervision includes mentoring, skill-building, recreation, transportation, and crisis management. Many programs train their direct-care staff to implement milieu-based treatment approaches, such as DBT or group processing. Direct-care staff members are the core of a program’s treatment system, typically providing experiential opportunities for those in treatment to practice in real life situations what they are learning in the program.
Depending upon the type of program, direct care staff may include dorm staff, recreation staff, wilderness field instructors, milieu counselors, and shift-managers. Typically, direct-care staff members have at least a bachelor’s degree often with plans to pursue graduate-school training and a career in a mental health field.