Understanding Mental Health Referrals From Child Protective Services
Research shows that two out of three children in the United States will experience at least one traumatic event before the age of 16 years.¹ Understandably, this can have a negative impact on a child’s mental and emotional health.
For children who have experienced trauma, Child Protective Services (CPS) offers a vital service. When a child’s living environment is risky for their development, CPS may step in to provide protection, including mental health care.
Mental health referrals from child protective services are designed to connect at-risk youth with appropriate support. This is regardless of whether they remain in their homes, are placed in foster care, or move into a residential program.
For teens in distress, these services can be life-changing. They offer structured emotional support, skill-building, and healing opportunities during an especially vulnerable time. Understanding how these referrals work can help families, caregivers, and professionals access the right kind of care.
This guide aims to help you understand mental health referrals from Child Protective Services by exploring:
- What mental health referrals from CPS are
- How CPS collaborates with mental health services
- The basics of court-ordered therapy for teens
- Types of trauma care for children in protective services
- How Mission Prep can help families after Child Protective Services involvement
What Are Mental Health Referrals From Child Protective Services?
CPS mental health referrals are often a formal part of a child’s safety plan, meaning they are expected to be followed through as part of keeping the child safe and supported. That said, while CPS aims to protect children, the process itself can be difficult for children.
Research suggests that, because of this difficulty, emotional and physical safety should be emphasized. A sense of belonging, self-actualization, and emotional support are just as important as securing food and shelter for a child.²
A CPS mental health referral can happen for many reasons, but it’s most common when emotional or behavioral concerns are linked to:
- Abuse: Physical, emotional, or sexual abuse
- Neglect: Lack of basic care, supervision, or emotional attention
- High-conflict family environments: Where ongoing hostility, domestic violence, or instability affects the child’s sense of safety
When CPS makes a referral, it usually follows a detailed assessment. For example, caseworkers typically look at the youth’s:
- History: Past CPS involvement, medical records, or previous mental health treatment. Research shows that teens previously part of the CPS system sometimes give birth to children who also become part of the system.⁴
- Current behavior: Sudden changes in mood, aggression, withdrawal, or self-harm risk. Studies suggest that child abuse is one of the frequent risk factors for self-harm.⁷
- Emotional state: Signs of anxiety, depression, fearfulness, or detachment, and so on. Research also shows that depression and anxiety could be signs of early child maltreatment.⁸
How CPS Caseworkers Conduct an Assessment
To gather information, caseworkers often speak with teachers, medical providers, relatives, or therapists who know the child well. They may also review school attendance records, academic performance, or disciplinary reports.
If an assessment shows concerning patterns, for example, symptoms of post-traumatic stress or frequent panic attacks, CPS may connect the family with mental health providers who can address these issues.
The aim is to treat immediate symptoms and give the child tools and support for long-term stability. Depending on the need, this could mean outpatient therapy sessions, specialized programs for emotional regulation, or inpatient care in a safe, structured environment.
By making the referral part of the official safety plan, CPS ensures that mental health care becomes a priority alongside physical safety.
How CPS Becomes Involved
Referrals may start with a report from a school, hospital, law enforcement agency, or community member who notices signs of emotional distress or unsafe conditions. For example, a teen who frequently misses school, shows sudden behavioral changes, or discloses abuse to a trusted adult might prompt an investigation.
If CPS determines that mental health support is necessary to protect the child’s well-being, they initiate the referral process.
These referrals can take several forms:
- Outpatient counseling with licensed therapists specializing in trauma, attachment, or adolescent mental health.
- Inpatient treatment for CPS-involved families when safety concerns, self-harm risks, or severe psychiatric symptoms require a controlled environment.
- Specialized programs, such as DBT for teens under CPS supervision, to address high-risk behaviors or emotional dysregulation.
In some cases, the referral is paired with other interventions, such as parenting classes or supervised visitation, to address both the child’s and the family’s needs.
How CPS Collaborates with Mental Health Services
The CPS referral process for mental health treatment is rarely one-directional. It’s an ongoing partnership designed to make sure a child’s needs are consistently met over time. In other words, once a referral is made, CPS remains involved. They don’t control therapy sessions, but can help coordinate services, monitor progress, and ensure the care plan is working.
This coordination can include regular communication between CPS caseworkers, therapists, school counselors, and, when appropriate, the family. Updates are shared with proper consent so everyone involved knows how the child is doing and whether the treatment plan needs adjusting.
What this looks like in practice depends on the type of care, but the following is a general overview:
- Outpatient therapy: CPS may track attendance, request written progress reports, and meet periodically with the therapist to discuss goals and barriers.
- Residential treatment for CPS-referred teens: Caseworkers often collaborate directly with clinicians at the facility to address trauma, attachment challenges, and education, making sure no part of the teen’s development is overlooked.
- Foster care youth: Mental health programs and CPS often work together to provide consistent emotional support for CPS-placed teens, helping ensure placements remain stable and transitions are handled with care.
Families can expect these collaborations to be structured but flexible. If a teen isn’t engaging in therapy, shows new symptoms, or needs a different type of intervention, CPS can quickly revisit the plan. For instance, they might connect the youth to additional or more specialized services before problems escalate.
This proactive approach is one of the most important ways CPS helps protect not just a child’s immediate safety, but their long-term emotional well-being.
What You Need to Know About Court-Ordered Therapy for Adolescents
Court-ordered therapy for adolescents is sometimes the outcome after CPS involvement, particularly if a judge determines that mental health treatment is necessary for the child’s safety, rehabilitation, or family reunification. In these cases, therapy is legally mandated, and the child, caregiver, or both may be required to participate.
Types of Therapy Often Recommended
- Individual counseling for CPS case youth: To process trauma, address behavioral concerns, and develop healthy coping skills. Sessions often focus on helping the teen identify triggers and understand how past experiences affect current behavior. This type of therapy can increase emotional resilience and provide tools to handle stress in healthier ways. Individual psychotherapy is also recommended for CPS involved parents to provide emotional support and resources.³
- Family therapy after Child Protective Services: To rebuild trust, improve communication, and establish safe home environments. These sessions create a structured setting where difficult conversations can take place with the guidance of a trained therapist. The goal is to resolve past conflicts and give families strategies they can use to maintain a stable and supportive home long after CPS involvement ends. Research indicates that when families are struggling with child behavioral issues, CPS in-home family therapy is sometimes recommended and provides positive outcomes.⁵
- Group therapy programs: To strengthen social skills, reduce isolation, and provide a peer support network. Sharing experiences with others who have faced similar challenges can help teens feel less alone and more understood. ⁶ Hosted by a therapist, group sessions often include skill-building activities that promote empathy, cooperation, and mutual encouragement.
Court orders may specify the type of treatment needed. For instance, if a teen self-harms, the court may require DBT for teens under CPS supervision due to its focus on emotional regulation and distress tolerance.
The therapy process is monitored, meaning progress reports are submitted to the court or CPS to ensure participation and track outcomes. Failure to comply with court-ordered therapy can have serious consequences, potentially delaying reunification or resulting in further legal action.
Attending sessions consistently and working collaboratively with therapists fulfills legal
Trauma Care for Children in Protective Services
Children in protective services often have a complex history of trauma. To avoid triggering negative emotional and physical responses, trauma care should be evidence-based and adaptable to each child’s experience. Some trauma-informed therapies include:
- Trauma-focused cognitive behavioral therapy (TF-CBT): Helps youth reframe distressing experiences and develop healthier thought patterns.⁹
- Attachment therapy after CPS intervention: Supports children in rebuilding trust and forming secure relationships with caregivers.¹⁰
- Eye Movement Desensitization and Reprocessing (EMDR): Effective for PTSD treatment for CPS youth, targeting the lingering effects of trauma on the nervous system.¹¹
- Play therapy: Provides a non-threatening way for younger children to express emotions and process difficult events.¹²
In some cases, trauma care takes place in residential treatment for CPS-referred teens, where therapists can offer intensive, structured interventions in a stable environment.
In other cases, outpatient therapy paired with consistent caregiver support can be equally effective. The key is matching the treatment to the child’s developmental stage, personality, and needs.
Mission Prep: Advice on Family Therapy After Child Protective Services
CPS involvement can be overwhelming for families. It often brings a mix of relief, fear, and uncertainty about the future. One of the most effective tools for navigating this period is family therapy after child protective services. These sessions create a safe environment for honest communication, repairing fractured relationships, and setting healthy boundaries moving forward.
Mission Prep specializes in supporting families in transition, including those coping with CPS cases.
If you are navigating the CPS referral process for mental health treatment, we can help you understand your options, prepare for therapy sessions, and advocate for the right level of care, from outpatient counseling to residential treatment for CPS-referred teens.
Reach out to Mission Prep today to learn how we can help your family heal, rebuild, and thrive after CPS involvement.
References
- Lawrence-Sidebottom, D., Huffman, L. G., Beam, A. B., Guerra, R., Parikh, A., Roots, M., & Huberty, J. (2024). Rates of trauma exposure and posttraumatic stress in a pediatric digital mental health intervention: Retrospective analysis of associations with anxiety and depressive symptom improvement over time. JMIR Pediatrics and Parenting, 7, e55560. https://pmc.ncbi.nlm.nih.gov/articles/PMC10933721/
- Wilson, S., Hean, S., Abebe, T., & Heaslip, V. (2020). Children’s experiences with Child Protection Services: A synthesis of qualitative evidence. Children and Youth Services Review, 113, 104974. https://www.sciencedirect.com/science/article/pii/S0190740919311697
- Yoo, H., Racorean, S., & Barrows, V. (2020). Psychotherapy for child welfare cases: Clinicians’ and parents’ perspectives. Child & Family Social Work, 25(4), 775–784. https://www.researchgate.net/publication/339982745_Psychotherapy_for_child_welfare_cases_Clinicians’_and_parents’_perspectives
- Brown, E. C. B., & Lowry, S. J. (2022). Re-referrals to Child Protective Services for children born to young parents. Child Abuse & Neglect, 123, 105387. https://www.sciencedirect.com/science/article/abs/pii/S0145213421004567
- Heath, G. H., Fife-Schaw, C., Wang, L., Eddy, C. J., Hone, M. J. G., & Pollastri, A. R. (2020). Collaborative problem solving reduces children’s emotional and behavioral difficulties and parenting stress: Two key mechanisms. Journal of Clinical Psychology, 76(7), 1226–1240. https://pubmed.ncbi.nlm.nih.gov/32107782/
- Wanlass, J., Kelly Moreno, J., & Thomson, H. M. (2006). Group therapy for abused and neglected youth: Therapeutic and child advocacy challenges. Journal for Specialists in Group Work, 31(4), 311–326. https://www.tandfonline.com/doi/pdf/10.1080/01933920600918808
- McEvoy, D., Brannigan, R., Cooke, L., Butler, E., Walsh, C., Arensman, E., & Clarke, M. (2023). Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. Journal of Psychiatric Research, 168, 353–380. https://www.sciencedirect.com/science/article/pii/S0022395623004557
- Li, X., Tu, L., & Jiang, X. (2022). Childhood maltreatment affects depression and anxiety: The mediating role of benign envy and malicious envy. Frontiers in Psychiatry, 13, 924795. https://pmc.ncbi.nlm.nih.gov/articles/PMC9709293/
- Pollio, E., & Deblinger, E. (2017). Trauma-focused cognitive behavioural therapy for young children: Clinical considerations. European Journal of Psychotraumatology, 8(suppl. 7), 1433929. https://pmc.ncbi.nlm.nih.gov/articles/PMC5965038/
- Pereira, M., Sedes, L., Gadéa, E., & Shankland, R. (2025). Enhancing foster care relationships through attachment-based intervention: The SAFE Families study protocol, a randomized controlled trial of the Circle of Security Parenting Program®. BMC Psychology, 13(1), 107. https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-025-02424-6
- Rolling, J., Fath, M., Zanfonato, T., Durpoix, A., Mengin, A. C., & Schröder, C. M. (2024). EMDR-teens-cPTSD: Efficacy of eye movement desensitization and reprocessing in adolescents with complex PTSD secondary to childhood abuse: A case series. Healthcare, 12(19), 2421. https://pmc.ncbi.nlm.nih.gov/articles/PMC11476079/
- Clausen, J. M., Ruff, S. C., von Wiederhold, W., & Heineman, T. V. (2012). For as long as it takes: Relationship-based play therapy for children in foster care. Psychoanalytic Social Work, 19(1), 43–53. https://www.researchgate.net/publication/254374075_For_As_Long_As_It_Takes_Relationship-Based_Play_Therapy_for_Children_in_Foster_Care
