From Outpatient to Inpatient Care: Referrals From Outpatient Therapists for Teens
When teens need mental health support, the first line of treatment is usually traditional outpatient therapy. This is typically delivered as weekly sessions where teens can talk to a therapist, learn coping skills, and work through overwhelming challenges.
For many teens, outpatient care is enough to help them recover. But sometimes progress slows or symptoms worsen – even with consistent effort. This is when referrals from outpatient therapists for teens can make a difference. These referrals connect families to a higher level of care where safety, structure, and specialized treatments can provide more focused and structured support.
At Mission Prep, we understand how stressful it can feel when a therapist suggests that outpatient care is no longer enough. But it may be comforting to know that inpatient care doesn’t replace outpatient therapy; instead, it builds on it. With the right inpatient programs for therapy-referred adolescents, teens receive more intensive care, families gain support, and outpatient therapists remain part of the recovery team.
If your child has been referred from outpatient to inpatient care, a mental health professional can help you better understand what this means and what the process looks like. This guide can also improve awareness of referrals from outpatient therapists for teens, as it explores:
- What referrals from outpatient therapists for teens are
- The signs a teen needs inpatient treatment
- Common types of inpatient programs for therapy-referred adolescents
- How Mission Prep can help with intensive programs for teens who are not improving in traditional therapy
What Are Referrals From Outpatient Therapists for Teens to Inpatient Care?
When a therapist has worked with a teen for some time but notices that symptoms are not improving, they may recommend a higher level of care. Referrals from outpatient therapists for teens usually happen after careful discussions with the adolescent and their family.
A referral is not a failure of therapy or due to a lack of motivation from a teen. It is recognition that more intensive support is needed to keep the teen safe and moving forward in recovery.
These recommendations often lead to inpatient programs for therapy-referred adolescents. Inpatient care provides 24-hour support, structured therapeutic activities, and evidence-based interventions that go beyond what can be achieved in weekly outpatient sessions. In these settings, teens are removed from daily triggers, given space to recover, and introduced to therapies that may be more effective at this stage of their healing.
When therapy recommends residential treatment, it is usually part of a continuum of care. This means that the outpatient therapist may stay involved, often sharing background information and clinical insights that help inpatient clinicians understand a teen’s history. This ensures mental health continuity from therapist referral so the transition feels like the next step in a longer plan rather than starting over.
Partnership Between Outpatient and Inpatient Care: What Does This Look Like?
The connection between outpatient and inpatient providers is one of the most important parts of the referral process. A strong partnership between outpatient and inpatient care allows teens to continue their recovery with consistency, while families can feel reassured that their child’s progress is carried forward.
For example, outpatient therapists usually provide clinical notes, share insights about a teen’s triggers and strengths, and remain a resource for the inpatient team. Inpatient clinicians then communicate back with outpatient providers about goals, progress, and what to expect when a teen transitions home. This collaboration feeds into integrated care models for adolescent mental health, where both settings work together rather than separately.
The connection between outpatient and inpatient care also helps reduce the chance of relapse. For instance, if a teen has stabilized in an inpatient setting but the outpatient therapist knows they struggle during school transitions, this information can guide discharge planning. Further, if a teen makes progress in trauma-focused inpatient care for counselor referrals, those new skills can be reinforced in outpatient sessions once they return home.
In a nutshell, the goal of collaborative care is consistency, with both inpatient and outpatient providers supporting the teen’s recovery.
Signs a Teen Needs Inpatient Treatment
Parents often ask how they can tell when outpatient therapy is no longer enough. While every teen is different, there are common warning signs that may point toward the need for inpatient care. Recognizing these signs early can prevent repeated crises.
The signs a teen needs inpatient treatment may include:
- Safety concerns: If a teen talks about suicide, engages in self-harm, or shows aggression that puts themselves or others at risk, outpatient therapy may not provide sufficient support. These are often the clearest signs a teen needs inpatient treatment.
- Escalating symptoms: When therapy does not bring improvements or when symptoms like depression, anxiety, or trauma responses intensify, families often need teen mental health escalation solutions that include inpatient care.
- Difficulty functioning: Teens who stop attending school, withdraw from friends, or lose the ability to manage daily life may benefit from the stability that inpatient care provides.
- Treatment resistance: When traditional therapy methods are not working, intensive programs for teens not improving in therapy may introduce new approaches and closer monitoring.
As previously mentioned, these signs do not mean a teen has failed at therapy – or that they’re not trying hard enough. They show that the level of care likely needs to be adjusted. At Mission Prep, we remind families that seeking more support is a proactive step forward.
Common Inpatient Programs for Therapy-Referred Adolescents
There are many different types of inpatient programs, each designed to meet a teen’s specific needs. However, when therapy recommends residential treatment, the referral usually considers which approach will best address a teen’s situation. This can help guide families and professionals’ choices when it comes to the most suitable options for care.
For instance, the following are some of the most common therapy options:
DBT and CBT for Treatment-Resistant Teens
Two of the most widely used therapies in teen mental health treatment are dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT). When outpatient therapy alone is not helping, DBT and CBT for treatment-resistant teens can provide more structure and accountability.
- DBT focuses on teaching skills for managing emotions, handling stress without harmful behaviors, and building healthier relationships.¹
- CBT helps teens recognize and change unhelpful thought patterns that fuel depression or anxiety.²
These therapies are often included in evidence-based care for referred adolescents because they are research-driven, practical, and adaptable to inpatient settings.
Trauma-Focused Inpatient Care for Counselor Referrals
Some teens experience significant trauma that influences nearly every part of their daily life. Traumatic events may include abuse, neglect, serious accidents, bullying, or witnessing violence. These experiences can leave adolescents feeling unsafe, reactive, or emotionally shut down.
Trauma-focused inpatient care for counselor referrals provides safe and structured environments. In these settings, teens can begin to process their experiences with trained clinicians who understand the impact of trauma on the developing brain.
These programs often include several evidence-based therapies. One of the most widely used is Eye Movement Desensitization and Reprocessing (EMDR). EMDR helps the brain reprocess traumatic memories so they are less overwhelming.³ During EMDR, a therapist guides a teen through recalling painful experiences while using side-to-side eye movements or other forms of bilateral stimulation. Over time, the emotional charge of the memory decreases, and the teen can recall it without the same intense distress.
Other approaches include trauma-focused cognitive behavioral therapy (TF-CBT), which teaches teens how to recognize and change thoughts connected to trauma responses, and mindfulness practices that build self-awareness and calm.⁴ Inpatient care also opens the door to expressive therapies like art, music, or movement.
Research shows that art therapy and similar approaches provide non-threatening ways for teens to share feelings that may be difficult to put into words.⁵ These programs can help teens develop trust, become more resilient, and learn healthy coping strategies by addressing trauma directly.
Long-Term Residential Programs for Referred Youth
Some adolescents need more time to heal. Long-term residential programs for referred youth provide extended care that can last months or longer. Research shows that starting this type of treatment early can help minimize the negative consequences of mental health challenges later in life.⁶ Plus, these long-term programs allow teens to continue their education while receiving ongoing therapy and clinical oversight.
This type of care is often recommended for teens with complex diagnoses, repeated hospitalizations, or little progress in shorter programs. Though committing to long-term care may feel daunting, it can give families the stability and relief they have been searching for.
Family Therapy Post Referral
Healing isn’t something that a teen has to do alone. In fact, their family members have an important part to play in their recovery. This is why family therapy is recommended in most instances. These sessions help parents and siblings improve communication, set healthy boundaries, and support their teen’s progress.
Family therapy also ensures that when a teen returns home, the environment is supportive and consistent with the skills learned in treatment. Without family involvement, progress can be difficult to sustain.
Contact Mission Prep for Advice on Intensive Programs for Teens Not Improving in Therapy
At Mission Prep, we help families choose treatment options that suit the teen and their circumstances. Our team can explain what different treatments involve, answer questions, and help both the teen and parent feel comfortable with the next step.
We know that referrals from outpatient therapists for teens can feel intimidating. Yet these referrals are opportunities for more targeted care. This might mean emotional stabilization for therapy-referred youth, trauma-focused inpatient care for counselor referrals, or inpatient programs that emphasize DBT and CBT for treatment-resistant teens.
Our commitment is to offer integrated care models for adolescent mental health so families never feel left to manage the transition process on their own. Every referral, every program, and every therapy is one more step toward a steadier and healthier future. If you’re wondering whether your teen may need a higher level of care and how to manage this, reach out to speak with a professional at Mission Prep today.
References
- Fleischhaker, C., Böhme, R., Sixt, B., Brück, C., Schneider, C., & Schulz, E. (2011). Dialectical behavioral therapy for adolescents (DBT-A): A clinical trial for patients with suicidal and self-injurious behavior and borderline symptoms with a one-year follow-up. Child and Adolescent Psychiatry and Mental Health, 5(1), 3. https://pmc.ncbi.nlm.nih.gov/articles/PMC3037874/
- Halder, S., & Mahato, A. K. (2019). Cognitive behavior therapy for children and adolescents: Challenges and gaps in practice. Indian Journal of Psychological Medicine, 41(3), 279–283. https://pmc.ncbi.nlm.nih.gov/articles/PMC6532387/
- Gainer, D., Alam, S., Alam, H., & Redding, H. (2020). A flash of hope: Eye movement desensitization and reprocessing (EMDR) therapy. Innovations in Clinical Neuroscience, 17(7–9), 12–20. https://pmc.ncbi.nlm.nih.gov/articles/PMC7839656/
- de Arellano, M. A. R., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-focused cognitive-behavioral therapy for children and adolescents: Assessing the evidence. Psychiatric Services, 65(5), 591–602. https://pmc.ncbi.nlm.nih.gov/articles/PMC4396183/
- Riley, S. (2001). Art therapy with adolescents. Western Journal of Medicine, 175(1), 54–57. https://pmc.ncbi.nlm.nih.gov/articles/PMC1071468/
- Hirot, F., Huas, C., Durand, D., & Godart, N. (2021). The evaluation of therapeutic residential care for adolescents and young adults in France: A systematic review. Frontiers in Psychiatry, 12, 609365. https://pmc.ncbi.nlm.nih.gov/articles/PMC8173203/