Adolescent Intensive Outpatient Program (AIOP)
Mental health is as important as physical health. It is not always obvious when a teenager is struggling emotionally, but recognizing the symptoms early and enrolling them promptly in effective treatment is important for long-term wellbeing.
Our Goals
The AIOP is a short-term program (about 10 weeks), providing an increased level of clinical contact (9 hours/week). We provide intensive services to patients currently in outpatient treatment, with the intention of stabilizing intense emotion dysregulation that results in impulsive, life-threatening behaviors. Our goal is to prevent hospitalization, keeping teens (and families) at home and engaged in their communities.
For teens who are beginning to develop severe mood dysregulation or other impairing mental health symptoms, our program can be a step-up from routine outpatient services or serve as an initial point of entry into mental health treatment. Our program also provides step-down services to hospitalized patients, as a transition to more traditional outpatient care.
What is Dialectical Behavioral Therapy (DBT)?
Dialectical behavior therapy (DBT) is a state-of-the-art, evidenced-based form of cognitive behavior therapy, with a significant amount of research demonstrating its effectiveness. Dialectical behavioral therapy for adolescents (DBT-A) is a version of DBT specifically designed for teenagers and their families/guardians. DBT-A is utilized in our AIOP (DBT-informed) and Adolescent Comprehensive DBT Program.
DBT-A has been used to help teenagers struggling with non-suicidal self-injurious behaviors, suicidal behaviors, depression, anxiety, frequent mood swings, impulsive/disruptive behaviors, inappropriate anger, family and peer conflicts. At the core of many of these problems is emotional dyscontrol - difficulty with managing intense emotions - which results in impulsive, problematic behaviors.
Teens participating in DBT-A learn how to effectively practice mindfulness – being fully present in the moment and understanding the signs of unregulated emotions - before exploring a variety of related skills focused on understanding and regulating emotions, learning to manage/tolerate suffering and crisis without acting on impulses, maintaining satisfying relationships while ending destructive relationships, increasing self-awareness and interpersonal problem-solving. Teens and parents/guardians also learn how to validate one another, how to compromise and negotiate, and how to practice seeing the other’s perspective.
Weekly Schedule
Skill-Learning Groups: Parents/guardians and teens are divided into separate groups to introduce core DBT skills each week. Topics include: Emotion regulation, coping, problem-solving, distress tolerance, mindfulness, dialectical thinking, skills to effectively change behaviors and validation. (2 hours for teen, 2 hours for parent/guardian)
Process Groups: Teens will have one session each week where they can guide discussion, support one another, and practice interpersonal effectiveness, facilitated by therapists. (1 hour)
SWIM – Skills Work: Implementation and Mindfulness: In DBT, teens are taught to “ride the [emotional] wave.” In this pair of groups, we focus on “learning to SWIM.” Rest assured; no actual swimming is involved. Mindfulness practice will help teens to maintain and reinforce new habits. Implementation groups involve exercises in identifying values and building resiliency alongside skill development. (2 hours)
- Teens attend 1 skill learning group, 1 process group and 1 SWIM session per week. Parents/guardians must attend 1 guardian group per week.
- In addition to groups, AIOP services include 2 hours of individual therapy sessions weekly, medication management appointments, and potentially parent/guardian coaching or family therapy, if indicated. Teen phone coaching is also available.
Download our AIOP brochure below to see a sample group schedule.
Please note: Group availability is dependent on current patient enrollment and the schedule is subject to change.
Who is Eligible?
Adolescents ages 12 through 18 with the presence of suicidal ideation and/or self-injurious behaviors, defined as any intentional harm to self, in addition to at least two of the following criteria:
- Psychiatric hospitalization(s) and/or emergency room visit(s) within the last 6 months
- Significant impairment and demonstrated decrease in functioning at home and/or school
- Moderate to severe symptoms of depression or anxiety or frequent mood swings
- Impulsive and/or risk-taking behavior
- Extreme emotional outbursts
- Chronic emotion dysregulation affecting home, school, extra-curriculars, or social life with peers.
As their family is an integral component to an adolescent’s wellness, family members or guardians are required to be involved in the program. At least one parent/guardian must attend the weekly AIOP guardian group.
Adolescent Comprehensive DBT Program
We also have a 6–12-month comprehensive DBT program for adolescents ages 12-18. Weekly patient contact remains increased from traditional outpatient therapy (about 3 hours/week), but is less than that required for the AIOP. Consequently, patients must be relatively stable from an outpatient perspective (i.e. not recently hospitalized or considering psychiatric hospitalization). We focus on decreasing intensity and duration – while increasing tolerance – of stressful emotions, as well as increasing validating practices at home and school.
This program is for teens and families looking for longer-term treatment to address underlying precipitators of life-threatening behaviors (i.e., trauma, identity issues, family conflict). Some of our teens who graduate from the AIOP, step down to the comprehensive program. The comprehensive DBT program is adherent to the research protocols that established evidence for the treatment's effectiveness and includes individual therapy, medical consultation, multi-family skills groups, phone coaching and options for parent/guardian coaching and family therapy.
The eligibility criteria for this program differ from the AIOP. Please call our intake coordinator for more information.
Why Choose Us?
- Most groups are held outside school hours. The teen continues to attend school and remain connected with extracurricular activities, sports, employment, friends and family while receiving treatment.
- The teen remains living at home during treatment, providing an opportunity to use learned skills with environmental stressors in real time.
- Patients may also work with a child and adolescent psychiatrist or psychiatric nurse practitioner for medication consultation and management as needed.
- Adolescents attend weekly individual sessions with a licensed therapist.
- Phone coaching outside of traditional clinic hours is available if needed.
- Family therapy is provided as needed.
- Parents/guardians will also be able to work on specific problem behaviors and goals by combining techniques learned in the skills group with direct parent/guardian coaching - offered on an as needed basis.
Our Team
All licensed clinicians in our programs have received intensive DBT training. Our clinicians meet regularly as a consultation team to support one another and think creatively about the best ways to help teens and their families.
Christopher Botash
Jessica Costosa-Umina
Patricia Woodruff
Abigail Gleason
Alicia Stoudt
Cariann Coward
Deborah Copes
Julie Kappil
Marci DeTorio
Matthew Weinerth
Shannon Kelley
Subhra Rath
How To Get Started
Parents/guardians, therapists, counselors, psychiatrists, and other health care providers may refer patients to the AIOP or Adolescent Comprehensive DBT Program. Providers within the Upstate healthcare system may also place an order through the electronic medical record. Families will be asked to participate in a screening interview with our intake coordinator and complete introductory paperwork.
We attempt to work with all insurance providers (including public and private options) to secure funding for treatment. You may have a co-pay/out-of-pocket cost depending on your specific insurance plan. Intensive Outpatient Programs (IOPs) are typically classified as a higher level of care by most insurance companies and will require approval before beginning the program.
All new patients will be given a comprehensive diagnostic evaluation by staff, in part to determine if one of our therapeutic programs is a good fit for the needs of the adolescent and their family. Once participants are admitted into a program, they are assigned an individual therapist who will work with them to create a treatment plan that is individualized, flexible and focused on stabilizing the problematic moods and behaviors.
Call the AIOP Intake Coordinator for more information at 315-464-2479.