THE CHILD AND ADOLESCENT PROGRAM (CAP)
Adolescent Diagnostic and Family Treatment Unit (ADFTU)
Welcome to the Adolescent Diagnostic and Family Treatment Unit
The Adolescent Diagnostic and Family Treatment Unit in Belmont, Mass., provides structured 24-hour psychiatric treatment in an unlocked setting for vulnerable adolescents, ages 13 to 19, with complex psychiatric and psychosocial issues who require clinically intensive care.
In this acute residential treatment setting, we foster a therapeutic community that encourages motivated adolescents to reflect on their problems and find new ways of managing their lives. We are here to understand and assist troubled teens, helping them establish effective and lasting ways to navigate the challenges they face within their families, schools, social relationships and communities.
The program offers a full range of services, including assessment and diagnosis, psychopharmacology, family therapy, specialty consultations (adoption, trauma, educational placement, developmental disorders, addiction) and outpatient treatment recommendations. It serves as an alternative to or step-down from an acute inpatient hospitalization.
We operate year-round, offering treatment during the summer and the school year.Our Leadership and Staff
Sue Mandelbaum-Cohen, LICSW, Clinical Director
Bryan Pridgen, MD, Medical Director
A multidisciplinary staff of child psychiatrists, neuropsychologists and psychologists, licensed clinical social workers, primary care nurses, expressive art therapists, clinical educators and mental health specialists work as team to provide all treatment. Clinical staff have special training and expertise in the broad range of issues that create difficulty in the lives of adolescents and their families. They also have experience working with patients of diverse sociocultural and linguistic backgrounds.
Challenges Facing Today’s Teens
Adolescence is a period characterized by a variety of biological, psychological and social changes. Managing these changes can be stressful for both adolescents and their families. They sometimes lead to psychiatric and psychosocial issues that require professional care. Some of the most difficult challenges faced by today’s adolescents include:
- Depression and anxiety
- Peer victimization/bullying
- Internet addiction/technology dependency
- School avoidance
- ADHD and disruptive behavior disorders
- Sexual orientation/gender identity
- Suicidal ideation
- Trauma—physical, sexual or emotional abuse
- Complicated/delayed grief
- Developmental and learning disorders (i.e., Asperger’s Syndrome, language-based and non-verbal learning disabilities, executive function difficulties)
- Eating disorders (anorexia, bulimia, binge-eating)
- Obsessive compulsive disorders, body dysmorphic disorders
- Substance abuse
- Parent-child conflict/adjustment to changes within the family
Assessment and Care
Each adolescent receives a complete psychiatric and psychosocial assessment and evaluation. An individualized treatment plan is then designed. When necessary, further assessment, consultation, or both are obtained to address unique issues. Parents are actively involved in the initial assessment and all treatment decisions.
We use multiple clinical methods in tandem with a therapeutic environment to help adolescents develop the skills needed to manage emotions, distress and relationships. Teens learn about themselves by interacting with their peers in groups and the classroom and by living together in a community. Personal responsibility and motivation for change are key elements of the treatment orientation. This requires a commitment to personal safety and the safety of others. Through a strong partnership with caregivers, adolescents determine the most helpful strategies and behaviors for managing their feelings, impulses and actions.
Program and Services
The McLean Adolescent Diagnostic and Family Treatment Unit, located in the Academic Center building and on the second floor of East House, provides a full spectrum of care. Residential treatment service is available to adolescents who require 24-hour care, seven days a week. Service is in an unlocked setting, maximizing each teen’s responsibility and capacity for self-control. Groups and structured activities involve team building, preparing meals, and recreation. These activities enhance daily living skills and provide a sense of autonomy and membership in a community.
Teens are helped by:
- Individual therapy to identify strengths and challenges and explore relationships with family and peers.
- Cognitive behavioral therapy to identify the relationship between thoughts, emotions and actions and learn strategies to overcome negative behaviors.
- Dialectical behavioral therapy to learn coping skills to deal with emotionally overwhelming circumstances, interpersonal conflicts and self-destructive urges (for adolescents prone to self-destructive behaviors and suicidal thoughts). DBT aids in helping teens learn the precursors and triggers to feelings of distress and other ineffective coping patterns, as well as teaching them to replace ineffective coping strategies with effective ones. Teens learn how to regulate their emotions, avoid self-destructive behavior and improve interpersonal relationships.
- Group therapy five days a week to discuss interpersonal problems and learn coping skills. Using multiple clinical approaches—psychodynamic, cognitive, dialectical behavioral, psychoeducational and expressive arts—rather than a single approach is the most effective way to help adolescents.
- Family therapy to identify and address specific problems experienced by the entire family system.
- Psychopharmacology to assess the need for medication. All adolescents receive a thorough diagnostic evaluation by a child psychiatrist.
- Wellness and fitness groups to enhance both body and mind.
Extended Treatment and Aftercare
Adolescents generally stay in the program for 10 to 14 days with services covered by most commercial insurance plans. If there are outstanding needs that do not fulfill medical necessity criteria set forth by private insurers, however, treatment may be continued for an additional two to four weeks, depending on specific needs and circumstances. Private payment is required for extended care.
Reasons for an extended stay may include the following:
- Extended assessment and diagnostic evaluation in a structured clinical setting
- Medication trials that require an extended period of observation
- Intensive family therapy and psycho-education for parents
- Intensive acquisition of skills to manage self-destructive behaviors
- Neuropsychological testing
- School/academic consultation
- Structured community while awaiting long-term therapeutic residential placement
The treatment team collaborates with adolescents, their families, schools, outpatient healthcare providers and community agencies to promote the smoothest possible transition from the therapeutic milieu back to their neighborhood school and community.
Payment and Insurance
McLean accepts many insurance plans. Families should contact their insurance carrier, employer or McLean Patient Accounts at 617.855.3311.
Information and Referral
For further information or to make a referral, contact Gale Norway or Colleen Zagwyn at 617.855.2800.
The McLean Adolescent Diagnostic and Family Treatment Unit can be reached directly at 617.855.2743.
About McLean Hospital
U.S. News & World Report named McLean America's #1 Hospital for Psychiatry in 2013 . McLean Hospital is the largest psychiatric facility of Harvard Medical School, an affiliate of the Massachusetts General Hospital and a member of Partners HealthCare. For more information about McLean visit us on www.facebook.com/ McLeanHospital or follow the hospital on Twitter@McLeanHospital.