When your child is struggling emotionally or behaviorally, it’s natural to feel unsure about where to start. Children’s mental health care exists on a continuum, ranging from outpatient therapy to 24-hour hospitalization. Understanding these levels of care can help you choose the right support and feel more confident in your decisions.
- Outpatient Therapy (Least Intensive)
- What it is: Weekly or biweekly sessions with a therapy provider, either in person or through telehealth.
- Who it’s for: Children with mild to moderate symptoms who are safe at home and in school.
- Who provides it: There are many types of therapy providers, including Psychiatrists (MD/DO), Psychologists (PhD/PsyD), Licensed Clinical Social Workers (LCSW), Licensed Professional Counselors (LPC/LMHC/LCPC), Licensed Marriage and Family Therapists (LMFT), Board Certified Behavior Analyst (BCBA) . Explanations of the roles of these clinicians and their training may be found in a separate post!
- Services may include:
- Individual therapy
- Family therapy
- Please note, there are many modalities of therapy. This is covered in a separate post!
- Outpatient Medication management
- What it is: biweekly to monthly sessions with a prescribing clinician, either in person or through telehealth
- Who it’s for: Children with moderate to severe symptoms who are safe at home and in school.
- Who provides it: Psychiatrists (MD/DO) and Psychiatric Mental Health Nurse Practitioner (PMHNP; possibly DNP or PhD), and in some states (not Pennsylvania), Psychologists (PhD)
- Services may include:
- Prescribing of psychiatric medications (see more information about medications in other posts by Dr. M)
- Regular appointments to monitor symptoms and side effects
- Bloodwork and monitoring of growth, vital signs
- Intensive Outpatient Program (IOP)
- What it is: Structured therapy several days a week for a few hours at a time. The child continues to live at home.
- Who it’s for: Children with moderate to severe symptoms requiring more than weekly therapy but not full-day treatment. These youth still attend school, and they attend IOP after school multiple days per week.
- Services may include:
- Group therapy
- Emotional regulation skills
- Family support sessions
- Partial Hospital Program (PHP)
- What it is: Full-day therapeutic programming during school hours, M-F, with the child returning home each evening.
- Who it’s for: Children with severe symptoms needing daily structure and psychiatric care but not 24-hour monitoring. These children may be having difficulty attending school and/or engaging in their typical daily activities, but they are not at imminent risk of harming themselves or others.
- Services may include:
- Daily group and individual therapy
- Integrated school support
- Medication management
- Inpatient Hospitalization (Most Intensive for Crisis)
- What it is: 24-hour care in an age-appropriate hospital setting for immediate safety and stabilization. Child and adolescent units are are locked for safety and security reasons; approved adult family members are permitted to visit during select visiting hours. These units are typically staffed by psychiatrists, social workers, behavioral health technicians, and nurses. Daily phone calls to parents/caregivers are permitted.
- Who it’s for: Children in crisis, at risk of harming themselves or others, or unable to be safely cared for at home.
- Services may include:
- Crisis stabilization
- Continuous 24/7 monitoring
- Rapid psychiatric evaluation and treatment, including medication management
- Daily group and individual therapy
- Coordination with school and outpatient treatment providers
- Family meetings
- Typical inpatient hospitalizations last for 3-10 days
- When discharged, children should be stepped down to a lower level of care (like PHP, IOP, outpatient medication management, or therapy) upon discharge.
- Residential Treatment (Most intensive for longer term care)
- What it is: Live-in care with a combination of therapy, education, and skill-building over weeks or months.
- Who it’s for: Children whose needs cannot be met at home but who are not in immediate crisis.
- Services may include:
- Individual, group, and family therapy
- School programming
- Life skills and coping strategies
Care plans are flexible — children may move between levels as their needs change.
How to Choose the Right Level?
You do not have to choose alone; please seek guidance from a mental health professional.
When deciding, mental health professionals look at:
- Severity of symptoms
- Safety risks
- Daily functioning at home and school
- Available supports
If you are concerned that you or your child is unable to remain safe at home due to imminent risk of harm to self or others, please call or text 988, or go to your nearest crisis center or emergency room. Select counties in Pennsylvania have mobile crisis services available – these teams can come to your home to help assess risk and determine next steps.
Final Thought: The right level of care meets your child where they are today, while building skills for tomorrow. You’re not alone — help is out there, and the right match can make all the difference.
