What providers working with teenagers need to know.

Most common mental health disorders have an onset in childhood or adolescence, with the peak incidence occurring during adolescence. The earlier the intervention, the more successful it will be! If we can get teens help early on, we can avoid the progression of mental illness. Prevention and early intervention are critical to deeply helping individuals with mental health challenges. 

Last year, 46,000 teens in Colorado who needed SUD treatment did not receive it.

Suicide is the 2nd leading cause of death among youth in Colorado.


17.05% of Colorado’s teens endure at least one major depressive episode within a year.

Over 1/4 of Colorado’s youth report not having an adult they can talk to if they are struggling.

Mental Health Screenings can support early intervention

About mental health screenings

A mental health screening is a way to catch mental health conditions early. If the screening shows signs of a disorder, more testing is usually needed to diagnose a specific mental health disorder. We recommend pediatricians screen annually for depression and anxiety in their teen clients. Using these screening tools may increase the effectiveness of identifying mental illness in your clients. (Please note: these assessments may only be conducted by a licensed healthcare professional, with some requiring specialized training):

Diagnostic Interviews

Diagnostic interviews are structured assessments that gather information about the teen’s symptoms and mental health history. Examples of diagnostic interviews include the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) or the Structured Clinical Interview for DSM-5 (SCID-5).\\

Behavioral Assessments

Behavioral assessments gather information about the teen’s behavior and functioning in different settings, such as at home, at school, or with peers. Examples of behavioral assessments include the Child Behavior Checklist (CBCL) and the Behavior Assessment System for Children (BASC).

Cognitive Assessments

Cognitive assessments measure the teen’s cognitive abilities, such as memory, attention, and problem-solving skills. Examples of cognitive assessments include the Wechsler Intelligence Scale for Children (WISC) and the Delis-Kaplan Executive Function System (D-KEFS).

Trauma Assessments

Trauma assessments evaluate whether the teen has experienced trauma and assess the impact of trauma on the teen’s mental health. Examples of trauma assessments include the Child and Adolescent Trauma Screen (CATS) and the Trauma Symptom Inventory for Children (TSIC).

Substance Use Assessments

Substance use assessments evaluate the teen’s substance use and any related problems, such as withdrawal symptoms or legal issues. Examples of substance use assessments include the Substance Abuse Subtle Screening Inventory (SASSI) and the Adolescent Drug Abuse Diagnosis (ADAD) instrument.

Family Assessments

Family assessments gather information about the family’s history, relationships, and dynamics. Examples of family assessments include the Family Assessment Measure (FAM) and the Family Environment Scale (FES).

According to MOTT Children’s Hospital, 40% of parents struggle to tell the difference between teen depression and normal mood swings. To distinguish between normal mood swings, a clinician will examine three critical areas of concern: Intensity, duration, and domains in which intensity occurs.

If a teen has ongoing and intense symptoms, the best course of action is to access a comprehensive mental health assessment from a professional. Early diagnosis and early treatment dramatically improve clinical outcomes. 


Teen angst is:

  • Very specific
  • Stress-related
  • Often related to a realistic concern
  • Comes in waves
  • Brought on by insecurity
  • Temporarily disrupts life

Mental illness is:

  • Not very specific
  • Not related to any particular event
  • Persistent
  • Brought on regardless of self-esteem
  • Continuously disrupts daily activities

Normal teen experiences:

  • Struggling to make decisions
  • Feeling stuck
  • Confusing outside approval for self-worth
  • Feeling shame
  • Overthinking or worrying

Teen emotions:

It is developmentally appropriate for teens to experience emotions at a greater scale than any other age group. They are going through intense hormonal changes and do not have the prefrontal cortex development to process that intensity. Everything feels like a big deal to them because everything IS a big deal to them! 

Teen completing virtual IOP program

Criteria for medical stabilization

We recommend the Society for Adolescent Health and Medicine guidelines for determining if your patient may need admission for medical stabilization. If your patient meets any of the criteria included here, please call your local children’s hospital, local detox center, or medical unit for a consultation. 

  • The client is not physically safe and cannot keep themselves safe without someone with them at all times.
  • The client is in active psychosis or experiencing delusions that significantly interfere with their ability to function and remain safe.
  • The client is actively suicidal (expressing plan and intent)
  • The client is actively homicidal (expressing plan and intent)

We use emergency rooms as a last resort. They are not often trauma-informed, are expensive, and usually cannot keep clients for any sustained period of time. They are good at providing emergency stabilization, but it is not permanent or a long-term solution. 

Language is important when talking with struggling teens and their families. Here are some guidelines for when you are working with struggling families.

Keep it simple

  • Use the least amount of words to make your point.
  • Have a routine. Make it easy for the teen to predict what will happen during your time together.


  • Do what you say you will do. 
  • If a teen breaks a rule, even if they are usually well-behaved, follow through on the consequence every time.
  • Teens will learn that what you say matters and will listen when you speak.

Consistently set context

  • Give clear expectations before you do any new activity.
  • Before making a transition, clarify what, how, why, and where something is happening.
  • Is there unstructured time? Let them know what the space should look and feel like during that time. 

Stay on their team

  • Make sure the teen knows you have their back. You are on their team. You are not against them. 
  • If you feel like you’re not on their team, reschedule or postpone your time with them.


Teens are still learning how to express themselves

They will need help in getting it all out. Here are some tips on how to support them.

Believe the teenager

When a teen says, “You don’t get it,” believe them. It is vital for a teen to feel seen. When they feel seen, they begin to trust that they can share honestly. This is important if they need help or find themselves in a scary situation. 

Keep it short & sweet

A good guideline with teenagers is to share about 1/2 of what you want to say with them. We don’t recommend you share your own opinions or boundaries until they have gotten it all out. While they are talking, repeat what you heard them say, using their exact words. This will help them know you are actually listening to them.

Ask non-judgemental questions

Ask teens if there is more they want to share. Use empathy skills such as “I imagine if I were you, I might feel___. Are you feeling anything like that?”

Frequently Asked Questions 

Does virtual therapy work?

Yes. Research has shown that online therapy is as effective as in-person treatment. It can also reduce numerous barriers to treatment, including scheduling issues and the logistics and cost of transportation. Moreover, many people feel more comfortable receiving mental health treatment in a familiar and safe space.

What are the benefits of seeking therapeutic services at Antelope Recovery compared to seeing a mental health provider for individual therapy?

Antelope Recovery provides comprehensive and individualized treatment programs for the whole person. Our supportive and structured environment helps the teen stay engaged with treatment. Our groups not only allow teens to learn and practice new skills but also reduce stigma and provide solidarity that people experience in the presence of their peers. By working with families, we create long-lasting and durable transformations. 

What do I do if my patient has tried mental health treatment before and says it didn’t work?

Taking the first step is hard and more so when the person didn’t have a great experience with mental health treatment in the past. Our treatment is evidence-based and measurement-driven; we do what works and reassess and revise what doesn’t! Our care teams are empathic and passionate about helping teens and will be there to support the family every step of the way.

What if my patient is resistant to virtual programming? 

We know many clients are suffering from Zoom fatigue! We have plenty of creative ways to keep our clients engaged. Effective online learning and virtual engagement are our wheelhouse. We encourage teens to try it out, even if they are initially resistant. 

Do you offer services in any languages besides English?

At this time, we can only accommodate clients who are English-speaking. However, we hope to offer programming in additional languages in the future.

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