When Teen PTSD Requires Inpatient or Residential Treatment

There are some events that are so distressing, they leave long-term effects on the mind and heart of those who experience them. This is especially true for teens who are still psychologically developing. Like an earthquake, trauma can create fractures in their developing brains and psychological foundation. Their entire sense of self is at risk.

Events that can have such an impact are those that are recognized to be traumatic. A death of a parent, physical childhood abuse, sexual abuse, rape, a car accident, or experiencing the dangers of a natural disaster are some examples of traumatic events. When a teen develops symptoms, such as recurring invasive memories of the event, among other debilitating symptoms, and they last for at least three months, he or she may be diagnosed with Post Traumatic Stress Disorder (PTSD).

Symptoms of PTSD include flashbacks, bad dreams, and frightening thoughts. A teen might also exhibit symptoms of avoidance, such as staying away from certain places to avoid reliving the traumatic experience or forgetting the experience entirely. PTSD is a difficult psychological illness with severe symptoms, if not treated. In fact, PTSD is a diagnosis that is still undergoing investigation among experts in the field of psychology. Because this disorder is one that undermines a person’s internal structure, it is deeply related to our understanding of consciousness itself, and requires further understanding.

As a way to facilitate this understanding, Judith Herman, clinical psychology professor at Harvard University wrote one of the most meaningful books on PTSD, titled Trauma and Recovery. Herman proposed Complex Post Traumatic Stress Disorder (C-PTSD), a version of the diagnosis found in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Her proposed diagnosis addresses the psychological effect on an individual who has had a series of traumatic events, unlike the DSM, which outlines PTSD as a diagnosis for someone who has experienced a single traumatic event.

When a teen is suffering from complex PTSD or with severe symptoms that are getting in the way of functioning at home, school, or work, intensive inpatient treatment might be needed. This may be especially true with repeated experiences of trauma, such as abuse. In this case, the psychological picture is much different. There is usually a more complex presentation of symptoms and adding to the complexity, a teen may also have symptoms of other diagnoses. He or she might show signs of Depression, Obsessive-Compulsive Disorder, Borderline Personality Disorder, a Dissociative Disorder, or Social Phobia.

Depending on the severity of his or her symptoms, there are various levels of care that an adolescent might need:

Inpatient  – Teens at this level have been admitted to a hospital in order to address severe symptoms. They might be suicidal, experiencing psychosis, or in need of 24 hour care in a safe and secure environment. Those who are admitted at this level require medical and psychological stabilization.

Residential Treatment Facility – Teens at this level of care are participating in treatment all day, everyday. However, typically, there is not 24-hour monitoring. Instead, nurses and staff are on-staff to ensure safety. Teens live at a treatment center so that their symptoms can be monitored where their daily activities are highly structured. Adolescents need to be medically stable in order to be admitted to this level of care.

Intensive Outpatient – At this level of care, a teen receives treatment while living at home. The amount of time working with mental health professionals may be anywhere from 20 to 40 hours per week.

Outpatient – A teen may need support with his or her trauma, but it is not severe enough to require admittance to a hospital. He or she works with a therapist, a dietician, and a medical doctor periodically to address the physical and psychological needs.

According to the United States Department of Veteran Affairs, about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Although there have been many advancements to understanding the psychological effects of trauma, there is more to investigate in order to better treat and bring healing to the lives of children, teens, and adults.


Herman, J. (1997). Trauma and Recovery: The Aftermath of Violence From Domestic Violence to Political Terror. New York: New York: Basic Books