Our Treatment Therapies for Teens

Cognitive Behavioral Therapy is the foundational evidence-based approach for most adolescent mental health conditions, including depression, anxiety, OCD, and trauma responses. CBT helps teens understand the relationships among thoughts, feelings, and behaviors — and equips them with practical skills for recognizing unhelpful thought patterns, interrupting them, and responding differently. In adolescent CBT, we emphasize accessible language, real-life examples, and skill-building the teen can actually use between sessions.

CBT techniques appear across Muir Wood’s individual therapy, group programming, and family work. Teens learn to identify the cognitive distortions that fuel anxiety and depression, develop behavioral activation strategies when depression has reduced their engagement with life, and practice exposure-based techniques for anxiety when appropriate. For teens with OCD, CBT is often combined with Exposure and Response Prevention (ERP) strategies, which are used as part of an individualized treatment plan when clinically indicated.

Dialectical Behavior Therapy was originally developed for adults with significant emotional dysregulation, and its skills framework has become one of the most valuable additions to adolescent treatment. DBT teaches concrete skills in four domains: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. For adolescents, these skills address some of the most common challenges of the teen years — emotional intensity, impulsivity, conflict with parents and peers, and the urge to act on painful emotions in ways that cause harm.

At Muir Wood, DBT-informed skills are integrated into both group programming and individual therapy as part of the standard residential experience. DBT skills help teens recognize internal signs of activation in the moment, pause before reacting, and employ effective strategies to cope — practical tools they can carry into daily life during and after treatment.

Most teens who come to Muir Wood have experienced some form of adversity that shapes how they see themselves, relate to others, and respond to stress. What sometimes gets labeled as defiance, withdrawal, or acting out is often a protective response rooted in past pain. Our clinical philosophy is to ask “what happened to you?” or “what is this behavior communicating?” before “what’s wrong with you?”

In practice, trauma-informed care at Muir Wood means understanding that every issue or problematic behavior present in a teen’s life comes from some underlying cause in their personal history. Past traumas and adverse experiences affect how people think, feel, act, and react today. They shape the way teens experience themselves, other people, and the situations they encounter in daily life — including their perceptions, emotional reactions, memories, impulses, and sense of safety. Trauma-informed care means we aim to create emotional safety for our clients through predictable routines, clear expectations, consistent relationships, and compassion throughout all of our work. It means that every member of our team, not just the therapists, understands how a teen’s past experiences shape the way they present in our care, and how to respond in ways that support self-regulation and healing rather than deepening distress.

Some teens benefit from psychiatric medication as part of their treatment plan — particularly when anxiety, depression, mood dysregulation, or OCD symptoms are significant enough that therapy alone isn’t producing sufficient relief. At Muir Wood, our psychiatric team follows a non-ideological, least-necessary approach. Medication is used only when clinically indicated, always in combination with evidence-based therapy, and always in close collaboration with families.

A comprehensive psychiatric evaluation is included in each teen’s initial assessment. When medication is appropriate, our adolescent psychiatrists and psychiatric nurse practitioners (PMHNPs) consider the teen’s full clinical picture — current symptoms, co-occurring conditions, medication history, family history, and the teen’s own response to past treatments — before making recommendations. Parents are full partners in medication decisions. Our psychiatric team explains the reasoning, the options, and the tradeoffs in language families can actually use. When medication is not indicated, we say so.