Many families call us when an intense fear of being left is followed by pulling away from the person their teen felt closest to the day before. Our live-in mental health program in Southern California serves ages 12 to 17, with daily skills practice first and diagnostic labels last, if they apply at all.
Clinically reviewed by Alejandro Alva, M.D., Medical Director.
What this is
Treatment here focuses on the behavior pattern rather than placing a diagnosis on a teenager who is still developing. We are cautious about diagnosing personality disorders in teens, because identity is still taking shape during adolescence. What we work on is the fear of abandonment, the friend who is adored in the morning and cut off by evening, and the pull-close-push-away pattern at home. We see these emotional and behavioral patterns as a skills concern first, and an assessment comes before any stay begins.
Personality disorder symptoms that need treatment
When a message goes unreturned, it can feel like a catastrophe, and panic or anger may fill the gap long before anyone has actually left.
A friend, a parent, or a therapist may be seen as entirely good, then entirely bad, and the family can struggle to keep up with the reversals.
Goals, relationships, and values can shift depending on who your teen is with, and they may feel empty as soon as they are alone.
The reaction can arrive with no pause in between, the whole house stops what it was doing, and afterward your teen may feel deep shame and be very hard on themselves.
Your teen may want you near and then need distance, and it can feel like you go from trusted to blamed before dinner.
Plans may get cancelled and siblings may grow quiet, because everyone is trying to keep the evening calm.
Daily life
Therapy sessions, the dinner table, and the shared living room are all places where the same reaction can show up, and all three give your teen a chance to practice a different response.
01
Dialectical behavior therapy (DBT) skills are taught in the hour your teen is still upset, rather than arguing them into a stable sense of self. In individual therapy sessions, your teen puts words to the belief that they will be left.
02
In family therapy, parents learn how to acknowledge real pain without giving in, and how to hold a limit while staying a source of comfort. We also plan together for what to do if the old pattern returns at home, so your family feels ready.
03
Our staff stay steady and do not take it personally when your teen is upset with them, and the shared living space is where a different response gets practiced.
Shasta is our girls' house in Orange County, with six beds for teens ages 12 to 17. It has a pool and a patio, and staff are in the house overnight.
You can also walk through Ridgeview and Richards, our other two houses.
Our approach
Our treatment plans are built around your teen, so DBT, family therapy, and CBT are here because they fit, not because we offer them.
Emotional regulation skills, individual therapy, and coaching are offered while your teen is still upset, which is different from a weekly class that is easy to forget by the weekend.
Many of the hard moments, including feeling dismissed and the crises, happen at home. We teach a response that acknowledges the pain and still holds the limit.
Cognitive behavioral therapy (CBT) puts words to the belief that they will be abandoned, or that they are too much for anyone. It then shows your teen how those thoughts and behaviors feed each other, without ever treating them as dramatic.
When a crisis happens, we respond with a written safety plan and staffed supervision, not a consequence that could confirm your teen's belief that they are the problem. If self-harm is part of the picture, the safety plan is updated as risk changes.
Psychiatric care and medication management are available when the clinical team recommends them, since medication may ease the intensity of a mood or an impulse. We do not rely on medication alone to address a behavior pattern.
Your part
These patterns can leave a household waiting for the next blowup and strain relationships with parents and siblings alike. Family work teaches you a calm response you can keep using at home.
Fix it right away or give in.
Recognizing that your teen is truly in pain is not the same as agreeing to what they are asking for. Doing one without the other can feed the pattern.
Leave them here and hope the house fixes it.
Family therapy is where this pattern often shows up most clearly. We do not believe treating your teen alone can change a dynamic we never get to observe, so your part matters.
Wait until they are home to set a limit.
A written plan for the unanswered text, the refusal, and Sunday night is practiced before discharge, so you are not working it out on the spot at home.
Academics
Many teens have already missed a stretch of school because of their mental health and the stress at home. These skills can take months to develop, so accredited classes run on site for the whole stay.
Classes Matched To Your Teen
Classes run through Advantages School, our accredited school partner. We use your teen's transcript and current schedule to place them in the right courses, helping protect credits and their place in class.
Optional Tutoring On Harder Mornings
Tutoring is optional and available alongside the clinical day, and we do not wait for a calm week before your teen starts attending.
Preparing For Conflict At School
Before your teen leaves, we practice what to do after a falling-out at school, a text that goes unanswered, and walking into first period.
Please send their transcript, current schedule, and any IEP or 504 plan, so we can place classes and plan tutoring around their real coursework.
Length of stay
30
days in residence, by progress
Most stays run 60 to 90 days. Some finish closer to 30, and a few need longer.
90
Changing a long-standing pattern takes time, and a 30 to 90 day stay is one chapter of skills building rather than a finished result. We work with your family on a healthier dynamic at home, and step-down planning to our outpatient program or virtual IOP begins before discharge. Discharge is based on progress and not a set date.
When to call
If personality disorder symptoms are affecting your teen's safety, their schooling, or your family's ability to be together calmly, please call us. Aaron Earnest and the admissions team will be honest about whether residential mental health care fits your teen right now. DBT is usually a central part of the treatment, and if your teen is also hurting themselves, our self-harm page covers that. We will not rush a diagnosis.
Before you call
FAQ
Answers to what parents often ask before calling about care for teen personality disorders. If your question is not here, admissions can talk it through with you.
We are cautious about diagnosing personality disorders in teens, because identity is still taking shape during adolescence. Treatment focuses on the emotional and behavioral patterns first, and we will not rush a diagnosis.
An assessment comes before any stay, and Aaron Earnest and the admissions team will be honest about whether this level of care fits your teen. If your teen is also hurting themselves, our self-harm page covers that, and DBT is usually central to the treatment.
Most stays run 60 to 90 days, and some finish closer to 30 while a few need longer. A stay is one chapter of skills building rather than a finished result, and discharge is based on progress.
DBT skills, individual therapy, and coaching are offered while your teen is still upset, not saved for a weekly class. Cognitive behavioral therapy also puts words to the belief that they will be abandoned or are too much for anyone.
Parents learn how to acknowledge real pain without giving in, and how to hold a limit while staying a source of comfort. We also practice a written plan for the unanswered text, the refusal, and Sunday night before discharge.
Staff are awake overnight, and a written safety plan covers the bathroom, the overnight hours, and Sunday. The plan is updated as risk changes, and our self-harm and suicidal ideation pages cover those concerns directly.
Step-down planning starts before discharge, to our outpatient program after school or to virtual IOP from home. Aftercare includes a written plan, a next team trained in DBT, and check-ins at 30, 60, and 90 days home.
This page is reviewed by Alejandro Alva, M.D., our Medical Director. These free guides from public health agencies and medical groups cover the topic in more depth.
National Institute of Mental Health
MedlinePlus, National Library of Medicine
