With dialectical behavior therapy (DBT), therapists help teens manage their big emotions and other challenges using acceptance and change, only recommending hospitalization when it is absolutely necessary.
While there are certainly circumstances where hospitalization can make a major difference in a teen’s life, there are also times when hospitalization is not the most helpful option.
Here are a few reasons why hospitalization, even for suicidal thoughts, can be unhelpful:
1. Ideation does not always mean action
In the same way that you can think about going to the gym without actually getting up to go, or you can think about ordering a milkshake without actually going through the drive-through, your teen can have suicidal thoughts without giving them power or planning to act on them.
It is important for teens to realize that just because they are experiencing a certain thought or feeling, it does not mean that they have to act on it.
2. Hospitalization can be an unhealthy coping skill
When teens are hospitalized, it can give them a break from many of the hardships and stressors they are facing in life. In this way, hospitalization can be rewarding and start to serve as a coping skill. When life gets overwhelming, your teen will be able to be hospitalized and get somewhat of a break from the struggles they are facing.
This is an unhelpful and unhealthy cycle for teens to embrace in life. Instead of developing the skills and strategies necessary to manage their stress or their overwhelming emotions, they will look for ways out of hardship without facing challenges head-on.
3. Hospitals are controlled environments
Hospitals are safe, controlled environments where there are minimal stressors. While it is great for your teen to learn helpful strategies and coping mechanisms while they are in the hospital, these skills are far easier to practice and utilize in this safe setting.
Because your teen will not always be able to be hospitalized, they need to know how to apply healthy coping skills and strategies in the unpredictable situations they will face outside of the hospital. If your teen is struggling to handle their big emotions or they are having suicidal ideations, it can be helpful for them to learn how to use the tools they learn in therapy in the “real world” where life is a lot harder.
4. Hospitalization is not the goal
Ultimately, you want to help your teen learn to love their life so much that escaping it would feel bad, not good. DBT can help teens learn how to handle their big emotions head-on so that they are able to practice acceptance and find healthy ways to approach life’s challenges. This will help them live life to the fullest without wanting to escape when their life is overwhelming or painful.
In DBT, the only reasons for hospitalization are:
If a teen is truly at risk for committing suicide and cannot stay safe. When a teen moves beyond suicidal ideation to life-threatening behaviors like self-harm or actively planning a suicide attempt, hospitalization may be necessary.
If the teen’s parents and therapist are too burnt out to ensure that they can continue to provide a safe environment for the teen. When both parents and the therapist agree that respite is needed in order to ensure a safe environment, hospitalization will be helpful.
While it can be scary and devastating to see your teen wrestle with problem behaviors, suicidal ideation, or feelings of depression, it is crucial for you to realize that hospitalization is not always the answer.
Hospitalization provides a controlled environment where your teen will not get to practice the strategies that they will need to learn in order to handle their intense thoughts and feelings when they return to a real-world environment, and it will not teach them to develop strategies that will help them accept and appreciate life outside of a hospital.