When Your Teen Refuses Treatment: Is a Transition Team Right for You?
These are the questions that I hear most often when parents are considering enrolling their child in a treatment program and start thinking about safe transport:
“What if they refuse to go”?
“How can I get my child to boarding school, if he won't even go to school, counseling, or come home?
"She refuses to even get in the car with me to go anywhere let alone agree to go into a residential program that we have chosen for her.”
Facing the decision to send a defiant teen who is struggling with their behavioral or mental health to a residential treatment program feels overwhelming, especially when they refuse therapy or treatment.
- Would you be able to convince them to travel to a residential treatment program?
- Will they agree to participate and accept the help you are offering?
In this blog post, I want to guide parents through this emotionally charged process, highlight the role of transition teams, and give you tools to help you make the right decisions for your family.
The use of transition teams for treatment-resistant teens is controversial. I will help you understand the issues and share some success stories of families just like yours who used a transition team and are glad they did. I, for one, had no choice when I had to enroll my own child in a therapeutic program.
Helping Your Teen Get the Treatment They Need
It is distressing to learn that 1 in 6 teens between the ages of 6 and 17 faces a mental, emotional, or behavioral disorder, according to NAMI. Doesn’t hearing that statistic break your heart? What’s even more disheartening is that up to 75% of these children don’t get the help they need!
Remember twenty years ago, when teens who were rebellious, defiant and challenged authority were considered “troubled” or “at risk?” Pushing boundaries and testing limits is typical behavior for adolescents seeking independence and freedom.
More Mental Health Issues in Teens
While teenage rebellion and defiance were, and always will be, a parental headache, today, teens face more serious challenges. Sadly, our teenagers today are battling unseen demons:
- teen anxiety
- teen depression
- teen angst
- social pressures resulting from teen social media obsessions
This new mix of emotional and mental health issues can be a toxic cocktail that pushes parents to the brink. If you find yourself living in this chaotic realm, then let me first tell you that I am so sorry you are going through this! Secondly, I want you to know I understand that fear — I’ve been there!
Is Your Teen Out of Control or in Crisis: Do They Need an Intervention or Treatment?
The truth is that in your gut, you know your teen needs much more help than what they are getting now. At this stage, these kids have been “in refusal” mode for a long time. Getting their agreement on anything is nearly impossible. As parents, we need to understand that the last thing they want to do is leave their environment where they are in control.
The big question is: what level of treatment do they need right now? We all want to believe that some of the negative behaviors we see are just a phase, and in some cases, that is true. The problem is when we excuse the behavior until it becomes a crisis– or worse yet when we fail to recognize the signs that the behavior is much more than just typical teenage angst.
So, how can you tell if your teen’s behavior is crossing the line from difficulty and struggling to spiraling? Let’s take a look.
The signs of an out-of-control teen typically include:
- Teens that come and go as they please
- Vaping, using weed, experimenting with substances
- Excessive gaming or social media use that is impacting their daily lives.
- Truancy, skipping classes, or chronic unexplained absences from school.
- Defiance: refuses to follow any rules and challenges authority.
Behaviors that Signal a Need for Intensive Teen Treatment
Let’s explore the behaviors that signal it’s time to seek more intensive treatment for your teen – and how early intervention can make a difference.
The signs of a teen in crisis who requires immediate intervention:
- Self-harm: cutting, burning, or other forms of deliberately hurting themselves.
- Suicidal ideation or suicidal attempts
- Substance abuse or dependence that impairs their daily life.
- Violent outbursts or aggression towards others
- Legal issues that could result in juvenile detention
- Chronic depression, worsening anxiety, signs of PTSD, bipolar symptoms or risky behaviors
- Sudden and significant changes in their eating habits, neglecting personal hygiene, withdrawing or isolating from family and friends.
Interestingly, we find that teenagers with mood disorders and emotional issues who actively lash out may not be aware that their behavior is problematic. Teens in crisis often blame their parents for their behavior. According to psychologists, blaming parents is a defense mechanism. They lash out because they cannot face their feelings of frustration, shame and sadness.
When they lie, manipulate, and act belligerently, they justify their behavior by saying they do not have another choice because their parents don’t trust or understand them. However, the reality is that they want more independence and the freedom to make their own choices.
The Breaking Point: Knowing When Your Teen's Refusal Needs Intervention
The problem lies in how much we love our children. Our love blinds us to the severity of their struggles. We make excuses for their behavior, give second and third chances, and hope things work out. Unfortunately, delaying treatment can be dangerous. The decisions teenagers make impulsively can have lifelong consequences and put them at horrible risk.
By the time parents realize their teen needs intensive treatment like a Residential Treatment Center (RTC) or Therapeutic Boarding School (TBS), their child may have been refusing help for a long time. Consequently, getting a teen in this state to agree to leave their friends and the comfort of their home to go to treatment becomes nearly impossible.
The Decision to Seek Treatment: When Transport Becomes Necessary
So, how do you get a resistant teen to the treatment they desperately need? This is where the decision to find a transport service comes in.
The best way to find a reputable transport service for a treatment-resistant teenager is to get referrals from your therapeutic or educational consultant or the treatment center. You can also search online directories like the National Association of Therapeutic Schools and Programs (NATSAP.)
The Ideal Transport Method: A Family-Led Transition
Of course, the best option is to have the family drop off the teen at their school, treatment center or nature-based program. You will get an opportunity to bond, and you’ll see firsthand how your child will live for the next 3-12 months. But if this is not a viable option for your family, transport becomes the best alternative.
Should You Hire a Professional Transport Team for Your Teen?
Deciding whether to hire a professional transport team is a deeply personal and often emotional decision for any parent. Ideally, it should be your last resort when other options have been exhausted, or professional intervention becomes the safest and most responsible choice.
So, when does hiring a professional transport team become necessary? If your teen exhibits behaviors like refusing to discuss treatment, lashing out in anger, or threatening to run away, then a professional transport team may be your only recourse.
Example of situations that warrant this decision include:
- Uncooperative or Defiant Behavior: If your teen refuses to discuss or engage with any attempts to get help, they may resist you at every turn, making it impossible to get them to treatment on your own.
- Volatility or Anger: If your teen experiences frequent, angry outbursts that escalate to the point of causing fear or worry, a professional transport team can safely manage the situation.
- Threats to Run Away: If your teen has plans or intentions to run away to avoid treatment, professional intervention becomes crucial.
- Violence or Aggression: If your teen has a history of aggressive behavior or poses a threat to themselves or others, it’s critical to have trained professionals involved.
- Self-Harm or Suicidal Ideation: When a teen engages in self-harming behaviors or expresses thoughts of suicide, time is of the essence, and a professional team trained in handling such crises can ensure their safety.
In these challenging situations, professional transport can be a lifeline, ensuring your teen’s safe and timely arrival at a treatment facility. Hiring a professional transport team is a pivotal decision in getting your teen the help they need by any means necessary.
Though challenging, it’s important to remember that professional teams are trained to manage these difficult situations with compassion and expertise. By choosing a reputable service, you’re not just ensuring your teen’s safety—you’re giving them the best chance at beginning their journey to recovery in a safe, structured manner.
The Stigma Surrounding Transport Services
Unpacking the Controversy: Real Stories vs. Reality
Understanding the Risks and Ensuring Safe Transport for Your Teen
That said, I strongly advise parents to only work with professionally vetted, trusted entities with verifiable references. Ask your provider questions about the training and certifications of the individuals you will be relying on. Ask if they are trained in trauma-informed care. An experienced transport provider will always prioritize your teen’s well-being. Not sure what questions to ask? Download your free copy of the ‘How to Vet a Teen Transport Service’ checklist, courtesy of Empower My Teen. This guide will help you ask the right questions and make informed decisions for your teen’s safety and well-being.
Download the How to Vet a Teen Transport Service Checklist Now
The Benefits of Working with a Transport Team
There are many benefits to utilizing a professional transport team for resistant teens:
- Structured Support: The team will work with you and your educational consultant to meticulously plan the transport, considering your child’s specific challenges and building a plan around your needs.
- Bridge to Treatment: They facilitate access to treatment, even when the teen is resistant or unable to travel independently.
- Safe Transport to Residential Treatment: The transition transport team’s number one priority is your teenager’s safety. They are vigilant and look out for the teen’s physical and emotional well-being, minimizing risk for everyone involved.
- Peace of Mind: Knowing confidently that your teen will arrive safely at the treatment facility without drama or safety concerns and that they are indeed in good hands will allow you to focus on the approach to treatment and recovery instead of worrying about how to get your teen to treatment against their will.
- Increased Success: A smooth transition facilitates the likelihood of a positive outcome.
There are many success stories of families just like yours who used a transition team and are glad they did. I, for one, had no choice when I had to enroll my own child in a therapeutic program.
Success Stories:
“Hiring a transition team made all the difference for us. We feared Connor would resist or run away, but the team handled the situation with such expertise. They calmly got him talking, de-escalated his fears, and transported him smoothly to the boarding school. They kept us updated throughout the trip and even prepared Connor for what to expect at the school. It was a traumatic day for us, but their professionalism made the process much easier.”
Another family’s experience:
“We were worried about Amy’s reaction to going to a treatment center. She’d refused before, and we dreaded her threats of self-harm… Thankfully, within minutes of entering Amy’s room, the transition team representatives had her talking calmly. They were experts at de-escalation, and soon she walked out willingly, without a fight.”
Should You Hire A Transport Team for Your Teen?
Ideally, you can communicate openly with your child and convince them that enrolling in a therapeutic school or RTC is in their best interest. Explain the benefits, a willing participant in the treatment process is always preferred and has better outcomes.
Ask yourself: Is this the right step for my child? As their parent, you are the only person who can honestly answer that question.
When your teenager is in the midst of a mental health crisis or if their safety is at risk, professional transport is the safest, most compassionate and responsible choice.
Prioritizing Encouraging Willing Participation
As a parenting coach, I often help parents prepare for these difficult conversations with their struggling teens. We strategize, anticipate questions and responses, and develop techniques to manage emotions and de-escalate the situation if needed.
While there are always exceptions, most parents find that these conversations end up being productive. Many teens in these situations are unhappy and want to change but don’t know how to express their needs or how to ask for help. I see it over and over again, when given the opportunity for life-changing support, most are willing to accept it.
What to Expect of Your Transport Team
Depending on your teenager’s gender, the transport team may consist of a male and female agent or two male agents. If the level of risk is high, there may be a third agent.
Typically, these teams enter the home, speak with your child privately, and explain in a firm but compassionate manner that they are going to a new boarding school or treatment facility. They emphasize the necessity of the situation and ensure the teen understands they need to accompany them.
Most of the time, the transition is smooth because the teen is surprised and, let’s be honest, a little bit overwhelmed by the team’s arrival. While the process is generally smooth, it can be unsettling for both the teen and the parent. The crucial question every parent should ask themselves is:
What will happen to my child if they don’t receive treatment and remain in this environment?
If you answer that question with fright, worry, and concern, and you know that they won’t recover on their own or just work with a therapist once or twice a month, then you have a responsibility to lovingly do all you can to save your child.
What to Expect During the Transport Process
The entire process, from when the team enters your home to leaving with your teen, usually takes about 10 minutes.
The team will speak to your child alone; you will not be in their bedroom during this conversation. A typical discussion includes understanding, empathy, and a calm explanation of:
- How their poor choices led to this intervention.
- How future choices will determine how quickly they can return home.
- They will provide a thorough, detailed explanation of the treatment program and what to expect when they arrive.
Understanding the Risks and Ensuring Safe Transport for Your Teen
When I talk with parents about their experiences during the transition, it often reminds me of how it felt when you used to drop them off at daycare when they were three. Your teenager will most likely be angry, but they will also be informed. In my experience, these kids are usually completely fine, compliant, and even relieved by the time they reach their destination. I had to make this same decision with both of my kids who went into a program, and in hindsight, it was the best decision I’ve ever made. Not to say that there weren’t big challenges while on this emotional and financial journey, but the rewards were priceless.What are the outcomes for Teens who were transported to a treatment program?
Most of the evidence and information on outcomes is anecdotal. However, it’s reasonable to assume the following:
- High Completion Rate: A competent teen has a high success rate in safely transporting teens to treatment facilities.
- Transport has little impact on the treatment outcome: There’s no evidence that hiring a transport team has a significant impact on the child’s success once they arrive at treatment.
- Collaboration matters: For a smooth transition into treatment, there needs to be clear communication among all involved in the enrollment, transport and treatment process. And everyone involved should be focused on the teen’s well-being and needs.
The bottom line is all parties involved in getting your teen into treatment can positively or negatively influence the child’s treatment experience. At the end of the day, the goal should be to get the teenager ready to focus on getting the most out of treatment and start their journey to healing.
Tips for Parents: Preparing for the Transition to a Residential Treatment Center
- Open Communication: Start a dialogue with your teen about the benefits of the treatment or attending a rehabilitation program. Focus on positive outcomes and the program’s attributes, like the location, what therapies are available, the social activities, and the time to decompress and focus on themselves.
- Set Expectations: Be clear and open with your teen about what will happen if they don’t go to treatment willingly. Uncertainty and anxiety increase the likelihood of trauma. You know your kid best; you don’t have to tell them they are being picked up tomorrow. However, you can let them know what will happen if they refuse to cooperate.
- Explain that you will hire a transport team to take them, and they won’t know when it is happening.
- Be clear about the consequences and explain what the transport to treatment will involve.
- Let them know you are serious, and they have a choice to go willingly or to be transported against their will.
- Whenever possible, Involve Your Teen in the Process: Allow them to have a say in preparations to foster a sense of control and cooperation.
- Plan a Calm Departure: Organize a peaceful and respectful send-off to minimize stress for everyone involved.
Don’t Wait Until It’s Too Late
If your teen is in crisis, explore all available options, including transport teams. Seek expert advice to make the best decision for your child’s future.Finding Hope for Your Struggling Teen
Is your teen struggling with challenges that seem overwhelming? In the blog post, “Why I Sent My Out of Control, Troubled Son,” you’ll discover a real parent’s journey and find valuable insights that may offer hope and a path forward for your family.
Do You Need to Gain Clarity and Be More Confident in Your Parenting?
Explore my parent coaching services today for guidance and support. Read more to learn how coaching can benefit you and your family.
Potential Drawbacks of Teen Transport Services
- Potential for Trauma: Let’s be real: being removed from the safety of your bedroom by complete strangers and traveling to an unknown destination while being restrained is likely to be traumatizing for a child who is already vulnerable.
- Coercive Nature: Taking a child out of their home without their consent and traveling with strangers for hours to an unknown destination does raise ethical concerns. Teenagers who find themselves in this situation feel powerless and are often frightened and resentful. The negative experience will affect how they initially engage in treatment.
- Lack of Transparency: Some teams aren’t willing to openly share their method and practices with the family. The level of secrecy and lack of transparency can create mistrust and concerns about safety and even potential abuse. You need to be comfortable with whom you are entrusting your child; please vet the team you choose carefully!
- Cost: These services can be expensive, burdening families struggling with treatment costs.
Focus on Transport, Not Therapy: The transport team’s job is to get your teen to treatment safely. They are focused on logistics and can overshadow your child’s emotional and psychological needs. If you feel that your child will need someone to offer emotional or psychological support, it’s best to have an additional person on the team to look after your child’s emotional and psychological needs.
Evaluation Criteria for Parents Hiring a Transport Team for Their Struggling Teen
Choosing a transport teen requires careful consideration, weighing the benefits of safety, expertise, and timely intervention against potential drawbacks such as trauma, and coercion.
I cannot emphasize enough the importance for parents considering this type of service to choose a company that employs trained personnel that adheres to trauma-informed care best practices.
Whenever possible, explore alternatives such as:
- Voluntary transport with a trusted family member
- Hiring a therapeutic nurse or therapist to travel with your teen to treatment
- If safe, travel with your teen to treatment yourselves.
Ultimately, consider your child’s needs, your situation, available options, and the risk of your child running away or resisting transport.
Open communication, informed consent, and a focus on the teen’s well-being throughout the process are of the utmost importance to ensuring a safe and positive transition to treatment.
When to Choose a Teen Transport Team: Costs & Guidelines
A transport service is helpful in situations where:
- Safety is a Concern: If the teen’s behavior poses a risk to themselves, their family, or others during transport.
- The Teen is Resistant to Treatment: If the teen is unwilling or actively resists going to treatment.
- Distance is a Factor: For long-distance transport, particularly if the family lacks the resources or ability to make the journey safely.
- Specialized Needs: If the teen has specific mental health or behavioral challenges
- Family is Overwhelmed: If the family is emotionally overwhelmed or lacks the skills to manage the teen’s behavior during transport.
- Crisis Situation: In a crisis where immediate intervention is necessary
- Severe Mental Health Issues: Teens experiencing acute mental health crises, such as suicidal ideation or psychosis
- Substance Abuse: Teens struggling with substance abuse
- Behavioral Challenges: Teens with significant behavioral challenges, such as aggression or self-harm
- Legal Involvement: In some cases, court-ordered transport may be necessary
While transition transportation services can be valuable in these situations, I cannot emphasize enough the importance of working with a reputable provider.
Transport costs vary depending on the transport agency’s reputation, location, and distance traveled. Other cost considerations include:
- The distance to the treatment facility
- Travel expenses, including flights, gas, and hotel accommodations
- Method of transportation: crossing state lines or traveling internationally.
- The level of intervention needed: number of agents, medical training, type of escort (e.g., substance abuse escorts or escorts with specialized skills).
The cost to transport defiant teens or teens, teens in crisis, or teens in the situations discussed in this article range anywhere from $2,000 to $10,000, and, in some cases, it can be more.
The good news is that under certain circumstances, health insurance may cover some transport costs. Speak to your insurance provider beforehand to verify coverage.
Parent Success Stories – Real results from struggling and at-risk teens
What Parents Say About Working with Mary Warren
Read inspiring testimonials and success stories from parents whose teens found a brighter future, and see how Mary can help your family find healing and hope.
