Programs do work that outpatient therapy cannot do. When a family needs containment, milieu, and clinical hours that a weekly session cannot supply, a residential or wilderness placement is the right call, and we will say so. What we are describing here is a different problem: what happens in the six to twelve months after the family leaves you.
That stretch is where the gains either consolidate or quietly reverse, and it is usually the least resourced part of the whole episode of care. The discharge plan names outpatient therapy, the family finds whoever is available near them, and the clinician they land with has never worked with a program graduate. Sometimes the structure your team built gets dismantled in the first month, in good faith, by someone who does not know what it was for.
We are outpatient clinicians who have worked the other side of that handoff. We read the discharge summary, we work from your team's recommendations rather than re-litigating them, and we treat the parents as part of the case rather than as the people who drop the client off.
Where we can help
Our entire team is licensed therapists — no coaches, no unlicensed staff. That matters for what we can do in which state, so here is the honest version in two parts.
Therapy — our 6 licensed states, and growing
Full clinical care, including individual therapy for the teen or adult and family sessions. The work is telehealth, so a family does not have to live near us — they have to live in a state where the matched clinician is licensed.
- Florida
- Texas
- Idaho
- Illinois
- Utah
- Montana
We are adding states as licensure allows. License numbers by state are on the therapists page.
Every other state — planning, coaching, and collaboration
Transition planning and parent coaching are not state-restricted the way therapy is, so we can hold those pieces for a family anywhere. When the family also needs clinical care, we do not pretend to provide it across a line we are not licensed across — we work alongside a therapist local to them, hand over what your program built, and keep the plan and the parent support running so the local clinician is not starting from nothing.
While the family is still in your program
Not everything we do starts at discharge. The family track can run alongside your treatment, so the parents arrive at discharge already changed rather than arriving unchanged to a changed kid.
Parent coaching and family programming
A standing parent track that runs while their teen or young adult is in your care — the agreements they will come home to, the patterns the parents bring to it, and the work that is theirs rather than the client's. Because it is coaching and planning rather than therapy, we can hold it for a family in any state.
Collaboration with your clinical team
With a signed release, we work to your treatment plan rather than a parallel one — regular contact with the teen's or young adult's therapist, your language and your goals, so the parents are never being coached toward something your team is not doing. We are additive to your program, not a second opinion inside it.
Therapeutic family vacations
Multi-day family work built around real time away, designed to consolidate what your program has produced rather than compete with it. Three formats: local to your program, at our riverfront property outside Sandpoint, Idaho, or a destination the family chooses. Where the destination sits outside our therapy licensure, it is structured and named as intensive coaching rather than therapy — always before anything is scheduled.
Parent groups, virtual or on site
We can facilitate a recurring parent group for your program by video, or come on site and run it in person. It is a piece many programs want and find hard to staff, and it is straightforward for us to carry.
After discharge — adolescents and their families
For a teen coming out of wilderness, residential, an RTC or a TBS, the three pieces below are what we hold. The parent work is the piece most often missing, and in our experience it is the piece that decides whether the rest holds.
Parent support and coaching through the transition
The parents are the ones who have to hold the structure once the plane lands. We work with them directly — on the agreements they came home with, on what to hold and what to let go, and on the specific moments that undo a family in the first ninety days.
Transition planning that starts before discharge
We would rather be in the conversation while your team still has the family, not after. That means reading the discharge recommendations, talking with the program team where the family consents to it, and having the first outpatient appointment on the calendar before the family travels home.
Individual therapy for the teen
Ongoing individual work with a clinician who has read the discharge summary and understands what the teen actually did in your program — so the language, the skills, and the treatment goals carry forward instead of restarting from zero.
The vacation format is described in full on the family therapy vacation page, including the three location formats and how pricing works. When a family is still weighing formats rather than discharging from one, our family intensive for teens page covers that decision, and teen levels of care explained is what we hand parents who are trying to understand the continuum.
For adults leaving treatment
Adult discharges have the same handoff problem with a different shape. There is no parent to coordinate with, the client returns to a job and a marriage, and the aftercare plan usually assumes ninety days when the risk window runs closer to a year.
Transition planning built before discharge
Same principle for adults: the plan is written while the client is still supported, not improvised in week two at home. Aftercare that exists on paper but has no appointment attached to it is the most common failure point we saw from the inside.
Ongoing individual therapy through the first 6–12 months out
The window where relapse and regression cluster is longer than most aftercare plans account for. We hold a standing weekly or biweekly slot through the first year rather than tapering at ninety days by default.
Family sessions where the family is part of the plan
Adults leaving treatment usually return to the same relational system they left. Family sessions treat that system as part of the work instead of as background — with the client deciding who is in the room.
Parent or partner support when they are carrying the load
The spouse or parent absorbing the aftermath often has no clinical support of their own. Separate support for them protects the client's own therapy from becoming the only place the family gets help.
How the handoff actually runs
- Before discharge
- A consultation with the family, a review of the discharge recommendations, clinician match by state and clinical fit, and a first appointment scheduled for the week they get home.
- First 30 days
- Weekly individual work for the client, parent or partner support running alongside it, and a short written plan the family can actually follow — not a list of coping skills.
- Months 2–12
- Ongoing therapy at a cadence that matches how the client is actually doing, with family sessions added when the system is where the pressure is. We escalate and say so plainly when a higher level of care is the honest answer.
What we are not
Worth being explicit, because a referral that comes to the wrong place costs your team time and costs the family more than that.
- A higher level of care. We are outpatient. We do not run PHP, IOP, a step-down residence, or any monitored setting.
- A monitoring or compliance service. No drug testing, no supervision, no reporting to a program or a court.
- A crisis service. We are not staffed for acute risk, and we will say so and point to emergency resources rather than hold a situation we cannot hold safely.
- A placement or educational consultant. We do not place clients into programs and we neither pay nor accept referral fees.
- A replacement for family work you already do well. If you run family therapy in-house, we would rather slot into the gap — the parent track, the group, the vacation, or the handoff — than duplicate it.
Fees and insurance
Individual therapy may be in-network with many major insurance plans, depending on the clinician and the plan, and we provide superbills for out-of-network reimbursement. Parent coaching and family work are typically private pay. Current fees and the full insurance picture are on the pricing page, and we confirm what applies to a specific family on the consultation call before anything gets scheduled.
FAQ
Common questions
Can you work with a family while they are still in our program?
Yes, and that is usually the better version. The parent track, a parent group, and family programming can all run alongside your treatment, with a signed release so we are working to your plan rather than a parallel one. Families who start before discharge land at home with a plan already in motion instead of a referral to chase.
Which states can you actually take a family in?
Our whole team is licensed therapists, and we are licensed in Florida, Texas, Idaho, Illinois, Utah and Montana, with more added as licensure allows. In those states we provide full clinical care by telehealth, so a family can continue with the same clinician wherever they live in them. Outside those states we still provide transition planning and parent coaching, and we work alongside a therapist local to the family for the clinical piece rather than practicing across a line we are not licensed across.
How soon after discharge can a family start?
Ideally the first appointment is on the calendar before the family travels home. When a referral reaches us before discharge, we schedule the intake for the week they arrive. When it reaches us after, we work to get them in within roughly a week, subject to the matched clinician's availability.
Do you take insurance?
Individual therapy may be in-network with many major insurance plans, depending on the clinician and the plan, and we provide superbills for out-of-network reimbursement. Parent coaching and family work are typically private pay. We confirm all of it on the consultation call before anything is scheduled.
Will you coordinate with our clinical team?
Yes, with a signed release from the family. We will read the discharge summary, take a call with the treatment team, and work from the recommendations your team made rather than re-litigating them. Without a release we work only from what the family tells us.
What happens if the client needs more than outpatient care?
We say so directly and help the family move. We are not the right level of care for acute risk, severe untreated substance dependence, or presentations that need a monitored setting, and we would rather return a referral than hold one we cannot serve well. The same applies to licensure: if a family needs therapy in a state none of us is licensed in, we say so up front and help them find a local clinician rather than stretching the coaching lane to cover it.
What is the difference between what you do and ordinary outpatient therapy?
Mostly that we have worked inside programs. A program graduate handed to a clinician with no program experience often spends the first months explaining what they went through, and sometimes gets the structure their program built quietly dismantled. We start from the discharge plan and treat the family as part of the case.
Fifteen minutes to see whether we are useful to you
The most useful version of this call is short and specific: what your census looks like, where families actually go home to, and where the handoff breaks down for you. If we are not the right fit for your population we will tell you on that call rather than after a referral.
Or email Appointments@MountainFamilyTherapy.org and note that the referral is coming from a program — those get routed to Cade directly.
We are not a crisis service. If someone is in immediate danger, call 911 or 988 (Suicide & Crisis Lifeline).
Something to hand a family: the aftercare page for parents says the same things in the parent's language, with no pitch aimed at your team.