When your teen begins mental health treatment, it’s natural to hope for noticeable changes and wonder how to track progress. Maybe you’re waiting for them to seem happier, communicate more openly, return to their usual routines, or feel more like themselves again. But what happens when those changes don’t appear right away? Or when your child seems to be improving one week, only to struggle again the following? For many parents and caregivers, understanding what progress actually looks like can be one of the most challenging parts of supporting an adolescent through treatment.

In Tennessee, the need for adolescent mental health support is significant. According to Mental Health America’s 2025 report, approximately 1 in 5 Tennessee adolescents (ages 12-17) experienced a major depressive episode during the previous year, based on data from 2022-2023. Of those adolescents, 63.7% did not receive mental health services for depression. These numbers highlight the importance of accessible mental health care, but they also raise an important question: Once an adolescent begins treatment, how do we know it’s working? The answer isn’t as straightforward as we might expect.

Progress In Mental Health Is Not Always Linear

A teenager’s progress during behavioral health treatment rarely follows a straight line. Some days, your adolescent may seem more engaged, communicate more openly, or handle a difficult situation with greater confidence. There may also be days when undesired behaviors resurface, emotions feel overwhelming, or previously learned coping skills are harder to use. A difficult day does not erase the progress that’s already been made.

“In therapy, the stages of change describe change as a gradual, cyclical process rather than a single, all-or-nothing event or action,” said Amanda Pinckert, therapist at Embrace U’s Knoxville location. “Setbacks are inevitable and expected during the change process.”

In many cases, behaviors that parents find concerning have developed as ways for adolescents to cope with difficult emotions, communicate unmet needs, or regain a sense of control. Even when those behaviors are no longer helpful, changing them can take time. Treatment helps adolescents understand what may be driving their reactions while developing healthier ways to respond. That process requires practice, patience, and opportunities to try again when something doesn’t go as planned.

A teen who previously responded to frustration by yelling may still become upset, but begin recognizing when they need space. Another adolescent who typically withdraws might start expressing what they’re feeling, even if those conversations are uncomfortable. These changes may seem small, but they represent meaningful steps towards emotional awareness and regulation. Progress isn’t about never experiencing setbacks. Rather, it’s about gradually learning how to navigate them differently.

Learn more about the treatment programs Embrace U offers.

Redefining “Getting Better” for Adolescents

When parents think about their child getting better, they often will picture improvements in school performance, relationships, motivation, or behavior at home. While these are meaningful goals, some of the earliest signs of progress happen long before those larger changes become visible.

“We often see more inconspicuous changes first in treatment, like a child having an easier time getting out of bed, smiling more, or listening just a bit quicker,” said Pinckert. “Noticing those early changes in your child will be a motivating force for future change.”

For one adolescent, progress might mean participating in group therapy after weeks of avoiding conversations about their mental health. For another, it could mean acknowledging an unhealthy behavior, accepting feedback, or taking responsibility for a difficult decision. These differences reflect an important principle of mental health treatment: progress looks different for everyone.

Therapists often consider the stages of change, a framework that recognizes behavioral change as a gradual process rather than a single decision. Adolescents may initially feel unsure about treatment, slowly become more open to receiving support, and eventually begin practicing new skills in their everyday lives. This means that simply showing up, participating in a conversation, or recognizing the need for help can represent meaningful growth. Rather than measuring improvement solely by what an adolescent has stopped doing, it can be helpful to recognize what they’re beginning to do differently.

Why IOP and PHP Offer a Different Kind of Support

For some adolescents, traditional weekly therapy provides the support they need to manage their mental health. For others, challenges may begin affecting multiple areas of daily life, requiring more frequent, structured care. This is where intensive outpatient programs (IOP) and partial hospitalization programs (PHP) can play an important role. These levels of care provide structured mental health treatment for adolescents who need more support than traditional outpatient therapy, without requiring overnight hospitalization.

At Embrace U, treatment may include:

• PHP: a level of intensive level of daytime care, involving treatment five days per week for a minimum of five hours per day.
• IOP: a structured level of daytime care, involving treatment three days per week for a minimum of three hours per day, allowing adolescents to continue participating in aspects of their everyday routines.

The additional time in treatment creates opportunities for therapists to understand an adolescent’s challenges, build trust, and reinforce new skills.

“In an IOP/PHP setup, therapists have an opportunity to see more of the behaviors and struggles that caregivers so often try to articulate to us,” said Pinckert. “With more time spent together, we also have the opportunity to build a solid foundation of trust within the therapeutic relationship, as we have more moments to support our adolescents with struggles in the moment.”

Rather than discussing a challenging situation only after it happens, adolescents may have opportunities to practice emotional regulation, healthy communication, and problem-solving in a supportive therapeutic environment, alongside same-aged peers. This approach can be valuable when progress feels inconsistent, as it allows adolescents to revisit skills, identify patterns, and receive ongoing guidance.

The need for accessible support remains significant. According to KFF’s analysis of the 2024 National Survey of Children’s Health, nearly 41% of Tennessee children aged 3-17 who needed mental health care experienced some degree of difficulty accessing it. Programs such as IOP and PHP offer additional options for families seeking an appropriate level of support for their adolescent’s needs.

The Small Signs Therapists Look For

Some of the most meaningful indicators of progress aren’t immediately obvious. While improvements in school, relationships, or behaviors may take time, therapists also pay attention to smaller changes that signal developing emotional awareness and coping skills.

Sign 1: Greater Willingness to Participate – An adolescent who once avoided treatment may begin contributing to group discussions, asking questions, or becoming more comfortable expressing their thoughts. Outside treatment, this might look like getting out of bed with less difficulty, showing renewed interest in a favorite activity, or spending more time with family. These changes can indicate that an adolescent is becoming more engaged with their surroundings and open to support.

Sign 2: Improved Emotional Awareness and Communication – Recognizing emotions is an important step toward learning how to manage them. An adolescent who previously shut down during disagreements may begin identifying why they’re upset. Another might communicate a specific need rather than expressing frustration through an argument.
“Our adolescents have expressed feeling empowered and confident as their communication skills improve, and they are able to use coping skills intentionally during moments they struggle,” said Pinckert.
These improvements may also affect relationships with siblings, friends, and caregivers as adolescents become better equipped to communicate their feelings and needs.

Sign 3: More Intentional Use of Coping Skills – Learning a coping skills in therapy is one thing, but recognizing when and how to use it in everyday life is another. Therapists look for moment when adolescents begin applying what they’ve learned, whether that’s taking a break during an argument, asking for help before becoming overwhelmed, or using grounding techniques when experiencing anxiety. An adolescent may not use those skills perfectly every time, however, recognizing an emotional trigger and making an intentional effort to respond differently is progress worth acknowledging. Over time, these small decisions can build greater confidence, independence, and emotional resilience.

The Role of Family in Treatment Progress

An adolescent’s mental health journey doesn’t happen in isolation. Parents and caregivers play an important role in creating environments where skills developed in treatment can continue to grow. However, supporting progress doesn’t mean constantly monitoring behavior, expecting immediate results, or encouraging an adolescent to improve faster.

“Our teens often feel immense pressure to prove themselves to both their peers and families, and they often verbalize this during treatment,” said Pinckert. “Families being able to validate this pressure can often help teens who struggle with motivation or avoidance of treatment, due to fears of failure or feelings of overwhelm.”

One of the most meaningful things families can do is recognize effort without demanding perfection. Parents or caregivers using the labeled praise strategy is an encouraged method because it involves recognizing specific positive behaviors rather than offering general compliments. For example, instead of simply saying, “Good job today,” a parent or caregiver might say, “I noticed you took a moment to calm down before ewe continued our conversation. I really appreciate the effort you made.” This type of encouragement helps adolescents identify the choices they’re making differently and understand that those choices matter.

Families can also support progress by maintaining open communication, validating difficult emotions, and working with their adolescent’s treatment team to establish realistic goals. It’s equally important for parents and caregivers to recognize their own emotional needs throughout the process, as well. Embrace U is one of the only outpatient programs to offer a parent support group that connects parents with therapists in open discussions about treatment.

“Caregivers often experience that, while their child is struggling and going through treatment, their own parts and struggles come up as well,” said Pinckert. “I always want to encourage caregivers to explore with me what their support system looks like and finding people that they can lean on during this time.”

Supporting an adolescent through mental health challenges can be exhausting, especially when progress feels uncertain. Building a support system, seeking guidance, or participating in therapy themselves can help caregivers navigate those challenges while maintaining their own well-being. The goal isn’t for families to manage every difficult emotion their adolescent experiences. It’s to create an environment where growth feels supported, understood, and sustainable long-term.

What Lasting Progress Really Means

One of the most important goals of mental health treatment is helping adolescents carry the skills they’ve learned beyond the therapy setting. Progress shouldn’t end when a program does.

At Embrace U, treatment focuses on not only helping adolescents develop coping and communication skills, but also on applying those skills in their everyday lives, whether at home, at school, or with friends. Through individual therapy, group sessions, family involvement, and practical activities, adolescents have opportunities to practice responding to situations they may encounter outside of treatment. As adolescents prepare to transition out of IOP or PHP, continued support may include connecting families with trusted outpatient providers to help maintain progress after discharge.

So what does sustainable progress actually look like? It doesn’t mean that an adolescent will never experience anxiety, depression, frustration, or emotional setbacks again. Instead, it means that they may recognize when they need additional support, recover more effectively from difficult moments, communicate their needs, or trust themselves to navigate a challenge.

“Sustainable progress after discharge can look like an adolescent showing resiliency during challenges and hardship, and a belief in themselves that they are capable of handling what may come up as their journey continues,” said Pinckert.

Ultimately, lasting progress isn’t measured by the absence of difficult days, but by an adolescent’s growing ability to navigate them with greater awareness, confidence, and support.

Every Step Forward Matters

If your adolescent is still struggling while receiving mental health treatment, it doesn’t automatically mean that treatment isn’t helping. Progress may be happening in ways that aren’t immediately visible, and setbacks can be a part of learning new skills. Persistent or worsening difficulties should still be discussed with their treatment team so that support can be adjusted when needed.

At Embrace U, we understand that every adolescent’s mental health journey is different. Our IOP and PHP programs provide structured, compassionate support to help adolescents develop the skills, confidence, and resilience needed to navigate life’s challenges. If your child needs additional mental health support, you don’t have to navigate the journey alone. Contact Embrace U to learn more about our programs and how we can support your family. Call 833-733-4325 to take with our intake team about cost, schedule, and treatment goals.