Before You Refer to the Hospital: De-Escalation, Safety Planning, and Wraparound Care for Teens in Crisis

About this episode

The episode discusses the complexities of managing suicidal teens in crisis and the potential harms of defaulting to hospitalization.

Before You Refer to the Hospital: De-Escalation, Safety Planning, and Wraparound Care for Teens in Crisis When a suicidal teen is in crisis, is the hospital really the safest call? What outpatient therapists need to know. Curt Widhalm, LMFT, leads this episode from his work running a comprehensive DBT private practice in Los Angeles that specializes in higher-acuity adolescent cases, including teens with serious suicidality, self-harm, and emotional dysregulation. These are exactly the clients most often routed toward psychiatric hospitalization or platform-based care, and Curt argues the default-to-hospital reflex frequently makes things worse, not better. Drawing on recent research and his clinical experience, Curt walks through the iatrogenic harms of adolescent psychiatric inpatient care, why post-discharge is the highest-risk window for completed suicide, and how clinician anxiety can drive premature 5150 holds and crisis referrals. Katie Vernoy, LMFT, joins with years of LPS-designated assessment experience from community mental health, naming what really happens when a teen gets sent in, including the relational rupture that often starts the moment a crisis evaluation is…

People in this episode

Host: Curt Widhalm

Guest: Katie Vernoy

Topics covered

• de-escalation
• safety planning
• wraparound care
• teens in crisis
• psychiatric hospitalization
• outpatient therapy

Keywords

• suicidal teens
• crisis intervention
• iatrogenic harms
• risk assessment
• family-integrated care

Mentioned in this episode

Organizations: DBT private practice, community mental health

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