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Adolescent Mental Health 
Intensive Outpatient Program

Clear Reflection IOP Brochure JPEG.jpg


What is an adolescent IOP program, anyway?

Our Adolescent Intensive Outpatient program (IOP) in Milford, NH is designed specifically for teens ages 12-18, and their families, who find themselves in need of support beyond once per week counseling and don't meet the need for inpatient hospitalization or residential mental health treatment.


In working with teens over the years we have found that we have a lot more success with adolescents and families at this intermediate level of care than in just once per week individual counseling. By nature teenagers have a harder time opening up to therapists, or to anybody, while discussing sensitive topics unless they trust who they are working with. This relationship can be very difficult to establish with an individual therapist who they only see once per week.


We use the time that kids are with us (6-9 hours per week) to establish a trusting relationship and get to know them on a deeper level which we believe leads to more effective therapeutic relationships and in turn lends to more positive, lasting, and transformative change.


This model also affords us the opportunity to offer supplemental therapies like movement and mindfulness groups, arts and crafts, music groups, board games and puzzles, nature activities, and a family component to the program.

What kind of kids do you work with?

We work work with teens, and their families, who could be struggling with any of the following:


       1. mental health concerns -  whether developmentally or biologically based, this can look like depression and anxiety (lack of interest, low motivation, avoidance), self harming behavior (superficial cutting not requiring medical attention), suicidal ideation (without plan or intent), or social isolation (school avoidance, lack of peer relationships, excessive time spent on internet or phone). Teenagers who have a family history of mental illness might be at a higher risk for developing these concerns and early intervention can make a big difference. 





2.  family dynamic concerns - like strained relationships between teens and parents or changes in family structure through divorce or loss of a parent. These situations can be extremely challenging and dis-regulating for teens (even when they say they aren't) and can manifest as mental health or behavioral health symptoms immediately or even later in life.

         3.  peer or school related concerns - school can be a difficult place for some kids and for different reasons. We work with teens who might be involved in bullying situations (either victim or perpetrator). We can also help navigate poor grades, school avoidance, or disruptive behavior in teens. Our team has worked with school counselors to help with IEP plans or with other potential accommodations.

        4.  navigating the normal challenges posed by the difficult stage of life called adolescence.



How does the program work?


The IOP meets 3 times per week from 3 pm to 6 pm and offers an optional Multifamily Parents Group once a week.

Monday: 3pm - 6pm

Wednesday - 3pm -6pm

Thursday - 3pm - 6pm 

Parents Group meets weekly on Thursdays from 5pm - 6pm

We do ask for a minimum of 2 day per week attendance and encourage all 3 days if possible.

You can expect your child to participate in the program anywhere between 2 and 3 months and then be scheduled to follow up with individual therapy either with Clear Reflection or a referral will be made.



depressed teenager
sad teenager
technology use
family dynamics
ovrwhelemed teen
parents fighting with teenager
healthy group of teenagers
emotionally strong kids

The Adolescent Intensive Outpatient at Clear Reflection has two main parts:

First is the adolescent group therapy component. This is the main component of our program and what we believe to be the most effective aspect of the IOP. This is where we shine and where we might be different than a lot of other programs!


The groups include structured process groups, didactic coping skills groups, and unstructured community building groups. Whether in a process group, during an arts and crafts activity, or taking a group walk on a beautiful day,  the underlying focus and theme of the program is always on being a positive and healthy group member. We believe this is achieved by committing to our non-negotiable group norms called "The Behavioral Guidelines" which are essentially an outline on basic human decency and healthy living which can be achieved by anyone willing to commit to the practice! 











The benefit of this type of behavioral based focus is that it is not specific to any mental health diagnosis or a particular stressor. We believe, and have seen time and time again over the years, that focusing on positive solutions rather than problems, creating proactive and concrete plans, and establishing and committing to healthier habits are the most effective practices and  A comprehensive approach for optimal health!

Individual check ins with counselors and case managers are done throughout the program and healthy snacks such as fruit, cheese, crackers, and popcorn are provided daily!



The Second component of the program is the family component. The family component includes weekly multi-family parents group, biweekly phone calls to parents from a case manager, self-paced educational modules online (coming out Summer 2023), and referral to long-term family therapy when needed. Family sessions can be accommodated when necessary and per child and parent’s agreement.


Success is linked to active participation in both components of our program and those who are willing and able to dedicate themselves to our simple (but not necessarily easy) approach often report drastic improvements in their lives!

group therapy
family therapy
parents group
healthy snacks
individual counseling

While the program description above is a simplified, cliff notes version, Victoria goes into much further detail on our approach and philosophy in the Parents Handbook below:   

Parents Handbook

Parents Group Flyer

The Behavioral Guidelines

Digital Flyer

Is the Adolescent Intensive Outpatient Program covered by my insurance?

Most likely! The Adolescent Intensive Outpatient Program at Clear Reflection Counseling Associates is in network with most commercial insurance plans and all 3 NH Medicaid plans! Give us a call and we'd be happy to check for you if you aren't sure.

Beautiful group space Intensive Outpatient Program

Our group space is comfortable and casual and provides an "at home" feel for teens to relax into the space.  

friendly russian torts
therapy dog

Meet Indie, Our trained facility therapy dog!

fun group space, teen mental health program

We promote a "seriously fun" approach to mental health treatment by incorporating games, puzzles, walks, arts and crafts, and music into our therapeutic day. 

Group building
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