Intensive Family Outpatient Program

The Next Step Behavioral Health is pleased to be able to provide an Intensive Outpatient Program working with families with complex needs. This unique program provides a targeted curriculum to help families that are experiencing a high level of distress that cannot be resolved through traditional treatment approaches. The aim of this program is to keep families together within the community and divert the need for advanced judicial involvement or long term residential/inpatient treatment. The program incorporates the philosophies of Dialectical Behavioral Therapy as the foundational component of our treatment model. We will engage both client and caregiver(s) in an intensive 34-hour treatment program.

Dialectical behavior therapy (DBT) is a state-of-the-art, evidence-based form of cognitive behavioral therapy for teenagers who experience significant trouble managing their emotions, thoughts and behaviors.

In order to more effectively manage intense emotions that can lead to impulsive decision-making and problematic behaviors, clients participating in DBT learn how to practice mindfulness — fully being present in the moment and focusing on one thing at a time, without judgment — along with new problem-solving skills. When mindful awareness is combined with effective problem-solving skills, sensitive and emotionally reactive teenagers have the tools to respond flexibly to difficult and stressful life experiences.

This approach has helped teenagers who struggle with any or all of the following:

• Impulsive/disruptive behaviors

• Frequent mood swings

• Self-injurious and suicidal behaviors

• Depression and anxiety

• Family and peer conflict

• Anger outbursts

• Eating disordered behaviors

• Drug or alcohol abuse

• Poor coping skills

Considerable research has been conducted on DBT, and multiple randomized controlled research trials have demonstrated its effectiveness. At Next Step, we treat many young people who struggle with emotional ups and downs and assist families who want to help their children manage these intense emotional fluctuations. DBT is an excellent option for those who want a comprehensive treatment that teaches emotional, behavioral and cognitive skills.

Anticipated outcomes include:

1. Understanding, managing and regulating emotions

2. Tolerating distress and crises without making problems bigger

3. Maintaining satisfying relationships with others

4. Increasing self-awareness, expanding one’s ability to recognize alternative points of view and managing emotional situations

5. Increasing problem-solving skills, learning validation and effectively managing differences of opinion with family members

Program Overview


All new clients will be given a comprehensive diagnostic evaluation by one of our team clinicians to determine if IOP is the best therapeutic intervention for them. Full diagnostic feedback and treatment recommendations will be given as part of the evaluation. Current clients will participate in consultation for the same purpose.


Participants in the Intensive Outpatient Program agree to commit to the following treatment interventions over a 4-week period of time.

DBT Skills Training

DBT Skills training is made up of four modules: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. They are designed to specifically assist individuals in better managing behaviors, emotions and thoughts. The intent is to help people who experience problems with anger or the expression of anger, episodic depression, irritability or anxiety, intense or chaotic relationships, impulsivity, stress and feelings of emptiness.

Core Mindfulness teaches a person how to focus their mind and attention. Distress Tolerance develops acceptance of the current situation as well as crisis survival skills to decrease the likelihood of engaging in problematic behavior. Emotion Regulation skills include learning to identify and label current emotions, identifying obstacles to changing emotions, reducing emotional reactivity, increasing positive emotions and changing emotions. Interpersonal Effectiveness skills teach helpful strategies for asking for what one needs, saying no, and coping with interpersonal conflict.

Multi-Family Group

These groups will last 60 minutes and will be utilized as a forum to discuss concerns that exist within the family constellation and environment. Members will help reinforce new norms and learns to establish and accept boundaries and limits relative to the roles within the family unit. Parents/caregivers will learn how to more effectively communicate with their children, enhance their own coping skills and empower their child to use DBT skills to deal with problems

Individual Group Structure (90 minutes)

Orientation and introductions (5 minutes)

Here and now, interpersonal focus (15 minutes)

Mindfulness activity (5 minutes)

Practice review (20 minutes)

Short Break (5 minutes)

DBT Skills Training (60 minutes)

Short Break (5 minutes)

Multi-Family Groups (60 minutes)

Mindfulness activity and/or additional summary time (10 minutes)

DBT Individual & Family Therapy

1 hour each week will be allocated for participants work on specific problem behaviors and apply techniques learned in the skills group to their goals. This session will be conducted outside of the normal IOP hours.

Skills Coaching by Phone

Available to help participants apply skills at the moment they are needed before high-risk behaviors occur.

Consultation Team

Our clinicians meet regularly as a consultation team to support one another and think creatively about the best ways to help teens and their families.

DBT Parent Skills Training

Parents have the opportunity to work on specific problem behaviors and parenting goals by combining techniques learned in the skills group with parent management training. Offered on an as needed basis as an add on component that is exclusive of the program.

IOP also includes medication management as needed.

Knoxville                                    Johnson City                          
252 Harry Lane Blvd.               207 N. Boone St.
Suite 202                                   Suite 600
Knoxville, TN 37923                Johnson City, TN  37604

402 Greenbelt Drive
Maryville, TN 37804

Phone: (865) 338-5384
Fax: (865) 338-5383

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