Treatment General		If you decide that you are going to treat these patients, and you certainly may depending on your comfort level, you have to ensure that they will be safe! Some things that you can tell the parents to do to make the home safer are: Remove all guns from the home!! Remove all knives Remove all medications, especially Tylenol, cold medications and anti-depressants - either remove them or make sure they are in a safer place You must establish a therapeutic alliance with both the parents and the patient. However, it is essential that you breach confidentiality if a patient is actively suicidal or homicidal. It is very important that you collaborate with a psychologist or psychiatrist in your community and coordinate treatment with them. Many studies have recommended cognitive behavioral therapy (CBT) in conjunction with psychopharmacologic therapy, such as with an SSRI. One of the largest, conducted from 2002 to 2004, is known as the TADS study - the Treatment of Adolescents with Depression Study. It reported that 71% of adolescents responded positively to a combination of CBT and treatment with an SSRI. This was twice the placebo rate. If you choose to hospitalize a patient, this can accomplish several things: Most importantly, it removes a suicidal adolescent from a stressful environment! It deters an immediate suicide attempt It sends a clear message to both the teen and the parent that this behavior is a serious threat to their health and well-being Finally, it allows the mental health care provider to establish care for the patient and to determine a plan for outpatient management Return to top of page