Adolescent Services
Olathe & Lawrence, Kansas
Increase thriving by teaching skills that instill competence & confidence while managing symptoms
Group Therapy for Struggling Adolescents
Difficulties in regulating painful emotions are central to the behavioral difficulties of many adolescents (see Characteristics of Unskilled vs Skilled below). From these individuals’ perspective, painful feelings are most often the “problems to be solved.” These behavioral difficulties might be considered ADHD, anxiety, or depression as many of the symptoms and behaviors overlap and interact. For example, studies have found that having an anxiety disorder in early or middle childhood can increase your child’s risk of developing a depressive disorder in later adolescence. Both anxiety and depression can lead to dysfunctional behaviors, including suicidal behaviors, substance use, overeating, emotion suppression, overcontrol, and interpersonal mayhem, which are often behavioral solutions to intolerably painful emotions.
The Two Tents Intensive Outpatient Program (IOP) utilizes Dialectal Behavioral Therapy - Skills (DBT-S), ACT (Acceptance Commitment Therapy) for Adolescents in the form of DNA-V and exposure therapy. Our unique blending has become the BOLD Living Skills taught to help your young person and your family find more effective ways to regulate their emotions and thereby, their behaviors. All three clinical models have decades of evidence in effectively treating anxiety, depression, and the complications of ADHD, shame and guilt.
IOP Skills training is Monday through Thursday (4x per week) from 3:00-6:00 pm in a group setting usually over 5-6 weeks (~18-24 group sessions). Family Skills training weekly 4:30-6 pm on Wednesdays.
DNA-V & What Unskilled Living Looks Like
The purpose of DNA-V is to help develop values and live with vitality. The discoverer, noticer, and advisor provide the means to engage in valued action, supporting the values that lie at the center of the model. Values can be thought of as a compass that guides people through the storms and confusing times of life and toward the things they care about.
The Valuer influences Behavioral Regulation
Developing The Valuer is the process of helping to create contexts that empower young people to clarify what brings them vitality or value and then to choose value consistent actions.
Unskilled Behavioral Regulation looks like:
Impulsive behaviors such as cutting classes, blurting out in class & spending money,
Risky sexual behavior,
Risky online behavior,
Binging and/or purging,
Drug and alcohol abuse,
Aggressive behaviors,
Suicidal and nonsuicidal self-injurious behaviors.
Skilled Behavioral Regulation looks like:
The ability to successfully regulate one's thoughts, and behaviors in different situations
Effectively managing stress, controlling impulses, and motivating oneself.
The capacity to take action, sustain motivation, and persevere through challenges toward an identified goal.
The Advisor influences Cognitive Regulation
The advisor represents our inner voice. It is an incredible skill that helps us humans navigate the world efficiently. In contrast to the discoverer, the advisor space is about avoiding trial and error. It involves judging, evaluating, generating rules, listening to our self-talk, and problem solving. The advisor can become a problem if we use it blindly, we can lose contact with the physical world and use worry, rumination, our own self-talk or rules even if they do not help us grow.
Unskilled at Cognitive Regulation looks like:
Extreme, polarized, or black-or-white thinking and acting
Poor perspective taking and poor conflict resolution,
Invalidation of self and other,
Difficulty effectively influencing one's own and others’ behaviors (i.e., obtaining desired changes).
Skilled Cognitive Regulation looks like:
The ability to make constructive and respectful choices about personal behavior and social interactions based on ethical standards, safety concerns, and social norms.
Temperament toward reliably meeting commitments and fulfilling obligations of challenging roles.
Abilities to plan, strategize, and implement complex tasks along with the realistic evaluation of consequences of various actions, and a consideration of the well-being of oneself and others.
The Noticer influences Emotion Regulation
The Noticer represents a group of behaviors all humans are born with. Noticing creates the space between internal experiences (feelings and thoughts) and outward behavior, offering an opportunity to choose a behavior rather than “having to” react when difficult feelings and thoughts show up. When we don’t automatically react to our inner experience, we’re often able to better choose actions in the service of what we care about (our values).
Unskilled at Emotion Regulation looks like:
Emotional vulnerability;
Emotional reactivity;
Rapid, often exaggerated changes in mood, where strong emotions or feelings (uncontrollable laughing or crying, or heightened irritability or temper) occur.
Anger outbursts;
Steady negative emotional states such as depression, anger, shame, anxiety, and guilt;
Deficits in positive emotions and difficulty in controlling emotions.
Skilled Emotion Regulation looks like:
The ability to be aware of and constructively handle both positive and challenging emotions;
Experiences a range of positive and negative emotions in a safe context;
Demonstrates the skills to manage and express their emotions in effective ways;
Is able to notice the activity of his or her advisor in a given situation, and not react to it.
The Discoverer influences Self-Regulation/Relationships
The Discoverer finds new ways to be in the world. When people are in discoverer space, they’re behaving in ways that allow them to grow, learn, and expand their behavioral repertoire. Verbal behavior is often tied to the physical actions of testing and exploring.
Unskilled at Self-Regulation & Relationships looks like:
Lacking awareness of emotions, thoughts, and urges
Poor attentional control;
Unable to reduce one’s suffering while also having difficulty feeling pleasure;
Identity confusion, sense of emptiness, and dissociation.
Unstable relationships and interpersonal conflicts,
Chronic family disturbance,
Social isolation,
Efforts to avoid abandonment (unhealthy attachments)
Difficulties getting wants and needs met in relationships
Difficulty maintaining one’s self-respect in relationships.
Skilled at Self-Regulation & Relationships looks like:
The ability to accurately recognize one’s own emotions, thoughts, and values and how they influence behavior.
The ability to accurately assess one’s strengths and limitations, with a well-grounded sense of confidence and optimism.
The ability to establish and maintain healthy and rewarding interpersonal relationships with diverse individuals and groups. Relating to others with acceptance, understanding, and sensitivity to their diverse perspectives and experiences. This includes the ability to collaborate and coordinate action with others.
Along with the ability to communicate clearly, listen well, cooperate with others, resist inappropriate social pressure, negotiate conflict constructively, and seek and offer help when needed.
DBT-S
DBT-S
Utilizes Dialectical Behavior Therapy Skills training
DBT Skills Training groups are for clients who would like to cope more effectively with intense emotions, addictive behaviors, and/or relationship struggles. DBT Skills are taught to reduce self-destructive behaviors and learn more adaptive ways to manage painful emotions.
These skills include:
Mindfulness
Relationship Effectiveness
Emotion Regulation
Distress Tolerance
DNA-V
Discoverer
Noticer
Advisor
Valuer
DNA-V is an evidence-based model that promotes psychological strength, and that values consistent living, vitality, and success. It is designed to help people cope with challenges, stress, and change. DNA-V can be thought of as a combination of Acceptance and Commitment Therapy (ACT) and positive psychology, and is underpinned by contextual behavioural science.
Parents
Requried Involvement
Day 1 Orientation Monday 3-6 pm
Weekly Family Skills Group: Wednesdays from 4:30-6 pm
The goal of Family Skills Group is to build strong and effective partnerships with families that can help children and families thrive. These partnerships are grounded in positive, ongoing, and goal-oriented relationships with families.
Insurance
Covered by most major insurance companies.
Payment plans available.
The Adolescent Intensive Outpatient Program (group therapy) is either in-network or we can usually get authorization (coverage) from these companies. We are not a covered service and cannot get coverage from KanCare (including Aetna KanCare), Medicaid or Medicare. For those families, we do offer a self-pay rate, scholarships and payment plan options. At the assessment we will provide you a written review of your insurance benefits and out-of-pocket costs, if possible.
Aetna
BlueCross BlueShield / New Directions
Cigna
Humana
United Health Care/Optum (commercial, not Medicaid)
12-18 Year-Old Group
Weekly Family Skills Group
Wednesdays
4:30-6:00 pm
BOLD is a process for making Wise Mind decisions. Utilizing experiential learning, in-group practice, artful expression and daily goal setting we hope to support young people confront their defense mechanisms, cope with negative thinking; notice, understand and express their emotions while discovering new ways to interact with the world toward what matters to them.
That is the essence of BOLD Living.
What BOLD Living Looks Like
We hope that a young person completing the TWO TENTS IOP is displaying many and continuing to move toward all 20 of these Signs of BOLD Living.
I am Breathing Deeply & Slowing Down
My breath is like a ship’s anchor. It helps me stay where I want to stay, even when emotional forces are trying to pull me out to sea. I don’t always realize that my breath is a great source of strength and stability.
I am Unhooking From My Advisor
My thoughts and feelings no longer dominate me or jerk me around. They lose their impact and influence over me. This makes it much easier for me to choose how I behave.
I am Shifting Into Wise Mind
I am able to feel our emotions and focus on the facts. In Wise Mind, I make decisions based both on how I feel and the facts. Wise Mind helps me do what is healthy and effective.
I am Confronting My Defenses
At some point, everyone feels & copes with physical & emotional pain. Defense Mechanisms (DMS) are anything I do to avoid feeling emotions (especially, pain). I can confront my DMS by moving toward a Value, using a skill, or choosing to act opposite.
I am Validating Myself & Others
I try to see other's and my own feelings, thoughts, and actions as making sense, accurate, and acceptable in a particular situation by praising effort, strategy, choices and accepting corrective feedback.
I am Accepting Support
I am practicing Willingness to accept reality and use skills, values, tools, practices and/or a mentor that help me act like the kind of person I want to be.
I am Managing My Emotions
I try to understand and balance my emotions to be able to act Effectively toward what matters to me by Checking the Facts, Problem Solving or Acting Opposite when my emotions are challenging.
I am Taking a Break & Coming Back to Deal with the Issue
I know when and how to Take a Break (TAB) by focusing on something else for a while to reboot my mind so I can deal with the crisis, issue or emotion.
I am Discovering Sparks of Wonder
Sparks come from the gut & tap into our true passions. They motivate and inspire. Wonder is something beautiful, unexpected, unfamiliar, or inexplicable which increases curiosity and hopefulness.
I am Feeling My Feelings
By walking the middle ground between stuffing and sticking. I notice feelings without holding on to them. I feel emotions and then let them go when they are ready to go.
I am Breaking Old Patterns
Radical Acceptance does not mean that I have failed or that Ihave to put up with a hurtful situation. Radical Acceptance instead is about using my time and energy in a way that helps me move forward.
I am Setting Boundaries
Boundaries are limits. Setting boundaries is the way we communicate what is Ok and not Ok in relationships. I can assert my boundaries in several different areas: time, social media, personal information, & physical intimacy.
I am Thinking Flexibly
With a growth mindset I try to embrace challenges; persist in the face of setbacks; see effort as the path to mastery; learn from criticism; and am inspired and find lessons in the success of others.
I am Listening To My Values
Listening to my values means discovering what’s important to me in life—what matters to me and how I want to behave toward myself, in relationships, and in the wider world.
I am Bolstering My Noticer
I have emotional needs. There are emotional and behavioral consequences, if those needs aren’t met or if being met through unhealthy means (i.e., risky sex to feel connection). I can find healthy ways to get all these emotional needs met more often.
I am Forgiving Myself & Others
I am making a conscious, deliberate decision to release feelings of resentment or vengeance toward myself. a person or group who has harmed me, regardless of whether forgiveness is deserved.
I am Practicing Relational Agility
I am confronting the myths and factors that are interfering with my relationships and deciding on goals and priorities leading to healthy relations.
I am Deciding On Actions & Acting
Once I know what I want, I need to choose actions that will take me toward my goals and values. This may take courage, because sometimes I have to face my fears in order to do the things I care about.
I am Promoting Vitality & Self-Care
By connecting with others; embracing the moment; caring for myself; challenging myself & learning new things; being physically active; & giving to others & having a positive influence.
I am Choosing My Own Adventure
Choice Points come up all the time. Even though many things can pull me Away, I am moving ‘Toward’ my values by acting effectively and behaving like the sort of person I want to be.
The TWO TENTS TEAM
Clinical Director Bio
I’m a GenX, postmodern, question everything person who happens to be blessed with parents who took in orphans, prayed for food, answered their callings and sacrificed so their children knew they were loved. That mix created an irreverent soul that cares deeply for children, families and especially adolescents.
I have close to thirty years of experience working with and for children, youth and families catalyzing change at the individual, family, organizational and systems levels. With a Masters in clinical psychology, I have provided crisis management, intensive in-home therapy and wrap-around services for children with emotional and behavioral challenges. I have 20+ years’ working or volunteering with youth and young adults through youth ministry and community programs. In partnership with North Kansas City Hospital co-created the Quarky app to connect Kansas City 14-24-year-olds to articles, events and resources focused on mental health and well-being. Currently, I developed and direct the Two Tents Intensive Outpatient Program (IOP) for adolescents struggling with anxiety/depression. We are building strong partnerships with our area school districts and I am an invited speaker on Anxiety, Depression, Grit, SEL and Parenting. These opportunities have made me innovative, practical and taught me to think about enhancing the whole safety net surrounding at-risk children, youth and families.
I have a wonderful wife, Kori, who founded and runs the Renew Counseling Center in Olathe, a 13-year-old, Nora, twin boys (Grayson who is eight and Jude who went to heaven way too early) and have recently adopted two foster siblings (9 & 6) Chandler and Milla into our home.
I want to be a resource to the families that are currently in or have completed our program and don't take on individual clients.
Jason is willing to Present, Consult, Train or just be a Resource for Parents, Schools, Churches and Teens.
Clinical Team: All have their own private practices and see individuals and/or families. Contact them directly, if interested.
Joe Segraves, MA, LPC
Lawrence Site Director | Clinician
(913) 768-6606
Administrative Team:
Paperwork, Finances and Community Engagement make the work possible.
Why Two Tents?
You have options for adolescent intensive treatment: Some more conveniently located; some that meet at more convenient times; some that are connected to larger institutions. Below are some reasons families choose to join our program.
Helping Adolescents with Anxiety (Short Clips)
Topics
Be on the Journey Together I They Can't do this on their Own I Educate Yourself First I Using Mindful Action I Recognizing Anxiety I Anxiety is Bigger than "Mean" Thoughts I Creating a Thrive Filter for your Young Person I You're going to have to Parent Differently
Designed to Enhance & Partner (not compete) with:
Individual and/or family therapy
Medical interventions (psychopharmacology)
Education (school counselors / teachers / nurses)
Weekly communication with schools / therapists
Weekly AfterCare offered (click for details)
Parent Support Group on 1st & 3rd Wednesdays 6-7:20 pm
Many Adolescents are Struggling
The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of 10,123 adolescents aged 13–18 years in the continental U.S. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.
Results
Anxiety disorders were the most common condition (31.9%), followed by behavior disorders (19.1%), mood disorders (14.3%), and self-medication disorders (11.4%), with approximately 40% of those with one class of disorder also meeting criteria for another class of lifetime disorder. The overall prevalence of disorders with severe impairment and/or distress was 22.2%; (11.2% with mood disorders; 8.3% with anxiety disorders; 9.6% behavior disorders). The median age of onset for disorder classes was earliest for anxiety (6 years), followed by 11 years for behavior, 13 years for mood, and 15 years for self-medication disorders.
Conclusions
These findings provide the first prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents. Approximately one in every 4–5 youth in the U.S. meets criteria for a mental disorder with severe impairment across their lifetime. The likelihood that common mental disorders in adults first emerge in childhood and adolescence highlights the need for a transition from the common focus on treatment of U.S. youth to that of prevention and early intervention.
Many Adolescents are Struggling
The National Comorbidity Survey-Adolescent Supplement NCS-A is a nationally representative face-to-face survey of 10,123 adolescents aged 13–18 years in the continental U.S. DSM-IV mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview.
Results
Anxiety disorders were the most common condition (31.9%), followed by behavior disorders (19.1%), mood disorders (14.3%), and self-medication disorders (11.4%), with approximately 40% of those with one class of disorder also meeting criteria for another class of lifetime disorder. The overall prevalence of disorders with severe impairment and/or distress was 22.2%; (11.2% with mood disorders; 8.3% with anxiety disorders; 9.6% behavior disorders). The median age of onset for disorder classes was earliest for anxiety (6 years), followed by 11 years for behavior, 13 years for mood, and 15 years for self-medication disorders.
Conclusions
These findings provide the first prevalence data on a broad range of mental disorders in a nationally representative sample of U.S. adolescents. Approximately one in every 4–5 youth in the U.S. meets criteria for a mental disorder with severe impairment across their lifetime. The likelihood that common mental disorders in adults first emerge in childhood and adolescence highlights the need for a transition from the common focus on treatment of U.S. youth to that of prevention and early intervention.
TWO TENTS IOP AfterCare
The intensive program is a great opportunity to learn a lot of skills and decide on what big changes need to be made individually and as a family to move for more effectively. Sustaining change is hard.
AfterCare reinforces the skills taught, has been shown to decrease relapse and supports the climb up their Growth Ladders. Parent Support Group helps parents do the same.
Weekly AfterCare Every Wednesday
8575 W. 110th St., Suite 320, Overland Park, KS 66210
5:30 to 6:50 pm
Click here for more information and AfterCare schedule.
Two Tents Program & materials
DNA-V from The Thriving Adolescent © 2015 Louise Hayes and Joseph Ciarrochi / New Harbinger Publications.
BOLD from Get Out of your Mind & into your life for teens © 2012 Joseph Ciarrochi, Louise Hayes and Ann Bailey / New Harbinger Publications.
DBT Skills Training Manual © 2015 Marsha M. Linehan / The Guildford Press
DBT® Skills in Schools: Skills Training for Emotional Problem Solving for Adolescents (DBT STEPS-A) by James J. Mazza, Elizabeth T. Dexter-Mazza, Alec L. Miller, Jill H. Rathus, and Heather E. Murphy. Copyright © 2016 The Guilford Press.