ASCEND/Young Adult Services

as-cend: V. to go or move upward; rise; advance.

Ascend is an intensive outpatient service that was developed to help young adults between the ages of 18 and 28 who are struggling to navigate the path from adolescence to young adulthood. It is based on our philosophy of practice that if individuals accept their strengths and challenges they can use that acceptance to develop goal directed behaviors, sustained achievement, meaningful relationships and overall health and stability.

Service Description

To help clients attain increased self-reliance, Ascend thoughtfully integrates individual, family, group and art therapy with DBT skills training, medication evaluation and management, and life skills training and support. Treatment in Ascend will take place within a dynamic and cohesive peer group, and participation in the service includes up to 6 to 8 clients at a time to ensure that each client’s unique needs are met. Primary treatment goals related to mood stability and functional behavior are addressed alongside academic and vocational planning and support. Treatment progress follows a structured model that involves identifying realistic strength based short and long term goals. These goals inform intervention and supports with specific attention to patterns and symptoms that have served to impede growth and success.  Regular treatment team meetings are used to conceptualize, assess, and modify treatment planning and progress.

Our model is based on our extensive collective experience in psychiatry, mental health, prevention and education. The service was initially developed by integrating the components of successful milieu treatment with concrete intervention that reflect the reality that sustainable change requires attention to concrete goals and daily life skills. The original program has been enhanced through outcome based studies and observable success.

Clients in the Ascend program participate in 15-17 hours per week of intensive treatment and support. Each participant attends all of the groups in the service, which range from psychotherapy groups to goal directed and behavioral groups. Groups also incorporate art therapy and attention to addictive behaviors. Groups are categorized into two different types and respectively focus on both underlying mental health, behavioral or relationship issues that impair a client’s ability to function on a daily basis and concrete goals related to improving self care and individual functioning. Frequency of individual therapy, family therapy, medication management, academic and vocational coaching are based on collaborative decisions informed by short and long term goals.  More detailed information about specific program components is found on our Service Components and Schedule.

Family Involvement

Family involvement in Ascend is crucial to the client’s success. Outcome data and observations have shown us that clients whose parents actively engage in the therapeutic process while their son or daughter are in the Ascend service are better able to sustain progress post discharge.

Intake and Admission

Prior to admission, the Intake Coordinator will conduct a thorough assessment to determine whether Ascend is an appropriate level of care and effective plan to help the client attain their goals. The initial intake and assessment may span several telephone and in person meetings and time to collect data and feedback that brings clarity to treatment formulation and recommendations.  We aim to make the intake and admission process efficient but recognize that it takes time to gather the appropriate information that informs effectual treatment planning.

The Ascend intensive outpatient service does not participate with health insurance plans. However, many health plans include benefits for out of network mental health treatment. In addition, many plans require pre-authorization for services. We strongly encourage families to research their health benefits prior to admission so that we can provide any necessary documentation for authorization.

Stages of Treatment

Once admitted, participation is voluntary and requires a minimum commitment of three months. Clients and their families gradually progress through three stages of treatment.

Stage I, Intensity, focuses on short and long-term goal identification, forming working alliances with the treatment team and developing connections to peers in the service.

Stage II, Progress, emphasizes the implementation and monitoring of treatment goals.

Stage III, Ascent, is characterized by the achievement of increased self-sufficiency, motivation and self-advocating skills. Clients in this stage gradually transition out of Ascend.


One to two months prior to discharge, discharge planning begins. Upon discharge from Ascend, clients gradually decrease the intensity of treatment and support. The transition plan is collaboratively made and involves continuation of modalities of treatment that support long term sustained change. This can include ongoing work with their individual and family therapist as well as participation in art therapy group, process group, DBT group and/or a goals group. Furthermore, the client may wish to continue meeting with the Director of Education/Vocation Services in order to pursue educational and/or vocational goals. The Ascend psychiatrist only manages medication(s) of Ascend clients while they are actively participating in the service. Two to four weeks prior to discharge the client schedules an appointment with either their prior treating psychiatrist or is referred to a new psychiatrist. The Ascend psychiatrist and the client’s individual therapist facilitate this transition.

Contact Us

7201 Wisconsin Ave
Suite 700
Bethesda, MD 20814

Phone/fax 301 654 7770