ASCEND Intensive Outpatient Services

Ascend is currently meeting in-person. A hybrid of in-person and teletherapy is used when needed. Please contact: Amye Fried at 301-654-7770 x705 or or Caryn Harris at 301-654-7770 x714 or harrisc@metcounseling to inquire more and set up an intake.


Young adults in Ascend spend 15-17 hours per week in intensive treatment and 3 hours/week volunteering. The program integrates four different modalities of therapy: individual, group, family and medication evaluation and monitoring. Treatment components also attend to physical health and wellness and to individual and group work on concrete academic and/or vocational goals.

Process group

Process group is a central component of Ascend. Process groups give clients a safe place to work though conflicts and emotional issues. Not only can clients gain insight into their own thoughts and motivation, but they can also offer suggestions and support to their peers. The connection the clients establish with peers and group facilitators is based on trust and as result the young clients feel safe to explore and share fears, feelings and problems. Ultimately, they experience difficult interactions and complex emotions in a new and empowering way.

Dialectical Behavior Therapy (DBT)

DBT is an empirically based therapy developed by Marsha Linehan. DBT focuses on helping people manage difficult relationships and overwhelming emotions. It is based on the belief that sustainable progress requires a “dialectical” ability to accept one’s current reality and to simultaneously hold onto hope and make changes in one’s life. Awareness and acceptance are practiced and become the foundation to achieve and protect effective behaviors. It is taught as a skills curriculum and is divided into four modules. The four modules include:

  • Mindfulness – is the ability to be aware of bodily sensations, emotions and thoughts associated with the present moment. It applies to developing control over one’s attention. Mindful living is central to the other modules.
  • Distress Tolerance – is built through accepting reality as it exists and then focusing on the variables one has control over. It also encompasses learning ways to self soothe and reduce the suffering that can be associated with emotional pain.
  • Emotion Regulation –helps one to identify and better understand how they experience emotions and the functions they serve. We use this understanding to develop skills to decrease the sensitivity and intensity we have to negative emotions. This further applies to managing feelings without being reactive or destructive to one’s self, goals or relationships.
  • Interpersonal Effectiveness – teaches skills for expressing oneself, stating one’s needs, setting limits and preserving important relationships. It rests on the ability to identify our objectives and to discern destructive patterns of behavior. Skills are taught to have more control, choice and success in balancing goals, relationships and self esteem.

Each module offers a number of skills to achieve the desired goal, allowing clients to eventually identify and practice those that are most effective for them.

Art Therapy

Art therapy is a form of self-discovery and expression that uses the creative process of making art to improve a person’s physical, mental and emotional wellbeing. The creative process involved in expressing one’s self artistically can help people to identify, contemplate and resolve existing struggles as well as manage behaviors and feelings, reduce stress, and improve self-esteem and self awareness. Art therapy is grounded in expression of feelings and thoughts and NOT artistic ability. The members are given the opportunity to share their artwork in an effort to practice putting words to their feelings and to connect with each other.  The experience provides a weekly visual diary of their inner world and an opportunity to apply newly understood feelings into their lives.

Narrative Therapy

Is a form of psychotherapy that helps clients create, understand, accept and tell a cohesive personal life story. Their life story is based upon an in-depth understanding of their values, skills, general knowledge, challenges and strengths.  Clients are given a prompt at the beginning of the group that helps deepen their self knowledge in one of the above mentioned areas.

Life Skills

In Life Skills, we introduce and practice skills that are associated with living a higher quality and more functional life. The skills introduced in group include, but are not limited to: social skills, interview skills, resume writing skills, and time management and organizational skills. In addition, the group learns, often through hands on experience, how to manage finances, set up a bank account, navigate public transportation. It should be noted that the skills of each individual in the Ascend group are assessed and, when possible, are personalized to best meet their needs.

Yoga and Fitness

Yoga and fitness are critical components that provide clients with the confidence and strength to make informed decisions about their health and fitness. Every week, clients participate in yoga to develop balance, core strength, and focus through flow and restorative yoga practices. Fitness also meets weekly and challenges young adults to identify their internal and external strength, flexibility and endurance.  Our trainer assesses each individual to identify their ability level and develops a plan for success at any fitness level.

Goals Group

This group focuses on establishing short-term and long term goals. The purpose of the group is four-fold:

1) To identify areas for personal growth and make a commitment to actively address these areas.
2) To regularly monitor and assess progress made in regard to goal setting as well as the Ascend Program as a whole.
3) To become and remain focused on what a client wants in their life.
4) To create and execute a plan to meet goals both in and out of the program.

Goals are categorized in two ways: short-term and long-term.

Short-term goals are objectives the client hopes to achieve within 1-4 weeks. Examples of common short-term goals for clients beginning the program include: using DBT skills to practice coping effectively, beginning to identify what you have control over and what you don’t, establishing and maintaining a consistent schedule, increasing physical independence by decreasing anxiety related to transportation, reaching out to people outside the program for social purposes, begining or continuing an exercise regime, and developing a plan to implement time management and organizational skills.

Long-term goals are goals the client hopes to establish at some point in his/her lifetime. Examples of long term goals may include: pursuing a degree or career, living independently, finding a job, developing and following a budget, developing and sustaining social relationships, improving family relationships, knowing and accepting oneself, being kind to myself, feeling worthy, and staying safe even when distressed.

Treatment Team Meetings

Treatment team meetings start upon admission and occur monthly through the course of treatment. Initial treatment team and Discharge meetings are 45-60 minutes and intermittent meetings are 30 minutes in length.

During these meetings, short and long-term goals are set and reviewed collectively and modified according to observable change. In addition, over-all progress is discussed, areas of concern are identified and discharge/continuing care plans are made. We encourage participants to have an active role in their treatment meetings, which models the competence and autonomy that will correlate with success beyond treatment.

Family Involvement in Treatment

In addition to weekly family therapy, parents are expected to participate in a 1-hour parent intake, an initial treatment team meeting, a twice monthly DBT/Support group and the final discharge/graduation meeting.  Additionally, the Program Coordinator contacts each family weekly to offer feedback from the treatment team and to closely track progress.  Individualized decisions are made collaboratively regarding family involvement in treatment team meetings.

Contact Us

7201 Wisconsin Ave
Suite 700
Bethesda, MD 20814

Phone/fax 301 654 7770