Years of Struggle Led to a Secret Crisis. Then Sophia Started Charlie Health.

Written By: Ashley Laderer

For most of her life, Sophia faced behavioral health challenges with limited access to support. Virtual intensive treatment made all the difference.

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When Kristina learned that her 16-year-old daughter, Sophia, was self-harming and had written a suicide plan, her world stopped. “Sophia is my life,” she said. “I can’t imagine life without her.”

Kristina immediately reached out to Sophia’s therapist, but her daughter’s self-harming behaviors and suicidal thoughts proved too concerning to manage in once-weekly therapy. “This is beyond what I can help you with,” Kristina recalls her daughter’s therapist saying. 

Sophia is not alone. A recent study from the Centers for Disease Control and Prevention (CDC) shows that one in five teenagers struggles with suicidal ideation — a risk often tied to other mental health symptoms, like persistent feelings of sadness or hopelessness. The data points to a trend of rising distress among adolescents, especially girls, often exacerbated by a lack of accessible, specialized support.

Sophia’s long-standing struggles

Sophia struggled with her well-being from a young age, although it wasn’t always clear why. As a toddler, she had violent temper tantrums, and in elementary school, she would have meltdowns and refuse to go to school. Some mornings, Kristina had to carry her to the car. 

Around this time, experts diagnosed Sophia with oppositional defiant disorder (ODD) and obsessive-compulsive disorder (OCD), which were misdiagnoses. It wasn’t until sixth grade that a specialist identified Sophia’s behaviors as neurodivergent and diagnosed her with autism spectrum disorder. “Once Sophia understood that her brain works differently from others, it helped her understand why things were harder for her,” Kristina said. 

The crisis point: Suicidal intent and self-harm

While the autism diagnosis provided more of a roadmap for Sophia, she continued to struggle with depression symptoms and panic attacks. She found a therapist but could only see her once every couple of months — not enough to stave off a crisis. 

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The biggest concern came when she lost interest in spending time with her horse, Faith. “[My mom] couldn't get me to go to the barn, and something was wrong if I didn't want to go to the barn,” Sophia said. Things escalated from there, with the teen turning to self-harm to cope and going so far as to consider taking her own life, all unbeknownst to Kristina.

Sophia’s girlfriend made the difficult but life-saving decision to alert Kristina to the unfolding crisis. “She said, ‘Go to this specific place in her room, and here's where you will find what she's been using to self-harm, and you will also find her suicide plan,’” Kristina recalls.

A mother’s search for intensive support 

After Sophia’s therapist told Kristina that addressing suicidal intent and self-harm was out of her scope, she suggested looking into intensive outpatient programs (IOPs) — programs that offer more support than traditional once-weekly therapy, but not full-time care. 

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While the option seemed great on paper, Kristina ran into a barrier almost immediately: like many people living outside a major metropolitan area, the closest in-network IOP was a 90-minute drive away. That would mean three hours of travel, three days a week. The program also only offered one time slot, which conflicted with Sophia’s visits with her horse, and Kristina worried that such drastic changes in routine would exacerbate her daughter’s anxiety. 

Thankfully, Sophia’s therapist came through with another recommendation: Charlie Health’s fully virtual IOP, which was covered by their insurance. The team rallied around Sophia immediately. They helped her make a safety plan for the weekend and set her up with individual therapy and group sessions starting the following week. Instead of commuting hours every day, Sophia could log into virtual sessions at times that worked for her and spend spare time at the barn with Faith. 

Leveling up from sporadic individual therapy sessions to nine-plus hours of weekly treatment was overwhelming at first, but Sophia adjusted to the new intensity quickly. The flexibility to complete all these therapy hours from home (especially with her cat in her lap) made the transition more bearable, she recalled.

Finding community in neurodivergence 

There was another bonus to Charlie Health that Kristina and Sophia didn’t even know to expect: neurodivergent-affirming care, which validates neurodivergent identities instead of trying to change them. “The world wants everybody to fit into the square-shaped world, but Sophia’s a star, and she does not fit into that mold, and that’s OK,” Kristina said. 

As part of her program, Sophia connected with other neurodivergent teens and, for the first time, began forging meaningful social connections with peers who had similar stories and struggles. “That gave us a base to all get along and be respectful of each other,” she said of the other group members. 

Sophia even made a new best friend — a major accomplishment for someone who had always struggled to connect with peers. “He had just finished [the program], and I was just starting,” Sophia says. “We kind of just messaged sporadically, and we got closer. We told each other our stories and what we learned from Charlie Health.”

The pair learned they lived only a couple of hours apart and started meeting up in person. Now, as Charlie Health alumni, they continue to provide support for each other. “One of us will say to the other, ‘Hey, you're not using your DBT skills! You need to be using those right now!’” Sophia said, noting that it’s helpful to remind each other of the tools they learned in IOP.

Looking forward — at last

Today, Sophia is still growing into herself, but with a much stronger sense of direction. Before Charlie Health, she had a hard time seeing a future for herself, but now she’s actively working towards a bright one. Sophia has her sights set on attending college and becoming a vet after graduation. “I’m starting to finally kind of figure out who I am,” she said. 

Throughout Charlie Health’s IOP, she learned valuable tools to help her manage difficult emotions. Her mother notes that a flip didn’t switch overnight, but with time, Sophia’s been better able to handle her anxiety and other behavioral health symptoms. “She has different coping skills now. She has a voice that she didn't have before,” Kristina said of her daughter. 

Through it all, Sophia’s bond with Faith remains a constant source of comfort and connection. “Taking care of myself has helped me care for her,” Sophia said. “"I know she won't give up on me so I don't give up on her either."