New Research: Why Parents Noticing More Mental Health Symptoms Can Help Teens Heal Faster

Written By: Charlie Health Editorial Team

Teens and caregivers often see mental health symptoms differently. Charlie Health’s recent study explores what this means for outcomes in virtual intensive outpatient programs.

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When a young person enters treatment, two stories often emerge: how they describe their own symptoms and how their caregiver describes what they see at home. These perspectives don’t always match — and new research shows how that discrepancy can indicate a teen’s treatment outcomes, and expose opportunities for clinical support. 

In a recent analysis by Charlie Health of 763 caregiver-teen duos, researchers found that when caregivers rated their child’s depression and anxiety symptoms as more severe than the child rated them, the child actually had better outcomes in treatment. In other words, higher caregiver concern at intake was linked to greater improvement by discharge.

This finding, and others, were recently published in a peer-reviewed article, representing one of the largest data sets exploring parent-child agreement in a virtual intensive outpatient (IOP) setting. Read on to learn more key takeaways from our research and learn how to access our virtual programs for you or someone in your life.

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Who participated in this research?

Our analysis included 763 teens and their caregivers, providing a window into the experiences of families navigating serious mental health concerns in a virtual treatment setting. Here’s a bit about the teens and caregivers who participated in our research:

• The majority of teens identified as white (70.8%)
• Most were female (52.4%) and neurotypical (40.4%)
• On average, teens were struggling with “moderate” levels of depression and anxiety, with scores around 13 on the PHQ-9 and nearly 11 on the GAD-7
• Nearly one in four (38.8%) teens reported engaging in self-harm, averaging just over six days in the past month
• The vast majority of caregivers were parents (93.7%)
• Many caregivers were also struggling with their own emotional well-being, with about one in four (44%) scoring in the “poor mental health” range on the WHO-5

It’s important to note that this research comes with limitations. The caregiver survey had a relatively small and not fully representative sample, and some demographic categories had to be combined due to low numbers. Because of this, the findings may not apply to every family or identity group, especially those who are underrepresented in mental health research. Future studies with larger and more diverse samples will help clarify how caregiver-youth agreement affects treatment outcomes across different populations.

Key finding: How caregiver-teen disagreement at intake predicts better outcomes

As mentioned, many teens entering our program were experiencing significant mental health challenges, with moderate depression and anxiety and, in some cases, recent self-harm. At discharge, we saw a clear pattern: teens who reported higher levels of depression and anxiety at intake tended to show the largest improvements over the course of treatment (based on the 221 caregiver–teen pairs who completed discharge surveys). That makes sense — when there’s more room to improve, the change is naturally bigger, and the intensive nature of our programs likely supports these meaningful improvements, researchers found. 

But an even more striking finding emerged when researchers compared teen and caregiver perspectives at intake. When caregivers rated their teen’s depression as more severe than the teen rated it themselves at the start of treatment, the teen was more likely to report lower depression at discharge. In other words, the greater the caregiver’s initial concern relative to the teen’s self-report, the better the teen’s eventual outcomes. This effect was meaningful, with intake agreement explaining 11% of the variance in depression scores at discharge.

Why might caregiver overestimation have a positive effect? It could reflect high caregiver engagement, vigilant monitoring, or strong motivation to ensure the teen gets support — all factors that can play an important role in treatment success.

Why this research matters for families and clinicians

This research underscores that multiple perspectives matter in treatment. Teens and caregivers each bring unique and valuable insights to the table, and disagreement between them is normal. Differences in perception don’t mean anyone is wrong — they often reflect developmental, relational, or communication dynamics within the family. 

Importantly, when caregivers notice distress early or perceive it as more severe than the teen does, it may actually support better treatment outcomes. These findings remind us that effective mental health care isn’t just about treating the teen; it’s about supporting the family system around them.

This research reinforces what we see in practice — and have already seen in other research: involving caregivers isn’t just helpful, it predicts better outcomes for teens in treatment.

Charlie Health offers evidence-based treatment for teens

At Charlie Health, these insights directly inform our virtual Intensive Outpatient Programs. Teens receive individual therapy, family therapy, and support for healthy communication in peer groups, all while clinicians track progress using validated measurement tools. Caregivers are intentionally engaged throughout treatment because aligning family understanding is a key part of the healing process. With this kind of support, managing your well-being is possible. Fill out the form below or give us a call to start your healing journey today.