Therapeutic Planning: Trends from 2024 & Predictions for 2025

Every year at McMillan Education, we experience a deep sense of responsibility and privilege in our work with families who are reaching out because their children aren’t doing well in learning and in life. Whereas many of our families have the gift of focusing on how they can help their children maximize their potential and get ahead in a competitive and uncertain world, these parents are experiencing day-to-day challenges that range from watching their children struggle to learn, socialize, and emotionally self-regulate to experiencing the full-blown terror of having a child in an acute mental health crisis. Parents are looking for answers and we continue to guide them during these difficult times through our expertise in child, adolescent and young adult development, our clinical experience as mental health professionals and learning specialists, our deep knowledge of effective treatment and educational solutions, and our compassion. 

Now, in our 70th year, we celebrate the decades of work lifting up students and families and developing deep relationships with the schools and programs where their challenges are best addressed and transformed into a healthier, more successful path forward.

This past year brought some unique challenges to families, to service providers, and to our work. Here are some highlights from 2024 as well as some of our predictions for students and the industry in 2025:

Student Trends and Predictions:

2024 brought many families to our door who were facing, most commonly, the following challenges:

  • Elementary-aged children on the autism spectrum:
    Thanks to our expertise in developmental differences and disabilities, we have been privileged to assist the increased number of families looking for guidance for their younger children struggling with challenges related to Autism Spectrum Disorder or other neurodivergent learning and developmental profiles. Most of these children are in the public school system, and many are already benefitting from a significant level of special education support services. Yet even ample school services have proved inadequate to meeting these childrens’ needs in the public school environment. On the whole, these children are experiencing levels of emotional and behavioral dysregulation and social and executive distress that make accessing learning and healthy development extremely challenging, if not impossible. Our team also saw an increase in physical aggression as a significant feature of this profile’s set of challenges. Even the best public schools can only do so much when these students require smaller classrooms, a full integration of specialized instruction to learning, and a robust social pragmatics curriculum. Many of these students would also benefit from occupational therapy in schools in order to enhance self-regulation and optimize the capacity for attention to learning and social interaction. We predict that this population will continue to grow in 2025.
  • Young adults not ready for college:
    College readiness continues to be both a sign of delayed development and a major disruptor to healthy development among our young adults. The profile of the young adult unable to manage the social, emotional, and academic demands for college continues to be primarily male with features of attentional and executive deficits, as well as, for a significant number, a range of challenges related to Autism Spectrum Disorder. While we continue to see young adult males in need of a “time out” from college to address mental health needs, skill deficits, and transcript repair, we have seen a surge of neurodiverse high school students looking for post-secondary guidance aimed at building college-readiness and independent young adult life skills. We predict that this population will continue to rise in 2025.
  • Older young adults not ready for adulthood:
    The crisis among young adults, regardless of whether they have been able to complete college or not, who are lacking the requisite emotional self-regulation, social, executive, and independent life skills to manage “adulting” successfully continues to grow. Most notably, this crisis has seen an increase in the time it takes for families and the young adult to confront the challenges and seek qualified assistance. Likewise, we have seen a longer timeline emerge for this population to complete effective treatment and consolidate the skills necessary to live and thrive independently as adults. As a result, “young adulthood” is more uniformly understood among practitioners and programs as extending to the age of 30. Treatment efficacy is still evolving for this population, which fits neither adult treatment modalities nor perfectly with the younger young-adult treatment modalities. We predict that 2025 will see more older 20-somethings seeking treatment and skill development support programs designed to consolidate effective “adulting” skills.
  • Increase in acuity and severity of mental health presentations, particularly among young adults:
    2024 saw a continuation of young people presenting with more acute and severe mental health challenges, including mood disorders, substance abuse disorders, thought disorders, and self-harming behaviors. In our experience, young adults have been particularly affected by serious mental health challenges known to emerge during that period of development. Regardless of age, we saw an increase in complex emotional and behavioral dysfunction characterized by a combination of Autism Spectrum Disorder challenges and serious mental health presentations. Unfortunately, this population is finding community-based treatment to be inadequate to creating robust outcomes, ending in students cycling in and out of treatment and having a major impact on education and employment. We predict that this trend will continue in 2025.
  • Increase in our specialty areas of college planning for neurodivergent students and students with a history of treatment and school disruption:
    2024 brought a sizable increase in the number of neurodiverse students we serve seeking college planning. We have seen a wide range of needs in this population, from high functioning students requiring a moderate level of specialized support in college to students requiring high levels of specialized support in a college environment. It has been a privilege using our training and experience in working directly with neurodiverse students and our deep knowledge of college programming designed to support the range of needs in this particular population in our college practice.

Similarly, the number of students seeking college guidance who also have a challenging academic and treatment history to account for in their application process continues to rise. These students have either completed treatment or are still actively in treatment, which means that they present with a range of needs in identifying colleges that provide an environment where they can thrive and where they will find adequate support. They also require specialized expertise to launch a successful candidacy, which has unique challenges characterized by school changes and disruptions, transcript and curricular anomalies, and limited activities outside of school, among other features of their unique histories. Finally, this population benefits from experts who have the clinical background to understand how their mental health challenges may present in the college process and provide them the strategies to work through those challenges. It’s been a privilege to combine our expertise as clinicians and college planners to help this growing population create a future of growth and optimism.

Industry Trends and Predictions:

2024 brought many industry trends to the forefront both in independent schools and in treatment program, including the following:

  • Elementary-aged children on the autism spectrum:
    Sadly, the independent school world has not yet adequately adapted to the growing needs of this population. The rapidly growing demand for schools that understand and provide specialized services for younger students with developmental differences has largely been left unfilled. While some have a recent successful history of making adjustments to programming to accommodate these students, too many have continued to believe that they can meet their enrollment demands by marginalizing this population, which will only continue to grow. Sadly, there also appears to be no appetite to build new independent schools specifically designed for this growing and needy population. We predict that this lack of imagination and investment into early early education of neurodiverse students will have a longer-term, negative impact on independent schools.
  • Young adults not ready for college:
    The constriction of the private behavioral health industry since the corporate take-over of this sector began during COVID has meant that there are fewer programs available to “failure to launch” young adults, who require academic, independent, executive, and attentional skill development (but not other specialized interventions) in order to ready them for college’s and young adulthood’s demands. While the response to developing programs in the private behavioral health realm that address the specific needs of the more significantly neurodivergent population has been relatively effective in meeting the demand for these programs, the socially and neuro-cognitively typical young adult who is not college ready has largely been left behind. More young adult programs are currently designed for the more clinically acute young adult and/or the young adult presenting with Autism Spectrum Disorder-related challenges. While we do not anticipate a growth in college-ready programming for this clinically softer “failure to launch” population, we hope we will see a resurgence in the future.
  • Older young adults not ready for adulthood:
    Fortunately, more young adult programming has chosen to expand to include older young adults. However, while the required treatment and skill development to address the deficits of these two age groups are largely the same, there is still a heavy implicit emphasis on younger, college-aged students in these programs. We hope to see programs create more specialized treatments, skills curriculum, activities, and goals for older young adults requiring this assistance in order to successfully launch into an independent adulthood. While we do not anticipate this development in 2025, we also hope to see an increase in the number of these programs in order to meet the growing demand of the crisis in “delayed adulthood” currently unfolding.
  • Increase in acuity and severity of mental health presentations, particularly among young adults:
    2024 saw the continued impact of the corporate take-over of private behavioral health in treating adolescents and young adults with significant mental health challenges. The corporate preference for shorter-term, insurance-driven treatment that produces higher profits for corporate ownership has resulted in young people cycling in and out of short-term residential programs, intensive outpatient programming, and partial hospitalizations with little or no healing or sustainable progress. We have been privileged to continue to work with the few private behavioral health programs that have survived the corporate take-over and continue to prioritize robust longer-term, integrated, comprehensive mental health care of the highest quality over quick and high margin profit-driven programs. We are saddened and distressed by the closures of lighter adolescent therapeutic boarding schools that have been a casualty of this corporate take-over as the need for them remains high. Sadly, we do not anticipate a resurgence of these smaller, more effective, owner-operated behavioral health programs in 2025. We will continue, however, to guide our families uniquely to these programs while warning against the corporate, profit-driven model of mental health care as the best options for our families.
  • Increase in our specialty areas of college planning for neurodivergent students and students with a history of treatment and school disruption:
    We anticipate that this demand for specialized guidance in the college planning process for neurodivergent students and students with a mental health history will continue to grow. Likewise, the college programming designed to support these young people will continue to rapidly evolve, as will our expert knowledge of these program changes. We are resolved in our commitment to being the industry leader in working with these populations and in guiding them toward the specific college programs and environments where they can thrive. We also look forward to continuing to help these students launch successful applications that yield positive, student-centered outcomes.

While 2025 will bring many more challenges to families and students, we are here and ready to help them to respond to immediate challenges and to plan ahead for brighter futures!

About The Author

Sarah McMillan, Ed.D.