San Juan Cottage admits up to 18 adolescents between the ages of 15 and 17 who present a danger to themselves or others due to a psychiatric disorder. Youth admitted to San Juan Cottage often experience suicidal behavior, self-harm, aggression, emotion dysregulation, psychosis, impulsivity, difficulties with relationships, and/or inability to complete self-care tasks. San Juan Cottage also admits forensic patients for competency evaluations and/or restoration.
The cottage is divided into two separate living areas: Rainier and Glacier. Each side of the cottage has two pods with four single bedrooms. The Rainier side includes two additional single bedrooms near the day hall. Most youth initially begin their treatment on Glacier, but may move to Rainier as they demonstrate safe behavior and the ability to be more independent and responsible in their treatment. Some patients may remain on Glacier if they need closer attention due to concerns such as aggression, self-harming behaviors, the inability to carry out basic activities of daily living without close supervision and/or for forensic or legal purposes.
Treatment on San Juan Cottage is focused on helping patients develop necessary skills to safely return to their families and communities. The treatment program is primarily based on principles of dialectical behavior therapy. Other modalities, such as cognitive behavioral therapy, trauma-focused cognitive behavioral therapy, motivational interviewing, and collaborative problem solving are also incorporated into treatment and milieu programming on San Juan Cottage. Staff are trained to help patients practice skills to manage feelings, make safe choices, and achieve their treatment goals.