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For a more complete description of our program, feel free to download a copy of our new Parenting Handbook.


Since 2008, Direction has provided mental health care to adolescents in the Greater Nashua Area. As the only program of its kind in the region, we offer a much-needed “intermediate” level of care for teens who have needs that are too complex to be effectively managed in an office outpatient setting, but do not reach the threshold warranting inpatient hospitalization. We offer an alternative for outpatient providers, emergency rooms, school guidance counselors, primary care physicians, parents, and other local agencies seeking mental health care for their patients, students, clients, and children. To date we have treated over 3,000 kids and their families.

For some teens, Direction serves as the point of entry to psychiatric care. For others who already are engaged in treatment, it provides crisis stabilization when outpatient treatment alone is insufficient or ineffective. For those kids who do require inpatient level of care, it serves as a step-down program to provide smoother transition back into the community. It appeals to parents, patients, and other providers because of its ability to provide a wide array of services in a relatively short period of time. It appeals to insurance companies for the same reasons, and because it accomplishes its goals in a more cost-effective way.

The Facility

In February, 2024, Direction moved to a new space at Millyard Technology Park.  It boasts 8500 square feet spread over two levels.  More than just a great space for conducting therapeutic groups, it  brims with musical, athletic, and art-related possibilities.    There is s a gymnasium with a basketball hoop, pickleball net, and professional-grade exercise equipment.  In addition to numerous musical instruments, the facility has a both a PA system and high-end recording equipment.   Outside, there is a huge parking area and area along the river which make for great outdoor activities such as frisbee.  We are located at one end of Mines Falls which offers beautiful nature trails for therapeutic walks with the kids.  There is a cafe located immediately upstairs from us.  It looks like no other mental health facility of its kind.  

The Treatment Team

Duncan Gill, MD, is Direction's owner and a Board-Certified in Child and Adolescent Psychiatry as well as General Psychiatry. Unlike many other similar programs, he is on-site in Nashua during program hours 5 days per week and actively involved in our clients’ care.

You can learn more about all our staff here.

Admission to Direction

Kids come from hospitals, emergency rooms, schools, homes, and pretty much everywhere else.  We don't need any particular formal "referral" -- just give us a call.  

The programs are paid for by the vast majority of insurances.

Level of Care

The Intensive Outpatient Program (IOP) operates 3 hours per day, between 3 PM and 6 PM, and the Partial Hospitalization Program operates 5 hours per day, between 1 PM and 6 PM.  

Program Structure

Group therapy forms the core component of treatment in Direction’s IOP and PHP, and is led by the therapist duo Valerie Boles and Erin White.  The treatment model we have created and refined over the years is called Direction's Community-Based Education.  It is superior to any model of treatment for this population than we have encountered before, regardless of "diagnosis".  

We offer two Parenting Groups per week, one in-person and one virtually.  In it, we teach Direction's Community-Based Education, why it is so effective, and how it can be transformative in your own family.

The Medical Director provides medication management to those kids for whom it is appropriate. One advantage of his strong presence at the program is that it allows him to closely monitor medication effects and respond quickly with changes when indicated. Essentially, it allows him to manage medications in a manner more similar to an inpatient psychiatrist, and to provide more intensive psychiatric services than many other programs provide.

Program length of stay is variable, and dependent on each client’s own particular clinical needs, but generally is a few weeks. Clients generally attend the program 5 days per week, though frequency of attendance may be reduced as clinically appropriate.  Clients who attend the PHP step down to the IOP afterward.  


Discharge planning begins upon admission to ensure suitable aftercare arrangements are made prior to completion of the program.

Direction usually has between 15 to 25 kids attending each day.


Transportation to and from the program must be provided by the family, though some children may be  able to drive themselves.

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