the night before program your experiences with day treatment/ intensive outpatient programs?

Hey.

So it’s the night before I start day treatment at new foundations center. It’s a small mental health facility in Northfield IL about a half an hour from Evanston. The day program is a clubhouse style recovery model. They have groups from nine til two Monday through Fridays. They also have some group home support, crisis intervention and job support.

I was there in 2012 for about a month while at Friedman Place. From that end of Chicago it took like an hour to get there. Way too long a journey for me! And without anyone dragging me out the door or talking me into going even when depressed I soon couldn’t do it anymore. That happens here still but it’s a lot harder with Jess and caseworkers and Jonathan on my case.

So this is easier. I better like this place. I’ve tried a ton of programs in the area or it feels like it. Really there aren’t that many and the ones that sound really good are private pay or for people who have good healthcare insurance as in not Medicaid. I went to Trilogy Behavioral health which is a wonderful huge provider of mental health in this area. They have a very good day program with a large assortment of groups. They have a therapist who’s certified in drama therapy and that was the most enjoyable group for me. When I was at Friedman I participated in many groups and also had a case manager who helped with transportation to store haircut ETC. She also took me to a cat shelter for my own personal pet therapy (recommended by hospital social worker)

Unfortunately Trilogy does not work with Medicaid transportation which is free. To go I’d have to get paratransit tickets which cost $30 a book which is way not affordable!

They also have an awesome medical clinic with a very compassionate thorough nurse practitioner and from what I hear awesome doctors and psychiatrists. Unfortunately as I’m living here at Albany you have to use their doctors.

I also went to turning point in scokie. It also had a good amount of groups. A lot of them did worksheets and were CBT cognitive behavioral therapy focused which was not something I took to well as that therapy generally doesn’t work for me. Also I found it hard to believe this place that for some could be the only mental health provider in the area (with many licensed social workers, counselors psychologists psychiatrists) doesn’t have the training to work with eating disorders, self-injury (even though they claim to,) or substance abuse. Given that these are components of many people’s mental health issues it made me wonder what they do have training in. No really I know they have training and many of the therapists were very nice. Some weren’t flexible to information from clients about our ideas on how to improve groups ETC. And as I said a huge reliance on worksheets and a narrow lense (as I believe CBT is) of viewing a person’s issues and just a person in general.

Then I tried Norwigean American intensive outpatient program. This was actually within a hospital. You had to attend three days a week. The other clients were very nice although too many were so medicated I’d say over medicated. They were constantly falling asleep and could not concentrate or participate and complained of how sedated they felt. However instead of contacting their psychiatrists or nurses at their facilitys (as far as I know, and I think some of these people had good heads on their shoulders and would have mentioned that) they seemed to blame the person. Telling them they needed to be awake, in spite of sedating medications and just bugging them endlessly about it. That they weren’t participating and all that. It was heart breaking. I stood up for them as best I could in group trying gently to explain how when someone’s brain is being swamped with these powerful chemicals it’s really not their fault. I didn’t see a change in the care these people got or how they were treated and that got me mad.

And people say that has nothing to do with you! Well yes and no. It’s not me but it kind of is. Or maybe that’s just a trigger from my past. I witnessed a lot particularly emotional/ verbal abuse. So when I have to stand by and watch people be in a way bullied and put down day after day it’s hard to deal with, hard as in more like overwhelming anxiety producing!

Secondly is their ridiculously rigid attendance policy. If you miss a day they have to have a whole conversation with your caseworker on exactly why and it’s this whole thing. If you’re out because of a doctor/ psychiatrist coming (and you never know when that will be more on that later) they need to see the doctor’s notes. Unfortunately my first week of program I ended up in a bit of a crisis related to a close friend going through a hard time and not knowing how to best support her. Another trauma trigger. I’ve had to support as a young child parents in crisis. And have felt and was made to feel like I was all they had. I’ve also been put down by my parents about the type of friend I am. So old feelings about my worth as a friend/ ability to be adequately supportive just came flooding back. Some self-injury came about and a nice long night at the crisis center. I was happy for no inpatient stay but the next couple days I wasn’t really in any shape to go anywhere. So I missed two days my first week. This program was like six months long. I had plenty of weeks to go.

Well they were unbelievably ridiculous about it. This one therapist in particular who was the person who talked back and forth to my caseworker/ staff here. She was literally like well this is a really serious issue (what happened) because it affected my ability to attend the program and my well-being. Yeah in that order. That’s like the first thing I heard. And anytime that particular situation came up, what they saw as not having solid boundaries that I’d be so deeply affected by my friend’s situation to send me into crisis, what they brought out as evidence was my stupid two day absence. It’s not just me. Some poor developmentally disabled man threw up on the way there and they didn’t send him home! I guess once you’re here from transportation you’re stuck here. Good thing it’s a hospital LOL!

So yeah just got tired of the whole thing. What did it was realizing how sad it was these people were forced by the staff where they were living to go to this program, and by program staff, when many weren’t happy or more importantly couldn’t even decide how they felt due to such high doses of meds. So I left. I hadn’t made any connections with anyone except someone who seemed nice until she violated my confidentiality by reading over my shoulder on the computer. They did a group where everyone had to go up in front of the group individually and talk about their issues and be questioned and I didn’t like that. So yeah.

So here I am. So frustrated that other programs that seem really well staffed with people specializing in trauma and self-injury with things like expressive arts (real expressive arts not a therapist blindly using art) process groups, and pet therapy are all private pay/ with good health insurance. The only program I can think of I haven’t tried in the area that’s open to me is where my friend goes to IOP. Because we’re so close staff there and here want us going to different day treatment to get a break from each other and have separate treatment venues. Which makes sense. This is her secondtime through there and she really likes it. Watch me have issues! I’m just a very picky girl! Seriously I guess I only find certain things/ approaches/ personalities helpful. I think with the things I go through it’s hard to form a trusting connection. And these programs are so group oriented that you can’t go through the natural connection, conflict reconnection that naturally happens in individual therapy. Because it’s all about the group. That’s the other thing I hated about that IOP I went to. There was no one therapist you worked with on your treatment plan. It was random whichever therapist would go over treatment goals with you. They said it’s a team approach. Well then the whole team should be discussing the treatment with each client which I’ve heard happening. I said how important it was for me to be able to really connect with the person I’m working on goals with and checking in with. Again this was deemed another manifestation of my poor boundaries that I attached to one particular person and had trouble letting go. Who knows. Sometimes they made me feel worse.

All that to say I’m anxious about tomorrow a little. I went in 2012 and then for a trial day in February. From then I decided to go to turning point. So I know some of the staff that are there but not everyone. I’ll be interested to see how things go and if I like it. I’d really like to hear all of your experiences with intensive outpatient or day treatment programs. Hopefully we’ll get a nice discussion going.

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