Is a Residential Treatment Center the Right Choice?
A loved one is experiencing mental health problems – or perhaps you are dealing with mental illness yourself. As you look into treatment options – outpatient, inpatient, etc., one option that may be recommended is a residential treatment center.
What is a Residential Treatment Center?
A residential treatment center provides intensive, comprehensive assessment and care for individuals dealing with complex mental health and/or addiction issues.
But is this type of program right for you or your family member? After all, any type of treatment approach isn’t right for everyone. Consider the following information before you make a decision about whether residential treatment is the best choice.
Who Is the Best Candidate for and When is a Residential Treatment Center Necessary?
While a variety of individuals can benefit from the structured and supportive environment of a residential treatment center, some of the best candidates are those who:
- Have complex diagnostic or treatment issues;
- Need a more structured environment or do not have a natural environment ideal for supporting their treatment;
- Have not responded sufficiently to previous treatments;
- May have a higher risk of decompensation. (While stable, they may need a greater degree of watchful oversight to address potential suicidal risk, “acting out” behaviors, etc.).
What is Residential Treatment Like?
For an individual who meets one or more of the above criteria, a residential treatment center can provide many benefits, such as the following:
- A supportive environment. The community and therapeutic milieu provided in a residential treatment environment can be treatment approach themselves. Many individuals with mental illness do not live in a naturally supportive environment and may easily become socially isolated or frustrated after an acute treatment episode. Others lack the life skills necessary to function productively, and the therapeutic environment of a residential program provides a safe place to learn and practice them. It helps foster more responsible behavior, greater self-esteem, and positive relationships.
- A greater degree of structure. Residential treatment centers provide structured and stabilizing routines throughout the entire day. These can be beneficial to individuals with impulsivity, compliance issues, medical problems, or high-risk behaviors.
- More intensive, longer-term care. If a behavioral health problem is particularly severe or complex, outpatient treatment is not sufficiently intensive, and inpatient treatment is not long enough to help patients develop new coping and social skills. Ten- or 28-day programs are an increasingly popular option in many residential treatment centers today.
- More extensive diagnostic assessment process and tools. An estimated 85% of individuals with addiction are also dealing with a mental illness. Additionally, individuals with one type of mental disorder may also have other mental health issues. Proper assessment and diagnosis is important to guide the best treatment plan possible. Residential treatment programs typically provide more extensive assessment, often using sophisticated tools and technologies such as psychological tests, brain scans, and even genetic testing.
- Broader range of treatments. A residential treatment center typically offers a broader “menu” of services than other settings. Once assessment is completed, residential program offer a robust selection of therapies, from traditional psychotherapy to recreational therapy. The fact that the environment is more structured and supervised makes some treatments, such as medication adjustments, more feasible. The logistics of obtaining therapeutic assessment and high-tech treatments are also easier when services are provided literally under one roof. Finally, this environment is also ideal for implementing detailed protocols for specific disorders, such as obsessive-compulsive, substance abuse, and eating disorders.
There are many benefits to residential treatment. One way to remember the overall benefits is to think of the “4-S” approach to treatment: Supportive, Structured, Safe, and Sophisticated.
Residential treatment is not appropriate for everyone. Patients with short-term or milder disorders may benefit sufficiently from outpatient treatment, while individuals with critically acute problems or significant suicidal risk may need inpatient care. But for many individuals, the “happy medium” provided by an effective residential treatment center offers the best head start on regaining a productive and enjoyable life.
For more information about residential mental health and addiction treatment, view our in-depth guide.
Mindfulness During the Holidays
Jennifer Farley, PsyD
Lindner Center of HOPE, Staff Psychologist
The holiday season can be an enjoyable and peaceful time for many of us. We adults know that this can also be a busy, tense, overstimulating, overindulgent, and overwhelming time. Any of these experiences can be triggered, for example, by holiday memories of the past, our current experiences, or worries about the future. We also may have expectations for how our holidays “should” be, which can bring about even more stress in planning them or sadness or anger if our experiences fall short of what we wanted.
Using mindfulness, or focused attention on the “here and now,” can be helpful in making the holiday season more tolerable and, hopefully, more enjoyable. Mindfulness involves being self-aware of one’s thoughts or feelings or behaviors in the current moment and without judgment. Why the current moment? Because thinking about the past can bring about sadness (and depression) and thinking about the future can bring about worry (and anxiety). Being mindful without judgment is also important – it helps prevent an emotion from being experienced more intensely. For example, telling oneself, “I’m a horrible friend for not giving them a gift,” is far different than, “I have the thought that I am a horrible friend for not giving them a gift.” Similarly, reflecting, “I’m sad that my family member isn’t here,” is experienced differently than “I have the feeling of sadness about my family member not being here.” The without judgment part also comes from not judging oneself or anyone else for having a particular thought, feeling, or behavior. Telling oneself, for example, that they’re “bad” for thinking or feeling a certain way is a judgment – having a thought or feeling simply makes one human. What we do with a thought or feeling is what matters more.
Thoughts about how the holidays “should be” can intensify people’s emotional experiences further. Many people, for instance, experience “shoulds” surrounding holiday traditions. While these can bring comfort to our holidays, “shoulds” can also weigh people down with guilt, burden, or anxiety. Family traditions are important, but so is the consideration of how a specific tradition might be unreasonable to expect – for oneself or others. Letting go of the word “should” allows more flexibility and adaptability to an experience, and as such, can bring about more joy and a lot less tension. Do you really “need” to host Christmas dinner? Or is it that you prefer it but can adapt to having someone else host?
Mindfulness can be practiced by observing and describing one’s current thought(s) or feeling(s). Mindfulness can also involve doing something with intention. Consider how you might – with focused intention – wrap a present, look at Christmas lights, drink your cup of coffee or hot chocolate, hug a loved one, sing a Christmas carol, hang ornaments on your tree, watch a favorite holiday movie, or study the fire in the fireplace. Doing something with intention helps you remain in the present moment. Be aware of how your phone or other distractions prevent you from being fully present with others. If you find yourself diving deeper into a holiday memory, try to catch yourself first, and mindfully reflect if it’s a happy or heartwarming memory or one that could bring about sadness or hurt or anger.
One classic holiday movie (A Christmas Story) features Ralphie and his myriad of Christmas-related incidents. There are two scenes that highlight mindfulness practice: 1) when Ralphie looks with amazement at the snow-covered scene outside his bedroom window on Christmas morning, and 2) when Ralphie’s parents sit together in the dark and gaze at their Christmas tree. Another movie (Elf) depicts a father making a choice to fully participate in singing a carol with his family. These pop culture references may help highlight ways you might practice mindfulness in your own ways this holiday season. As a result, may your next month or so be experienced with mindful moments that bring self-awareness, peace, and joy.
“En Lindner Center of HOPE tambien hablamos espanol” (In Lindner Center of HOPE we also speak Spanish)
Lo que fui es lo que soy….
(“What I was is what I am”. An article addressing the challenges and consequences of immigration from a social and psychological perspective and how this process ends up shaping us in multiple and unexpected ways while trying to maintain and cultivate original roots.)
Soy venezolana. Soy psiquiatra y psicoanalista. Le debo a mi país la esencia de mi formación como professional y mi Corazon latino. Finalmente, luego de mucho esfuerzo tengo una practica solida como psiquiatria y psicoterapeuta en Mason, Ohio. Volver a estudiar fue un requisito inevitable para poder recuperar un pedazo de mi identidad perdida que no cupo en mi maleta a la hora de emigrar y que alimentaba de forma negativa a la nostalgia que no he podido sacudirme desde que llegue a los Estados Unidos de America. Desde que empece a trabajar formalmente siempre había querido encontrar una manera que me acercara a la comunidad latina y desde donde pudiese compartir mis ideas y experiencias en relación a distintos temas relacionados a la salud mental. Es una deuda pendiente con mi raiz latina. Mi intención es abrir un espacio que considero indispensable para abordar la salud mental sin tapujos ni prejuicios hasta ahora muy ligados a la manera como nuestra cultura tiende a referirse a cualquiera que sea la enfermedad mental. Todos podemos hablar con comodidad y compartir nuestra experiencia y nuestro sufrimiento físico cualquiera que este sea pero cuando se trata de nuestro sufrimiento psíquico tendemos a esconderlo o a avergonzarnos y sin darnos cuenta terminamos aislándonos y de esta forma empeorando nuestra padecer.
Así que entre mis resoluciones de ano nuevo estuvo darle inicio a esta columna y como seguramente les ha pasado a ustedes tambien con sus propias resoluciones me ha costado arrancar y con mucha suerte estarán ustedes leyéndome antes de que el ano termine…. Es decir casi con un ano de retraso en mi calendario de ilusiones.
He decidido titular mi columna “Lo que fui es lo que soy”. Es el nombre de una de mis canciones preferidas y recoje lo que a mi manera de ver es una utopia porque no es posible negar los efectos del tiempo, el espacio y la distancia en la identidad de todo emigrante pero a la vez es tambien un ancla que me permite estar atenta a la necesidad de preservar y cultivar mi identidad Latina.
No hay duda que al pisar otro pais con el proposito de emigrar se produce una division, una ruptura entre lo que dejamos atras y lo que empezamos a construir. Sin duda las redes sociales, las llamadas telefonicas, el facetime o el whatsapp sirven de cuerda que intenta mantener cierta continuidad entre estos dos mundos. Eso contando con que el internet y las telefonicas esten de nuestro lado, cosa que no es lo usual en paises como el mio. Es una cuerda que a veces se siente floja o muy tensa dependiendo el dia y el interlocutor y caminar en ella da mucho susto por no decir vertigo y es entonces cuando empezamos a evitarla o a caminar en puntillas para que no se rompa. Nos comunicamos menos con los que quedaron del otro lado, o decimos menos omitiendo asuntos importantes por aquello de no preocupar al otro y asi sin darnos cuentas vamos perdiendo gente querida muchas veces ignorando por que.
Hace poco lei que “la emigracion distorsiona las leyes de la fisica. Es todo alucinante y un poco incomprensible”. “ Todo el que emprende el largo y azaroso viaje de la migración —que te cambia como persona, que siempre te somete a toda clase de sorpresas, que te arroja a orillas inesperadas— se convertirá en otra persona más rápida e imprevisiblemente de lo que espera y de lo que hubiera pasado en lugar de origen. Todos cambiamos, queramos o no, a medida que vivimos, pero ese cambio se dispara si nos mudamos de ciudad o de país o de continente. Así que irse implica siempre, en cualquier contexto, que te harás otra persona más pronto que tarde, y por tanto irás dejando de tener cosas en común con quienes te rodeaban en tu mundo anterior.”
Esta columna es mi intento por mantener esa cuerda firme a sabiendas de que las consencuencias de la migracion son muchas, y algunas irreversibles. No me queda otra que hacer el intento. Tratar de dibujar en este espacio maneras de navegar entre estos dos mundos y revisar sus consecuencias en lo psicologico. En mi proxima columna explorare el tema de el duelo como proceso inevitable en toda migracion.
Margot Brandi, MD
Medical Director, Sibcy House
New Treatments Available to Help People with Drug Addictions
The statistics surrounding addiction are shocking and the impact is devastating.
In 2017, 70,000 people[i] in the U.S. died from drug overdoses – the highest number in history. Hamilton County accounted for 570 of those deaths[ii]. The City of Cincinnati alone saw a 79% increase in overdose deaths from 2014 to 2017.
The region, including Kentucky and Indiana, continues to be hit especially hard by the opioid epidemic. Overdose death rates[iii] here are among the highest in the country. As a result, children in our communities experience parental loss rates that nearly double the national average.
For someone with addiction, sobriety can be a long and painful process. As addiction becomes better understood as a mental illness[iv], new approaches are being implemented to help people maintain long-term recovery.
Lindner Center of HOPE recently unveiled a new 10-day, in-patient substance use disorder detox and evaluation program that increases our community’s capacity for treatment, and employs the latest proven methods.
The approach includes a comprehensive evaluation for each person, and each visit is uniquely designed to meet that person’s needs. Upon completion of the program, patients receive an individualized plan-of-action to increase the odds of continued sobriety.
“Our expert addictions team found that a one-size-fits-all treatment approach doesn’t work for sobriety,” said Paul E. Keck, MD, president and CEO of Lindner Center of HOPE. “Each individual must have a personalized path to success. That’s what this program is designed to do.”
Treating the Whole Patient
According to the Substance Abuse and Mental Health Services Administration[v], 80 percent of people who have a substance use disorder also have a mental illness. So a personalized approach to recovery is vital.
Program participants first complete detoxification with close medical supervision. The in-patient portion of the program includes about nine hours of daily programming. The patient also participates in an additional 10 hours of internal addiction programming and access to community support groups.
While completing the inpatient portion, patients stay in Lindner Center’s Sibcy House – a one-of-a-kind facility dedicated to individualized, compassionate comprehensive care. Each patient resides in a private room, complete with a full bath. The program includes:
- Sessions with a psychiatrist, social work and addictions therapist
- Testing determined by an addictions therapist
- Coaching sessions with a chemical dependency specialist
- Patients also participate in additional programming tailored to their individual needs.
For more information about the program, visit Lindner Center of HOPE’s website or call 513/449-8415.
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Lindner Center of HOPE treats most substance and behavioral addictions. Plans may include medication-assisted treatment, therapy or support groups, and screenings for underlying issues like depression and anxiety.
About Lindner Center of HOPE
Lindner Center of HOPE, located in Mason, OH, is a comprehensive mental health center providing patient-centered, scientifically advanced care for individuals suffering with mental illness. Learn more at LindnerCenterofHope.org.
[i] WKRC. (2018, November 30). Acting Attorney General addresses the opioid epidemic during Cincinnati visit. https://local12.com/news/local/acting-attorney-general-to-address-the-opioid-epidemic-during-cincinnati-visit
[ii] WCPO Staff. (2018, July 30). Staggering numbers in Cincinnati’s opioid crisis, but health officials see progress. https://www.wcpo.com/news/local-news/hamilton-county/cincinnati/staggering-numbers-in-cincinnati-s-opioid-crisis-but-health-officials-see-progress
[iii] Demio, T. (2018, Aug. 3). Children here experience parental loss at higher rate than national average
[iv] National Institute of Mental Health. (2016, May). Substance Abuse and Mental Health. https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health/index.shtml
[v] Substance Abuse and Mental Health Services Administration. (2019, Jan. 30). Mental Health and Substance Abuse Disorders. https://www.samhsa.gov/find-help/disorders
Cincinnati — A National Hub for Mental Healthcare
Services, resources and research unmatched in Midwest
Mental illness is a condition that affects one in five Americans[i]. While more celebrities are revealing their own struggles, and research has led to new understanding and treatments, mental illness remains shrouded in stigma. Many barriers prevent access to treatment as well, including cost.
Communities across the country are stepping up to confront these challenges. Cincinnati is increasingly being recognized as one of the leaders.
When Frances and Craig Lindner founded Lindner Center of HOPE, their dream was to build the nation’s leading mental healthcare facility. That was in 2008.
Today, Lindner Center of HOPE is a nonprofit renowned regionally and nationally for the depth and breadth of services offered in one location. Mental health researchers around the world look to Lindner Center’s research team for the latest findings in the field.
How did the Lindner Center of HOPE earn its distinguished reputation? And what does this mean for tri-state residents and families looking for help with mental illness?
Lindner Center of HOPE is a Leading-Edge Care Center
It starts by staying on top of emerging trends in mental healthcare. The Lindner Center has launched programs to meet needs for current issues like Internet and gaming addiction[ii] and substance abuse detoxification[iii], while continuing to treat a comprehensive list of mental disorders.
Having the right people and partnerships in place is also vital. Since 1996, Lindner Center president and CEO Paul E. Keck, MD, has been among the world’s top 10 most cited scientists in the field of psychiatry and psychology. Susan L. McElroy, MD, chief research officer, was the eighth most cited in the same period.
In the decade since the Lindner Center of HOPE opened its doors, it has cared for more than 37,000 patients from all 50 states and 10 countries. Its multidisciplinary, team approach provides continuous personalized care for each individual.
Local Collaboration Leads to Better Treatment
Partnerships between the Lindner Center, UC Health and Cincinnati Children’s Hospital mean each of these world-class healthcare providers connect seamlessly to give local patients access to the latest treatments available, and a broad array of specialized medical services.
Together with the University of Cincinnati, the Lindner Center was among the initial members that established a national network of mental health centers similar to those established for cancer and cardiac care. A founder of the National Network of Depression Centers, Lindner Center has conducted more than 100 studies with renowned health research organizations like Mayo Clinic and Cincinnati Children’s. This work has brought new, effective treatments first to members of the local community who have lost hope for a better life.
This level of collaboration between world-leading institutions, and the breadth of services offered at Lindner Center is unmatched in the Midwest and among the best nationally.
As one patient’s parents said, “Without the Center, it’s doubtful (our son) would be alive today and certainly not the productive young man he is now.”
Continuing the Fight
We have never had better evidenced-based treatment and achievable recovery for psychiatric disorders than we do now. Yet, the scale of the problem is growing.
Americans are now 2.5 times[iv] more likely to suffer from a major psychiatric disorder in their lifetime than cancer, heart disease and diabetes combined. Fewer than half of the people who need care receive help, often due to stigmas associated with the disease. Insurance reimbursement for mental healthcare in Cincinnati is among the lowest in the U.S.
The Lindner Center of HOPE is uniquely positioned to fight this crisis. In addition to new and ongoing programs, community leaders Linda and Harry Fath, and Frances and Craig Lindner, pledged $75 million[v] to the Center to further enhance treatment and reduce stigma.
As a non-profit, the Lindner Center depends on financial support to meet the high demand for essential services. Philanthropic gifts have enabled the Center’s clinicians to enhance thousands of lives, while expanding our community education and critical research programs.
There is no better time than now to help others who are suffering. A recent combined $75 million donation from Cincinnati humanitarians Linda and Harry Fath and Frances and Craig Lindner is the foundation of the Center’s Challenge Of Hope campaign, with the goal of raising an additional $50 million.
Your donation will help make unprecedented strides in removing barriers for people taking needed steps toward mental wellness.
To share your gift of HOPE today, please go to: LindnerCenterofHope.org/donate
About the Lindner Center of HOPE
Lindner Center of HOPE, located in Mason, OH, is a comprehensive mental health center providing patient-centered, scientifically advanced care for individuals suffering with mental illness. Learn more at LindnerCenterofHope.org.
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[i] National Alliance on Mental Illness. Mental Health by the Numbers. https://www.nami.org/learn-more/mental-health-by-the-numbers
[ii] Borter G. (2019, Jan. 27). The digital drug: Internet addiction spawns U.S. treatment programs. https://www.reuters.com/article/us-usa-internet-addiction-feature/the-digital-drug-internet-addiction-spawns-u-s-treatment-programs-idUSKCN1PL0AG
[iii] Lindner Center of HOPE. 10-Day Substance Use Disorder Detox and Evaluation. https://lindnercenterofhope.org/residential-treatment-programs/detox/
[iv] Reuben, A. (2017, July 14). Mental Illness Is Far More Common Than We Knew. https://blogs.scientificamerican.com/observations/mental-illness-is-far-more-common-than-we-knew/
[v] Lindner Center of HOPE. (2017, Dec. 18). Lindner Center of HOPE Receives Commitments Totaling $75 Million from Community Leaders Linda and Harry Fath, and Frances and S. Craig Lindner. https://lindnercenterofhope.org/news/lindner-center-of-hope-receives-commitments-totaling-75-million-from-community-leaders-linda-and-harry-fath-and-frances-and-s-craig-lindner/
“In the News” – Dr. Tuell joins Fox and Friends to Discuss Internet Addiction
Lindner Center of HOPE Clinical Director of Addiction Services Dr. Chris J. Tuell joined Fox & Friends on January 28, 2019 to talk about a new program at the Lindner Center designed to identify and treat Internet addiction.
“This program helps those struggling with a loss of control to re-center their lives to avoid additional complications,” said Dr. Tuell.
According to Mental Health America, children with Internet addiction often struggle with other mental health problems like alcohol and substance use, depression, and/or aggression.
Addiction experts at the Lindner Center of HOPE assess if patients are suffering from one or more co-occurring disorders, like depression, in addition to unhealthy Internet habits. Studies have suggested pre-existing depression or anxiety could lead to a gaming addiction. Identifying underlying mental health conditions can help personalize treatment plans for each “Reboot” patient.
“In the News” – Dr. Bosse joins FOX19’s Morning show to discuss SAD
Dr. Nicole Bosse appeared on FOX19’s Morning Show (Cincinnati) to talk about Seasonal Affective Disorder and how local residents can recognize the signs of SAD in themselves and others, help themselves avoid seasonal depression and find help through treatment at the Lindner Center of HOPE.
Seasonal affective disorder (SAD) is a form of depression triggered by a change in seasons.
In fact, more than half a million people in the U.S. suffer from SAD. In fact, 4 in 5 people who suffer from SAD are women.
“It is important to not think of seasonal depression as a minor case of the “winter blues,” said Nicole Bosse, PsyD, staff psychologist and member of the OCD and anxiety team at the Lindner Center of HOPE. “SAD is a type of depression and needs to be treated seriously. We urge people to seek professional help if they feel their mood is atypical this time of year.”
Your donation can help the Lindner Center continue state-of-the-science research and treatment to help patients get the care they need for a number of conditions, including SAD. Donate here:
Getting Past Your Past
Chris Tuell Ed.D., LPCC-S, LICDC-CS
Clinical Director of Addiction Services Lindner Center of HOPE
Assistant Professor, Department of Psychiatry & Behavioral Neuroscience University of Cincinnati College of Medicine
In 1987, Francine Shapiro went for a walk. While on her walk, Francine was contemplating some very upsetting personal events that were occurring in her life at the time. But as she began to focus on this upsetting information, she noticed that her eyes began to flicker from side to side. More importantly, she noticed that the once upsetting information was no longer as upsetting. Shapiro felt that she had stumbled on some aspect of how the mind processes information. Eye Movement Desensitization and Reprocessing, better known as EMDR, was born.
For the past 30 years EMDR has become one of the most effective therapeutic approaches in the treatment of trauma. EMDR is not only approved by the American Psychiatric and Psychological Associations, but also by the United States Department of Defense and the Veterans Administration, as an effective therapy in the treatment of post traumatic stress disorder (PTSD). Dr. Shapiro believes that one of the major theories behind EMDR is the bilateral stimulation of both hemispheres of the brain. When we sleep at night, our brain continues to process information. This occurs during rapid eye movement sleep or better known as REM sleep.
The brain processes the events of the day, keeping what is important (e.g. family, work, school, friends), and purging what is unimportant (e.g., What I had for dinner last Tuesday). How many times have we have been faced with a tough decision and resorted to, “I’ll just sleep on it,” only to awake the next morning with a better idea of what to do? But when a traumatic event occurs, the processing of this information becomes disrupted. The brain becomes unable to process and clear the event or information, resulting in the trauma experience continuing to occur as if it is happening all over again. In this playing-out, the right hemisphere of the brain, the part of our brain that experiences emotions such as fear and anxiety, continues to be activated by the unresolved trauma. The patient experiences this activation through intrusive thoughts, flashbacks, and disturbing dreams, the basic elements of PTSD.
EMDR involves the bilateral stimulation of both hemispheres of the brain while targeting the upsetting aspects of the trauma. In therapy, the therapist recreates what happens naturally during REM sleep, with the movement of the eyes as they follow the therapist’s hand, stimulating both hemispheres of the brain. Over the years, additional bilateral stimulation methods have been found to be effective (i.e., tactile, audio). This targeting involves, not only activating the image of the event, but also identifying the negative thoughts, emotions and sensations experienced by the patient from the trauma. During the reprocessing of the trauma experience, the logical, rational part of the brain, the left hemisphere, is integrated with the right emotional hemisphere. This results in the patient having a more adaptive response to the trauma. The patient may still have memory of the event, but the emotional aspects of fear and anxiety have dissipated. During EMDR, the left hemisphere of the brain, the rational, logical part, is integrated with the emotional right hemisphere of the brain, resulting in the patient feeling and knowing that, “The trauma is no longer happening to me now; The trauma is in the past; I am safe now.”
EMDR is not a wonder cure nor is it a quick fix. EMDR involves hard work by the patient and it takes a good amount of clinical skills in order to implement. This is not about touching the person’s forehead and he or she is better. The patient and therapist have to be responsible and work at this process, but it does appear to go much more rapidly than traditional types of therapy. If a trauma can occur within a few moments, why do we automatically accept that it has to take years to undo it?
More than 20,000 practitioners have been trained to use EMDR since its discovery. The use of EMDR has been found to be beneficial in other areas of mental health besides, PTSD. Areas such as panic disorders, anxiety disorders, grief, pain, stress, addiction, and abuse, have shown to be responsive to this unique therapy. One aspect of EMDR that I have found to be valuable is the fact that it is unnecessary for me, as the clinician, to know all the details and specifics of a patient’s trauma in order for EMDR to be helpful. Many individuals who have experienced trauma stay clear of therapy for fear of reliving the memories and feelings. The EMDR protocol allows for such traumatic episodes to be addressed and reprocessed without describing the details of the trauma. As a practitioner, I have found EMDR to be a valuable therapeutic tool in assisting patients in moving past one’s past.
For more information about EMDR: https://www.emdria.org
Psychological Assessments across Different Settings
By Jennifer Farley, PsyD,
Lindner Center of HOPE, Staff Psychologist
There are a number of reasons someone may undergo a psychological evaluation. The type of testing that is done depends on the individual’s functioning and the setting in which testing may be pursued.
In childhood, early observations of potential problems may come from teachers. Teachers may observe struggles in behavior such as impulsivity, talking or interrupting others during times when there is an age-appropriate expectation of silence, and/or oppositional behaviors towards others. Teachers may also be the first to wonder if a child has an underlying learning or attention disorder. If the teacher’s attempts to help the child are unsuccessful, the teacher may recommend testing in the form of a Multi-Factored Evaluation (MFE). Psychological testing may be part of this evaluation and can include intellectual testing and academic achievement testing by a school psychologist. Parent and teacher questionnaires may also be included in the MFE. Depending on the nature of the child’s observed difficulties, others (such as speech and language therapists and physical therapists) may do their own screening. If findings reveal that the student experiences problems that would make learning difficult, accommodations are then recommended and interventions and/or accommodations are then put in place through a 504 Plan or an Individualized Education Plan. It is noteworthy that clinical diagnoses are NOT made from this type of evaluation and findings and recommendations are specific to helping the child learn better.
Others may seek testing from a clinical psychologist in a clinical outpatient setting, and this can be pursued on their own or they may be referred from another clinician (such as a primary care physician or psychiatrist). In this type of evaluation, testing is pursued with the referral question in mind (such as whether someone has Attention Deficit/Hyperactivity Disorder, depression, anxiety, a learning disorder, dementia, cognitive problems due to a medical condition, etc). Testing in this type of evaluation is designed with the referral question in mind; the psychologist tailors the tests to help determine the person’s functioning in the areas that could be affected by a cognitive or emotional disorder. Tests can range from intellectual assessments to personality measures to behavioral questionnaires (which can be completed by the patient themselves, parents, and/or teachers) to academic achievement measures. Clinicians such as neuropsychologists and developmental psychologists can do all these tests and then add additional measures specific to their specialization (such as when documenting problems related to a head injury or when evaluating for Autism Spectrum Disorder). The psychologist can use this information to make a diagnosis and provide recommendations for treatment of the condition. Often, such as for school-age or college-age patients, recommendations for academic accommodations are also
Sometimes, psychological testing is completed for patients during an acute inpatient psychiatric hospitalization (when the patient is in a mentally unstable condition). In these cases, testing is often used for diagnostic elucidation so as to help guide decisions about types of medication to use. Recommendations may also be made about additional assessments or resources to pursue following one’s discharge from the hospital. The clinical psychologist completes these evaluations within a short time, since these acute hospitalizations last (on average) about 7 days, and there are usually just a few measures that are administered. Tests are specific to the question about the individual’s diagnosis and may only include emotional/personality measures.
Another setting in which psychological testing may occur is within a residential psychiatric setting. This setting is for patients who are experiencing psychological distress that is not severe enough to warrant an acute inpatient hospitalization. Length of stay in a residential setting can vary from 10 days to several months, depending on the purpose of the stay (i.e., evaluation and/or treatment). The purpose of testing in a residential setting is to help comprehensively understand – by way of several different measures – one’s personality functioning, cognitive functioning (which can include neurocognitive skills such as attention, memory, and executive functioning), and other factors (such as external stressors, substance use, medical conditions, etc.) that have contributed to the patient’s condition(s). The patient’s internal strengths and weaknesses are explored, with the intention of making recommendations for how treatment can be tailored to work with the patient’s strengths to compensate for their weaknesses. The clinical psychologist works closely with the other members of the treatment team (such as the psychiatrist, social worker, and the therapists) to understand the patient, develop a treatment plan, and (if a longer stay) to begin implementing the recommendations. The patient’s progress is then monitored and, if needed, further testing can be done to help assess changes in the patient’s functioning as a result of the treatment.
Prior to any psychological testing, the patient (and/or his/ her family) should understand the purpose of the evaluation and how it can be useful for guiding treatment and other recommendations.
Second Session of 2018 Free Series Providing Information on Mental Health, Substance Use Disorders, Treatment and Strategies for Coping
Free Community Education Series Offered the Third Wednesday of Every Other Month
The second session of a free education series to help community members increase awareness of mental health, substance use disorders, treatment and strategies for coping is April 18, 2018. Stacey Spencer, EdD, Lindner Center of HOPE staff psychologist, will present ADHD Through the Lifespan.
Lindner Center of HOPE with the support of Manor House in Mason, Ohio is once again offering a Free Community Education Series to increase awareness of mental health issues and substance use. The series offers expert discussion of Mental Health, Substance Use Disorders, Treatment and Strategies for Coping for community members seeking information.
The series is held at Manor House, 7440 Mason-Montgomery Rd., Mason at 6 p.m. the third Wednesday of every other month.
Register by calling Pricila Gran at 513-536-0318. Learn more by visiting lindnercenterofhope.org/education.