Residential Treatment

Residential Treatment:

Rogers is a comprehensive psychiatric hospital, nationally recognized for specialty residential treatment programs for eating disorders, addiction, obsessive-compulsive disorder and anxiety disorders for children, teens and adults.

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January 14, 2016 - 12:37pm

Eric Storch, PhDThis fall, Eric Storch, PhD, clinical director at Rogers Behavioral Health–Tampa Bay, along with other clinical and medical practitioners from Rogers, participated in the Association for Behavioral and Cognitive Therapies’ (ABCT) 49th Annual Convention. Among the variety of symposiums, presentations and displays he attended, two symposiums in particular shared a message Dr. Storch feels very passionate about: that exposure therapy (ERP) is the best practice for treating obsessive-compulsive disorder (OCD) and anxiety.

ERP, a therapy technique that gradually exposes a patient to feared thoughts, images or impulses, has been shown to reduce anxiety and distress over time. At Rogers, ERP has been used as an active component of cognitive behavioral therapy (CBT) and our treatment outcomes have shown this method is effective for treating OCD and anxiety. Though some OCD and anxiety treatment providers use CBT without the ERP component, Rogers continues to use ERP as a part of CBT because of the method’s proven effectiveness. 

Sessions on “New Measurement Targets and Tools in Pediatric Anxiety and OCD” and “Improving CBT for Childhood Anxiety Disorders Through a Focus on Mechanisms of Change” discussed the importance of exposure and response prevention as a core component of treatment for OCD and anxiety. 

“It’s great that professionals in our field are always trying to find new techniques to achieve better results, but the current research in the field shows that exposure therapy is still the tried-and-true evidence-based approach and should continue to be the foundation of treatment,” says Dr. Storch.

“These are not easy cases. Sometimes providers use a ‘kitchen sink method’ and hope that one of the many techniques used will help their patient,” says Dr. Storch, “But it’s important that we continue to focus on what works best in the case of OCD and anxiety—that’s exposure therapy.”

Presenters at these symposiums also discussed techniques for tailoring treatment to each patient’s needs. “It’s important that behavioral health professionals learn how to adapt their treatment to the diverse group of patients they’re going to treat over their careers,” says Dr. Storch. “It isn’t effective to use a one-size-fits-all approach to OCD and anxiety treatment and that’s why we offer each patient an individualized treatment plan at Rogers.”

Dr. Storch also explains that national conventions, like ABCT, are a valuable opportunity for professionals to share knowledge with each other and add to the field’s development. “The conference is important because it disseminates information and makes the research and discussions more accessible to a greater number of people,” he says. “It helps build professional relationships and collaborations to further facilitate progress in behavioral healthcare treatment.”

January 8, 2016 - 12:34pm

When most people think of seeing a psychiatrist or psychologist, they picture talking face-to-face with someone. That is getting harder with a national shortage of psychiatrists. However, more providers of behavioral health—and their patients—are turning to and accepting an alternative: telepsychiatry.  

Rogers Behavioral Health is among those finding two-way video can work. And some patients even prefer it. 

Telepsychiatry, or telemedicine, allows patients to receive treatment from their psychiatrist through a video conference program, similar to Skype or FaceTime, but with heightened security. Under the supervision of nursing staff, patients use the program at Rogers’ campuses to speak with a psychiatrist, who could be hundreds of miles away.

“Kenosha, Wisconsin, is a community that has a psychiatry shortage that is more significant than the national average,” says Debbie Minsky-Kelly, director of partial hospital operations at Rogers Memorial Hospital–Kenosha. Minsky-Kelly and the rest of the Kenosha team have led the way for Rogers in improving access by using telepsychiatry beginning about 18 months ago. 

“Before we had telepsychiatry, our patients’ face-to-face therapy time was limited because our psychiatrists had to travel to see patients and sometimes harsh weather conditions made traveling dangerous,” says Minsky-Kelly. “The technology has made our psychiatrists more readily available to provide care, including in emergency situations, which has helped to increase our patient safety.”

At the Kenosha clinic, two physicians are exclusively using telespychiatry to treat patients, but all members of Kenosha’s medical staff are being trained to use the technology. “After our staff quickly became comfortable working with the system, it was easy to see the value of this resource and the full potential it could have,” says Minsky-Kelly. “Without this program and our clinic’s teamwork, we would not have been able to increase our services and recruit some of the best physicians available both on-site and off.”

In addition to the staff, patients and their families have also been highly satisfied with the technology. “We’ve found that many of our patients actually prefer using telepsychiatry over face-to-face psychiatry,” says Susan Johnson, a registered nurse at Rogers–Kenosha. “Sometimes, when patients have never received behavioral health treatment before, the thought of being in a room with a psychiatrist can be a little intimidating. Some patients are more comfortable speaking with their psychiatrist through technology instead of face-to-face interaction, which can be a big leap for many who have trouble working up the courage to seek help.”

Children as young as six years old to patients that are well into adulthood have been using the system. “If a patient is nervous about using telepsychiatry for the first time or is fairly young in age, our nursing staff is happy to hold a practice session for a patient to help familiarize them with the routine,” says Johnson.

Like all technology, there can sometimes be minor glitches or setbacks to the system. “We have experienced the occasional internet connection failure, but we’ve worked hard to prevent those issues and are sharing our knowledge throughout Rogers’ system,” says Minsky-Kelly. “Any minor issues we encounter are similar to the hiccups we face in face-to-face therapy, but the benefits to using telepsychiatry and the increased time patients have with their psychiatrists have far outweighed our little bumps along the way.”

When using a video program, a doctor may not be able to gather the same information about a patient that he or she would normally be able to in a face-to-face session, such as the presence of alcohol on a patient’s breath. “The registered nurses assess patients prior to every telemedicine session and pass along any important health information that the doctor may not have been able to gather from their computer screen,” says Johnson. “The nurses help to pick up where the technology may fall short and together we create a more comprehensive approach.” Strong patient satisfaction scores support expanded use of telemedicine when needed and appropriate, Minsky-Kelly says. 

Rogers currently has 13 psychiatrists certified for telemedicine across our system, with plans to add more. Various intensive outpatient and partial hospital programs use telepsychciatry at Rogers’ Wisconsin-based locations. Our regional locations in Chicago, Nashville and Tampa Bay also regularly use the technology in their outpatient programs as well.

January 4, 2016 - 8:23am

Statistics show that this time of the year, 45 percent of us are going to make a New Year’s resolution, but of that percentage, only 26 percent will maintain our resolution past the first six months. It seems as though the odds are stacked against most of us when it comes to changing our ways and making major life changes, but Sue McKenzie, co-director of Rogers InHealth, insists that achieving lasting change is possible not only for New Year’s resolutions, but for achieving mental health as well. 

“We have to spend some time honoring our good reasons for our bad habits, which may sound a little peculiar, but what happens if we don’t do that is we can fall back into our old tendencies. We can make a change and maintain it for a short time, but the minute we have a problem with that change, we are going to go back to our bad habits,” says McKenzie.

If we do take the time to make these acknowledgements, the effects can be life-changing. McKenzie says, “When we do acknowledge our good reasons for our bad habits, we can gradually begin to move into making the change we want to make and get serious about how we’re going to maintain that change over a lifetime.”

The hardest part may be deciding to seek treatment and end our unhealthy habits which may stem from an eating disorder, addiction or other mental health concern. “Most of us are either on the fence about a change or are working hard to maintain it,” says McKenzie.

So what can we do to help ensure that our changes will last? “There’s two things to remember that we can all do in our lives,” McKenzie says, “Have people that you trust and respect that you can check in with every once in a while. Typically, someone who knows and loves you can see that something problematic is going on before you even do. The person you check-in with could offer a simple adjustment that allows you to have a better quality of life.”

The second tip McKenzie has is: “If you’re the person that sees a harmful tendency in someone that you love and trust, be a gentle, nonjudgmental mirror. Meaning, have a conversation with that person and try saying, ‘I’ve noticed things are different for you lately and I want you to have more joy in your life, can we talk about it?’”

The team at Rogers has seen the benefits of family members helping a patient identify an issue, McKenzie says. 

“We know that a family’s unconditional support and willingness to talk about a problem can be a key part of making the decision to seek professional help. Families can also provide a source of hope and a unique perspective on their loved one’s life, knowing that their life could be a lot better.”  

December 18, 2015 - 7:31am

Every year, we are faced with the challenge of maintaining our traditional holiday routine, while also taking on new activities. As our to-do list piles up, it can take a toll on our mental health. The unrealistic expectations of what our holiday is “supposed” to be like, including how we are “supposed” to feel can sometimes be too much to handle. “We look at the holiday season with the expectation that we’re going to be filled with a lot of joy,” says Chad Wetterneck, PhD, cognitive behavior specialist for posttraumatic stress disorder programs. “While that may be true for some people, it’s really a time with a lot of strong emotion based off of how holidays have been for us in the past.”

“For those who have experienced a lot of joy during their past holidays, the season is a positive time. For others who have not found joy in previous holidays, the season can be a negative experience,” he says. “Even those who are usually joyful during the holidays can experience some grief. This year may be different because family or friends are unable to join them or because someone they love has passed away.”

When trying to keep up with holiday expectations, some put their own well-being on hold for the sake of others, which can become risky. “Overspending is something that some people are going to encounter this holiday. The best way to combat it is to think about whether you can set up a budget ahead of time,” says Dr. Wetterneck. “If you don’t have the financial resources this year, try telling friends and family that you’re going to give a gift that means a lot and talk about the meaning when you give it—rather than focusing on the dollar amount.”

With all the hustle and bustle of the season, it can be easy to jump to commit to an activity with loved ones without realizing how booked you already are. “It’s helpful to think ahead of time about what you’ll actually be able to accomplish or have a trusted friend who can help you decide what to commit to,” he says. “When someone asks you to join them for an activity, try telling them, ‘Let me get back to you,’ so you have more time to consider your schedule.” 

Some of us are likely to sacrifice our own self-care during this busy season. “Build some time in for yourself or even for the group you’re spending time with,” says Dr. Wetterneck. “Try suggesting that your group spend 15 minutes listening to holiday music or taking a walk to enjoy the holiday lights.”

Sue McKenzie, co-director of Rogers InHealth, explains that many people battle with their own internal stigma or personal expectations. “When some people face a challenging time, such as during the holiday season, they may tell themselves that should be able to ‘just tough it out,’ that they ‘should be able to handle it’ on their own,” she says. “People may avoid reaching out for help because they fear what it may say about themselves—but in reality, it’s healthier to ask for help than to set unrealistic personal expectations.”

McKenzie suggests that we help each other this holiday season by passing along our personal advice for coping with the stress. “We share our recipes with friends and family during the holidays, so why don’t we share our recipes for peace, for handling the holidays and for inner acceptance?”

December 11, 2015 - 7:51am

Experiential therapy is a hands-on experience-based approach that assists in healing and overcoming mental or emotional challenges. At Rogers, there’s a variety of experiential therapy approaches available to patients, including art and music therapy, recreational therapy, yoga, horticultural therapy and adventure therapy—which uses challenge courses at various campuses.

“All of the experiential therapies at Rogers engage groups through interactive experiences which can deepen their understanding of their treatment,” says Mike Hoelzer, art therapist at Rogers Memorial Hospital—Oconomowoc. “Patients could be using experiential therapy to work on their emotional awareness and expression, learning coping skills or developing new leisure skills.” 

Experiential therapy puts people in situations they may never have been in and the results of this therapy technique are encouraging. “I’ve seen so many people come into our program and express feelings that they may never have expressed before, learn new skills that they didn’t think they were able to accomplish, build new relationships, take healthy risks and learn to trust people,” says Hoelzer. “It’s quite an incredible way to work with people in a treatment setting.”

Although the activities used for art therapy sound like fun, there are difficult topics and realizations that patients have to face during their sessions. “The projects and tasks we do can be very exciting, but there is a lot of work going on in the therapy process, no matter what type of experiential therapy our patients may be participating in,” says Hoelzer. “At first, patients may be defensive about revealing their emotions, but when people start opening up in treatment, their defenses go down and their feelings start to become more readily expressed. Having the bravery to show true emotion is extremely important to begin problem solving and developing skills to cope.”

Hoelzer explains that through the creative process in art therapy, the patient and therapist may be able to pinpoint the exact stressor that caused the patient to seek treatment, talk about that moment and discuss how they may be able to improve their skills. “Others have used art therapy to express that after seeking treatment, they no longer feel alone and have been able to connect with others who face similar issues,” says Hoelzer. “Creating a piece of art can also serve as a great reminder for patients who want to hold onto the skills they learned in treatment and make those techniques a regular part of their life and activities.”

“When training parents, teachers and other adults in the community, we help them to understand how times when our children and youth are involved in movement, art and other activities are unique opportunities to connect at deeper levels,” says Sue McKenzie, co-director of Rogers InHealth. “Rather than see these times as breaks for the caregiver, they are times when we want to be more attentive and ready to listen.” Experiential therapists know that such experiences can be healing for the patient and in day-to-day life, they can be nourishing for relationships.

Rogers InHealth offers patient stories about facing challenges and new experiences, such as those available through experiential therapy.

December 9, 2015 - 8:57am

During the holiday season, many people make the annual trip to gather with their families and share in a special meal. You may notice that a loved one has developed unusual eating habits since the last time you saw her or him. It’s only natural to want to help, but Maxine Cimperman, registered dietitian at Rogers Memorial Hospital—Oconomowoc, explains that you shouldn’t immediately jump to conclusions. “It’s important to understand that you should not base suspicion that a friend or family member has an eating disorder off of one meal,” she says. “Eating disorders need to be diagnosed by a trained clinician and are based on a prolonged pattern of behaviors.”

That being said, the holidays can be a particularly difficult time for individuals who struggle with an eating disorder. “They will likely struggle with anxiety around the meal, and will often avoid social gatherings around food altogether,” says Jordan Murray, registered dietitian at Rogers’ Oconomowoc location.  “Take note if your family member or friend avoids entire food categories, like carbohydrates or fats, or consistently avoids eating in with a group. Individuals with eating disorders may be overly selective of what types of food they will eat.” 

According to the National Eating Disorders Association (NEDA), 20 million women and 10 million men in the United States suffer from an eating disorder at some point in their life, which equals about 1 in 10 Americans. “What’s especially troubling is that the prevalence of eating disorders continues to climb, particularly in adolescents,” says Cimperman. 

So how do you find help for someone who may have an eating disorder? “Start by talking to the loved one that you’re concerned about,” says Murray. “Opening the lines of communication gives them an opportunity to ask for help. Open-ended questions are best, as a confrontational approach may lead to defensiveness. Try saying, ‘It seems like you are struggling to enjoy food like you used to, is there anything you want to talk about?’”

Parents can also be on the lookout for possible warning signs of an eating disorder. “They should keep an eye on their child’s exercise pattern, dieting, food avoidance or any dramatic changes in weight,” says Cimperman. “The number one risk factor to developing an eating disorder is dieting. When a parent steps in and tries to help their child by pushing food or monitoring their child’s food intake, it can create a power struggle between the parent and child—which may worsen the problem.”

Murray emphasizes the importance of not stereotyping people with eating disorders. “You cannot make the assumption that someone has disordered eating patterns simply based on their physical appearance,” he says. “Many who eat normally may naturally maintain a low body weight, while someone who struggles with an eating disorder may be at a very normal body weight.”

“Eating disorders occur across all ethnic groups and in males as well, although males may be less likely to seek help for the problem,” adds Cimperman. “Help may also be less available for males as many treatment centers do not work with males, but the residential Eating Disorder Center at Rogers’ Oconomowoc location is one of the few that does.”

Request a free screening for someone who may need professional help for an eating disorder here

December 1, 2015 - 7:55am

Michael M. Miller, MD, medical director of the Herrington Recovery Center at Rogers Memorial Hospital and attending physician for the adult dual diagnosis partial hospitalization program at Rogers’ new Silver Lake Outpatient Center in Oconomowoc, has served a leadership role in the research and writing process of the American Society of Addiction Medicine’s (ASAM) new policy statement on marijuana, cannabinoids and legalization. The statement was written to inform Congress, the media, the general public and especially physicians and other healthcare professionals about cannabis and cannabis products and the health impact of expanded access to these substances.

Taking several months to draft, the policy statement addresses the most recent research from medical science on the potential positive and negative health effects of marijuana use, the climate of the current national debate over legalization, the differences between policy initiatives of decriminalization and full legalization, and possible future public health and safety measures.

As more states begin legalizing marijuana use for medicinal or recreational purposes, some public leaders believe there are no reasonable arguments to limit the public’s access to marijuana and they look to legal, commercial sale as a means of generating tax revenues. The writing committee that Dr. Miller led and the Board of Directors of ASAM sought to inform decision-makers that there are potential harms that they and the society believe require further research and cannot be ignored. 

“This new policy this can help educate young people, parents and others that America’s relationship with marijuana are more benign than is justified by the medical facts,” he says.

Dr. Miller strove to assure balance in the document to provide an accurate account of the medical and psychiatric actions of cannabinoids including THC, cannabidiol and synthetic cannabinoids, as well as the potential health consequences of expanded access, especially for youth.

“This policy might be useful as a patient education document in any clinical setting where persons with addiction or psychiatric conditions are receiving treatment.” Besides the possibility of developing an addiction, several long-term health effects of marijuana use have been documented, including adverse psychiatric effects, such as impairment of motivation and learning. “Identifying at-risk groups is an important prevention strategy. Children and adolescents are particularly vulnerable to health risks and they should not use these products,” says Dr. Miller.

With an extensive history of providing addiction treatment, Dr. Miller was able to add another experienced medical opinion to the committee. Other members of the writing team were Norman Wetterau, MD, the president of the New York Society of Addiction Medicine, and Jeff Wilkins, MD, the past president of the California Society of Addiction Medicine. “It was an honor to be asked to take the lead in drafting a document that we expect will be referenced quite often. I have known each of my colleagues in the writing team for a number of years, but this was one of our closest and most important collaborations,” he says.

Rogers provides comprehensive, evidence-based treatment for individuals suffering from cannabis use disorder as well as a wide range of psychiatric conditions and other aspects of substance abuse or drug addiction.

November 19, 2015 - 9:21am

Now approaching its first anniversary of providing comprehensive residential programming to adolescent girls, Nashotah has proven to be a valuable service to patients from all across the United States who are ready to make real change. Serving about 50 patients in its opening year, the program helps young women improve their personal safety and quality of life by validating their emotions which may lead to dangerous behaviors and teaching skills to help them express their genuine feelings. While in treatment, the safety risks associated with emotional dyregulation are decreased and preventative measures are used to to help many of the girls who are at risk of developing personality disorders.

“Oftentimes, the families of the girls in Nashotah have a hard time understanding how their daughter can have strong, unexplainable emotions or not act like themselves,” says Erik Ulland, MD, medical director of Nashotah. “Families may think that their child is intentionally trying to be manipulative or controlling, when in reality they are actually feeling these emotions and can even feel ashamed for it.”

 The goal of the Nashotah program is to practice dialectical behavior therapy (DBT) the way it was originally designed to assure girls achieve the greatest gains possible. Clinicians were trained by Marsha Linehan’s Behavioral Tech, and follow all required components of DBT. Girls in Nashotah are self-motivated and have spent an average of 60 days in treatment in Nashotah’s first year. When in programming, they work towards becoming comfortable with expressing genuine vulnerability, instead of expressing less genuine emotions that feel less intense. 

There is a considerable focus on mindfulness within the program, which is the core skill of DBT. It is explained as being aware of the current moment in one’s body and senses—observing, and describing events nonjudgmentally. Without mindfulness, one does not have choice. Girls in the program work on their private journeys, but find comfort in knowing that others are working towards similar goals.

The program also emphasizes the importance of active family involvement and that all patients, staff and families follow the therapy guidelines of DBT. Dr. Ulland explains that when adolescent girls seek treatment for emotional dysregulation before becoming young adults, they have a greater likelihood of creating behaviorally healthy lives. “When these young women receive early programming, our treatment in Nashotah can even be preventative—protecting a patient from developing depression or more severe symptoms down the road.” 

When leaving the program, many patients self-report significant gains across the board and are able to reduce their symptoms. “It’s been clear that this program doesn’t just help someone’s daughter, it may allow parents to be able to connect with their child in a way that they may not have been able to for a year or more,” says Dr. Ulland.

He also has hopes for Nashotah in the years to come, “In the future, it will be very helpful to collect data on how well these young women have been able to maintain their skills learned in the program. If they and their families have continued practicing mindfulness, I believe that they will be have more successful lives and reach their potentials.”

November 19, 2015 - 8:56am

Offering young adults with depression or other mood disorders specialized residential programming since February of 2014, FOCUS in Oconomowoc, WI, has created a pattern of positive patient outcomes. Recently, the program added a second track for adults over 30 years old. 

“Though the program is still fairly young and our results are unpublished, most of our patients have shown significant improvement,” says Rachel Leonard, PhD, clinical supervisor of FOCUS. “We still need to do more research and we are continuing to do so, but our initial results show many of our patients have experienced significant reduction in symptoms of depression and anxiety.”

In the program’s first year, the treatment team has refined their process. “This program has grown from targeting six young adults initially, to now targeting 21 young adults and soon up to 11 adults over 30. As we have grown, we have worked to ensure that we offer consistent messaging, interventions and structure across FOCUS—which improves communication not only among the treatment team, but to our patients as well,” she notes.

FOCUS was created to fill a gap in residential programming. The team has gained a greater understanding of who may benefit from this treatment model. “As we’ve gained experience treating young adults in this program, we’ve found that these treatment strategies could benefit a wider range of people that includes older adults and now we’re taking that next step,” says Dr. Leonard.

As the program became more well-known, it was clear that referring clinical professionals and older adults were in need of similar programming for adults over 30. “We’ve found that some of our young adults who may have experienced ‘failure to launch’ had many of the same symptoms as some older adults with depression and anxiety. The same treatment model would be beneficial for them as well, with some minor adjustments. These older adults may not necessarily be experiencing ‘failure to launch,’ but their depression or anxiety could be making their lives take a turn for the worse.”

Dr. Leonard explains that the two age groups benefit from receiving programming in separate tracks. “Patients are more comfortable in a group that they can relate to. It can be difficult for adults over 30 to connect with someone who is having difficulty navigating college or their first job.”

Based on the program’s early positive results and response from the clinical field, the future of FOCUS looks promising. “We’re excited to begin serving a new population of adults in our program and it will be great to feel confident that we will be able to help more individuals get back to living more fulfilling lives.”

November 6, 2015 - 8:48am

Biz Times Nonprofit of the YearAfter securing one of three finalist positions for the 2015 BizTimes Large Nonprofit Organization of the Year, Rogers Memorial Hospital was awarded this honor at the BizTimes Nonprofit Excellence Awards at Potowatomi Hotel and Casino in Milwaukee. The award—which is granted to a small and large nonprofit organization in southeastern Wisconsin—acknowledges the winner’s exemplary dedication to their mission and their community’s well-being, exceptional structural sustainability and teamwork, as well as superior organizational skills in management and operations.

Four hundred award nominees, nonprofit advisors and a committee of BizTimes’ editorial team members attended the event. Members of Rogers’ administration and leadership represented Rogers Memorial Hospital during the ceremony and joined other local nonprofits, for-profits and volunteers in the community celebration. 

“To be honored as a finalist and then go on to win the BizTimes’ Large Nonprofit of the Year award is a wonderful accomplishment for our organization,” says Paul Mueller, CEO of Rogers Memorial Hospital, “It shows that we are fulfilling our mission and the community recognizes our dedication to providing the best behavioral healthcare possible to those in need.”


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