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.

Life. Worth. Living.

April 22, 2016 - 12:27pm

Experiential therapy globeExperiential therapy globeFor some, having a mental illness can feel like you’re caged by a monster, leaving you unable to participate in the daily activities that you would like to engage in. That is the metaphor that Ashley Samson, experiential therapist at Rogers Behavioral Health–Chicago, started with in December 2015 when she designed new projects for her patients. Over time, that metaphor was adjusted to be more relevant to the different patient age groups in Skokie, IL.

“When each patient attends their first experiential therapy group at Rogers–Chicago, he or she is offered the opportunity to visually track their progress,” says Samson. “The children and teens enrolled in the obsessive-compulsive disorder (OCD) and anxiety partial hospital and intensive outpatient programs record their personal growth with ‘freedom balloons.’”

Using dry-erase markers, Samson draws balloons on the window of the experiential therapy room as a space for each child to collect their successes and share with others. “The children write down what they’re proud of that session on their balloons, whether it be the completion of an exposure or an accomplishment that gets them one step closer towards their treatment goal or discharge,” she says. “The freedom balloons help the kids display a sense of pride and share their successes against the ‘monster’ or disorder that has held them captive.”

Samson adapted the metaphor for adults with OCD enrolled in the partial hospital and intensive outpatient programs and FOCUS partial hospital program. “When our adult patients first arrive, they are given a clear ornament, which we refer to as a ‘progress globe,’” she says. “During check-in, each patient creates a handwritten note of personal success or finds a small object that represents their positive change and puts it in their globe. Our adult patients usually prefer to be more private than our younger patients about tracking their accomplishments, so the globes were a way to continue the metaphor in a more reserved way.”

Upon discharge, patients can take their globe home as a token of their achievements or smash the globe if they wish to shift the metaphor toward reclaiming their freedom from their mental illness. “It can be helpful for many patients to see and feel their progress as tangible objects,” says Samson. “These simple traditions are a wonderful way for patients to see that even small successes like coming to treatment on time or completing an exposure can add up to increased confidence and a greater sense of pride in their hard work.”

According to Samson, one patient who started a progress globe decided to continue higher level treatment at Rogers Memorial Hospital–Oconomowoc before returning to outpatient programming in Skokie. “When I asked her whether she’d like to take her globe with her or leave it at our clinic, she told me that she’d prefer we held onto it for her as a ‘place-keeper’ or personal reminder that she would be back to continue her journey to wellness.”

April 13, 2016 - 1:52pm

Post-detox treatmentMany adults wrongly believe that once they complete their detox treatment, they will immediately be freed from their drug or alcohol addiction. Beth Shaw, counselor, addiction intensive outpatient program at Rogers Memorial Hospital’s Lincoln Center Outpatient Center in West Allis, knows the work has just begun.

“When patients first come to our addiction intensive outpatient program, many of them don’t understand how deadly their disease is or how much power it has over them,” she says. “Many patients mistakenly think that the physical pain of going through detox will be the hardest part of their journey to recovery, but the real work comes afterwards in post-detox treatment.”

While patients receive inpatient care or residential treatment, they may have temporary protection from many of their outside stressors. “Patients live in somewhat of an artificial world before they get to an intensive outpatient program,” Shaw says. “They don’t have contact with those who helped facilitate their addiction or many of the triggers that caused them to abuse drugs or alcohol, which means that we have to address these issues in the intensive outpatient program while they have connections to the outside world.”

Many of Shaw’s patients have a family history of addiction, abuse, neglect or other emotional issues. “Family sessions play a major role in our program—not only to form a solid support network for the patient, but to bring to light any underlying family problems that may have caused the patient to find an unhealthy coping mechanism,” she says.

Once patients begin treatment in the intensive outpatient program, they often find that the program is not the intimidating experience they might have expected. “Our patients quickly realize that the treatment team isn’t here to tell them they’re ‘bad people’ or scold them for their addiction,” says Shaw. “They see people with similar struggles and realize they are not the only ones with this disease.”

Shaw explains that the group therapy sessions in the program help create a sense of accountability. “I’ve heard over and over again how patients thought about giving up, closed their eyes and pictured the faces of those in their group therapy,” she says. “Then they realize that the treatment team and those in their group are all ‘in this together.’”

The specialized treatment available at Rogers Memorial Hospital gives patients an advantage, Shaw believes. “An obsessive-compulsive disorder consult is two doors down from my office. Having speedy access to specialized treatment gives patients more complete care,” she says. “Rogers works hard to find solutions for patients, including those with ‘difficult cases.’”

March 15, 2016 - 1:04pm

According to the National Alliance on Mental Illness (NAMI), about one-third of people with mental illness also experience substance abuse—meaning that they have a “dual diagnosis.” Amy Kuechler, PsyD, attending psychologist for the adolescent dual diagnosis program at Rogers Memorial Hospital–Brown Deer, explains that teens with mental illness—such as depression, attention deficit hyperactivity disorder (ADHD), anxiety or trauma—may be even more susceptible to substance abuse.

“There are a few reasons why teens may be more susceptible to use substances,” she says. “The adolescent brain is not fully developed, so teens struggle to consider the consequences of their behaviors and instead respond to immediate gratification—like the immediate high from substance abuse. Teens also test ways to separate themselves from their families and place more importance on their peer relationships and ‘fitting in.’”

What’s especially concerning is how accessible many substances are for teens to use to get high. “Many parents are unaware that products in their home are commonly abused by teens, such as over-the-counter cough medicine or various aerosol cans.” These substances are easy to find, legal to use and many can be purchased online.

Dr. Kuechler explains that unhealthy habits formed in adolescence have a good chance of carrying over into adulthood. “Ninety percent of adult substance abusers started using substances in their teens with fifty percent starting before the age of 15,” she says. “This is important to note because early treatment and intervention are potentially the key to prevention.”

If your teen abuses substances, Dr. Kuechler suggests looking for common warning signs of mental illnesses commonly associated with dual diagnosis:

  • Increased isolation and withdrawal from activities your teen used to enjoy
  • Increased moodiness, particularly increased irritability and argumentativeness
  • More secretive behaviors, lack of motivation
  • Truancy at school, difficulty with authority or increased interactions with law enforcement
  • Associating with a new group of friends
  • Lying, stealing, cheating or manipulating
  • Changes in sleep patterns or appetite

According to Dr. Kuechler, both disorders in a dual diagnosis should be treated simultaneously because they are often related. “If only one disorder is treated, there’s a good chance symptoms of the untreated disorder will increase,” she says. “For example, someone who is struggling with alcohol abuse and depression may manage their depressive symptoms through drinking. If the person’s treatment only focuses on stopping their excessive drinking, there’s a possibility they may learn to deal with their depression through another unhealthy strategy, while never truly addressing the underlying issue.”

Rogers Memorial Hospital’s adolescent dual diagnosis program is based in cognitive behavioral therapy (CBT) and motivational interviewing (MI), which are evidence-based techniques. “We start by using MI as a therapeutic strategy that encourages teens to develop a desire to make changes in their lives and become active in their treatment,” she says. “Then we focus on using CBT to help teens understand that their thoughts, feelings and behaviors are all related. By changing just one of those things, the whole dynamic of how they live their lives can be changed.”

Rogers offers various individualized, comprehensive partial hospital and intensive outpatient dual diagnosis programs for teens and adults at multiple Wisconsin locations including Oconomowoc, Brown Deer, West Allis, Kenosha and Madison. The adolescent dual diagnosis partial hospital and intensive outpatient programs at Brown Deer are Rogers’ first offering for that age group and are clearly serving a need. “Overall, we are teaching adolescents that they have the power to improve their lives and the way they see the world,” says Dr. Kuechler.

 

March 11, 2016 - 10:40am

Five clinical leaders from Rogers Behavioral Health will share their insights at the 2016 Anxiety and Depression Conference in Philadelphia, PA, sponsored by the Anxiety and Depression Association of America (ADAA).

“ADAA is one of the leading conferences that focuses on anxiety, obsessive-compulsive disorder (OCD) and depressive disorders where researchers and clinicians from throughout the world convene to share ideas,” says Eric Storch, PhD, clinical director of Rogers Behavioral Health–Tampa Bay and a Morsani College of Medicine professor. 

“The ADAA annual meeting is unique because it brings together the top researchers and top clinicians in the world for the purpose of improving the way we treat, someday cure and prevent the suffering caused by the disorders related to anxiety and depression,” adds Karen Cassiday, PhD, clinical director of Rogers Behavioral Health–Chicago and president of the ADAA.

Rogers’ presenters will offer their insight on the following topics. The full schedule is available online:

  • Dr. Cassiday will chair the roundtable, “Taming Treatment-Refractory Situations: Hot Tips for Clinicians with Difficult Cases,” with Dr. Storch as a presenter on family accommodation;
  • Dr. Cassiday is the primary presenter for the workshop session, “What if I die? Overcoming Health Anxiety in Kids and their Parents,” and the roundtable, “Exposures Uncut: Challenges Faced When Conducting Exposures With Children and Adolescents;”
  • Dr. Storch is one of the presenters in the roundtable, “Effective, Essential Therapist-Prescribing Clinician Collaboration in the Treatment of OCD: An Expert Roundtable Discussion,” and the symposium, “Advances in Intensive Cognitive-Behavioral Therapy for Anxious Youth;”
  • Jerry Halverson, MD, medical director of Rogers Memorial Hospital–Oconomowoc and FOCUS adult mood disorders programs, and Rachel Leonard, PhD, clinical supervisor of FOCUS, will co-present a workshop session, “Multi-Modal Residential Treatment for Individuals Struggling to Transition into Adulthood due to Symptoms of Depression and Anxiety;
  • Dr. Halverson is a co-presenter in the symposium, “Focal Brain Stimulation: Practical Considerations for the Clinician;”
  • Dr. Leonard is among the distinguished list of presenters in the Ignite symposium session, “Increasing the Effectiveness of Intensive/Residential Treatment Models for OCD Across the Lifespan;” and
  • David Jacobi, PhD, clinical supervisor of the Child Center, is one of the presenters in the roundtable, “Woulda, Coulda, Shoulda: Lessons Learned From Treatment ‘Failures.’"

As expected, Rogers’ specialists are eager to share their knowledge with others in the field. “A workshop Dr. Jerry Halverson and I are presenting discusses treatment for individuals struggling to transition into adulthood due to their depression and anxiety—these individuals are often characterized as experiencing ‘failure to launch,’” says Dr. Leonard. “The transitional period of time between adolescence and adulthood is characterized by high rates of depression, often with other co-occurring disorders, so identifying treatments that target the needs of this unique population is incredibly important.”

Stephanie Eken, MD, regional medical director, and national outreach representatives Blair McAnany and Rick Ramsay will attend the conference as representatives of Rogers Behavioral Health. 

Rogers’ specialists will also be available at our exhibit table to answer programming questions at the following times:

  • Dr. Storch, Friday, April 1, from 9-10 a.m. and Saturday, April 2, from 11 a.m.-noon.
  • Dr. Leonard, Friday, April 1, from 10-11 a.m. and Saturday, April 2, from 9-10 a.m.
  • Dr. Eken, Friday, April 1, from 10:30-11 a.m.
  • Dr. Jacobi, Friday, April 1, from 12:30-1:30 p.m. and Saturday, April 2, from 9-10 a.m.
  • Dr. Halverson will be available for much of the conference
March 8, 2016 - 8:03am

Phoenix Comfort RoomSince childhood, many of us have known that it’s important to be a good host—whether that means offering a refreshing beverage or the softest seat in the house. When children, teens and adults seek treatment at any of our locations, we strive to treat them as we would want our own friends and family to be treated. A team of care providers at Rogers Memorial Hospital–Brown Deer felt that they could do more to be hospitable to children and teens when experiencing difficult times during treatment. 

When youth are enrolled in programming in Brown Deer, WI, and various other locations, a “comfort room” is available for patients as an environment to wind down in and practice coping skills learned in treatment. “The idea of the comfort rooms are great, but the rooms at our location had blank white walls and made some patients a bit nervous,” says Josh Larson, an art therapist at Rogers–Brown Deer. “We wanted the kids to enjoy being in the room and feel like it was a safe space, but the room’s appearance wasn’t allowing that to happen.”

So, a team of four art therapists, one recreation therapist and one mental health practitioner came to Heather Hodorowski, manager of experiential therapy at Rogers–Brown Deer, with a proposal. “Staff expressed that they wanted to create purposeful murals in the comfort rooms,” says Hodorowski. “I was proud that they wanted to fit the project into their regular work schedule and I was impressed with their initiative—so, I gave them the tools to run with the idea.”

The planning process incorporated the entire treatment team at Brown Deer. “I sent out a survey for naming the child and adolescent treatment tracks and the team decided on “Lotus” for the children and “Phoenix” for the teens. Then those involved with creating the murals naturally incorporated those images into the comfort rooms,” says Hodorowski. “We often use the metaphor that even though lotus flowers flourish in the mud, they still have the ability to rise above the surface. The phoenix represents regeneration, growth and technique development for moving forward with anxiety, depression or psycho-social stressors.”

Lotus Comfort RoomOnce the mural ideas were decided on, staff were eager to get to work. “We agreed that using bold, cool-colored earth tones would be more likely to offer a calming effect than other colors,” says Larson. “We each took turns picking up a paintbrush whenever we had spare time and after 110 hours of painting, the project was complete.”

Hodorowski explains that staff have already seen a major impact in the way children and teens accept the rooms. “The comfort rooms finally live up to their name and are actually popular among our patients,” she says. “We’ve found that they’re more willing to speak up and ask for ten minutes to spend in the room until they feel more prepared to continue treatment than they were before.”

“The comfort room also offers another way for patients to interpret their therapy and connect what they hear in group throughout the day,” adds Larson. “Visualizing what is discussed in therapy can be beneficial for children or teens who learn better with imagery.” In the future, staff at Brown Deer hope to create murals in the comfort rooms of the child and adolescent day treatment and adult inpatient programs. 

February 26, 2016 - 11:53am

This Eating Disorders Awareness Week, countless people from around the country will share their stories of recovery to reduce mental health stigma, encourage others to get a screening, raise awareness and even help in their own healing process. Since anorexia nervosa, binge eating disorder, bulimia, and other eating disorders affect all ages, genders and races, you might already expect that each person’s eating disorder journey is as unique as they are. But you may not expect the complete mind, body and soul transformation that each person undergoes on their path to wellness. 

Mari’s Story

For college students who are balancing school, athletics, work and family responsibilities, life can be challenging enough. But for Mari, her obsessive dieting and exercise routines put a strain on her body and mind that was greater than any final exam or conference championship could ever have done.

As an eager college freshman, Mari began taking courses at the University of Wisconsin–Stout in September 2013, hoping to one day earn her degree in dietetics. She always had a passion for living a healthy and active lifestyle, so it was no surprise when Mari made the university’s tennis team as well. With so much going for her, Mari had only a promising future ahead, but then things got more complicated during Mari’s first winter break at home. 

“I noticed that I had gained a few pounds, only a few, and I felt something switch inside of me,” says Mari. “I started to feel really insecure about myself and I felt myself becoming more conscientious and aware of my weight.” Like many young adults who gain a little weight their freshman year, Mari thought it was something that could easily be solved by dieting and maintaining an active routine. But as a year passed and her disordered eating progressed, Mari’s family began to notice how dangerously thin she’d become. 

“My family had expressed concern for my health, but it wasn’t until I had two menstrual periods in one month that I realized my body wasn’t well internally—so then I decided to visit my school’s clinic,” says Mari. “The doctor who I was scheduled with had done my physical exam for the tennis team the year before. When she saw me, she immediately knew that something was wrong and ran an EKG and other tests.”

After realizing the severity of Mari’s symptoms, as well as her progressing heart failure, Mari’s physician suggested that she seek professional treatment. Mari says it wasn’t until she received a feeding tube in Rogers Memorial Hospital’s inpatient program in Oconomowoc, WI, that she realized anorexia nervosa had taken over her behaviors. 

Emily’s story

Not all people immediately realize the severity of their eating disorder when they first begin treatment. That was the case for Emily, another young college student.

“I began seeing a psychiatrist my junior year of high school for my anorexia, which had begun to develop when I was ten years old,” says Emily. “I also received treatment in an inpatient program, but I put a lot of effort into convincing my family and my doctor that I had been restricting my diet for attention—that I didn’t really have an eating disorder. I became very good at tricking myself and others, but in reality my life revolved around the personal list I had made on ‘How to Be Perfect.’”

When Rogers began offering eating disorder services close to Emily’s home in Tampa, FL, her psychiatrist suggested that she try the more intensive treatment available at Rogers Behavioral Health. Emily agreed, “I decided that this would be my ‘practice run’ for taking treatment seriously.”

After taking a semester off of school and work, Emily was ready to fully commit to her wellness. When Emily met her treatment team in Tampa’s partial hospital program, she realized that she could no longer remain emotionally disengaged. “Right away, my team knew that I needed help creating an emotional baseline and they developed an ‘emotion wheel’ that I still use today to help express what I’m feeling,” she says. 

While in treatment, Emily found great help from her group therapy sessions, her faith, and her family. “Even now, when I sit at the dinner table and feel myself struggling with a certain food, my little brother looks up at me with the biggest smile because he knows when I need the extra reassurance,” says Emily. “And that’s enough to help me stay on track.” 

Denise’s story

Not all people with eating disorders like Emily and Mari are college-aged, female, or even have the support that comes with living with parents and siblings. Rogers is known for its treatment of males with eating disorders, and Denise represents the less stereotypical older woman with these challenges.

At the time, Denise was a mother in her mid-twenties when she had a conversation with a friend about purging and decided that it might be a good way to get back to her pre-baby weight. “I had four kids and I hadn’t gotten any results from dieting,” she says. “What started out as my method for weight loss eventually turned into a pattern of binging and purging up to 20 times a day, for 15 years.”

In Denise’s early forties, she developed depression after experiencing an “empty nest,” which caused her to lose her appetite. With no desire to eat, Denise’s bulimia was replaced with anorexia nervosa. Still believing that she didn’t have an eating disorder, Denise lost consciousness while driving her daughter. Her daughter then grabbed the wheel and steered them both to safety from the passenger seat. 

“It wasn’t until I began receiving residential treatment at the Eating Disorder Center that I began to acknowledge that I had an eating disorder,” she says. “While receiving treatment and doing a lot of personal discovery, I found out a lot of the reasons of why I had an eating disorder. I always say that my birth certificate says ‘Rogers’ on it.”

Moving forward

Denise says she learned a lot from both younger patients like Mari and Emily, as well as middle-aged patients like herself. “I also found that the art therapy I received brought out feelings in me that I didn’t realize I had,” she says. “At first, the thought of creating art was scary, but I found out that I’m actually pretty creative. Today I create mosaics, I’ve illustrated a children’s book and I’ve even written my own book.”

Emily has found that she continues to make progress in her recovery by sharing her story and donating her time to others. “It’s so rewarding for me to volunteer in the Tampa community and right now I’m a mentor at a girl’s juvenile facility,” she says. “People who have really changed my life were complete strangers to me and I want to continue sharing my faith and my experience with others.”

Mari has also emerged from her treatment transformed with a newfound career choice and personal cause. “Because of the treatment I received at Rogers, I’ve changed my major from dietetics to psychology,” she says. “My family and I can’t believe how far I’ve come and I’m just so passionate about eating disorder treatment that I want to be dedicated to this my entire life. I know I’ve already touched lives and I just want to continue to give hope to other people.”

 

February 23, 2016 - 12:14pm

National Eating Disorders Awareness WeekFebruary 21 through 29 is Eating Disorders Awareness Week, an observance organized by the National Eating Disorder Association (NEDA). This year’s theme: “3 Minutes Can Save a Life: Get Screened. Get Help. Get Healthy.” promotes early intervention and education about the causes, dangers and treatments for eating disorders. Brad E.R. Smith, MD, medical director of eating disorder services at Rogers Memorial Hospital–Oconomowoc, explains that this national observance is a great opportunity to seek out available programming options.

Whether you realize it or not, it is very likely that you or someone you know is affected by an eating disorder. “Up to 30 million men, women and children in the United States suffer from anorexia nervosa, binge eating disorder, bulimia, or other eating disorder,” he says. “People with eating disorders also have a higher mortality rate than those with any other mental illness.” So what are some of the factors that make this such a dangerous disease?

“One of the biggest challenges we face is that people who have eating disorders may not recognize that they are ill and so they may be resistant to accept treatment,” says Dr. Smith. “People with eating disorders have a tendency to minimize, rationalize, or hide their eating disorder symptoms and behaviors. They might also seek out a variety of specialists and interventions that address the serious medical consequences of their behavior without tackling their underlying problem—because in all cases, it is never just about the food.”

Rogers Memorial Hospital offers multiple levels of care for eating disorder treatment, including inpatient, residential, partial and intensive outpatient programs. “A number of effective treatments for eating disorders exist for children, teens and adults,” he says. ”This includes cognitive behavioral therapy (CBT), a type of psychotherapy that addresses an individual's thoughts, behaviors, and feelings to make changes.” 

Even with the right treatment approach and a multidisciplinary team, achieving lasting recovery still takes time. 

“Recovery doesn’t happen overnight because we are interrupting harmful eating behaviors that have become deeply engrained and almost unconscious for many,” says Dr. Smith. “Treatment helps people with eating disorders to change what they do, normalize their eating habits and reframe the irrational thoughts that sustained their disordered eating behaviors.”

Call 800-767-4411 to schedule a free screening today. 

February 19, 2016 - 11:21am

FOCUS adolescent mood disorders programImagine a 16-year-old girl sitting in her room, overwhelmed by her own emotions. She was once outgoing and involved in high school sports and clubs, but now she finds herself wanting to just be alone. She carries around thoughts in her head that confuse and exhaust her, feeling like she can’t connect with her family or friends. 

This is just one example of the type of situation a teenager may be in that Rogers can help with its new FOCUS Adolescent Mood Disorders Program planned for opening in March. This program offers comprehensive residential treatment for adolescents age 13 to 17 struggling with primary mood disorders, bipolar disorder, depression and co-occurring disorders. The program becomes Rogers’ eighth residential treatment program on the campus of Rogers Memorial Hospital–Oconomowoc.

Peggy Scallon, MD, who joined Rogers in February, will serve as medical director. She has spent much of her 20 years in psychiatry treating children and adolescents. “I love to work with children and teens because they are so honest and engaging. They have their whole lives ahead of them, so the positive impact of effective treatment will be with them for decades,” says Dr. Scallon. “I am so excited about the new FOCUS Adolescent Mood Disorders unit because I want to make a meaningful difference in the lives of our patients and their families. We have an enthusiastic team and we will transmit our passion for working with youth into change for the better.”

This new program will complement Rogers’ existing treatment specialties. “The FOCUS Adolescent Program will expand Rogers’ current programming for anxiety, obsessive-compulsive disorder (OCD) and eating disorders, to address youth with depressive disorders,” says Dr. Scallon. “We recognize that adolescents with depressive disorders may have a complicated mental health situation that can also include trauma, family difficulties and experimentation with substances. This program will be able to address the multiple factors that may be contributing to a teen’s mental health difficulty.”

“This FOCUS program is different from Rogers’ other adolescent residential programs because it provides treatment to teens who are experiencing more severe symptoms than we’d normally serve in our other programs,” says Eddie Tomaich, PhD, manager of the FOCUS adolescent program. “Staff in this program will be cross-trained to handle more complex cases, such as teens that may have anxiety coupled with severe depression.”

Treatment involves evidence-based cognitive behavioral therapy (CBT) and is supported by behavioral activation, mindfulness skills and strong family involvement. “We’ve found that when patients practice behavioral activation, or gradually reboot their activity levels, such as through exercise or public outings, they become less likely to isolate themselves and experience a decrease in their depressive symptoms,” says Dr. Tomaich. Through this program, our patients’ families have access to Parent University, a program that educates families and prepares them with skills to help their child make a more successful transition from our care to home life.

Dr. Scallon explains the goal of the FOCUS adolescent program is to teach teens techniques they can use to better cope with life’s challenges. “In the program, we will use individual, group and family therapy strategies that build upon existing strengths and teach new skills,” she says. “Our emphasis upon psychotherapy will empower our residents to leave the program, and return to their lives healthier and happier.”

February 3, 2016 - 10:52am

Bradley Riemann, PhDAn article published by National Public Radio (NPR) discusses a study based in the United Kingdom that researched two online programs that were created to treat depression. The results showed that the programs were ineffective, mostly because the patients weren’t likely to keep up with the program or remain engaged. The article goes on to suggest that face-to-face, traditional psychotherapy should be the method of choice for consumers. At the same time, other recent blogs and articles claim that online therapy is becoming more desirable among patients. So what should you believe? Bradley Riemann, PhD, clinical director of the OCD Center and cognitive behavioral therapy (CBT) services at Rogers Memorial Hospital—Oconomowoc, explains how there are two sides to every coin.

“The biggest issue that people have to be aware of is that you can’t generalize all computer programs, applications and other software into one pile. Just because these particular programs were found to be unsuccessful, doesn’t mean others wouldn’t be,” says Dr. Riemann. “The first thing you have to sort out is whether there is any data supporting the application you’re interested in. When we go to a doctor and ask for an antidepressant, we’re going to get a medication that has been thoroughly studied and found to be helpful for most people. But when purchasing an application or online therapy, that luxury is not automatically given to us and we have to be proactive and savvy consumers.”

Besides researching the program, Dr. Riemann recommends that consumers:

  • Explore the computer program’s website
  • Look for published outcomes, journals or articles on their website
  • Stay away from programs that use unclear language to describe their outcomes
  • Remember that if a group says their product is tested, it doesn’t mean their outcomes were positive in that test

Dr. Riemann explains that if the researchers from the U.K. would have changed certain variables in their study, they may have found different results, possibly showing that the programs could be successful under different circumstances. “If the researchers had gotten their subjects from a psychological clinic, versus a primary care clinic, those seeking that type of treatment might be more likely to do the computer-based treatment and you might find very different outcomes. The programs might not have worked in this design, but they might work in a different design.”

Some claim that online therapies will cause patients, especially those suffering from depression, to isolate themselves even more than their condition causes them to—but Dr. Riemann presents an alternate possibility. “If a person is depressed and isolating themselves as a result of that depression, they may not be able to go out and seek ongoing counseling or even leave their house. Classic, traditional forms of psychotherapy or even going to a psychiatrist’s office for medications may be very difficult if not impossible,” says Dr. Riemann. “But, if a program works, it’s going to lower their depression enough to allow them to leave their house and seek further treatment.”

Although online therapy could be a useful tool, Dr. Riemann explains there is natural healing aspect to social interaction. “Human interaction is helpful for more than just treating depression, it’s helpful for any psychiatric condition because we’re social beings by nature. Social support, whether it be friends, family or licensed clinicians, helps us to cope with our problems and buffers us from the stressors of the day,” he says.

However, our current technology has begun to blur the lines of what is considered human interaction. “Telepsychiatry, a therapy method which allows a patient to talk with their doctor on a television or computer screen, who could be thousands of miles away in theory, has been found to be quite helpful for patients,” says Dr. Riemann. “I’m not recommending telepsychiatry be used as a replacement for traditional therapy, but there are some people who can’t access face-to-face therapy because they don’t live near therapists, costs are too high or their condition doesn’t allow them to leave the house.”

He goes on to explain that increasing access to therapy, no matter the mode, may be helpful for many. “The fact of the matter is: the vast majority of people have access to computers, smartphones and tablets, but some people don’t have access to well-trained clinicians and psychiatrists. As a result, anything we can do to increase access to treatment is a positive thing, as long as that treatment has been found to work.”

January 18, 2016 - 9:41am

An article published by New York University discusses recent research that found an increase in the number of American high school seniors who abuse prescription opioids, or drugs that your doctor may prescribe to relieve pain. The study also found that for many of those students, their prescription drug abuse put them at increased risk of transitioning to heroin. The article explains that teens may begin using prescription opioids because they are relatively easy to access at home. Despite this study’s findings, Ian Powell, MD, addiction specialist, says that Rogers Memorial Hospital–West Allis is not currently experiencing this significant increase in adolescent opioid addiction.

“As is often the case, by the time a study’s research is published, that data is usually about two years old already,” says Dr. Powell. “We are not currently seeing a large population of young patients in our withdrawal management program and intensive outpatient program that started out using prescription opioids,” says Dr. Powell. “Instead, we have seen a population of adolescents that have transitioned straight to heroin. In many ways the problem is already here, but we aren’t seeing the specific pattern that the article suggests for a number of reasons.”

Dr. Powell explains that the number of doctors and dentists who are educated about prescription drug abuse is growing, as is the available technology to help decrease drug abuse. “The Wisconsin Prescription Drug Monitoring Program, for example, is a tool that practitioners in Wisconsin can use to monitor the drugs their patients are receiving from other doctors,” says Dr. Powell. “It makes it easier for practitioners to share information across the state and will help reduce the current 30 to 40 percent of adults and teens in Wisconsin who use prescription opioids and transition to heroin.”

So what can parents do to help prevent this problem? “You should make it a habit to throw out your or your child’s pain prescriptions when the injury has healed,” says Dr. Powell. “Saving your medications because you think you might need them later only increases the risk that you or someone else in your household may abuse the prescription.”

Dr. Powell also offers advice from the provider’s perspective. “Our primary goal, as physicians, is to relieve our patients’ pain—whether it be physical, mental or emotional,” he says. “But we do have to be aware of these dangers and take the appropriate actions to reduce widespread addiction.”

People seeking addiction services may not always suffer from addiction alone. Sometimes, a person with a metal illness uses drugs or alcohol to cope with their mental illness and develop an addiction—this is called dual diagnosis or co-occurring disorders. Amy Kuechler, PhD, attending psychologist at Rogers Memorial Hospital–Brown Deer, explains that although there is no single reason why a person develops co-occurring disorders, those with mental illness are more susceptible to developing a substance use disorder. “One reason for the increased risk is because substances may be used as a way to cope or attempt to manage the symptoms of the mental illness,” she says.

At Rogers’ Brown Deer campus, the most common drugs used among the adolescent patients with a dual diagnosis are synthetic marijuana and cough medicine because they are fairly easy to obtain. “In our treatment center, we have treated limited cases of heroin use, because many of our patients were still abusing opiate pain medication when they reached out for treatment and had not progressed to heroin,” says Dr. Kuechler. “But, that doesn’t mean other treatment centers aren’t experiencing an increase.”

When someone has a dual diagnosis, it’s important that their conditions are treated at the same time, such as Rogers does. “One of the main reasons we treat both substance use disorders and mood disorders concurrently is because they really are contributing factors to one another, so to only treat one disorder could result in an increase of symptoms for the other disorder,” says Dr. Kuechler. 

“Rogers Memorial Hospital–Brown Deer offers one of the only dual diagnosis partial hospitalization programs for adolescents available in southeastern Wisconsin, as well as an intensive outpatient program for dual diagnosis,” she says. “In addition to helping patients, these programs emphasize family support and education for their child’s treatment, because dual diagnosis is not only a patient concern—it is a family system issue.”

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