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.

September 18, 2014 - 11:37am

Teen SuicideTeenagers are inundated with expectations in their homes, schools and social lives leading to an estimated half a million attempting suicide each year. It is not uncommon for teens to experience varying degrees of stress, self-doubt, pressure to succeed and worry about their future. Unlike adults, teens struggle with the ability to look at life’s stressful events as temporary. For some, a series of stressful events may lead to a belief that the unhappiness is an overwhelming burden that will go on for the rest of their life. As time goes on they may begin to feel depressed and anxious. At moments, suicide may feel as if it is the only viable solution to their problems and stress.

Common stressors teens experience can include: increasing demands at school, bullying by peers, managing romantic relationships, facing peer pressure to use drugs or alcohol, becoming increasingly independent from their parents and the pressures of finding a job or preparing for college.

Parents should be aware of some of the following signs of teen depression:

  • Significant changes in eating and/or sleeping habits
  • Withdrawal from friends, family and regular activities
  • Feelings of worthlessness, sadness or low self-esteem
  • Neglect of personal appearance or complaints about physical illness (headache, stomachache, etc.)
  • Persistent boredom, significant difficulty concentrating or a decline in the quality of school work
  • Loss of interest in pleasurable activities
  • Thoughts of death
  • Intentional self-harm

Signs you may see from a teenager who is planning to commit suicide (may include, though not limited to):

  • Talking about being a bad person or feeling empty inside
  • Giving verbal hints with statements such as: “Nothing ever works out for me. Everyone would be better off without me. I can’t take it anymore.”
  • Giving away possessions, cleaning his or her room, writing goodbye letters or posting farewells on social media
  • Becoming suddenly cheerful after a period of depression

In general, what should you do if you think that a teen close to you feels suicidal?

Ask them directly whether or not they have been thinking of killing themselves. People often feel uncomfortable talking about suicide, but doing so may save your loved one’s life. It is a myth that talking about suicide “puts the idea” into someone’s head. People who feel suicidal want to know that someone cares and will listen to their pain. Always take statements of wanting to die seriously. Do not leave your child alone.

Seek help immediately. If your teen states that they want to die or if they have thoughts about suicide, seek help from a qualified mental health therapist who can help identify and problem-solve your child’s needs.

With support from family and appropriate treatment, children and teenagers who are suicidal can go forward to feel hopeful and live productive and happy lives. If you feel a teenager you know is exhibiting some of these signs, Rogers Memorial Hospital can help. Our inpatient and day treatment programs provide a safe environment where teens can work on stabilizing their symptoms and identifying ways to manage their emotions when feelings of hopelessness arise.

To schedule a free screening call 800-767-4411 or request one online at rogershospital.org.

The following resources also provide information on teen depression and suicide:

September 4, 2014 - 12:20pm

Experiential Therapy

Art, dance/movement, drama, music, recreation/adventure and relaxation are part of a category of therapies collectively referred to as experiential therapy. At Rogers Memorial Hospital, experiential therapy is thoroughly integrated into our patients’ treatment experience. More than a third of the programming (35%) our patients receive is experiential in nature.

Rogers has one of the largest experiential therapy programs in the area, with nearly 40 experiential therapists working at our five locations in Wisconsin. Our experiential therapists help patients make stronger, deeper connections to key concepts covered in their ‘talk’ therapy sessions by reframing them in concrete ways. Rogers' therapists provide encouragement and support as well as interpretation and redirection, skill education and non-intrusive observation that help shift patients’ perceptions about their illness to new, recovery-focused ways of thinking.

The Nail Stack

The Nail Stack is a puzzle that is used as an opportunity to identify obstacles and improve a patient’s self-esteem. Participants are told they must balance 14 nails on a single nail head and the nails cannot touch anything except each other. Our patients work as a team to tackle this challenge. Sometimes, the level of frustration rises as the puzzles seems unsolvable. When frustration happens, experiential therapists at Rogers use that moment as a learning opportunity to show patients how to cope with everyday stresses they may encounter. (Scroll Down To See Nail Stack Solution)







 

Nail Stack Solution

 

September 3, 2014 - 9:29am

Each September the Substance Abuse and Mental Health Services Administration (SAMHSA) observes Recovery Month, highlighting the prevention, treatment and recovery services that help individuals celebrate recovery from a mental health or substance use disorder. This fall, Rogers is addressing treatment issues by adding addiction programming at their Brown Deer, Oconomowoc and Madison, Wisconsin locations.

This fall, addiction programs offered by Rogers Memorial Hospital are expanding to include a new dual diagnosis track at the Herrington Recovery Center (HRC) and a dual diagnosis intensive outpatient programs and partial hospitalization programs in Madison and Brown Deer.

“Most addiction programs have little to no psychiatric services and few deal intensively with co-occurring disorders,” said Michael Miller, MD, FASAM, FAPA, medical director of the HRC. “By incorporating 14 hours per week of cognitive behavioral therapy (CBT) for patients in our residential program, we are able to effectively treat addiction and common co-occurring psychiatric disorders like mood disorders, anxiety, OCD and trauma.”

Located at Rogers Memorial Hospital in Oconomowoc, WI, the HRC is part of a top psychiatric hospital, where psychiatric consultation and concurrent treatment of mental health concerns by board-certified psychiatrists is available. This dual track gives HRC the ability to truly integrate addiction and psychiatric care, helping patients suffering from substance abuse and a significant anxiety disorder at one time. The schedule for the dual diagnosis track has been arranged to allow for more specific programming, including sessions with behavioral specialists who provide CBT, and other tools including behavioral activation and exposure and response prevention.

As with the current program, the HRC will offer experiential therapies along with core addiction services, including 12-Step facilitation. The HRC is also addressing tobacco use disorder and offers education and recovery interventions to address nicotine. Abstinence from smoking improves a person’s chances of lasting success in abstaining from other alcohol and addictive drug use. The board-certified addiction specialist physicians at the HRC integrate pharmacological therapies for alcohol, opioid and nicotine addiction into psychosocial therapies for addiction and, when indicated, specialized psychiatric therapies and medication management.

In addition to the new track at the HRC, Rogers’ clinic in Madison is also opening an intensive outpatient dual diagnosis program, while Rogers’ Brown Deer is looking to add both an adult and adolescent dual diagnosis intensive outpatient programs and an adult dual diagnosis partial hospitalization program.

August 25, 2014 - 8:59am

youth sports can lead to eating disordersDid you know that youth sports can lead to eating and weight problems with certain individual kids or teenagers? Did you know that within some youth sports leagues weight restrictions are put on certain positions within a sport? Many popular sports are known to be "weight sensitive" including ballet, gymnastics, figure skating, wrestling, track/cross-country, and horse-back riding.

Did you know that football and rowing also have weight restrictions? Youth football leagues typically put caps on weights for entering the league and for certain positions. For instance, in certain leagues you must weigh 80 pounds to carry the football, and you cannot carry the ball if you weight over 100 pounds. Football and other sports typically have weight limits for safety reasons, however, in certain situations these types of weight restrictions can be detrimental to children’s health.

This is particularly true for kids who may be pursuing a certain position within a sport, or become obsessed with reaching a target weight for the sport in order to participate. This ultimately can lead to unhealthy weight loss, poor nutrition, disordered eating habits, and eating disorders.

Kids may restrict their food intake, increase their activity level, and exercise more to reach a desired weight to get a desired position. These behaviors become dangerous when they lead to dehydration, unnatural weight loss, and possibly abnormal body functions including low potassium.

These days our children have vast opportunities to participate in sports, whether it’s through school, local parks or recreations departments, sports leagues or athletic clubs. There are also multiple levels of sports in which children and teenagers compete including recreational, intramural, league, and even select. This is all in an effort to keep kids active with their peers, within their community, and for their health. What a wonderful thing!

Here's some advice for moms and dads…

Listen to your kids! Talk to coaches if you have concerns. Watch your child’s eating, sleeping, and activity patterns. Allow one activity per semester so kids don’t get too overwhelmed. Remember, health comes first!

What to watch for:

  1. Increasing discussion about weight limits in sports. This may come up as a nonchalant topic after a weight check at the doctor’s office, or a health check. Ask questions and get a good understanding of your child’s thought process.
  2. Changing habits – changes in eating patterns: eating less, paying close attention to calories or food labels, restricting intake, avoiding certain high fat/carb/calorie foods, restricting/over eating cycle, laxative use, or purging.
  3. Obsessing: Frequent weighing of self or obsessions regarding a certain measurement.
  4. Over-exercising: your child/teen should not have to exercise much more above and beyond their athletic practice times. If you notice that they are exercising before and/or after their practices, a red flag should go up!

What to do:

  1. Talk with your child and get a good idea of what is going on.
  2. Call your primary health care provider and schedule an appointment.
  3. If you have concerns that your child has an eating disorder, call Rogers Memorial Hospital at 800-767-4411. We can provide free telephone screenings or additional information about our specialized programs. We also offer an online screening.
July 24, 2014 - 11:15am

If you or someone you know suffers from Posttraumatic Stress Disorder (PTSD), you may benefit from a type of therapy called prolonged exposure, or PE, which helps you process single or multiple/continuous trauma in a way that reduces your symptoms.

This cognitive behavioral therapy treatment for adult men and women diagnosed with PTSD consists of a course of individual therapy and therapist-directed assignments which help reduce specific PTSD symptoms as well as depression, anger and general anxiety.

PE therapy has three components:

  1. psychoeducation about common reactions to trauma and the cause of chronic post-trauma difficulties
  2. imaginal exposure, a revisiting or repeated recounting of the traumatic memory in your imagination
  3. in vivo exposure, gradually approaching trauma reminders, such as situations and objects that are feared and avoided despite being safe.

At the PTSD partial hospitalization program at Rogers Memorial Hospital-West Allis Lincoln Center location, PE Treatment is individualized and conducted by therapists and behavioral specialists trained in this technique. After your initial assessment, you will work with a highly trained therapist or behavioral specialist to design a hierarchy of exposures, working one-on-one on imaginal exposures and complete assignments under supervision.

A patient's ability to engage in these procedures in a health manner primarily determines how long treatment lasts. While group therapy is part of PTSD treatment, all PE work is individual and not done in the groups.

June 24, 2014 - 3:25pm

Paddle Boarding to Recovery at Rogers Memorial HospitalAt Rogers Memorial Hospital, our treatment consists of many components. What makes our treatment approach unique is the multiple levels of therapy we provide including family, group, individual -- and experiential.

Often an overlooked piece, experiential therapy can be essential to a healthy recovery. This type of therapy involves a range of activities from art and music to recreation. With a ropes course, a climbing wall, access to multiple lakes and acres of trails through a beautifully wooded setting, Rogers is an ideal location to practice this form of treatment.



Something new: Paddle boarding

One of the most recent additions to the many experiential therapy activities offered at Rogers is paddle boarding. Paddle boarding utilizes a traditional surf board and a paddle, which is used to propel the boarder across the top of the water while standing on the board.

Paddle boarding offers many benefits, both physically and mentally. As in all experiential therapy activities, attempting and accomplishing a new task will build confidence. With an activity like paddle boarding, we remind our patients of their capabilities and strengths, while providing support as they challenge themselves to overcome fears and self-doubt. That’s empowering!

With increased exposure to the different activities offered, including paddle boarding, we often find this helps decrease the avoidance and anxiety surrounding experiential therapy for those who are hesitant to participate. Any physical activity can provide relief from anxiety and stress. While a patient is focusing on accomplishing the task at hand rather than on the therapy itself, he or she can let their guard down and feel free to be themselves.

With more confidence and a sense of relaxation, paddle boarding and experiential activities can invoke positive moods and give patients an uplifted outlook. And, by trying new and different leisure activities, patients find healthy interests to pursue in their free time.

Getting mentally and physically fit

In addition to the mental benefits of paddle boarding, this activity in particular also promotes a healthy lifestyle and physical fitness. Paddle boarding requires balance, coordination, strength and even patience. It can truly test an individual’s ability to persevere and once they have conquered the task, it will provide an undeniable sense of accomplishment.

Paddle boarding is rapidly increasing in popularity, and working its way up to one of the top water sports. Rogers Memorial Hospital is proud to be able to introduce this unique opportunity as both a form of therapy and an exciting new wilderness experience for our patients.

June 3, 2014 - 9:05am
Kristin Miles, PsyD

By Kristin Miles, PsyD


Kristin Miles, PsyD, is an attending psychologist at Rogers Memorial Hospital-West Allis’s Child and Adolescent Day Treatment program. Learn more at rogershospital.org.

Media in its multiple and ever-changing forms – TV, Internet, Facebook, Twitter, computer and video games – plays a prominent role in our lives. With this unprecedented 24/7 access, many children and teens have difficulty managing their media use. So what is the danger in multi-tasking multiple streams of entertainment and information?

Developmentally, the brains of pre-teen and younger teens have yet to develop self-regulation skills, and this impacts their ability to identify when it is too much. Research from the University of Bristol found that children and teens that spent more than two hours a day in front of a screen had a 60 percent higher risk of psychological problems. These findings are part of a growing body of evidence that indicates there is a connection between media use and children’s mental health.

How can media affect my child’s mental health?


Media can have both a positive and negative effect during the growth years, depending on how the medium is used. It can be a positive experience for shy children in helping them develop interpersonal skills, create a sense of community or, in others, teach empathy or tolerance.

However, research also shows that when media is overused it can become a significant distraction for children, which can impede learning or cause short-term memory problems, cause a decrease in attention span, disrupt sleeping patterns, or cause excessive moodiness or aggression and other behavioral issues. As children enter their teenage years, they find themselves more susceptible to peer influence which may make them more likely to engage in risky behaviors like skipping school, drinking or drugs.

What is an appropriate amount of time for my child to engage in media?

A study by the Kaiser Family Foundation stated that children as young as eight years old are spending nearly 7.5 hours a day consuming media. A 2013 policy statement from the American Academy of Pediatrics (AAP) offers guidelines which cover all media avenues including television, movies, video games and Internet or tablet applications. The AAP policy statement suggests screen time should be limited to less than one or two hours per day. Kids that had more than two hours per day were more likely to experience a drop in school performance, short attention spans and even increased belligerence.

Besides time limits, how can I help guide my child’s media experience?

Parents need to strike a balance in their children’s media experience that minimizes potential health risks and fosters appropriate and positive media use. If you are finding it difficult to enforce media limits for your children, consider the following suggestions:

  • Create “screen-free” zones at home
  • Make meal and family times technology free
  • Offer non-electronic activities like books, puzzles or board games
  • Develop a family media agreement where children and parents agree to communicate openly on media use

When my child is using media what can I do to ensure it’s safe and age appropriate?


The immediacy of media means your child or teen will probably be exposed, whether it’s with parental guidance or away at a friends or families. However, you can limit their exposure by:
  • Keep the computer in a public part of the house
  • Know and understand the media your children are using
  • Utilize a kid-safe browser and search site such as Zoodles, Kido’z, or KidZui
  • Create a code of conduct to follow (i.e. don’t share passwords or personal information, avoid strangers)
  • With older kids, discuss various media messages and advertising
Sources: Common Sense Media
May 28, 2014 - 9:58am

Sue McKenzieSue McKenzie, co-director of Rogers InHealth works to provide stories of hope and recovery to eliminate the stigma surrounding mental illness.

Stories change us. In my role at Rogers InHealth I have the joy of creating and participating in environments for people to encounter stories of hope, connection and recovery. Recently over 400 people who provide services to those facing mental health and addiction challenges gathered together at a Milwaukee college. The goal was to brainstorm about how to best address the complexities of trauma, poverty and depression. While participating as one of three panelists chosen to provide context and insight, I shared a brief story about a four-year-old boy.

I had the great pleasure of interviewing his mom and his special education teacher, Janice, for a program Rogers InHealth leads for school staff on engaging and motivating children with mental health challenges.

John’s* mom enrolled him in a local school district after he was expelled from a private preschool. Yes, a four-year-old expelled from preschool! Both adults expressed that John was a good kid with some tough challenges. This often led to others seeing him as a bad kid. Janice mentioned an example of a struggle his classroom teacher was having with John during naptime. After a few weeks of no nap, frustrations rose. Finally one morning, Janice took a walk with John and asked him about naptime. John readily offered that he hated the music the teacher put on. Now, I am not sure if the music was just irritating or if it somehow triggered something for John, but he was clear about his feelings. Janice went home that evening and thought about this dilemma. The next day she brought a pair of headphones to the teacher and suggested she offer them to John. John used the headphones that afternoon and rested with the other children.

Do you feel John’s relief? The teacher’s? Will you remember this story? That is why stories change us. When hearts and minds connect as they often do with a real story of real people, we discover insights that are relevant to our life.

What might you or another gain from a friendly walk or a simple solution? What happens when you ask another what they need and, if possible, provide it without judgment?

The combination of trauma, poverty and depression is very complex and daunting to address. John’s story reminds us that to effectively engage these tough issues we must engage with each unique person we encounter in our work and community life. In that engagement, we find our common humanity and possibly concrete ways to alleviate a bit of the suffering on the road to recovery-living.

To meet some of the awesome people I have interviewed in the past, go to rogersinhealth.org.

*Name changed to protect privacy

April 4, 2014 - 9:24am

DSM-5One of the primary changes in DSM-5 is that it now recognizes age-related aspects in each disorder and chronologically lists diagnoses that are most applicable to infancy and childhood first, followed by diagnoses that are more common to adolescence and early adulthood, and ending with those that are often diagnosed later in life. Within each disorder category, there are also modifications intended to help clinicians provide more accurate diagnoses that will lead to better treatment.

New Disorders

The fifth edition includes several new depressive disorders, including disruptive mood dysregulation disorder (DMDD) and premenstrual dysphoric disorder (PMDD).

The American Psychiatric Association, which publishes the guidebook, indicates DMDD has been included to address concerns about potential overdiagnosis and overtreatment of bipolar disorder in children. DMDD provides a diagnosis for children up to age 18 years who exhibit persistent irritability and frequent uncontrollable behavior that may even be violent.

In addition, PMDD is now an official diagnosis that recognizes an extreme form of premenstrual syndrome characterized by strong emotional symptoms such as depression, anxiety, moodiness and irritability.

New Specifiers

While none of the core criteria for the symptoms of major depression have changed, the DSM-5 includes two new specifiers for depression. Now, the specifier “with mixed symptoms” allows for the presence of manic symptoms as part of the depression diagnosis in patients who do not meet the criteria for a manic episode. “With anxious distress” has also been added as a specifier because the presence of anxiety may impact treatment choices and the patient’s response.

Dr. Jerry Halverson, Rogers’ medical director of FOCUS and adult services, indicates the “with anxious distress” specifier may only be used with patients who exhibit at least two of the following symptoms during most of an episode:

  1. Feeling keyed up or tense
  2. Feeling unusually restless
  3. Difficulty concentrating due to worry
  4. Fear that something awful may happen
  5. Feeling loss of control of himself or herself

“The rationale for this is that the co-occurrence of anxiety with depression is one of the most commonly seen comorbidities in patients,” Dr. Halverson explained. “The addition of this specifier allows clinicians to indicate the presence of anxiety symptoms that are not reflected in the core criteria for depression or mania, but may be helpful when creating a treatment plan.”

He added that the specifier change from “post-partum” to “peri-partum” is also important. “This change in specifiers recognizes what clinicians and patients have known for a long time. Women can suffer from a major depressive order either before or after birth. Now, women who struggle with depression while pregnant can access the treatment they need.”

DSM-5 also includes guidance for the assessment of suicidal thinking, plans and risk factors, so that clinicians can address the prominent role of suicide prevention as part of a patient’s treatment.

Bereavement Exclusion Removed

In the past, any bereavement following the death of a loved one that lasted less than two months was not classified as a major depressive episode (MDE). The new edition, however, acknowledges that the grieving process may include an MDE that requires treatment just as with any other stressor. DSM-5 also removes the implication that grieving the death of a loved one may only last two months, which is important because most clinicians recognize that this grief usually lasts one to two years, and it offers guidelines to help clinicians distinguish between normal grief and an MDE.

“DSM-5 recommends that, even if it seems that depressive symptoms are an understandable reaction to a significant stressor such as the death of a loved one, the clinician should carefully consider the possibility of an MDE,” Dr. Halverson said. “DSM-5 also recognizes that the depressive symptoms related to bereavement-related depression respond to the same psychosocial and medication treatments as any other MDE. In fact, sometimes bereavement can precipitate an MDE and should be treated as promptly as possible. This exclusion enables clinicians to make a diagnosis of depression even during bereavement, with the hope that earlier treatment can be provided as needed.”

March 12, 2014 - 12:58pm

ADSM-5 OCD, PTSD, Anxiety few of the primary changes in DSM-5 include the reorganization of chapters for better groupings of disorders – including obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) – and the framework within those chapters that recognizes age-related aspects. This is important because it reflects the nature of some disorders within a patient’s lifespan. DSM-5 lists diagnoses that are most applicable to infancy and childhood first, followed by those that are more common to adolescence and early adulthood, ending with those that are often diagnosed later in life.

New Chapters for OCD and PTSD

“One of the most important changes regarding OCD and PTSD is that these two disorders have been removed from the anxiety disorder chapter where they were in the previous edition,” Bradley C. Riemann, PhD, clinical director of Rogers’ OCD Center and Cognitive Behavioral Therapy (CBT) Services, said. “Now, two new chapters surrounding OCD and PTSD (“Obsessive-Compulsive and Related Disorders” and “Trauma- and Stressor-Related Disorders”) have been created.” He says these changes were due to increased research and evidence demonstrating common threads running through a number of OCD-related disorders; for example, obsessive thoughts and/or repetitive behaviors.

Although Dr. Riemann says the change won’t really impact patients, the differences seem to reflect what clinicians have been seeing in their practices for quite some time. “These disorders can be related. That’s why DSM-5 places them sequentially in the guidebook to reflect their close relationship.” He added that what’s really important is that the DSM keeps evolving and getting more specific with each revision.

Obsessive-Compulsive and Related Disorders

Disorders in this chapter have features in common such as an obsessive preoccupation and repetitive behaviors. In addition, they reflect a relationship to one another in terms of overlapping symptoms and response to treatment. Hoarding and skin picking (newly recognized in DSM-5) fall within this category, along with hair pulling and body dysmorphic disorder (BDD), which is manifested by a negative preoccupation with body image that is focused on a minor or perceived flaw.

“This chapter provides more consistency among diagnoses, with fear, anxiety and avoidance being key,” Dr. Riemann said. “Now, the definition of obsession has also changed, with ‘urge’ replacing ‘impulse.’ Plus, new specifiers for tics and insight have been included. Patients no longer need to recognize that their obsessions or compulsions are excessive or unreasonable.”

Trauma- and Stressor-Related Disorders

PTSD is included in this new chapter, with criteria that differs significantly from those in the previous DSM. Now more explicit in regard to how an individual has experienced “traumatic” events, PTSD also includes a subtype for preschool children and four symptom clusters (re-experiencing the event, heightened arousal, avoidance, as well as negative thoughts and mood or feelings).

Anxiety Disorders

In addition to removing OCD and PTSD, DSM-5 now adds separation anxiety disorders and selective mutism to the chapter on anxiety disorders. (Selective mutism is a disorder in which a person normally capable of speech does not speak in specific situations or to certain people.) Previously, these diagnoses were provided primarily to infants, children and adolescents, but the fifth edition now recognizes their role even in adulthood. For example, children of adults with separation anxiety disorder and those with avoidance behaviors that occur in the workplace as well as at school are included in this chapter.

If you or someone you know is living with any of these disorders, call Rogers at 800-767-4411 for a free screening or request one online.

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