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.

July 1, 2016 - 8:46am

Eric Storch, PhD Rogers Behavioral Health’s Tampa, FloridaNashville, Tennessee; and Skokie, Illinois; locations offer a variety of partial hospital and intensive outpatient programs for children, teens and adults with anorexia nervosa, binge eating disorder and bulimia nervosa. The Rogers’ teams, however, often find their patients also dealing with comorbid conditions related to anxiety.

Anxiety disorders are quite common among youth and adults and these disorders frequently co-occur with disordered eating behaviors,” says Eric Storch, PhD, clinical director of Rogers Behavioral Health–Tampa Bay and a Morsani College of Medicine professor. “Although exact prevalence rates are difficult to specify for many reasons, we receive many calls from individuals seeking treatment for comorbid eating and anxiety symptoms.”

Matthew Brown, DO, child and adolescent psychiatrist of Rogers Behavioral Health–Chicago, explains that disordered eating habits can develop from a person’s fears. “Many eating issues stem from some sort of anxiety, such as feeling too fat to be loved, nervous that he or she will never be loved or desiring to be the ‘perfect’ weight,” he says. “Many eating disorders are about control and control tends to be driven by anxiety.”

But do anxiety disorders always revolve around food? “Youth and adults presenting for intensive treatment of anxiety disorders at our regional locations display a wide variety of difficulties. These difficulties range from social difficulties; to fears of specific places, people or things; to nearly anything imaginable,” says Joshua Nadeau, PhD, clinical supervisor of eating disorder and obsessive-compulsive disorder and anxiety disorder services at Rogers–Tampa. “Eating disorders—that is, anxiety manifesting as disordered associations with weight, body shape, or eating habits—are one example of impairment related to anxiety.”

Dr. Storch explains that there currently is not enough research in the field to explain the cause of comorbid anxiety and eating disorders. “To some extent, we focus very little upon the ‘why’ of the disorder and very much upon the ‘what now’ in terms of setting goals and helping our patients to reach them,” he says. “Our treatment program focuses upon providing skills training, reducing ‘maintaining factors’ (those things in your environment that reinforce disordered eating behaviors) and providing ample opportunities for practicing the adaptive skills in multiple settings.”

According to Dr. Storch, it’s important that comorbid conditions like eating disorders and anxiety are treated at the same time. “It is not enough to simply change the specific eating disorder behaviors, as the incorrect thought patterns associated with anxiety will more than likely manifest in other areas, and decrease the patients’ motivation for change in the future,” he says. “Our treatment of eating disorders and comorbid anxiety addresses the full range of complexity that people with these problems experience with the goal of healthy lifestyle, happiness and improved quality of life.”

“The Rogers regional programs represent a shift towards more evidence-based methods of addressing patients with anxiety disorders that manifest in disordered eating behaviors,” adds Dr. Nadeau. “Specifically, our programs utilize an adaptation of extended cognitive behavioral therapy (CBT) to provide education, teach and build skill competencies in problem areas, ‘defusing’ maintaining factors and building generalization across settings through significant amounts of skills practice.”

Rogers offers one of a few eating disorder programs that practice not only evidenced-based treatment for eating disorders, but we also have experts in evidenced-based treatment for anxiety as well. “Here we are able to treat the whole patient with the goal of placing them in control of their own lives and teaching them that they can be healthy and they can be successful if they are willing to invest in themselves,” says Dr. Brown.

June 23, 2016 - 10:57am

Compassion FatigueEvery day, patients with trauma or posttraumatic stress disorder (PTSD), courageously work with therapists, nurses and other professionals to decrease anxieties surrounding horrific events. Over time, the trauma patients endure and the anxieties that come along with it can become harmful for care providers.

“Secondary PTSD, or compassion fatigue, are non-clinical terms used when describing distress caused by treating the trauma of others,” says Jennifer Parra-Brownrigg, professional adult counselor at Rogers Memorial Hospital–Brown Deer. “Unlike burnout, compassion fatigue occurs between the provider and the person they’re caring for, not between the provider and their job expectations and employer.”

In her first position out of graduate school at a women’s crisis center, Parra-Brownrigg found many staff members gravitating to her to share their concerns. “In a crisis center, the client can release the anxiety, whereas staff were bottling tension as long as they’ve worked there,” she says. “After really listening to their worries and watching them become run down, I wanted to find ways I could help and became more interested in secondary PTSD.”

Parra-Brownrigg offers presentations to nurses at Moraine Park Technical College. “Nurses, along with therapists, have historically been some of the most prominent professions with a high turnout of secondary trauma,” she says. “I offer techniques for dealing with the incredibly difficult things that we hear and help with on a regular basis, because we can’t assume they’ll go away on their own.”

Skills Parra-Brownrigg teaches to prevent compassion fatigue include:

  • Developing clear boundaries between work and home
  • Building a strong connection with other treatment providers
  • Keeping a list of self-care activities
  • Using personal values as foundation for motivation
  • Getting to know yourself, how you grieve and what you can control
  • Mindfulness activities

Parra-Brownrigg would also like to offer support her colleagues. “Hopefully we will be able to incorporate yoga, mindfulness walks or other self-care techniques into our work routine in the near future.”

PTSD therapists can rely on one another. “We can ask ourselves how we can be more effective in helping each other stay strong as a team,” says Parra-Brownrigg. “Accepting our limitations is difficult.”

Parra-Brownrigg says her goals are to first educate and then create preventive action. “We’re so present with our patients that we can’t help but invest part of ourselves,” she says. “We can refill our energy and lean on each other to stay strong, focused and able to provide care for the long-run.” 

June 20, 2016 - 1:36pm

OCD Awareness Walk 2016This Saturday, 20 Rogers Memorial Hospital team members participated in the second annual OCD Awareness Walk in Oconomowoc, Wisconsin. The two-mile walk around Fowler Lake was hosted by OCD Wisconsin, an affiliate of the International OCD Foundation (IOCDF).

Rogers was the lead sponsor for the event. Nicholas Farrell, PhD, clinical supervisor at the residential Eating Disorder Center, offered a few words before the walk.

Emphasizing the seriousness and prevalence of the disorder, Dr. Farrell explained OCD affects the overall quality of life of many families every day. “Most recent estimates suggest that OCD is present between 2 and 3 million American adults,” he says. “That’s roughly the population of Houston, Texas.” Approximately 1 half million American children and teens also have OCD.

“There is hope and with everyone’s efforts at this walk, we can spread the message that people are not alone in their struggles and there are several effective treatments available,” says Dr. Farrell.

A student with OCD was also awarded the $500 Barry Thomet Scholarship for her outstanding success in school and perseverance in treatment.

June 14, 2016 - 8:05am

Psychiatry residents treating eating disordersAccording to Mental Health America, eating disorders may occur with a wide range of other mental health conditions, including anxiety disordersdepression and other mood disordersposttraumatic stress disorder (PTSD) and substance use disorders. Because these conditions are commonly co-occurring, psychiatrists will likely have a patient who has an eating disorder at some point in their career, regardless of discipline.

Over the past four years, the eating disorder inpatient unit at Rogers Memorial Hospital–Oconomowoc has accepted four to six Medical College of Wisconsin residents for four-week elective rotations. In psychiatry, residency programs are four-year commitments. In July 2015, the Medical College approached Rogers to create a more formal agreement allowing eight residents each year to participate in a required eating disorder rotation at Rogers during the residents’ third year of training.

Mara Pheister, MD, director of residency education in psychiatry at the Medical College of Wisconsin, says the relationship benefited both parties. “We found Rogers’ eating disorder unit to be very unique and one that we don’t have any experience with in our program, so that seemed to be something that would work well for both Rogers and the Medical College,” she says.

A recent graduate of the Medical College residency program was also coming on board at Rogers. “It was helpful that Dr. Elizabeth Hamlin, an adult psychiatrist here at Rogers-Oconomowoc, was also joining our team right as she was finishing up her own residency,” adds Brad Smith, MD, medical director of eating disorder services. “She was interested in helping train the residents and we knew she would be well-versed with the program. It all just came together at the right time.”

Even though the residents are only at Rogers for a few weeks, they gain a large amount of experience. “Our residents primarily work on the eating disorder inpatient unit because there is a higher flow of patients than in our lower levels of care, which creates more learning opportunities,” says Dr. Smith.

“The inpatient unit is also a familiar level of care for psychiatry residents, who typically come to us with extensive experience in various inpatient psychiatry settings,” he says. “They are very accustomed to the general work flow and demands of an inpatient setting, and now get to experience how to provide treatment for individuals with eating disorders in that level of care.” The psychiatry residents also gain experience in the residential level of care which is less familiar to them.

Residents are evaluated on their performance on the unit by Dr. Smith and Dr. Hamlin. “Each resident is assigned four to six patients to follow closely and keep the same normal routine that an attending psychiatrist would,” says Dr. Smith. “That includes labs, charting, vitals, medications and reviewing what has happened with each patient over the last 24 hours with Dr. Hamlin.”

Not every resident will treat eating disorders in their professional career. “Even if the residents aren’t planning on going into eating disorder work, we hope they have a positive experience with us and may find another area of psychiatry they would like to practice at Rogers,” says Dr. Smith. “They get an opportunity to see a very structured way of delivering cognitive behavioral therapy (CBT) and experience a private hospital setting, which may be different than their other experiences.”

“It’s a great setting to learn and increase their understanding about how exposure and response prevention (ERP) works in eating disorders treatment,” adds Dr. Hamlin. “Our treatment also has a strong focus on experiential therapy.”

Overall, the program helps residents become more familiar with the very best of the community’s resources. “The majority of our residents stay in the Milwaukee area to practice, so it’s important for them to have working knowledge of the different treatment options and systems that are available in our area,” says Dr. Pheister. “Each system participating in the program has different strengths, so it’s especially helpful for the residents to learn in the different areas of expertise at each location.”

But what do the residents think about the program? “Since the residency program at Rogers is still new, we’ve only had about six residents rotate through so far, but the response has been very positive,” says Dr. Pheister.

Marc Gunderson, MD, a current resident with the Medical College, is among those who value their residency program at Rogers. “I have a new appreciation for the pathology and comorbidities associated with eating disorders,” he says. “I have a better sense of what treatment for these patients involves and will be better able to assess whether a patient requires an increased level of treatment.”

The challenging experience helps residents prepare for conditions they will likely encounter. “This is a pathology we get little exposure to on many of our other rotations,” says Dr. Gunderson. “Eating disorders are complex and often comorbid with other disorders, which makes for multi-faceted treatment.”

Dr. Hamlin explains that the residents are educationally prepared, but have not had much previous experience working with patients with eating disorders. “All the residents know how to talk to patients and handle medications, but not all know eating disorder pathology or how to approach patients separately from their disorder,” says Dr. Hamlin. “They’re surprised about the variety in each patient’s eating disorder. Each disorder is as different as each person.”

In a world where face-to-face psychiatry is getting harder to find, the additional time spent with psychiatry residents most importantly helps patients. “They feel good that someone is learning from their journey with an eating disorder and they really benefit from the extra one-on-one time with another clinician,” says Dr. Hamlin.

Rogers partners with various universities, colleges and professional organizations to offer graduate placements and practicums in multiple disciplines throughout the system.

June 10, 2016 - 8:45am

Stephanie Eken, MD and Amy Mariaskin, PhDHosted by the International OCD Foundation (IOCDF), the 23rd Annual OCD Conference gathers a unique group of researchers, therapists, families and individuals with obsessive-compulsive disorder (OCD) from around the globe to share research, techniques and personal experiences with OCD. Over the years, acceptance to present at the conference has become more competitive and attendance has steadily risen.

For this year’s conference in Chicago, Ill., IOCDF received 400 proposals for 140 available workshops, support groups and evening activity slots. Fifteen Rogers representatives will present, including Stephanie Eken, MD, regional medical director, and Amy Mariaskin, PhD, clinical co-director of Rogers Behavioral Health–Nashville.

Sharing New Resources and Experiences

“There are few OCD providers spread out across the country and even across the world,” says Dr. Mariaskin. “We rarely have an opportunity to be in the same place and share knowledge.”

Both doctors have previously presented at the event and enjoy gathering new, enriching knowledge each year—and sharing it as well. “It’s important for us to present because Rogers offers levels of care that very few in the country provide,” says Dr. Eken. “I’ve presented to both clinicians and families because each group wants to know what the treatment experience could be like.”

In addition to academic and clinical presentations, the family member and personal testimonies keep the true purpose of the conference at the forefront. “I love to hear the parent and child presentations,” says Dr. Eken. “I think they’re amazing.”

A Preview of Select Presentations

In collaboration with other professionals, Dr. Mariaskin will help children develop their own powers in the workshop “Superheroes vs. OCD-Villains: Using ACT to Conquer OCD.” “The workshop is based in acceptance and commitment therapy (ACT) and this will be the second year we’re offering it,” she says. “Kids will get to build their own masks and see themselves as superheroes after we give them tools to fight their OCD. Last year the kids had a great time.”

With their peers, Drs. Eken and Mariaskin will also present “Treatment of OCD in Young Children.” “As hard as it is to get anyone on board with treatment that requires confrontation with feared stimuli, with kids it’s even more difficult because they live in the moment,” she says. “It’s hard to convince children that facing their anxiety—which feels terrible at the time—will help them feel better in the future. We will talk about these challenges in treatment and how to make it fun and developmentally appropriate.”

Symptoms of OCD can also present differently in children than in adults. “It’s developmentally appropriate for children to have some rituals and strong preferences,” says Dr. Mariaskin. “We’ll offer advice on how to tease out these symptoms from typical development.”

In the presentation, Dr. Eken will discuss medications for children with OCD and how to avoid overprescribing. “Sometimes, children are given medications that could probably be avoided if therapy was also a component of their care,” she says. “We’ll also offer creative ideas for getting a child to take their medications.”

In a second presentation “Family Accommodation in Children and Adolescents with Co-Occurring OCD and Anxiety and Depressive Disorders,” Dr. Eken will discuss how parents can limit accommodation to their child’s disorders. “So many people with OCD have depression related to their lack of regular functioning,” she says. “We’ve offered a presentation on this topic a few years ago, but now we have more data and research to offer.”

Go online for a complete schedule of Rogers’ OCD Conference presentations.

May 31, 2016 - 8:14am

Patient Care GrantsOptimal mental health is critical for overall well-being, but for those struggling with behavioral health challenges, life-changing treatment can be costly. Unfortunately, as with general medical care, insurance doesn’t always cover the total cost of a person’s behavioral health treatment or the length of treatment that may be most beneficial. No one wants to face going without a life-saving medical operation for you or your loved one because of finances. The same is true for your or a loved one’s mental health or addiction care.

With the passing of the Affordable Care Act, insurance coverage for behavioral healthcare has increased, but many families still face tough financial burdens. Rogers Memorial Hospital Foundation offers assistance and resources to qualified families whenever possible, and people with obsessive-compulsive disorder (OCD) and anxiety have a unique option available to them.

“With help from generous donors, the Foundation offers a limited number of treatment grants for adults, teens and children with OCD and anxiety and little or no coverage,” says Matthias Schueth, executive vice president of Rogers Memorial Hospital Foundation. “We assess whether a person is financially eligible and clinically appropriate for the program. If they are, they may receive a grant for treatment at no cost to them.”

OCD and anxiety are prevalent disorders, but they are treatable, especially when addressed early. Treatment in the program is provided by an experienced Rogers therapist who helps staff a local neighborhood clinic. “Currently, about three to four patients are enrolled in the program, but we can offer care to as many as six,” says Schueth. “It’s pretty unique for families to be able to receive treatment they may have thought was not even an option.”

Patients receiving care through the OCD and anxiety grant receive cognitive behavioral therapy (CBT) and an evidence-based treatment approach offered in all Rogers’ programs for OCD and anxiety. “The number of treatment hours is less intensive than in Rogers’ other programs and is tailored to individual need,” says Schueth.

Many are unaware the new legislation may give them more options for treatment. “A lot of people have been discouraged throughout the years because they didn’t have any insurance coverage, so they are not actively looking for services,” says Schueth. “It’s important we tell the community there may be better coverage available and, if not, this grant might help.”

“Hopefully, some will look for treatment for the first time ever,” says Schueth. “We hope this donor support will help patients overcome the stigma of mental illness and seek the help they need.”

How can you apply? Visit Rogers Memorial Hospital Foundation’s website, complete and submit your application and participate in the clinical review.

May 16, 2016 - 12:44pm

Nashotah Program CanvasImagine leaving your job and family, picking up everything to move hundreds of miles away to enter treatment for your mental illness or addiction. You’ve been searching for months for a program that can help and for what feels like the hundredth time, a doctor tells you that you are in the right place. Do you believe it? Maybe not—but what if you heard from someone who has actually been there?

Across Rogers Behavioral Health, many prospective patients and families do. Some say there’s something more honest and encouraging about reassurance from someone that has experienced similar struggles and has been in the very program they are about to enter.

Handprints and marks of healing

At Rogers Behavioral Health–Nashville, all patients participate in a ‘”discharge circle” upon discharge from their program. The patient’s family, treatment team and fellow patients talk about the progress that person has made, provide encouraging words and more as they move into lower levels of care or out of programming.

“At the end of that circle, patients paint their hands, put their handprint on the wall of our experiential therapy room and write a quote next to their handprint,” says Kathryn Boyer, experiential therapist at Rogers–Nashville. “The handprint says ‘I was here and I made it through this’ and the quote provides inspiration for future patients.” Each is as individualized as the person who left it, but many have a common theme of finding peace with imperfection.

Staff members in Nashville first started the project for patients with obsessive-compulsive disorder (OCD) and contamination anxiety, who, at the end of programming, would be able to paint their hands, give high-fives and avoid over-washing throughout the day. “When they first came to us, they were washing their hands up to 30 times per day, 15 minutes per time. Seeing them be able to do this upon discharge is amazing,” says Boyer.

Several patients have told Boyer the wall provides encouragement to get through programming, especially when first arriving for treatment. “New patients see the discharge circle and all the support that comes from everyone involved in the treatment process, and it’s been very beneficial.”

The large display of handprints is also inspirational for staff. “Some days can be difficult, but it always helps when I go into the experiential therapy room, think about the stories behind each handprint. I’ve learned so much from them,” says Boyer.

Child and adult patients at Rogers Memorial Hospital–Brown Deer contribute to a similar project displaying painted handprints, semicolons and other marks as a sign of overcoming mental health challenges and completing treatment.

Letters and pictures of encouragement

Patients and loved ones of patients in Nashville also write letters of encouragement to future patients and families. “For patients, it feels like they’ve left something here,” says Boyer. “The greatest benefit I’ve seen is for parents whose children are entering treatment. When they see that patients have written something that talks about their progress, it gives them peace of mind.”

Children enrolled in Rogers Behavioral Health–Tampa Bay’s eating disorder partial hospital program and OCD and anxiety partial hospital and intensive outpatient programs , as well as Rogers Behavioral Health–Chicago’s child and adult programs also write letters to future patients. “In Tampa, we keep a book of letters in our office and share it with children and their parents as they begin acclimating to programming,” says Katie Merricks, behavioral specialist at Rogers–Tampa Bay.

But parents aren’t the only family members who benefit from the experience. “Many parents take a copy of their letter home to share with family members, friends and others in their lives so they too can understand what this process has been like,” says Merricks. “We’ve had siblings and grandparents write letters as well, so you really get many perspectives on the treatment process when reading the book.”

Sometimes, young patients choose to draw their personal reflections instead of writing. “The youngest person we’ve had make a letter was an eight-year-old, and it was mainly a drawing and a thank you,” says Merricks. “The handwritten letters and drawings are so much more personal.”

Merricks explains there’s something special about receiving encouragement from a former patient. “We can tell them, as clinicians, that they’re not alone and our treatment is great. But seeing a testimony from someone who’s shared a similar journey and struggles makes them feel so much more comfortable with trusting our care,” she says. “We have parents who pick up and move with their child across the country, leaving little ones and loved ones behind. The letters provide confirmation that they’re making the right decision.”

Canvasses to celebrate

Nashotah Program CanvasIn Nashotah, a residential dialectical behavior therapy (DBT) program for high school girls with emotional dysregulation at Rogers Memorial Hospital–Oconomowoc, patients create their own graduation canvases which are displayed in the program’s community space. “The visual personal statements of their recovery journeys which the girls paint inspire others to complete the program,” says Lisa Herpolsheimer, manager of Nashotah.

As in Nashville, inspirational quotes play an important role in the project in Nashotah. “They often write a quote that is meaningful to them from the dialectical behavior therapy (DBT) skills and philosophy, such as learning to accept themselves as they are fully and at the same time learning to change and grow,” she says. “Seeing peers finish their canvases makes the other girls look forward to painting their own.”

Herpolsheimer explains that seeing the canvasses also helps newcomers because, though the program can be challenging, it is manageable and they can be successful. “New patients relate well to the realness of the other girls as they see similar interests based on what their paintings represent,” she says. “The girls also look forward to seeing what their peers may choose to paint. Admiring the finished canvas is a way to celebrate recovery.”

May 12, 2016 - 1:38pm

Keeping Meals and Treatment FreshRogers Memorial Hospital–Oconomowoc and Rogers Memorial Hospital–West Allis have been growing some of their own produce to help children and teen patients connect plant growth to their personal changes, reduce food avoidance and keep meals and seasonal treats tasting great. John Williams, director of dining services at Silver Lake Outpatient Center in Oconomowoc, WI, makes a point to include children from the Child Center and Adolescent Center when he grows the produce that will be used in their meals and other dishes at Silver Lake Outpatient Center.

“I believe that if I can get their hands working with food from soil forward, it can help patients with their transitions here at Rogers,” says Williams. “Exposing the kids to the growing process can help reduce their picky eating tendencies, since they’ve been hands-on with the food from its early stages.”

Williams began growing herbs such as oregano, thyme, sage, mint, green onions, cilantro and more on the Oconomowoc campus when he joined Rogers in May 2015. He incorporates all of the produce into dishes at the Oconomowoc and Silver Lake locations—including sauces, flatbreads and chicken meals to name a few. He explains that growing your own produce is also a great way to save. “Herbs can cost as much as $8 a pound and growing your own is a way to get that fresh taste for a low cost,” says Williams.

Patients also enjoy the sensory experience of growing their own plants. “We encourage the kids to pick the plants and taste them as they grow,” says Williams. “Some of the kids may have never grown plants before and it’s a wonderful new experience for them and will hopefully create some healthy habits that will carry over into their adulthood.”

For three years, Rogers’ West Allis location has been growing produce such as peppers, tomatoes and strawberries to showcase in their garden show held every June. Patients in Rogers’ West Allis day treatment program for children and partial hospitalization program for adolescents are involved in the entire process from the first planting to enjoying the harvest. “We talk about gardening in general as an excellent coping skill which helps decrease depression,” says Nancy Goranson, PsyD, attending psychologist at Rogers Memorial Hospital–West Allis. “It’s a positive family activity and helps young people learn responsibility because they have to regularly care for something outside of themselves.”

Dr. Goranson also explains that gardening helps patients learn that by taking small steps, they can achieve large accomplishments. “The commitment needed to water a plant daily, pull weeds, and enjoy the beauty of flowers or delicious food that results from this work helps our patients see that they can take daily steps to meet their program goals.”

The Rogers’ team has hopes to expand the gardening possibilities in the years to come. The dietary services team at Rogers Memorial Hospital–Brown Deer plans on growing produce with patients for the first time this spring and Williams would like to increase the number of Rogers’ locations that garden. “It’d be great to eventually have tomato plants here in Oconomowoc or gardening space at the Eating Disorder Center in Delafield,” says Williams. “Now that we have the greenhouse in Oconomowoc, it’s going to be exciting to see how the patients grow alongside the produce they care for.”

May 6, 2016 - 10:54am

Honest, Open, ProudWhen a teen breaks a bone, friends and family often ask for “the story” of how the bone broke, how long it will take to heal and may even ask to sign the cast. But when a child is challenged with a mental health difficulty, it can be tricky for him or her to decide whether to share their journey, when to share it or how to share it. Wisconsin’s Initiative for Stigma Elimination (WISE) created a program—“ Honest, Open, Proud-High School” (HOP-HS)—to proactively empower teens to make thoughtful decisions about disclosing their story.

“HOP-HS helps teens in grades 8-12 who have faced a mental health challenge, whether or not they have a formal diagnosis,” says Sue McKenzie, co-director of Rogers InHealth . “In a series of five sessions lasting an hour each, teens practice skills for reversing their hurtful ‘self-talk’ and take a deep look at the costs and benefits of talking to others in various settings such as work, school or with friends.”

Suzette Urbashich , co-director of Rogers InHealth, explains that not every child makes the decision to disclose. “But for situations where the teen does decide to share their challenges and strengths, the program helps prepare them to respond to unanticipated reactions,” she says. “One month after the initial sessions, the group re-convenes for a check-in session to see how things are going.”

Program facilitators are being trained across Wisconsin to implement HOP-HS, helping teens assess the story they tell themselves about their journey and to draft a version of their story to begin shaping and reshaping for various audiences. Key concepts explored in the training include the five levels of disclosure:

  • Isolation: teens may separate themselves from friends and family, feeling that they are alone in their journey
  • Secrecy: fearful of showing weakness, youth may develop a persona to disguise their pain or difficulty even to those closest to them
  • Selective Disclosure: teens may chose “safe” or trusted people to share their struggles with, such as a parent, which can give a child the confidence to share their story with more people who can offer support or tell them they are not alone
  • Indiscriminate Disclosure: a teen feels confident enough to discuss their mental health journey with people that may react negatively
  • Full Disclosure: youth feel comfortable discussing their story with all people, not only to help themselves, but to help others

McKenzie explains that HOP-HS was adapted from an adult version of the program, originally created by Patrick Corrigan, PsyD. “As WISE began using the program, we realized that a key age group was missing from the HOP suite of programs: youth,” she says. “So, WISE partnered with Corrigan to develop a version of the program that would be relevant to high schoolers.”

The evidence-based adult version of the program demonstrated a statistically significant reduction in stigmatizing attitudes about self and others with mental illness, a decrease in depressive symptoms and anxiety about disclosure, as well as an increased willingness to seek help. “Sharing one’s story isn’t a simple decision. It requires careful thought and support,” says Urbashich. “HOP-HS guides youth to develop the strategic disclosure skills they need to make the daily decisions of if, what and to whom to disclose.”

According to McKenzie, there are plans to enhance the program in the future. “We hope to increase the number of trained HOP facilitators throughout the state, conduct randomized controlled trial research, collect data and share the program nationally and internationally,” she says. “To increase involvement and awareness about the program, Suzette and I have begun presenting at state-wide and out-of-state conferences. This March, we attended the 29th Annual Research and Policy Conference on Child, Adolescent, and Young Adult Behavioral Health in Tampa, FL, to share the program on a national level—which was very exciting.”

On May 25, 2016, a HOP-HS facilitator training session will be held in Oconomowoc, WI. To find a HOP program facilitator in your area or to be trained as a facilitator, contact

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.”


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