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.

January 11, 2012 - 1:00pm

Signs of school problems

Dr. Eken says it’s important for parents and school professionals investigate when children are showing the common signs of problems at school:

  • Physical complaints (headaches, stomachaches)
  • Lack of interest in normal activities
  • Isolation, or less interaction with peers
  • Grades that are not typical for the student
  • Lack of personal hygiene
  • Talking about sadness or anger at themselves

Holiday break is supposed to be just that – a chance for kids to get break from homework and tests. Children are expected to return to school, rejuvenated, ready to learn more. But for some kids, this simply isn’t the case.

For children affected by mental illness, these transitions can be even more difficult. For children with ADHD, it becomes an issue of having to concentrate even harder in order to keep up with new material. For the child with social anxiety, the idea of returning to school can create resistance. For many other children, holiday breaks translate into relief from bullying or social situations where friendships are difficult or nonexistent. Returning to this environment is not something these children look forward to.

Stephanie Eken, MD, FAAP, is the medical director of the Child Center at Rogers Memorial Hospital. She is a board-certified child and adolescent psychiatrist, who is also a pediatrician. Dr. Eken says that children who are having trouble with school frequently complain of stomachaches, headaches or fatigue and are often evaluated emotional causes to those problems. With an increased awareness of these symptoms, it’s more commonplace for pediatricians to refer children for mental health treatment.

Common causes of school refusal

“The most common cause of school refusal is separation anxiety. For children who are bullied or don’t feel good about themselves, the school break can be a reprieve,” Dr. Eken said. “But, they may have anticipatory anxiety about returning to school.” Children who have trouble starting a new school year or adjusting to a new school may also struggle with the transition following a long holiday break.

With academic and emotional concerns, parents are often at a loss, not knowing how to make this transition better for their child, and unsure of the best way to help them. Dr. Eken offered suggestions for parents whose children struggle at this time of the year. “It helps if they have some structure over the break so they don’t have to change routines when school begins. It can also help to get additional therapy over the break to support them. But it’s really important that parents highlight the child’s strengths and let them know that you’ll be there to advocate for them.”

Raising awareness with school professionals

Dr. Eken explained that there were many school professionals who simply need to understand more about each child’s challenges. “When they think about childhood OCD, they think about contamination issues,” she said. “But children who are dealing with perfectionism aren’t as easily understood. In fact, teachers may be providing the positive feedback that that child’s work is ‘perfect.’ What they don’t see is the time the child spends at home, maybe hours, to complete another ‘perfect’ assignment.”

Dr. Eken said children with ADHD may have trouble adjusting because certain personality traits are being used to describe their behavior. “When they don’t understand the causes of the behavior, some teachers are unknowingly signaling to the child that there is something ‘wrong’ with them.”

Children with separation anxiety may fear for the safety of their families or themselves and may seek reassurance from adults. “By nature, teachers can be very reassuring, but this can make it harder for kids with anxiety to face their fears,” Dr. Eken said. “We help educate the teachers. We teach them how to work with the kids and create a stronger support network for them at school.”

Supportive treatment for children and families

Dr. Eken and the treatment team at the Child Center work with kids and their families to develop healthy coping techniques and routines that help children feel more in control of their world and better able to handle the everyday challenges they encounter at school. “We work with the child, parents and the schools to help them advocate if they need other accommodations,” Dr. Eken said.

During treatment children and families come to recognize the thoughts and behaviors that may lead to avoidance of certain situations. They learn about co-morbidity, or co-occurring diagnoses. “They may be referred for depression, but we need to treat the underlying anxiety, OCD or ADHD to really help them with the depression,” Dr. Eken said.

“We incorporate many different therapies to help kids build confidence in themselves and realize their strengths,” Dr. Eken said. “With the skills they learn in treatment, they can be better prepared for these annual challenges.”

January 10, 2012 - 1:42pm

substance-use disorderWhen you’re recovering from a substance-use disorder, the traditions of New Year’s can make this annual event more challenging than typical social gatherings. To help residents celebrate the arrival of 2012 and to give them ideas on creating new and alcohol-free traditions, the members of the Herrington McBride Alumni Association hosted a special New Year’s party at the Herrington Recovery Center.

“New Year’s Eve is the hardest holiday of the year for people in recovery from substance-use disorders,” said Herrington Manager Cindy Suszek. “The alumni wanted to create a night of ‘sober fun’ for the current residents. They understand how difficult it can be to make that transition to a lifestyle that’s free from alcohol and addiction.”

Residents enjoyed activities like live music, karaoke and pool tournaments. The alumni also provided a full New Year’s menu, including tenderloin, twice-baked potatoes, salad bar and cheesecake. According to the leadership of the Herrington McBride Alumni Association, they hope to make this an annual event due to the level of involvement from the residents from start to finish.

“When things wrapped up, the residents and alumni worked together to clean up and put things back,” said Suszek. “I know the alumni really want to provide examples of how they’re living a life of recovery and help the current residents get a good start to their New Year. From all accounts, it was a huge success.”

January 6, 2012 - 2:29pm

The mother of a former patient who came to the Child Center recently shared that she had experienced a vivid dream about herself and her daughter seeking a safe path home in the middle of a terrible storm. She believes the dream symbolized the struggle their family went through to find help for her daughter. Today, the mother says, her daughter is stronger, their path is safer and she is confident that brighter days lie ahead.

“We are incredibly eternally grateful that you responded to our cries for help. Thank you for “rescuing” our daughter from her dangerous, frightening situation. You have not only pulled her up to safer ground, but you have made the path safer for all of us as a family to return home. I am certain that we are looking forward to brighter and happier days ahead. Many thanks to each and every one of you for your patience, kindness, knowledge, caring, and support. Our daughter is our precious gift and we are so thankful to have her coming home with us.”

We are honored to be able to share this mother’s story with you. Her full account of the dream is here:

  • "I recently had a dream and was able to recall most of it in the morning. In the dream, my sister was driving me and my daughter home after spending the afternoon together. I didn’t want my sister to go out of her way and to just drive straight home. I talked her into letting us out of her car and walking the rest of the way home.

  • As my daughter and I continued on foot, the sky grew dark and a terrible storm was fast approaching. We were soon struggling to walk against the fierce, cold, biting wind. Suddenly, there was a violent, torrential downpour. We were becoming increasingly blinded and scared in the darkness, howling winds, and the pounding rain.

  • What should have been a relatively short trek home, seemed to take forever. We felt so vulnerable and afraid, but we pushed each other to continue on until we reached our warm, safe home.

  • Up ahead in the distance, we could see a blur of red and white flashing lights. Several police cars, fire trucks, and ambulances were on the side of the road and also blocking both lanes near the bridge. EMTs and firemen were working furiously to aid the victims involved in a horrible car accident.

  • Everyone warned us to stop and someone would take us home. The bridge was flooded and impassable. I decided that we should forge ahead, but we had to find solid ground. If we could hike alongside of the road through the rocks, stones and the woods, we could safely make it home.

  • I encouraged my daughter to climb over the guard rail and step onto the large rocks and I followed her. Her left foot slipped on the wet rock, and she quickly plummeted down the embankment towards the dangerous, rocky river below. She was so brave and strong and she managed to grab hold of an angled, rusty, metal beam on the bridge. Shaking and crying, I frantically worked my way down to help her back up. I was absolutely terrified that we were both going to fall. I began to yell for help. The noise of the raging river, the rain, wind, sirens and people above us drowned my cries for help. The next thing that I remembered was my husband kissing me on the forehead and reassuring me that “everything will be alright.

  • I have been feeling so guilty, lost, lonely, frightened, and helpless with our daughter for the past year. I believe that my dream/nightmare was very symbolic and representative of our struggles to help our daughter through the “storm.” I can also say that I am concerned that we will be able to stay strong and continue on the right path. "


 

January 5, 2012 - 10:52am

Former patient featured as a “Woman of Substance” Denise Folcik, came to Rogers Memorial Hospital for treatment for anorexia, bulimia and obsessive-compulsive disorder.

Denise Folcik is a person who immediately comes across as confident, happy and lighthearted. She is an outspoken advocate for eating disorder treatment, speaking to many community groups and the Wisconsin State Legislature. Recently, Denise was profiled in “Women of Substance,” a feature of Eating Disorder Hope’s website.

Nearly seven years ago, Denise came to Rogers Memorial Hospital for treatment for anorexia, bulimia and obsessive-compulsive disorder. Like many of the patients who come to Rogers, she is amazed at the differences in her life before treatment and today. She smiles and says, “I tell people that it says “Rogers” on my birth certificate, because that’s where my life began.”

Finding the courage to take control in positive ways

With the support of her family and her therapist, she was admitted to the Eating Disorder Center at Rogers. There, she began another journey of self-discovery and found the courage to take control of her life in many positive ways. “I give myself a lot of credit. I did a lot of hard work in treatment!” She added, “But I give Rogers a lot of credit, too. I can’t say enough good things about the staff at Rogers.”

Denise is quick to point out that there was no quick fix. She had to be admitted for inpatient treatment four times and frequently resisted making changes. But each time she came closer to understanding that she needed to stop viewing her eating disorder as something that was helping her. “You have to commit to getting better,” she said. “It isn’t until you get to that place that treatment will make a difference.” Denise also notes that she avoids the term “recovery” and, instead, views her continuous journey as “being in discovery.”

Journaling is one of Denise’s coping strategies and she frequently writes about her experiences in treatment. She recently published her book “In ED’s Path” which she hopes will help others with eating disorders. In her book, Denise chronicles the beginnings of her eating disorder, her struggles with OCD and the new challenges she had to face as she began her new life.

“At Rogers I learned a lot about how ED was affecting my life. Today, I can really, truly say ‘I’m happy,” she said. Denise recently remarried and says her husband is very supportive of her and her fight against her disorders. “Sometimes when I find myself drifting toward those old patterns, I’ll ‘tell’ on myself so he knows what’s going on,” she said. “There is no shame in having an eating disorder or asking for help when you need it.”

December 13, 2011 - 1:05pm

Patients at Rogers Memorial Hospital are already enjoying a brand-new experiential therapy center. The center was opened in the fall of 2011, and features a gymnasium, weight room, art studios and recreation and movement rooms designed to help Rogers’ experiential therapists work with patients in a comfortable and safe environment. In the weight room and gymnasium, for example, Dwight Steffes, MSRT, a long time experiential therapist at Rogers, helps patients learn how to exercise in a body-positive and healthy way.

By: Dwight Steffes, MSRTEating Disorder Treatment, Excercise, Experiental Therapy

Exercise is often an under-addressed component of eating disorders treatment. To most people, an exercise program may simply be an integral component to healthy living. However, for those who struggle with an eating disorder, maintaining a healthy exercise program can be exceptionally challenging. For patients in treatment at Rogers’ eating disorders programs, Emotional deregulation, disordered body perspectives, and avoidance behaviors can drive a lot of abnormal thinking in what otherwise might be a healthy physical exercise program.

Many in the eating disorders treatment community tend to avoid this issue or outsource the issue of healthy exercise to their client’s personal trainers. That approach can be problematic; most trainers know a lot about physical fitness but have little understanding of the cognitive and emotional connection between exercise and physical fitness. This is why the experiential therapists at Rogers are so crucial to a holistic recovery for Rogers’ patients. Rogers’ experiential therapists help patients identify what is, and is not, a healthy approach to exercise.

Exercise incorporated as part of an overall eating disorder treatment plan

Patients entering into the Eating Disorder Center at Rogers will soon meet with an experiential therapist who will conduct a brief interview related to the patient’s history with exercise. The therapist is looking to identify the patient’s exercise habits that may be associated with eating disordered thinking, obsessive-compulsive disorder, general anxiety and depression. These observations will be incorporated into the patient’s overall treatment plan.

Each patient is rated on an activity scale based on his or her general physical and emotional health. Exercise issues are addressed through individual sessions with Rogers’ experiential therapists. These sessions may lead to written assignments, readings, exposures by behavioral therapists, and programming in the hospital’s fitness facility or at the local YMCA.

Once patients are medically stable, they can begin working with an experiential therapist as part of their treatment plan. Patients who have compulsive exercise issues begin by working on assignments designed to help them identify underlying issues that drive their compulsive exercise behaviors.

Supervised, supportive settings

The new fitness room at Rogers, recently constructed as part of a new inpatient and experiential treatment facility, is an option available to individuals within the eating disorder programs. Experiential therapists work one-on-one with each patient to help them experience a healthy exercise program.

Patients are encouraged to focus on exercise from a physical perspective and are reminded that exercise is not about cognitive or emotional issues. A check-in is provided before each session to create awareness of personal feelings and thoughts that may push the patient into doing more than what is healthy. Each program is customized to address the particular issues and needs of each patient. For instance, patients who have never been in a fitness program before may experience some anxiety around being physically active or in a fitness room or gymnasium setting. In this case, the therapist would work with the patient to slowly acclimate them to the equipment and the environment.

The swimming pool at the nearby YMCA offers an excellent opportunity for our Eating Disorder Center patients to address body-image issues; and the YMCA’s exercise room provides an opportunity for patients with social anxiety to gain experience working out around others.

Each patient’s treatment plan is different

Patients are often given individual assignments that may help them come to understand how they came to be in treatment in the first place. Assignments can help the resident become more knowledgeable about how they may have used exercise in an unhealthy manner.

For example, these assignments may ask our patients to explore:

  • Exercise as an addiction,
  • Exercise as an avoidance behavior,
  • Obsessive-compulsive exercising,
  • The relationship between body-image and exercise, and
  • The relationship between depression or anxiety and exercise.

Each assignment asks a series of questions that may give a patient an opportunity to examine their own history with exercise and how it may have been influenced by an eating disorder.

Coming home with a roadmap to successful exercising

Before patients leave treatment, they are given an exercise plan that reflects the work that they have been doing with our experiential therapists. Recommendations about weights and cardio work are provided with the stipulation that a patient must stay within a healthy weight-range to be able to continue working out.

This discharge plan typically requests patients focus on three things. They must make every effort to:

  1. Be compliant with their meal plan, weight and physical programs.
  2. Address issues of self-esteem using thought challenging primarily to deal with their connection between self-worth and exercise.
  3. To increase social activities and leisure pursuits to avoid getting caught-up in an addictive cycle of exercise.

Ultimately, addressing and incorporating exercise into a patient’s treatment plan helps Rogers eating disorders patient develop an awareness of their approach to exercise as a whole and helps them to understand limitations or challenges they face personally.

With the knowledge and experiences of what healthy exercise programs look and feel like, Rogers patients discharge with the tools they need to continue to make choices that support their long-term recovery goals.

December 9, 2011 - 9:07am

By: Theodore E. Weltzin, MD, FAED
Medical Director, Eating Disorder Services at Rogers Memorial Hospital

Eating Disorder Treatment for Males

It is not unusual for a male to have an eating disorder, as a growing body of evidence indicates that men are as concerned about body image as women.

Males make up approximately 10% of anorexia nervosa and bulimia nervosa eating disorder patients. If you include binge eating disorder, as many as one in four of all eating disorder patients are males.

Why males?

There are many reasons why a male might develop an eating disorder. Exercise and athletic competition, especially sports that require low body fat or extreme weight loss, represent a risk for developing exercise dependence and eating disorders in males. Anxiety disorders and perfectionism have also been shown to be contributing risk factors. Other factors that may increase males’ risk of developing an eating disorder include alcoholism, history of obesity, teasing and physical abuse.

Males with eating disorders often engage in activities that increase their muscularity as the perception is doing so will increase their masculinity, boost confidence and improve their attractiveness.

More likely to binge

Negative attitudes and restrictive eating increase binge eating in both males and females. Males are more likely than females to binge as a result of body image concerns. Feeling anger can also trigger binge eating in males, whereas females tend to binge in order to suppress negative feelings.

Excessive exercise

For males, “excessive exercise” is often brought about as a way of either counteracting the effects of eating or attempts at weight loss. The need to excessively exercise is, in many ways, seen as similar to purging by self-induced vomiting, as both can be reactions to a real or imagined uncomfortable or “full” feeling.

Specialized treatment for males

The treatment of males involves nutritional interventions aimed at normalizing eating and, in most cases, normalizing weight. Treatment may also include cognitive-behavioral therapy that aims to identify and challenge errors in thinking, reduce preoccupation and overvaluation of food and weight, and to normalize behaviors related to eating disorders. An important part of treatment involves addressing co-occurring psychiatric concerns.

Anticipating and developing alternative ways of dealing with anger and irritability is an important aspect of treatment for males. In treatment, feelings of anger and irritability may increase for males who abstain from binge-eating.

While men and women have a similar response to treatment, males seeking treatment for eating disorders also often have to overcome the misconception that eating disorders are a female phenomenon. A common belief is that the treatment environment and clinical approach is primarily geared towards women. Males also report much less support from family, friends, school, coaches, and employers than they believe is given to females struggling with the same disorder.

Rogers can help

Rogers Memorial Hospital offers specialized eating disorder treatment for males. You can request a screening at 800-767-4411 or the online screening request form.

December 7, 2011 - 10:30am

add, adhd, children, gifts, holidaysThe key to finding the “right gift” for a child with attention deficit hyperactivity disorder (ADHD) is as varied as the child. A little time invested in learning about the child’s specific interests and strengths will help you discover a good match for any child. There are also many hobbies or crafts that emphasize a child’s creativity and make good gifts for children with ADD/ADHD.

Read the full article for a list of tips and suggestions for gifts that will generate interest with children who have ADD/ADHD.

December 2, 2011 - 1:20pm

Children and teens with eating disorders find ways to manage their triggers

By Jessica J. Witt MSN, RN, CPNPEating Disorders and the Holidays: Coping for Children and Teens
Clinical Services Manager - Eating Disorder Services Milwaukee

December 1st has arrived – and it’s difficult to believe that only a week has passed since Thanksgiving, family get-togethers, and, of course, Black Friday shopping! These are all normal and fun things for children and families to look forward to.

However, for people with eating disorders the Thanksgiving holiday is one of the most dreaded. The spread of food, the relatives that have not been seen in a long time, the desserts, the inactivity, and the likelihood that other family members know nothing about one’s eating disorder is terrifying and triggering for people with eating disorders.

In my family, our celebration includes two Thanksgiving meals – a lunch at my in-laws and a dinner at my parents’ home. My children, therefore, will do the same. This is the reality for children in other families as well.

Imagine yourself in the shoes of a child or teenager with an eating disorder. How would one cope or not cope? Many kids and adolescents get admitted to the inpatient unit during this food overwhelmed holiday. Others – who are at less intensive levels of care, have developed coping skills in residential or partial treatment here at Rogers.

Coping skills at this juncture are crucial for these kids --- diversions include playing games with families, looking at old photo albums, journaling, reading, drawing, and even being able to talk to family members. It can be extremely helpful to talk about what they are experiencing, having an eating disorder and their treatment experience. Thanksgiving is the food focused holiday.

It is a grueling challenge for most kids – regardless of level of care. They have to be very strong and use those learned coping skills and lean on their families and support systems to make it through the day, and even the weekend. The Eating Disorder Partial Hospitalization Program is open the Friday after Thanksgiving and inpatient is always open 24 hours a day.

This time of year is quite stressful – but we are here to help children and teens to make it through the seasonal challenges of Thanksgiving dinner, St. Nick’s Day and, of course, Christmas and New Year’s.

November 30, 2011 - 2:16pm

BullyingParents commonly ask about the steps they could take to confront and manage bullying behavior and its consequences. The staff at Rogers work with adults to help them learn about the different roles that emerge in any bullying situation and how to identify more subtle forms of bullying behavior, such as gossiping and excluding others. The staff work closely with the children in our programs to help them learn about what bullying is and teach them strategies for coping.

Head over to the Rogers Child and Adolescent Day Treatment Website for the full story.

November 16, 2011 - 2:20pm

By: Jessica J. Witt, MSN, RN, CPNP
Clinical Services Manager - Eating Disorder Services Milwaukee

Be alert to children who are afraid to eat, touch, or be around candy.Eating Disorder Treatment

Halloween is the black and orange day that inaugurates the season of food-centered holidays in our nation. Children and teens get dressed up in their favorite costumes and gather as much candy as humanly possible in a two to three hour period. You have seen kids running from door to door and grabbing handfuls of candy, taking it home, and competing with brothers and sisters by counting how many pieces each one gets. This is totally normal and enjoyable…that is for most kids.

Some children and adolescents, however, do not partake in this event on all Hallows’ Eve. Not due to religious reasons or cultural beliefs, but because they are terrified to eat, touch, or even be around candy. Children and adolescents with eating disorders have extreme fear of eating foods high in calories and fat.

Recently, I asked children and adolescents in our program for eating disorders about their experiences with trick-or-treat and candy-eating in the past weeks. I asked, “How did Halloween and trick-or-treating make you feel?” the answers I received were:

  • “not good”
  • “guilty”
  • “anxious”
  • “excited”
  • “bored”
  • “weird/awkward/annoyed”
  • “unhappy, sad, mad, depressed”
  • “sick and gross”

One particular teenager stated “I felt guilty trick or treating, taking candy that I wouldn’t eat, and seeing it make people happy to be giving it, thinking it was making me happy to be getting candy”.

These are not typical post trick or treating comments! When asked how eating pieces of candy made them feel, some of the comments were:

  • “Bad, I felt fat afterwards.”
  • “I felt disgusted with myself afterward.”
  • “I ate candy and binged so not very well and I felt disgusting.”
  • “I felt terrible, unhappy, guilty and mad.”
  • “I got a headache and felt sick, I felt really bad about eating candy.”
  • “It made me feel anxious.”

Help is available for kids who focus on food, instead of fun

Children and teens with eating disorders really struggle at this time of year. Be aware of comments. Be concerned when they are not acting “like a kid should act” around the holidays. Halloween is just the beginning of a difficult fall and winter season that is so focused on treats and food.

Be mindful of what you say to these kids and if you have concerns with their eating habits or weight discuss it with them and/or their family. There is help – all it takes is a phone call!

For admission information or a free screening, call 800-767-4411, or 414-327-3000

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