Psychiatric Partial Hospitalization Program
|Address:||2115 Wisconsin Ave., N.W. Suite 201,|
|Washington, D.C. 20007|
|Telephone contact:||(202) 944-5353|
|Individual interviewed:||Janet Marcus, Program Director|
|Date of interview:||November 28, 2012|
INFORMATION ON THE PROGRAM
General background on the program:
The Georgetown Psychiatric Partial Hospitalization Program (PPHP) is an intensive outpatient treatment program for people with an acute psychiatric illness. It supplements, but does not replace, the patient’s visits to her/his own psychiatrist, therapist, or in some cases, cases managers. Treatment is carried out in collaboration with these clinicians. Given their important role family and social supports are encouraged to take an active role in the patient’s care.
Schedule and duration of the program
The program operates from 9:30 am to 3:30 pm Monday through Friday. The average length of stay is between two and four weeks. Lunch and snacks are provided daily.
Profile of individuals that participate in the program:
There is a culturally diverse population with ages ranging from 18 to the elderly, PPHP generally has a census of 12, but can have as many as 16 patients.
About the program
A personalized treatment program is provided to help patients gain control over his/her symptoms and develop more effective coping skills. Program staff meets regularly to develop an individual treatment plan for each patient, to evaluate the program and to make further recommendations upon the completion of treatment.
While in the program, the patient takes part in symptom assessment, a medication education/illness awareness group, a psychotherapy group, art therapy, expressive therapy, and cognitive behavioral therapy. In addition, any psychiatric symptoms, medication efficiency, and side effects are monitored.
Symptom assessment takes place at 9:30 am when the program opens. Patients are asked to share feedback on the progress of the symptoms that are causing them difficulty and in the use of coping skills used to manage those symptoms. Patients are also asked about their medications and any side effects/benefits they may be experiencing, along with sleep patterns and appetite.
The medication education/illness awareness group meets once a week to provide education about the patient’s medication, side effects, benefits, and rational use. This group also teaches coping skills needed to manage various aspects of each patient’s illness.
The cognitive behavioral therapy and mindfulness meditation group also meets twice a week. This group focuses on bringing: (1) awareness of the patient’s more reactive, automatic negative thought patterns so as to facilitate a shift to a more mindful way of being; and (2) awareness of the body through gentle mindful movements to relieve tension and stress.
Occupational therapy meets three times a week. A variety of methods are employed to promote self-awareness, build coping and stress management skills and promote active engagement of the individual in his/her occupation and roles in life.
Group therapy meets daily and provides patients with an opportunity to discuss feelings that may be surfacing and process them with others who quite probably can relate to one’s experience.
Art therapy/expressive therapy meets three times a week. This group employs a variety of expressive techniques, primarily with art, but also include writing and sharing of music and stories. Themes and structure facilitate exploring and healing emotions and life issues through work and reflection on both process and product.
A weekend planning goal-setting group meets each Friday. This group helps patients plan and structure their weekend to include both completion of essential tasks and provide for leisure activities.
The wrap-up group meets daily at 3:15 pm. It provides staff with an opportunity to touch base with patients before they depart for the day and to assess their safety levels.
A referral is required from a psychiatrist, physician, or therapist currently treating the patient desiring admission. The admission coordinator will set the next possible date for admission. There could be a waiting period depending on the census at PPHP. The evaluation is completed and the program started on the first day. The precertification for insurance is also done on day one.
Number and qualifications of staff
The PPHP interdisciplinary team is composed of nine professional staff members. The PPHP staff consists of: an attending psychiatrist, third year psychiatric residents, four MA prepared nurses, both an occupational therapist and an art therapist who are MA prepared and board certified. An administrative assistant contributes to the smooth running of the program. Since Georgetown is a teaching hospital, PPHP also has medical students, occupational and art therapy students during the academic year.
Availability of a psychiatrist and, if so, nature of role with patients
The attending psychiatrist and/or psychiatric residents meet with each patient two to three times per week to evaluate medications and progress in the program. The attending psychiatrist facilitates communication with the patient’s outpatient provider to provide continuity of care.
Before discharge each patient must have appointments for medication management and psychotherapy. Also there needs to be a schedule of meaningful activity for the patient after their participation in PPHP ends. This may involve traditional work, volunteering, college courses, and/or maintenance of activities of daily living.
There is no formal follow up after PPHP. Often patients call or drop by to tell the staff how PPHP has benefited their lives.
Data, if available, on what happens to patients after they complete the program
Although PPHP does not collect data after someone is discharged, upon admission and discharge from PPHP each patient is given a Beck depression inventory. Patients are pleased to find out that their scores drop significantly.
SUMMARY OF COMMENTS FROM DBSANCA SUPPORT GROUP MEMBER WHO PARTICIPATED IN THE PROGRAM
One DBSANCA group member was interviewed who participated in this program. Her participation took place in the mid 1990s. She was a patient in the program for three months. She was very positive about her experience. When asked whether, if she needed to participate in an outpatient program in the future, she would sign up again her response, without hesitation, was “Of course”. In addition, when asked whether she would recommend the program to other DBSA members, she responded that she highly recommends the program. However, she pointed out that “It depends on the individual. It is not a place for someone looking for something to do during the day. If you come you have to be prepared to work on yourself.”
When asked what she liked about the program she mentioned the following: (a) She learned about support groups, (b) It helped her build skills she didn’t have; including some new tools and hobbies, (c) She learned some things she could use to cope, (d) There was no referencing while in the program to what one’s diagnosis was, (e)t was more like a class which she liked, (f) She liked the art, (g) She liked being introduced to relaxation therapy, (h) The sessions on medication were good, (i) She learned a lot from her fellow participants. Her only critique is that she would have liked have liked to see more diversity in the staff.