Group Treatment Programs

Group Treatment Programs

Group therapy is one of the most important parts of our treatment program. Group treatment programs are both therapeutic and educational. The more our patients know about their disorders, the better they are able to understand and then control them. Groups are also effective for providing support for families and friends of our patients. We also educate them about eating disorders and psychiatric disorders, so they can better provide the support our patients need.

Group treatment programs are held at both the Thoreau Center (psychiatric care) and the Alcott Center (eating disorders service). Our group treatment programs include:

Thoreau / Milieu Groups:

Goals Groups

Individuals with mental illness are encouraged and supported in setting realistic personal and therapeutic goals for the day, which are reviewed and discussed in the evening wrap-up meeting.

Community Meeting

This meeting provides the patients and staff with the opportunity to openly discuss any issue which affects the entire milieu in a safe and supportive environment. Patients are encouraged to ask questions and give feedback regarding his or her experience on the Thoreau Center.

Wrap-Up Group

This group provides closure to each day by helping patients reflect on the challenges and successes of their daily goals along with an opportunity to discuss the days events.

Thoreau / Education Groups

Mental Health /Dual Diagnosis Education

This group helps patients understand the various aspects of dealing with (a) Mental Illnesses (b) Addiction to Alcohol and/or Drugs (c) Eating Disorders, Anorexia and/or Bulimia. Participants learn about their particular disease processes, ways to cope with their illnesses, and how to utilize the best treatment options.

Medication Education

As with any disease, the right medication can help people control and overcome their psychiatric disorders, addictions, and/or eating disorders. Medication sessions include discussions about side effects, tracking symptoms, self-monitoring and the importance of taking medication as prescribed, and the challenges of compliance.

Nutrition Education

Learn the basics of nutrition and how to create and balance healthy eating habits that foster good health and increased energy.

Thoreau / Coping Skills (Various Topics):

Communication Skills

This group focuses on understanding how to improve social skills as a way to minimize stress. Topics include: communication styles, assertiveness techniques, and strategies for positive social interactions.

Dialectical Behavioral Therapy (DBT) Skills

These groups provide an introduction to concepts and skills taught through Dialectical Behavioral Therapy. Strategies for self-care and safety, coping, managing emotions as presented under the DBT topics: distress tolerance, emotional regulation, interpersonal effectiveness, and mindfulness.

Dual Diagnosis/ Relapse Prevention

This group addresses the challenges of living with mental illnesses, addictions, and/or eating disorders identifying and preventing potential barriers to recovery. Topics focus on recognizing relapse symptoms, such as, early warning signs, and ways to be pro-active in treatment.

Anger Management

Focus of the group is on understanding healthy and unhealthy expressions of anger. The impact of unhealthy relationships along with expression of anger is explored and discussed, along with identifying options and strategies to cope with triggers.

Life Skills

This group explores the meaning of wellness and methods to create a balance of life. Topics address identifying daily challenges to wellness, ways to enhance well being and health, and how to improve self-care, time, and money management skills.

Dual Diagnosis/Recovery Skills/ Recovery Workbook

These groups address the special issues of members living with mental illness, eating disorders, and/or chemical dependency. Material will cover understanding addictions, identifying and preventing potential barriers to recovery, recognizing early warning signs, identifying ways to be pro-active in treatment, and seeking and accepting support.

Self Awareness

Through activity and discussions this group provides an opportunity to learn about factors that impact self-esteem and strategies to improve it. Clients will explore personal values and strengths and practice self-acceptance in a safe and supportive environment.

Thoreau / Activity Groups

Creative Expression

This group explores creative ways of expressing thoughts and feelings in a relaxing and supportive environment, examples include: collages, writing, drawing, ect.

Current Events

Newspapers are read and current topics and discussed in a supportive setting. This group provides participants an opportunity to express opinions on relevant issues, to stimulate discussions, and to raise awareness around local and global current events.

Gentle Exercise, Stretch/Relaxation

Beginning the day with either an enjoyable series of gentle exercises, stretches, or relaxation techniques can improve health, decrease tension, and improve focus and concentration.

Leisure Skills

Through experiential activities and discussion, this group helps clients to explore and identify new interests, and offers the benefits of healthy leisure activity as part of a balanced lifestyle.

Project Groups

This group offers a relaxed and friendly setting in which to work on creative projects. Therapeutic activity provides an opportunity to explore and develop new leisure interests, improve self-esteem, increase concentration, practice new coping new skills, create a sense of accomplishments, and explore creative ways of expressing thoughts and feelings.

Recreation

This group helps to engage individuals in interactive recreational activities. The focus will be on creating a fun and relaxed setting in which to practice and improve social, leisure, and relaxation skills. Activities may include: board games, group games, cards, ect.

Relaxation Skills

This group teaches the benefits of practicing specific relaxation techniques (guided imagery, progressive muscle relaxation, and breathing techniques ect.) that can be used for managing symptoms of stress and anxiety, sleeplessness, pain, or physical discomfort, and can become part of a balanced lifestyle.

Snack & Chat

This is an afternoon social hour with healthy snacks, good conversation and a relaxed fun atmosphere in which to experience positive social interactions.

Therapeutic Games/Activity

Creative games and activities designed to teach self awareness, coping, and social skills in a fun and educational format, games include: Coping Skills Scattegories, Insight or Social Bingo, Values Auction etc.

Alcott / Milieu Groups:

Intentions

Each morning patients come together after breakfast and “check in,” individually explaining how they are doing and stating an intended goal for the day. At the end of the day, during a wrap-up session, they reflect on whether they achieved their goals.

Wrap-Up

The “wrap-up” group mirrors the work of the intentions group. It provides an opportunity to come together at the end of the day to review progress toward goals outlined in the intentions group, and to discuss what went well and what did not.

Alcott / Education Groups:

Nutrition

Nutrition recommendations and guidelines are discussed continuously, including why eating is necessary and what impact various foods and nutrients have on the body and the brain. Nutrition groups also discuss strategies for interrupting disordered eating behaviors.

Eating Disorders

It is difficult to conquer the unknown. The better our patients understand their eating disorders, and the more they know about them, the better their chances of recovering. Discussions cover the impact of eating disorders on a person’s physical and psychological well-being.

Medication

As with any disease, the right medication can help people control and overcome their eating disorders and psychiatric disorders. Groups include discussions about side effects, tracking symptoms, self-monitoring and the importance of taking medication as prescribed.

Adolescent Groups

Adolescents aged 13 to 18 are grouped together to discuss developmental issues and other issues that are specific to their age groups.

Process Groups

Recovery is a process that is affected by many issues. Sometimes smaller groups are formed to discuss specific issues in greater depth. These “process” groups focus on a particular theme and discuss very in-depth information based on that theme.

Alcott / Coping Skills (Various Topics):

Interrupting Cycles and Promoting Behavioral Change

The same principles that are used for changing other harmful behaviors, including drug and alcohol abuse, self-injuring behavior and even anger, can be used to control eating disordered behavior. These sessions include discussions covering many different strategies for altering behavior, including Cognitive Behavioral Therapy (CBT), self-monitoring, identifying triggers, cognitive restructuring and chain analysis.

Adaptive Coping

What triggers eating-disordered behavior or psychiatric disorders? This group blends theories and strategies, and includes discussions of cognitive behavioral therapy (CBT) and related therapies, including chain analysis, Dialectical Behavioral Therapy (DBT), mindfulness and self-care. CBT emphasizes the role of thinking and its impact on how we feel and what we do. Because thinking causes us to feel and act the way we do, CBT teaches that we can affect how we feel and what we do by identifying the thinking that is causing unwanted actions and replacing it with thoughts that lead to desired actions.

Dialectical Behavioral Therapy (DBT)

DBT is a type of Cognitive Behavioral Therapy (CBT) that begins with accepting our behavior, then working to change it. It teaches patients skills for dealing effectively with others, handling emotions and changing harmful behavior.

Media and Culture

The perfect body image fostered by the media and by our culture manipulates people and creates feelings of fear, insecurity and decreased self worth. By understanding it, we can better avoid being negatively influenced.

Stages of Change

Using a model that has proven to be effective, this group examines how ready people are to make real, lasting changes in their behavior. Once patients have a realistic assessment of where they are today, they can more accurately assess what steps they need to take to advance to the next stage.

Assertiveness

Participants learn to identify, value and validate their feelings and needs, and how to appropriately express themselves with others. They learn the difference between passivity, assertiveness and aggression, and develop their skills through role-playing.

Family Issues

Family dynamics can have a major impact on an individual’s health. Participants discuss family issues, both past and present, and gain insights about the impact of these issues and how to deal with them.

Body Image

Individuals with eating disorders have distorted images of their bodies. This group explores body image and how it relates to participants, thoughts, feelings and perceptions, as influenced by messages received through the media and other cultural forces.

Relapse Prevention

Strategies for making a successful transition to a less intensive level of care are discussed. The group identifies high-risk situations, strategies for preventing relapse, the importance of maintaining healthy connections with people who can provide support, the role of the outpatient team and what to do if a relapse occurs.

Stress Management

The health implications of stress are discussed, as well as how to deal with and decrease stress, and general wellness principles for enhanced health and well-being.

Bulimia, Binging and Compulsive Eating

The focus of this group is on nutrition, overeating and strategies for controlling binging. Discussion includes Cognitive Behavioral Therapy (CBT), general wellness strategies and the use of Fairburn’s Model.

Alcott / Activity Groups

Writing Therapy

Writing facilitates reflection and expression of thoughts and feelings. It helps many people gain a better understanding of themselves and increases self awareness.

Expressive Therapy

People express themselves in many ways, including art, movement, drama and writing. Creativity, imagination and spontaneity help patients to explore and discover themselves – and by discovering themselves, learn to better control their behavior.

Adolescent IOP Groups

Parent Groups:

Parents attend 2 groups a week. One group focuses on Dialectical Behavioral Therapy (DBT) techniques to help parents more effectively tolerate distress, manage their emotions, and interact with their child during this difficult time of illness. The second group includes both parents and adolescents and focuses on building a better understanding of eating disorders and the recovery process.

Adolescent DBT/CBT Groups:

Adolescents attend 6 group therapy sessions weekly. These groups are designed to help your child cope with the recovery (eating normally) process, try new skills and techniques to challenge their eating disordered thinking, and help them plan more effective ways to tolerate their emotional distress.

Residential Groups

Body Image

Residents are exposed to the components of a healthy body image. They will explore their own body images as it relates to their thoughts, feelings, and perceptions that are influenced by messages received from their environment.

Cognitive Behavioral Therapy

This group addresses CBT strategies to promote behavioral change by discussing the importance of self-monitoring, identifying triggers, understanding the function of behaviors, cognitive restructuring, and considering alternative strategies. We will also use chain analysis to better understand sequence of behaviors. These principles can be applied to a myriad of behaviors including ED behaviors, substance abuse, self-injurious behavior, anger management, etc.

Community Meeting

Our community comes together to discuss community issues and ways of fostering a healthy milieu. Both staff and residents have the opportunity to raise concerns they feel need addressed.

Dialectic Behavioral Therapy

This group teaches specific skills for improving effectiveness with others, dealing with difficult and intense emotions, and decreasing maladaptive cycles of behavior.

Expressive Therapy

This group uses the modalities of art, movement, drama, and writing to explore self-expression. Creativity, imagination, and spontaneity aid in exploring parts of self.

Goals Revisited / Wrap up Group

This group is provides an opportunity for residents to come together at the end of the day and review their intentions/goals, process what went well, and what was difficult.

Intentions / Goals Group

Each morning after breakfast, the residential community comes together as a community. Residents review their progress and difficulties with their individual goals and strategies each week as a group. Feedback and discussion within the group explore new ideas for strategies in working towards identified treatment goals. This group will help residents learn from one another and receive and give support.

Journaling Group Therapy

Themes for writing are suggested with intention to facilitate both reflection and expression of thoughts and feelings.

Leisure and Recreational Activities

Time for leisure activities within the residence is structured into the weekly program schedule. Residents are encouraged to practice healthy leisure activities, self-care activities, and interpersonal skills with the community of residents as well as during ‘Independent Structured Time’ (residents structure their own time with personal hobbies or interests).

Nutrition Group – Shared Meals

The program nutritionist prepares residents to participate in the Shared Community Foods/Meals that are scheduled throughout the week. These foods are intended to challenge residents to increase variety, utilize recipes, and practice healthy coping skills at meals.

Nutrition Applications Group

This group addresses nutritional recommendations and guidelines and is led by a nutritionist. Residents learn why we need to eat, what various foods and nutrients do for the brain and body, strategies for interrupting disordered eating behaviors, and suggestions for planning for recovery. Written exercises and discussions focus on strategies to utilize in preparation for discharge planning. Examples include: meal planning, grocery shopping, restaurant experiences, eating with family/friends, and holidays.

Process Group

This group encourages residents to process their present experiences, emotions, thoughts, and stresses. Group leaders assist to facilitate therapeutic boundaries and discussions of healthy coping strategies within the group for processing to occur.

Psycho-education

Education and information on what is known about eating disorders and the impact of eating disorder behaviors on physical and psychological health are discussed. Topics may include: medication education, medical complications, psychiatric co-morbidities, substance abuse, self-monitoring behaviors in need of change, stress management, self-care, medication compliance, and symptom management. Specific concerns and questions will be addressed.

Relapse Prevention

This group outlines specific strategies for optimizing a successful transition to a less intensive level of care and/or to your outpatient team. We address the identification of high risk situations, strategies for preventing a relapse, the importance of healthy connections as support, utilizing your outpatient team, and what to do when lapses occur. Weekly rotating topics of discussion for the development of a relapse plan include:

Adaptive Coping

Residents learn to identify triggers that lead to maladaptive behaviors as well as practice healthy coping skills. We use a blend of theories and strategies including CBT (cognitive behavioral therapy), Chain Analysis and DBT (Dialectic Behavioral Therapy), mindfulness, and self-care.Discharge Planning
Course and outcome of treatment, discharge planning, and follow-up treatment is discussed.

Family Issues

Residents are given the opportunity to discuss family issues from both the past and present among other group members. The intention is for participants to both experience validation and connection from the group, as well as gain insight into how family dynamics effect movement toward health.

Media & Culture

This group provides education on how the media manipulates people to foster feelings of fear, insecurity, and decreased self-worth. We will learn strategies to deconstruct the media and discuss ways to combat their harmful effects.

Stages of Change

This group outlines a model that examines where people are in their readiness to make real behavioral changes. You will be able to determine where you are realistically at and to consider steps to move you toward the next stage.

Support System

This group assists residents in identifying and evaluating their informal and formal support system.

Self-Care Activities

Mental Health Counselors monitor and encourage the residents to participate in the following activities:

Healthy Physical Activity Group – Monitored Walk; Fresh Air

Residents go outside for fresh air, sunlight, and a leisurely walk on a daily basis (weather permitting). In an effort to promote healthy behaviors, smoking will not be allowed during the monitored walk.

Independent Living Skills

Residents practice skills in caring for the home environment. This includes picking up and organizing personal belongings in the common areas and individual bedrooms, picking up and organizing community activity items, and cleaning and organizing the kitchen space (clean the counters, refrigerators, and cupboards; discard expired foods; remove the trash; and take inventory of food for meal planning, labeling open containers of foods).

Medication Time

Residents are responsible for self-administering their prescribed and approved over-the-counter medications. Staff observes this process and communicates any concerns to the treatment team members.

Meal Planning and Preparation

Residents participate in weekly planning and preparation of three, shared meals using a variety of foods and menus. They also participate in taking inventory and ordering of groceries.

Relaxation Skills

Activities of relaxation are discussed and practiced. Examples include: breathing techniques, guided imagery, gentle movement, and guided meditation. Yoga classes are also offered several times a week.

Stress Management

This group addresses the short- and long-term effects that stress has on the body. We will focus on strategies to decrease stress and general wellness principles for enhanced health and well-being.

IOP Groups

Monday

DBT, Dinner, Process Group

Wednesday

Relapse Prevention, Dinner, Process Group

Thursday

DBT, Dinner Process Group

DBT (dialectical behavioral therapy) groups rotate amongst the 4 DBT modules: Mindfulness, Interpersonal Effectiveness, Distress Tolerance, and Emotion Regulation The goals of these groups are to provide eating disordered patients with adaptive coping skills to manage distress/emotions/etc as they interrupt there ED behaviors. Process Groups serve to individualize a patient’s treatment experience and receive support from the community. There are in the “interpersonal” therapy modality.

PHP Groups

We offer 15 different groups each week in the PHP program as well as Breakfast, Snack and Lunch meal support. PHP groups are on a 4 week rotation to provide a comprehensive therapeutic experience.

5 DBT groups

One from each module (see above) and one DBT skills coaching group

2 Expressive Therapy groups

These groups are led by Director of Expressive Therapy, Terri Eaton and utilize the creative expression of the individual to examine the body, emotions, and thoughts.

2 Process Groups

(weekend planning, weekend review) These groups help prepare and plan the individual for goals and challenges for the weekend.

1 CBT group

This group utilizes evidence-based Cognitive Behavioral Therapy to examine ingrained patterns of negative thoughts and behaviors.

1 Relapse prevention group

This group’s goals are to identify and prevent high-risk situations that may lead to negative coping patterns.

1 Body Image Group

This group examines the individual’s perception of their own physical appearance and how that can affect recovery.

1 Nutrition Group

Led by our attending Registered Dietician, this weekly group educates the individual about nutrition, portion sizes and normative eating practices.

1 PsychoEducation Group

This group is a rotating education group that teaches skills relevant to other treatment issues, such as anxiety, depression, anger, and self-esteem.

1 Relaxation/Restorative Yoga group

This group encourages a “whole-health approach” and encourages the positive connection between mind and body.