Evaluation and Treatment Planning
Upon admission to Averte, each resident will meet with a therapist to complete a Comprehensive Clinical Assessment. This initial evaluation period may last from 1-3 sessions and is designed to gather relevant clinical history in order to collaboratively develop a highly individualized treatment plan. We hope to create a trusting therapeutic relationship with the resident that emphasizes personal choice and places primary value on the individual’s perspective and personal goals.
Treatment is often more successful when one is encouraged to identify his or her own life goals in the context of existing strengths. We do not believe that a resident and the treatment team need to hold the same view of symptoms in order to work together in improving quality of life. In fact, residents frequently have a more personal explanation of their experiences, and an investment in understanding this perspective can aid the treatment process. Efforts to force residents to see that they are ill, or accept specific experiences as symptoms of an illness, are often fraught with frustration and met with denial or anger. Approaching the individual in a supportive, person-centered manner is crucial to the development of a collaborative therapeutic relationship. Frequently, the resident and their treatment team readily agree on specific short and long-term goals and can utilize resources to move towards achieving these. We may “agree to disagree” on the causes of identified barriers while working closely towards progress in the individual’s personal life goals. Individuals presenting with extreme resistance to treatment often engage well in this collaborative approach, allowing for initial safety and stabilization as a gateway to further therapeutic work.
The outcome of the Comprehensive Clinical Assessment is the creation of a personalized recovery plan. The Individualized Recovery Plan is derived from the resident’s goals and stated in their own words. The recovery plan involves identifying clinical and support services that may be used to make progress towards one’s goals. The resident will work closely with the therapist on the creation of this plan. Additionally, the resident’s psychiatrist will review and contribute to the recovery plan. We also encourage participation by other supports including family or friends, if desired by the resident. This plan is reviewed and updated as needed and at regular intervals throughout the resident’s stay, and is a measure of progress as goals are achieved and next steps are targeted.
Individual and group therapy are typically incorporated into the Individualized Recovery Plan as interventions that promote progress towards achieving one’s goals. These services are highly individualized based upon the resident’s plan, though may include a combination of cognitive behavioral therapy, psychoeducation about mental illness, and supportive person-centered counseling. For example, a resident with troubling auditory hallucinations or paranoid beliefs may find relief upon developing skills to identify and challenge related cognitive distortions, often by acknowledging other viable explanations for these experiences. Through this process, the resident decreases the power of these symptoms and directs his or her strengths towards improved quality of life through achievement of personal goals. For another resident who may struggle to cope with intense emotions, the process of learning to identify and challenge related triggering thoughts can improve his or her ability to effectively manage these powerful feelings. When indicated, we offer individualized skills-based therapy informed by the Dialectical Behavior Therapy (DBT) model.
Therapeutic services are based upon established evidence-based treatment models that are incorporated into the individual’s unique recovery plan. In conjunction with individual therapy, these services include Illness Management and Recovery, Supported Employment, and Integrated Treatment for Co-Occurring Disorders (please see descriptions on our website under these headings for more detailed information).
We recognize that a resident’s family may have a very important role in promoting future health and a positive feeling of social connectedness. We strive to provide individualized family supports, though recognize that many of our families live out of state and cannot attend regular meetings. With the consent and often the participation of the resident, we attempt to provide individualized family psychoeducation and support services. We view family involvement as a key element in our treatment program. We frequently provide family contact weekly or as indicated via telephone and email exchanges, and encourage family members to participate in clinical meetings with the client’s permission.