Thursday, September 28, 2017

Outpatient program for depression & anxiety, part one

First Session (Sept. 26, 2017)
I've been accepted into Saint Joseph Hospital's Intensive Outpatient Program (IOP) in Chicago (where I live). It's for adults struggling with mental illness. I'm one of the depressives. It goes from 9 a.m. to 12:30 p.m. Monday through Friday. I'm only required to attend three days a week.

The first hour we went around the circle and did check-ins. A facilitator asked each of us about our sleep, appetite, self-care habits, suicidal ideation if any and asked us to pick a goal for the day. The goal is apparently supposed to be a way of taking care of ourselves with an activity we like. Then we had a fifteen-minute break. Even if you smoke, you're not supposed to leave the building during this break. I appreciate that because it's hard to sit near someone who reeks of dissipated cigarette smoke. I only like cigarette smoke when it's still in the air.

The second hour we did a handout that had us write down an event that triggered us, write down our avoidance response, and then write an alternative coping response that would have been better. We had a different facilitator from the first hour. Everyone liked this exercise except me. I said it didn't tell me anything I didn't already know. (I guess I'll call them facilitators because some of them are students or interns.) 

At 11:00 we broke for lunch. Lunch was turkey sandwiches, oranges, water bottles and little cans of cola and ginger ale. There was some chatting. Not a lot.

For the last hour we did a handout rating how important our values are to us. The facilitator gave us values to choose from: family, work, spirituality, parenting, marriage/relationship, health, relaxation, and community. We had a different facilitator again. Then we evaluated ourselves on how well we're doing on our most important values, and wrote what we can do better. That exercise wasn't as annoying. You could cross out anything that didn't apply to you (I crossed out parenting and spirituality).

And that was it.  It was nice to get a meal. Tomorrow I'll find out how many weeks my insurance will cover.

Second Session (Sept. 27, 2017)
The first hour we checked in again with yet another facilitator who I hadn't seen the day before. This seems to be the only time you get to talk about what you're going through, but it seems to just serve the facilitator who checks off questions about sleep, suicide, appetite, etc. I was hoping for more of a support group where you discuss your problems with others and get feedback.

After the break, we got a handout on communication: reflection is saying back to someone what they've just told you. It shows you were listening. It was with yet another facilitator I hadn't seen before. There must be a whole staff here that hands off the duties of leading groups all week long. Reflection is a skill I already know well, but others had trouble focusing on the task at hand. I didn't bother to say that I didn't get anything out of this exercise.

This time lunch was turkey burgers and a bag of barbecue potato chips. There was almost no talking.

After lunch we spent the final hour doing a handout on negative thinking (how to change a negative thought into a positive one). This program uses the cognitive behavioral therapy (CBT) approach which teaches you how to change your thinking so it doesn't lead to depressive symptoms. The idea is that if you can change your thoughts, you can change your mood and it's very successful with many people who struggle with mood disorders. Unfortunately, I learned this technique 27 years ago and it has yet to help me with my depression.

My insurance will allow me 18 more of these sessions, but I want more guidance. These handouts have us come up with our own answers to our challenges. Ugh. I don't need more of my own opinions. Plus after we fill out the page, we take turns reading what we wrote. This puts people to sleep. Two people sat with their eyes closed during the last hour.

So far, I've mostly seen chirpy facilitators who ask questions off the page, pass out exercises and cheer us on to fill them out so we can figure out better ways to live. I don't respond well to chirpy or cheering. (The next post is Outpatient program, part two.)

1 comment:

Rayfield Waller said...

This sounds very boring, very institutional rather than analytical--like most modern day overpriced, under-humanized institutional medicine and therapy. It seems mostly harmless, but I am very disturbed by their conception of values. "Family"? "Community"? Was one of them "Recreation"? Sounds like the Obama ideology of bourgeois existence as boy scouts/girl scouts/Walmart outings. At least you are not mentioning that hideous aspect of the similar drug rehab ideology, 'The Twelve Step Program', which features heavy doses of Christian psychosis. The important thing I guess is the routine for you? If it helps you, I'm certainly all for supporting you.