Psychiatric illness is not a single condition, nor can it be treated successfully as such. Each individual has a specific history and biology, and at Pasadena Villa, we develop, for each person, a specific and individualized treatment plan. Your individual stay at Pasadena Villa cannot be exactly predicted as it is based on how well you respond to medications and therapy. For a few people, that is a relatively short period of time, for a few others it can be a very long period. We do not run a “90 day” or “yearlong” or any other predetermined length of stay for your individualized program. You will not be asked to stay beyond a period that provides maximum therapeutic benefit from our programs, nor will you asked to leave if you require long term assistance. Your length of stay is based on your progress, and your goals, as defined by your treatment team. Your treatment team consists of you, your family, you psychiatrist, your psychotherapists, your nurses and the other supporting professionals at Pasadena Villa.
Most psychiatric conditions we treat do not “develop overnight”, although they may take a turn very quickly in the form of a “break”. If you have had a “break” one of our primary goals is to minimize the potential of future breaks, and hopefully prevent, or at least minimize, any future hospitalizations. We believe that we must address many aspects of your condition if you are to effectively and efficiently treat your condition, so that you can be free of, or at least manage your symptoms and problems, for the long term, and not just during your stay with us.
For most people, that means about 3 or 4 months in the intensive RTC level of care, during which the treatment team focuses on correct diagnostics, optimization of medication, developing a therapeutic alliance with you and your family, and intensive therapeutic interventions, both group and individual, with you. For many people this will be followed on with about 6 to 9 months of supervised living in a step down setting, at one of our several levels of community housing. These are all delivered in our Social Integration Model of treatment. Let’s look at each of these components:
Correct Diagnosis: Although Pasadena Villa may be the first formal intervention for some of our patients, many have been involved with multiple providers and treatment systems in the past. Often we see people who have had a wide range of diagnoses over the years, some of which may appear contradictory. Part of our initial focus is determining an accurate and current diagnosis to ensure that we are treating you correctly and efficiently. This will be done by your treatment team, and will include a review of your clinical and behavioral history, a review of your medication history, along with interviews and observation by your psychiatrist, psychotherapists, nurses and supporting healthcare professionals. In some cases, we may refer out for either medical or psychological testing, to gather additional information for diagnostic and treatment purposes. The evaluations will result in a diagnosis, or group of diagnoses, that will be addressed on your initial treatment plan. This diagnostic work is constantly reevaluated during your stay, and may be updated on continuing treatment plan reviews.
Medication Optimization: During your stay, you will be treated by at least one psychiatrist to develop an optimal medication intervention to address your condition. Again, each person is an individual, and each medication regimen is highly individualized. Initially, your psychiatrist will prescribe a regimen based on an interview with you, and your clinical history. Throughout your stay, the supportive nursing staff and other healthcare professionals will be observing you throughout the day to ensure you are on the correct medications, and the correct dosage, administered on the most optimal schedule. Your psychiatrist will be regularly reviewing your medications and your individual response to them, and your meds may have several adjustments, until the optimum regimen is achieved. The ability to observe you throughout the day and night to optimize your medication regimen, by an entire specialized treatment team in addition to your psychiatrist, is one of the most valuable benefits of RTC. Each individual reacts to a medication regime in a unique fashion- for some people significant improvement is noted very quickly; for others it may take an extended period of time to adjust the medications to perform optimally. Again, medications may change during your stay so that we can ensure we have optimized the type, dosage and schedule for your individualized medications. Medication optimization, leading to stabilization, is the foundation required to effectively conduct psychotherapy and other interventions that will be of great therapeutic value to you in the management of your condition in the years to come.
Therapeutic Alliance: At Pasadena Villa, we are committed to helping you develop a system that will address your condition for the long term. Very few people are able to do this on their own, and thus require the support of family and professionals to help them manage and navigate their psychiatric condition. We spend a great deal of effort to help educate you and the important people in your life on the expected course of your condition, and what it will take to manage it in the future. Those important people may include family members, spouses, consultants and other professionals in your home area. Successful treatment of psychiatric conditions involves change, and change can be frightening. For many people, the strongest response to impending change is to run right back to a familiar way of life, no matter how unhealthy that may be. We will work with you and the important people in your life to manage the expectations of change, and to help you through the more difficult phases of growth to a healthier life. One of the first goals is to ensure you have the support from your family to stay in treatment long enough for those changes to occur, and become a solid part of your future life. If you start treatment with us, we want you to be successful for years to come- and it takes time to achieve significant therapeutic benefit.
Intensive Interventions: during your stay, your treatment team will be involved in a variety of therapeutic interventions with you. These will include individual and group psychotherapy, nursing interventions, milieu interventions, recreational therapy and leisure skills training, community meetings, and other interventions that may be individualized for your specific condition. No two people will have exactly the same set of interventions, even though many interventions are delivered in a group or social setting. All of our interventions are strictly “evidenced based” practices, and are currently accepted interventions in accordance with science based medicine and empirically based psychotherapies. As a Joint Commission accredited organization, we ensure that our professionals meet the highest standards of excellence in their ability to provide evidence based practices.
Social Integration Model: specifics of this model are discussed though out our literature, but in summary, Social Integration is both a philosophy of treatment, and a series of specific interventions used in our programs. The philosophical intent is to help you integrate into your society, rather than be isolated or even institutionalized. The entire goal of Social Integration is to maximize your ability to function in social settings- in your family, in school, at work, in public, and in society as a whole. Throughout your stay, many interventions will occur which are all in the service of helping you maximize your social acceptance and your social skills. These skills will vary from the most fundamental of personal hygiene, organization of your room, your understanding and respect of other people’s personal space, and your behavior at meal times, to more advanced interventions regarding appropriate topics of discussion, and independent living skills. As with all interventions at Pasadena Villa, the schedule is individualized- some people will spend much time on learning fundamentals; others will demonstrate fundamental skills from day one and quickly move on to more advanced therapeutic work. At its simplest explanation, Social Integration is dependent on knowing, and using, the skills that demonstrate good manners in social settings. We want you to learn and demonstrate the skills that result in social acceptance rather than social rejection.
Step down setting: 24 hour supervision in an RTC is safest for some people, but most people are able to step down to a less intensive level of care within about 3 or 4 months. Without observing and intervening therapeutically in a step down house, it is impossible to determine if the skills learned in RTC actually will be maintained outside the RTC. A primary purpose of the step down continuum of care is to practice and consolidate the gains made in RTC. Often we work with people whose conditions may be life-long and life threatening. Pasadena Villa maintains licensed step down community homes in both state locations, at a variety of levels of supervision, and has the ability to continue less intensive treatment and supervision for certain individuals who can move into their own apartments. As with all of our programs, care is individualized, in both intensity and length. Some people may stay for an extended period of time in a step down house, but most can expect to complete this portion of treatment in 6 to 9 months. Your therapist will discuss the options and help you and your family to determine what is best for your individual situation.
Pasadena Villa’s Smoky Mountain Lodge is an adult intensive psychiatric residential treatment center for clients with serious mental illnesses. We also provide other individualized therapy programs, step-down residential programs, and less intensive mental health services, such as Community Residential Homes, Supportive Housing, Day Treatment Programs and Life Skills training. Pasadena Villa’s Outpatient Center in Raleigh, North Carolina offers partial hospitalization (PHP) and an intensive outpatient program (PHP). If you or someone you know may need mental health services, please complete our contact form or call us at 407-215-2519 for more information.
