Partial Hospitalization Program
When I went to Rogers Behavioral Health’s partial hospitalization program, I was not in a good place. My Obsessive-Compulsive Disorder (OCD) had taken over my whole life, and after only the first week of school I was barely surviving. As much panic as missing school induced, I’m glad I went and got treatment.
For OCD, partial hospitalization is a full day program . The morning starts with a check-in to go over bans, and then exposures consume the rest of the time until lunch. Personally my bans were around certain areas of my OCD such as rereading, rewriting, apologizing, reassurance seeking, hand washing, confessing, avoidance, romance review, etc. Some bans caused more issues than others, but I saw some improvements (more resists and less submits) over my six weeks in the program.
Exposures were by far the least pleasant, but most important, part of the program. They work by creating a scenario that heightens anxiety by triggering an obsession, and the person then avoids doing a compulsion. For example, one of my obsessions is about morals and being a good person, so I would go around to staff and tell them curse words without apologizing or explaining why. Then I would sit with the anxiety until it went down to a manageable level. We were given timers to measure how long it took the anxiety to go down and we tracked our anxiety with a scale of one through seven (seven being worst).
A behavioral specialist works with each person to personalize a hierarchy of exposures; many of my exposures revolved around school and morals. Exposures continued after lunch as well, and some exposures would be assigned to do at home in the evening. Some of the exposures I did include touching a ball my dog slobbered on, touching wine bottles, demanding items from staff, coloring messily with the “wrong” colors, interoceptives, and many more. Interoceptive exposures are actions that mimic panic attack symptoms, with the intent to increase the tolerance for the bodily sensations. They include stair stepping, straw breathing, spinning, holding breath, shaking your head side-to-side quickly, rapid breathing, and putting the head between the legs.
After exposures the day got more exciting, with time for school and either active group or CBT group. Active group consisted of activities involving movement, generally with emphasis on games that require quick decisions, which can be challenging for those with OCD. Some days we would go on a walk and practice being mindful and in the moment. Card games were a favorite of mine, especially once we played games more complex than spoons.
Cognitive Behavioral Therapy (CBT) group was my favorite part of the day aside from school time. During that group we were taught about certain concepts related to mental health and wellness. We learned about growth mindset, mindfulness, conflict resolution, thinking distortions, and Exposure and Response Prevention Therapy (ERP). I enjoyed learning more about concepts that would improve my mental health, and it felt kind of like school. The age range for the program is elementary through high school, and with the small group size it was made sure that everyone was able to absorb the information.
Another resource I had was a goals list that was created for me, having the Activities of Daily Living (ADL’s) and other things that I struggle with. With OCD some things that are simple to many become very challenging, and the goals list is a good way to make sure that the activities needed to function are being done.
While I was making progress in the program, I would still go home in the evening and spend a great deal of time on school. My excessive amount of time spent on school, among other reasons, caused me to be referred to a higher level of treatment (residential). In hindsight I am glad I stepped up to a higher level of care. In addition, starting with a day program helped introduce me to exposures and the whole concept of facing my fears head on before being fully submerged in residential treatment.