Day Treatment Programs for Mental Health

day treatment programs

Summary

Day treatment programs are a comprehensive form of outpatient therapy used to treat various types of mental illnesses including mood disorders, anxiety disorders, eating disorders, schizophrenia and substance dependence, among others.

In day treatment programs, patients continue to live at home, but commute to a mental health facility, hospital or other specialized treatment center up to seven days a week for various types of counseling and educational and rehabilitation therapies.

While attending these programs, patients receive treatment by a team of healthcare practitioners that includes mental health professionals and general health physicians.

The goal of day treatment programs is to rehabilitate patients with various mental conditions so that they can function more independently in the community. To accomplish this, a variety of therapies are often used. These may include:

  • Psychosocial rehabilitation
  • Illness management skills
  • Family education/therapy
  • Psychotherapy
  • Medication management

Generally, day treatment programs are highly structured and intensive, and provide rehabilitative therapy that allows patients to live in the community while reaping all the benefits of rigorous medical treatment. However, these programs are most effective for patients whose psychiatric symptoms (e.g., mood fluctuations) have been stabilized, typically through the use of medications (e.g., antidepressants, antipsychotics). Patients with acute or unstable psychiatric symptoms may require inpatient psychiatric care.

About day treatment programs

Day treatment programs are a comprehensive form of outpatient therapy used to treat various types of mental illnesses including depressive disorders, developmental disabilities (e.g., autism), cognitive disordersand substance dependence.

In day treatment programs, patients continue to live at home in the community but commute to a mental health facility, hospital or other specialized treatment center up to seven days a week for various types of counseling and educational and rehabilitation therapies. At these programs, patients receive treatment by a team of mental health professionals(e.g., psychiatrists, psychologists, social workers, counselors)and general health physicians.

Day treatment programs typically provide clinical diagnostic and treatment services with a level of intensity equal to that offered during inpatient psychiatric care, but not on an around-the-clock basis. Generally, these programs last at least four hours per day and occur on a daily or near daily basis.

The length and duration of day treatment programs depend on the type of program offered by the treatment center as well as recommendations by a patient’s primary care physician or mental health professional(e.g., psychiatrist).

There are day treatment programs that are geared specifically toward elderly patients, adults, adolescents or young children. Programs for adolescents and children typically include an academic program, to either take the place of or to work with the child’s schooling.

The goal of day treatment programs is to rehabilitate patients with various chronic mental conditions so that they can function more independently in the community. To accomplish this, a variety of therapies are often used. These may include:

  • Psychosocial rehabilitation. Emphasizes social and vocational training to help patients function more effectively in the community. Programs may include vocational counseling, job training, money management, learning to use public transportation and practicing social and workplace communication skills.
  • Illness management skills. Patients learn about their illness and treatment techniques so they can make informed decisions about their care. Patients also learn how to identify signs of relapse and make a plan to respond to signs.
  • Family education/therapy. Patients often live with family members who must be as informed as possible to provide support to patients. Family members learn ways to recognize stressful situations that may trigger a relapse or ensure patients adhere to medication schedules.
  • Psychotherapy (e.g.,cognitive behavior therapy[CBT], group therapy). Various forms of therapy that encourage patients to talk about their condition as well as any related issues with a psychotherapist. In severe cases, psychotherapy may not be recommended until the patient’s symptoms have stabilized through the use of medications.
  • Nutritional counseling. Regular consultation with a nutritionist (licensed nutrition specialist) or registered dietitian is usually offered at day treatment programs for patients with eating disorders. Nutrition experts may help patients gain a fundamental understanding of adequate nutrition including the importance of a healthy, well-balanced diet. They will also make sure patients follow any dietary restrictions that may be necessary due to their use of medications (e.g., antidepressants).
  • Expressive therapies (e.g., art, dance and/or music therapy). Some patients may find happiness and relaxation from these therapies, which encourage imagination and self-expression.

The specific services and therapies offered by day treatment programs vary by facility. In some cases, patients are referred to a program by a school or physician. In rare instances, patients themselves may seek out a specific day treatment program. While undergoing these programs, patients should attend regular follow-up consultations with their primary mental health professional or physician. This will enable the physician to monitor their condition, preventrelapse and determine if the day treatment program is effective.

Conditions treated at day treatment programs

Day treatment programs are available for the treatment of various types of mental illness including:

  • Substance abuse and dependence. The chronic use of a substance, usually alcohol or drugs, that alters mood or behavior and significantly impairs an individual’s life.

  • Schizophrenia. A chronic and disabling psychiatric disorder that impacts a person’s ability to distinguish between real and unreal experiences, think logically, have normal emotional responses and behave appropriately in social situations.

  • Depressive disorders. chronic conditions marked by feelings of sadness, anger or frustration that may interfere with a person’s life. These include dysthymia and major depression.

  • Bipolar disorder. A condition characterized by alternating periods of depression and mania.

  • Anxiety disorders. Emotional disorders characterized by a debilitating and disruptive anxiety that can interfere with a patient’s daily activities. Types of anxiety disorders include generalized anxiety disorder (GAD), phobias, panic disorder, obsessive-compulsive disorder(OCD) and post-traumatic stress disorder(PTSD).

  • Borderline personality disorder(BPD). A condition that causes patients to have periods of unstable emotions that seriously affect their lives.

  • Eating disorders. These involve serious disturbances in eating behavior including unhealthy reduction of food intake (anorexia nervosa), severe overeating and/or dangerous methods to prevent weight gain, such as self-induced vomiting (bulimia nervosa).

  • Developmental disorders. Disorders characterized by a wide range of problems that usually first begin to appear during infancy, childhood or adolescence. These can include:

    • Attention deficit hyperactivity disorder (ADHD). A neurological condition characterized by inattentiveness, overactivity and impulsivity. ADHD is often accompanied by restlessness and mood swings.

    • Autism. A complex developmental disorder that affects the brain’s normal development of social and communication skills. Patients with autism are typically self-isolating, self-stimulating and unresponsive to reality.

    • Asperger’s syndrome. A developmental disorder that is similar to autism, but with a higher level of functioning. Patients with Asperger’s syndrome generally have problems with social skills and nonverbal communication.

    • Mental retardation. A below average general intellectual function and associated deficits in adaptive behavior that occurs before age 18.

  • Cognitive disorders. Conditions that affect an individual’s ability to think and reason. These include:

    • Dementia. A progressive loss of intellectual function that impairs an individual’s ability to engage in everyday activities. Alzheimer’s disease is a form of dementia. Patients with dementia often have difficulty thinking, remembering and/or reasoning.

Potential benefits of day treatment programs

Generally, day treatment programs are highly structured and intensive, and provide rehabilitative therapy that allows patients to live at home while reaping the benefits of rigorous mental health treatment.

For patients who have undergone inpatient psychiatric care, day treatment programs may provide a smooth transition with continued rehabilitation therapy that can help integrate them comfortably and safely back into the community. For patients with worsening symptoms, these programs may prevent hospitalization when administered in a timely fashion.

Day treatment programs usually offer timely crisis intervention, which may help resolve difficult situations such as suicide attempts. However, in cases of severe suicidal ideation, patients may require a more intensive level of care such as that offered during inpatient psychiatric care.Because patients are able to return home at night and on weekends, these specialized programs often enable them to develop a support network of friends and family who can help monitor their conditions when they are not in the hospital or treatment facility. However, day treatment programs are most effective for patients whose psychiatric symptoms have been stabilized.

Questions for your doctor about day treatment

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients and their families may wish to ask the doctor the following questions regarding day treatment programs:

  1. Can you recommend a day treatment program for my condition?
  2. Will I need a physician referral for admittance into a day treatment program?
  3. What kinds of treatment and therapy will I receive while attending a day treatment program?
  4. Does my child’s day treatment program include an educational plan? If so, how much time is spent on academic instruction?
  5. Is vocational training also included in my day treatment program?
  6. Who are the staff members of the day treatment program and what is their training?
  7. Who will be my (or my child’s) primary therapist during the day treatment program?
  8. How many hours of therapy will I receive during the day treatment program?
  9. Will I need to continue seeing my primary physician or psychiatrist while attending the day treatment program?
  10. How long do I need to attend the day treatment program for my condition?
  11. What should I do if my symptoms worsen while I am at home?
  12. Does my insurance cover day treatment programs?
  13. What follow-up treatment will I have after completing day treatment?
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