Tuesday, 11 August 2015

Guest Post: Partial Hospitalization Program (PHP)

As you know, I'm always looking for guest bloggers to write me a post about mental health, and Cassie from Cassandra's Curse kindly stepped forward to give you a bit of information about a Partial Hospitalization Program (PHP) that she received for treatment of her depression, which is a form of intensive therapy. Cassandra is an American blogger and writes about her mental health experiences, both with anxiety and depression, on her own blog, as well as discussing other lifestyle issues. She has suffered with depression since before the age of 5 and, since then, has been in hospital a couple of different times for her mental health, which is when she agreed on PHP.

After getting out of the mental hospital the second time I agreed to start PHP. Actually, I had agreed to start it before I went in. My insurance started March 1st. So my psychiatrist and I decided that I would start PHP March 2nd (Monday) because my symptoms were so bad. However, I didn’t make it that long, and I ended up in the hospital before then. I went into the emergency room late February 21st and was admitted to the mental hospital February 22nd after an extremely long time in the emergency room. (Although not as long as a poor man who had to stay in the emergency room for three days, who I met my third time in the hospital.) I stayed until late February 27th. There I met a good friend. But that’s a different story.

The hospital set me up to start PHP March 3rd. I went there with my sister because I don’t drive and the first thing they asked for was my insurance card. Which, of course, I didn’t have yet. My sister wasn’t feeling well and decided to skip her classes and wait with me. And we waited. And we waited. And we waited. Eventually I somehow got the insurance information from my parents and they called and found out it was legit, and I was allowed to enter the program. Of course orientation was over. And my appointment with the psychiatrist was soon so I just kind of waited in the break room until she came and found me. The first day is crazy. Everyone and their mom need to talk to you (psychiatrist, like ten nurses, your counselor, etc.). So I didn’t really do any groups. The second day I had to do orientation. Even though I sort of had it down from day one. But, luckily, that meant missing process group.

The schedule was:
8:00-8:30: arrival and check in
8:30-9:15: process group (goals/affirmation/orientation (rereading rules that we already knew))
9:15-10:45: process group (weekend review/treatment plan review/open process)
10:45-11:00: break
11:00-12:30:  coping skills group
12:30-1:15: lunch
1:15-2:00: coping skills group
2:00-2:45 coping skills group

I stayed for nine days, March 3rd to March 13th. My insurance covered ten days, but since I started on a Tuesday, I wanted to go back to school on Monday. Well, “back” to school. I was still taking my night classes. Which was highly frowned upon. While doing PHP you’re not supposed to do work or school or anything else. It’s too intense of a program.

The first process group we just went over goals and if we had met them and affirmations. Most of my goals had to do with school work, since I was missing school while I was there. I am particularly bad with goals. It is a something I need to work on. My affirmations included: “I eject negative thoughts,” “I am at peace with myself,” and “with each breath I become more relaxed.”

The next process group was the one that sucked. On Monday and Friday we just set weekend and treatment goals and then checked to see if we achieved them. But Tuesday through Thursday it was real process group. Where you tell your story. And where you process things. When it was someone leaving sometimes it was about that. When people came in it was why they were there. It took me almost the full time to tell my “story,” even though I don’t really think I have that much of a story. And even after they questioned me (especially the mom whose son killed himself, and he hid all his symptoms from her just as I did to my parents) later in the day someone else asked “so why are you even here?” So that felt more than a little demeaning. Basically she was saying I had no real reason to be there. And I knew it. Because I don’t have a reason to be as severely depressed as I am. I don’t have a reason to be as severely depressed at the age of five or six as I was. I don’t have a reason. And nothing seems to help.

Next was coping skills group. This group seemed to stretch on forever. Even though it was the same length as the process group before it, it didn’t seem like it at all. We did skills such as anger management, mindfulness, yoga, drama triangle, emotional eating, support systems, opposite action, cognitive distortions, and several more. The counselors tried to be engaging but often it was dry. And I am glad my counselor seemed to call me out for a visit during this group more than any other group.

The next two groups were mostly recreational therapy. We played games: apples to apples, taboo, and others. We would draw or write about our feelings. The drawing was fun. We used chalk or charcoal or something like that. It always took me a long time to decide what to draw. And then I ended up just drawing stripes, while everyone else would draw gorgeous landscapes and things. But no one cared. It was a safe place with little to no judgment. During these groups we also had medication education. This to me was ridiculous because I know a lot about medication for depression. Not so much the other mental disorders, but depression, I have down.

Once, we had a chaplain come in. This was the worst memory I have of PHP. He was talking about having a meaningful or substantial or something, I forget it now, life. He kept asking questions and going around the room. One of the questions was the word I forgot life and what it was to me. I said “I wouldn’t know” and he mocked me. He said you’re too young not to know what it is. I felt like crying. I feel like crying now thinking about it. I said “I’ve never had it.” And he mocked me again. Luckily another girl stood up for me and said something that I don’t remember. And then someone else chimed in saying that I needed to have a husband and children to know what a meaningful life was. It was horrible. We ended up reporting him to another counselor who said that his behavior was absolutely appalling, and the counselor apologized to me for the chaplain’s behavior.

Some days were scary. And people would say things that would warrant them a visit to the hospital. One person did leave and go to the hospital. But that’s what the program was for.

Overall, it was definitely an interesting experience. Everyone was really nice. I’m sort of glad I went. When they asked me what I learned I said that I needed to practice the skills and not just know them. So, have I been practicing them? Well, not really. But I did learn an important thing. I do not want to be a counselor. Because of the stories I heard in process group. Process group made me substantially worse. I do not want to hear those stories. I cannot hear those stories every day and have people process them with me. I know I was in an extreme situation with people in crisis and in a special program. But, I still don’t think I want to be a therapist.

Would I go again? Only if I felt badly enough that I had to. But, I think I would rather be in the hospital and not hear the horrible things that other people have gone through in process group.

When I left they gave me a poem:

Be Kind to Yourself
Author Unknown

There will always be times when it’s hard
to remember your strengths.
These are the times when you need to give yourself
special attention.
Be kind to yourself...
Kindness nurtures and gives hope to growing dreams.
Respect yourself...
Listen to your needs, and treat yourself as you would to a
Encourage yourself...
Remember what you truly want, and fight for it as you
for your life.
Appreciate yourself...
Don’t take for granted the qualities that make your unique.
Focus yourself...
It is with discipline and motivation that you will move
towards your goals.
Be giving towards yourself...
In that way, your strength will thrive,
and you’ll be realizing your goals a day a time.

You can read more from Cassandra at http://curseofcassandra.blogspot.co.uk/ or follow her on Twitter @CassiesCurse or Bloglovin.

Thank you so much for writing this for me Cassie, I found it really informative and really enjoyed learning about PHP. I am always looking for anyone to write a guest post for me, whether you'd like it to stay confidential or not, so if you're interested please email me at hannahvenables19@gmail.com or tweet me @hannahev19.
Life has no remote, get up and change it yourself.

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