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Adolescent Partial Hospitalization Program provides alternative to inpatient psychiatric care

Jan. 3, 2019, 10:58 AM

by Kelsey Herbers

Adolescents who are struggling with intense emotional, behavioral and social difficulties may find an alternate care path to an inpatient stay through Vanderbilt Psychiatric Hospital’s Adolescent Partial Hospitalization Program.

The program, which runs weekdays from 8 a.m. to 2 p.m., is a group-based model designed to provide comprehensive evaluation and treatment services for patients who would normally be admitted to an inpatient unit.

This approach allows patients to receive intensive therapy without requiring an overnight stay in the hospital and bridges the gap between traditional inpatient and outpatient settings.

Jessica Lavender, LPC-MHSP

“Partial hospitalization is often also a step-down, so if you’ve been in inpatient treatment but still feel scared about everything you’re going to face outside of it, partial gives you the ability to have that in-between level of therapy with support as you transition back into regular life,” said Jessica Lavender, LPC-MHSP, director of Partial Hospitalization and Intensive Outpatient Services.

According to Heather Kreth, PsyD, assistant professor of Clinical Pediatrics and former director of Vanderbilt’s Adolescent Partial Hospitalization Program, the program was the first of its kind in Middle Tennessee when it opened in February of 2014. The demand for this model was demonstrated when the program reached its capacity within its first week.

In early 2016, the program was expanded to nearly double its capacity, separating the adolescents into two groups for more effective therapy.

The program follows a strict daily schedule that involves various treatment types, including:

  • Skills Groups, which teach children skills for coping with symptoms
  • Process Groups, which are peer-led discussions on topics of the patients’ choice
  • Recreation therapy, which involves activities such as yoga and meditation for teaching mindfulness and the impact of exercise on the healing process
  • Nursing Groups, which focus on nutrition, sleep and medication adherence

Patients and families work with a child and adolescent psychiatrist to identify the best diagnostic fit for the challenges they face and consider the role of medications in addition to non-pharmacologic approaches to treatment.

Additional time is set aside for individual and family meetings and for the completion of schoolwork, as many patients miss school to participate in the program. The average length of stay is about two weeks, with a goal of getting the child back to school as quickly as possible.

For patients to be admitted, families must agree to maintain certain safety measures outside of program hours.

“In order to make a recommendation for Partial Hospitalization, it is critical that we collaborate with the family to determine the level of safety planning and supervision they are able to provide at home,” said Lavender. “We are often recommending measures such as 24/7 monitoring. It’s a lot of work for the family, but it also ensures that the family is very involved in the treatment process and that progress is sustainable after the program ends.”

Vanderbilt’s Adolescent Partial Hospitalization Program remains one of the only programs in Middle Tennessee that isn’t focused on a specific primary diagnosis. While it’s typically best suited for patients with depression and anxiety disorders, the program also helps patients with other diagnoses who could benefit from a period of stabilization.

The program is open to referrals for children between the ages of 13 and 17. Vanderbilt also offers a Partial Hospitalization Program for adults 18 and older that follows a similar schedule.

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