Appleton

Personalized, compassionate care for adults with chronic mental illnesses

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Overview

For over 20 years, Appleton has provided comprehensive diagnosis, treatment, and rehabilitative care for adults ages 18 and over with serious and persistent psychiatric conditions. We provide personalized care that helps individuals understand, accept, and effectively manage their illnesses and symptoms so they can learn to live as independently as possible.

For more information or to make a referral, please call 617.855.2319.

Our self-pay program is ideal for those who have a primary diagnosis of psychosis and/or bipolar disorder with or without co-occurring conditions such as substance use, mood, personality, and anxiety disorders. The average length of stay at Appleton is between two to three months, however, some residents may benefit from longer periods of treatment when clinically indicated.

Located on McLean’s campus in Belmont, Massachusetts, our residential program is one of only a few in the country specifically developed for people with psychotic disorders that is also on the grounds of a psychiatric hospital. Residents benefit from access to McLean’s full continuum of services and world-renowned physicians and psychologists who provide assessment, consultation, testing, and psychotherapy.

Individuals who come to Appleton may be entering residential treatment for the first time or may be transferring from another program in order to receive the tailored, comprehensive care that we offer. Residents may also come to our program from an inpatient unit at McLean or elsewhere and are in need of around-the-clock care while they continue to transition back to the community.

As part of McLean’s Psychotic Disorders Division, our dedicated multidisciplinary staff includes psychiatrists, clinical social workers, an occupational therapist, psychiatric nurses, and community residence counselors. Every resident is cared for by a personal treatment team which coordinates an individualized psychiatric assessment and treatment strategy, as well as an aftercare plan.

“Structured groups and support from my team at Appleton helped me to successfully transition to the community; they were essential for my recovery, including support from my husband, son, and family. I am a healthy and happy person because of the Appleton program.”– Former Appleton patient

Appleton is a renovated historic mansion that accommodates up to 25 residents. We offer a peaceful setting where individuals can focus on their treatment. There are semi-private and private bedrooms, spacious common living areas, and a kitchen and dining room. Breakfast is continental style, and lunches and dinners are prepared by our counselors who have oversight from our registered dietitian for meal planning. Residents have access to an art room, solarium, computers, and wireless internet. Cambridge and Boston are accessible by public transportation, offering numerous recreational, educational, and vocational opportunities.

Our treatment approach is based on a recovery model comprised of five phases designed for flexibility in which residents work with a designated clinical social worker and treatment team to progress at a pace most appropriate for the individual. Each phase builds upon the resident’s accomplishments, including stabilizing the illness, establishing a daily routine, learning to function better in the community, focusing on vocational goals, and solidifying gains in recovery and community reintegration.

An important component of treatment is the utilization of evidence-based modalities such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). These strategies have been proven to help individuals build constructive thoughts and behaviors. Our education-focused group therapy schedule offers 20 groups per week covering a broad range of topics such as symptom management, self-assessment, medication evaluation and management, family issues, and interpersonal skills. We place a special emphasis on stress management and overall health and fitness by incorporating activities such as meditation, yoga, nutritional support, gardening, and expressive therapies into our group schedule.

Support from family and friends plays a significant role in the recovery process and in long-term success. We meet with family members at the beginning of treatment, provide ongoing updates and consultations throughout a resident’s stay, and work together when developing an aftercare plan.

Treatment Approach

Appleton specializes in comprehensive diagnosis, treatment, and rehabilitative care for adults ages 18 and over who have a primary diagnosis of psychosis and/or bipolar disorder and may also have co-occurring substance use, mood, personality, or anxiety disorders. We provide personalized care that helps individuals understand, accept, and effectively manage their illnesses so they can learn to live as independently as possible.

Our treatment approach is based on a recovery model comprised of five phases designed for flexibility so that residents may progress through the program at their own pace. Working with the guidance of a designated clinical social worker and a treatment team of psychiatrists, an occupational therapist, psychiatric nurses, and community residence counselors, residents move forward by incrementally building on skills and accomplishments.

This process begins with Phase I, which involves understanding and stabilizing the illness and related symptoms as well as establishing therapeutic relationships with the resident’s treatment team. In Phase II, the treatment team assesses the resident’s capabilities and focuses on implementing a daily routine, identifying goals, and enhancing social skills needed for recovery. Using occupational therapy assessments for guidance, Phase III assesses the resident’s ability to function in the surrounding community. Individuals at this stage may begin to do volunteer work or take a continuing education class. During Phase IV, the resident is able to resume ongoing educational and vocational activities utilizing new skills acquired in the previous steps. During Phase V, the individual solidifies accomplishments in functioning within the community and begins to work with clinicians to develop aftercare strategies.

AppletonOur group therapy schedule focuses on illness education and is a central part of our program, offering 20 groups per week that cover a range of specialized topics such as symptom management, self-assessment, medication evaluation and management, family issues, interpersonal skills, and more. Individual and group therapy incorporate evidence-based modalities such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). CBT teaches that if individuals can change their thoughts, they will change their responses to and perceptions of the world. DBT emphasizes the development of four skill sets: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. These strategies have been proven to help individuals build more constructive thoughts and behaviors.

In addition to individual therapy within the program, we advise each resident to meet with an outpatient psychotherapist once or twice each week, which we help to arrange either at McLean or in the Greater Boston community.

We take a holistic approach to treatment, recovery, and well-being, placing a special emphasis on stress management, overall health, fitness, and nutrition. This includes incorporating activities such as meditation, yoga, nutritional support, gardening, and expressive therapies into our group schedule. Residents also have access to our on-campus fitness center, a certified trainer, and nearby athletic club.

Also included in our treatment approach are life skills groups, which include activities such as cooking and food shopping trips as well as community outings to bookstores, cafes, bowling alleys, malls, and museums. Weekly community outings are designed to build skills, support, and independence. We also take longer seasonal trips to places such as Martha’s Vineyard, Rockport, and Newport, Rhode Island.

We encourage residents to attend self-help groups on the McLean campus, including a Depression and Bipolar Support Alliance meeting offered a few times each week. For those with co-occurring substance use disorders, Alcoholics Anonymous, Narcotics Anonymous, and SMART Recovery meetings are available. McLean’s College Mental Health Program is also a good resource for young adults in need of support and group therapy.

Family and friends play a significant role in treatment, recovery, and long-term success. We meet with family members at the beginning of treatment, provide ongoing updates and consultations throughout a resident’s stay, and work together to identify community resources and opportunities for growth when developing an aftercare plan.

After completing the program, some individuals return to live with family, others step down to a community-based residence, while some move to a supported apartment. Each resident leaves with improved skills for a lifetime of future growth and development.

treatment team

Program Leadership

Erin B. Sandler, LICSWErin B. Sandler, LICSW, Program Director

Since joining McLean Hospital in 2013, first working at Appleton House as a clinical team manager, Ms. Sandler has implemented person centered care, building elements of dialogical practice into the Appleton group and milieu structure. She has intensive training in dialectical behavior therapy and has supervised social workers preparing for their LICSW.


William P. Carter, MDWilliam P. Carter, MD, Medical Director

Dr. Carter received his MD from Harvard Medical School before completing his residency in adult psychiatry at McLean Hospital. Staying on at McLean since residency, he has held leadership positions in teaching, research, and clinical settings. Board certified by the American Board of Psychiatry and Neurology, Dr. Carter is an assistant professor of psychiatry at Harvard Medical School.


Joseph Stoklosa, MAJoseph Stoklosa, MD, Clinical Director, Psychotic Disorders Division

Dr. Stoklosa is an instructor in psychiatry at Harvard Medical School (HMS) and the assistant program director for the MGH/McLean Adult Psychiatry Residency Training Program. He has earned several teaching awards from the HMS medical students, as well as from the MGH/McLean psychiatry residents. His research focuses on education including founding the Clinician Educator Program to train MGH/McLean residents to become clinician-educators.

Staff and Associates

Our multidisciplinary treatment team includes psychiatrists, licensed independent clinical social workers, occupational therapists, psychiatric nurses, and community residence counselors who work with referring physicians and mental health professionals on the resident’s behalf.

These dedicated and well-trained clinicians and support staff have extensive background in the treatment of serious and persistent psychiatric conditions and specialize in helping patients to understand, accept, and effectively manage their illnesses. Our clinicians have experience working with patients from diverse cultural and socioeconomic backgrounds from across the country and around the world.

Appleton operates within the Psychotic Disorders Division, led by Dost Öngür, MD, PhD.

Accommodations

Located on McLean’s campus only eight miles from downtown Boston, Appleton is a renovated historic mansion that accommodates up to 25 residents. We provide a home-like environment and offer residents spacious common living areas including a solarium, atrium, kitchen, and dining room. Appleton is designed to help residents feel comfortable as they focus on treatment and recovery.

Appleton solariumSemi-private and private bedrooms are designed to offer residents a comfortable retreat during leisure time. We offer wireless internet access and have computers available for patient use. Appleton’s comfortable sitting and gathering areas are full of natural light and picturesque views of the surrounding area.

Appleton is only a few miles away from many recreational, educational, and vocational opportunities in the Greater Boston area. There are numerous colleges, adult education programs, and volunteer opportunities that residents can integrate into their treatment plans. Cambridge and Boston are easily accessible by public transportation.

Admission & cost

Admission

Appleton specializes in comprehensive diagnosis, treatment, and rehabilitative care for adults ages 18 and over who have a primary diagnosis of psychosis and bipolar disorder with or without co-occurring conditions such as substance use, mood, personality, or anxiety disorders. Our individualized care helps residents effectively manage their illnesses and symptoms so they can learn to live as independently as possible. People come to Appleton from across the United States and around the world. We can help arrange admission from most domestic or international locations.

Our self-pay program is best suited for those who may benefit from a residential program structure. Though some residents may be seeking this level of care for the first time, individuals often come to Appleton from other residential programs or from inpatient units at McLean or elsewhere. The average length of stay is between two to three months; however, some residents may benefit from longer periods of treatment.

For more information or to make a referral, please contact:

Erin Sandler, LICSW, Program Director
Phone: 617.855.2319
Email: mcleanappleton@partners.org

We hope to answer your call directly or will return your call or email within one business day.

We work with individuals, their families, and referring clinicians to determine if our program is an appropriate option. A preliminary screening is conducted over the phone to gather as much pertinent information as possible, and during this time we also explain our mission and how our program works.

Cost

The fee for the Appleton residence is $600 per day. As a self-pay program, Appleton does not accept insurance or directly assist with insurance reimbursement. Some ancillary treatment expenses may be recovered through insurance.

Included in Day Rate

Clinical Services

  • Psychiatric assessment
  • Intensive group therapy
  • Registered dietitian to offer nutritional assessments, ongoing dietary support, and a weekly nutrition group for all residents
  • Family meetings via phone and in person
  • Psychoeducational services
  • Case management services, including ongoing communication with referring clinician, if applicable
  • Aftercare planning
  • Occupational therapy assessment with weekly OT support
  • Nursing support/appointments set up for medical needs

Non-Clinical Services

  • Double rooms
  • All onsite meals, snacks, beverages
  • Access to McLean fitness center and certified trainer
  • Community trips to museums, malls, bookstores, Harvard Square, etc.
  • Laundry services onsite

Not Included in Day Rate

These optional ancillary clinical and medical services may or may not be covered by insurance:

McLean Hospital Ancillary Services

  • Individual psychotherapy
  • Medication evaluation and management
  • Behavior therapy
  • Neurological services
  • Neuropsychological testing
  • Specialty imaging, MRI
  • Forensic consultations
  • Specialty psychiatric consultations

Other Medical Services

  • Ambulance services
  • Dental services
  • Emergency room visits
  • Laboratory testing
  • Physical therapy
  • Sleep study

FAQ

Where is Appleton located?

he program is located on the Belmont campus, in Appleton House. For more information on directions, parking, and local accommodations, please visit our Maps & Directions page.

Who benefits most from Appleton?

Our residential program focuses on treating individuals with a diagnosis of bipolar disorder or a psychotic disorder who would benefit from individualized treatment.

Is family involved in treatment?

Upon admission, our clinical social workers meet with the family, in person or by phone, for patient history and general information related to the patient. Weekly communication, phone calls and/or scheduled meetings, is a standard part of treatment. Family therapy is recommended if clinically appropriate.

Is smoking permitted?

Except during treatment commitment times or when curfew is observed from 11 pm - 6 am, smoking is allowed in designated outdoor areas only. No smoking is allowed inside any of our buildings.

When are visiting hours?

Visiting hours begin after 4:30 pm Monday through Friday, as visitors are encouraged to wait until the treatment day is completed, and as arranged with the case manager on weekends. All visits are approved by the case manager.

Are cell phones and other electronics allowed?

Residents are allowed to hold and use their cell phones and computers, except during treatment, with some guidelines to prevent disruption of the program and other residents.

Is the resident’s stay at the program kept private?

Privacy is of the utmost importance to Appleton and we ensure confidentiality through our highly trained, professional and discreet staff. No third party, whether known to the resident or not, has access to medical records, health information, or any information about a resident’s stay without prior, written authorization from the resident.

Are support and educational resources available?

From helpful online resources to self-help groups and more, McLean Hospital is committed to providing support and mental health education to aid patients and families on the path to recovery.

Is aftercare planning a part of the program?

The treatment team works closely with the individual as well as with family, significant friends, and outside providers to develop a personalized aftercare plan. Recommendations by staff are made based upon clinical needs, progress made during treatment, and long-term treatment goals.

Can former residents access their medical records?

All requests for medical records should be directed to McLean’s Health Information Management Department.

Are support groups offered?

To complement our programs’ services and encourage individuals’ initiatives in their own treatment course, many self-help groups are hosted by McLean.

Does McLean gather patient feedback?

McLean is dedicated to maintaining high-quality and effective patient care. To ensure that those standards remain at the highest level, we utilize a number of feedback instruments and quality indicators. Among these tools are the Perceptions of Care survey which monitors patient satisfaction and BASIS-24™, a psychiatric outcomes measurement tool created at McLean and widely used in the US and around the world, which delivers feedback on the patient care experience.