McLean Hospital 115 Mill Street Belmont, MA 02478
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.
Our 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.