Dissociative Disorders and Trauma Inpatient Program

The Dissociative Disorders and Trauma Inpatient Program is located on the Belmont campus, on the second floor of Proctor House. For more information on directions, parking, and local accommodations, please visit our Maps & Directions page.

Patients stay at the program between three and seven days. Inpatient stays are brief and focus on acute stabilization and management of crises and psychiatric illness.

Aftercare planning begins immediately upon admission.

Visitors are permitted, following program policies. Visiting hours are 2-8pm, seven days a week.

Please speak to the patient’s treatment team for more information. Additional details can be found on the Visitors page.

The nurses station can be reached at 617.855.2512. Patient phone numbers are 617.855.3392 and 617.855.3372.

The patient phones are turned on between 7am and 11pm. Cell phone use is also limited to these hours. Please limit calls on the telephones to 10 minutes. Family members are asked to give the treatment team an unblocked number where they can be reached during business hours.

Patients can talk to the nursing staff regarding emergency calls after 11pm.

Please talk quietly when on the phone as a courtesy to other people on the unit.

When answering the unit phones, please only say “hello” and take a message if the person is not available. Please do not give out any information about patients. It is important to protect the confidentiality of other patients—callers may not be aware that they are calling a hospital unit.

Patients are allowed to hold and use their cell phones and other devices, with some guidelines to prevent disruption of the program and other patients. To respect the privacy of all patients, photographic equipment or recording devices of any kind are not allowed.

If a patient’s cell phone has a camera, they may use the telephone functions only. Patients are asked to sign a cell phone agreement form on admission agreeing to this. If the camera function is used, the patient is not allowed to use their cell phone for the rest of the stay.

The use of personal laptops is limited to free time when groups are not in session, even if the patient is not attending the group. If you are always busy with the “outside” world, you are missing treatment opportunities.

Cords for cell phones, music players, laptops, etc. are stored in the nurses station from 9pm to 7am. Patients need to demonstrate personal safety and be off of sharps restrictions to use cords. Patients are responsible for these items, and we ask that they are not visibly unattended or in left in common areas.

Our patients are admitted to the unit on sharps restrictions. Sharps are considered to be any item that has the potential to cause harm, self-inflicted or otherwise.

Examples include scissors, nail clippers, tweezers, cell phone and computer chargers, headphones, earbuds, and other cords or straps. Hair dryers are considered sharps. Any makeup or toiletry items in glass containers are considered sharps. We do not allow the use of razors, but electric razors are okay. Flat irons and curling irons are not allowed on the unit. We keep yarn and needles in the office.

To ensure patient safety, the following items are not allowed on the unit: alcoholic beverages, drugs/medications, plastic bags, weapons, knives or other sharp objects, matches/lighters, glass bottles, mirrors, and glass picture frames.

Contact between family members and clinical social workers, including family meetings, are encouraged when clinically appropriate and with permission of the patient. Family meetings generally take place on weekday afternoons.

Living on a unit with 20 other patients can be stressful. Abiding by the unit policies and keeping an attitude of respect for each other and staff is essential to maintain a safe treatment environment.

Important Information

Patient identification wristbands must be worn at all times to ensure correct identification and administration of all medications.

Checks

Each patient must be seen by the designated checks staff member every 15 minutes, or more often if clinically indicated. The checks person is only responsible for doing checks and is not available for other activities, including staff talks, during this time.

Checks are done throughout the night. Staff use flashlights and need to see patients’ faces to assure patient safety.

Smoking

Smoking and possession of smoking materials are not allowed at any time. We offer nicotine replacement therapy and other support for smoking cessation. E-cigarettes and vaporizers are not permitted.

Families should refrain from bringing patients cigarettes or other smoking materials.

Possessions

All packages or luggage brought onto the unit by patients or visitors are examined by staff for safety measures.

Patients are strongly encouraged not to bring items of sentimental or monetary value to the hospital. We are unable to assume responsibility for personal items, including money.

Unit Permissions and Sign-Out Board

• Level 1 (hall restrict): patient must remain on the unit
• Level 2 (off unit with staff): patient may go off the unit in groups with a staff member

Patients must sign out every time they leave the unit and include the time of departure, destination, and expected time of return. If a patient is unable to be back at the stated time, they are asked to call the unit at extension 2512.

Room Assignments

The nursing staff makes room assignments based on the clinical needs of individuals and the wider unit. Room changes may occur at any time during the stay.

Patients are asked to socialize in common areas and not to be in each other’s rooms.

Patient rooms should be kept neat and clean. Fresh linens and towels are available in the linen closet. Soiled linens and towels may be placed in the laundry bags located near the bathroom and shower areas.

Dress Code

All patients are expected to be dressed by 9am on weekdays. No bare feet are allowed on the unit for hygiene reasons. In general, sunglasses and hoods are not to be worn on the unit. Please do not wear hoods while in bed.

Meals

• Breakfast: 8-8:30am
• Lunch: 12-12:30pm
• Dinner: 5-5:30pm

If there is a treatment-related reason why a patient cannot attend a group meal, they can let the nursing staff know to make arrangements for a meal to be saved. Patients must clean up after themselves in the kitchen.

Medications

Patients are responsible for coming to the med room for their scheduled medication times:

• Morning: 8-9am
• Midday: 12:30-1:30pm
• Evening: 4:30-5:30pm
• Night: 8-10pm

Please try to avoid asking for as-needed medication during change of shift reports, 6:45-7:30am, 2:45-3:30pm, and 10:45-11:30pm.

Infection Control

Simple precautions are needed to prevent the spread of infection and to avoid exposure to blood and other bodily fluids (saliva, urine, feces, and vomit), which may contain germs.

• Wash hands thoroughly after using the toilet, touching wounds, blowing your nose, or before eating or handling food
• Cover your mouth when sneezing or coughing; use a tissue and be sure to dispose of used tissues in a trash receptacle
• Use only your own fork, knife, spoon, straw, cup, plate, etc., and avoid sharing food or drink with someone else; any food or drink handled or partly eaten should be thrown away in a trash receptacle
• Personal items like makeup, earrings, razors, nail clippers, and clothing should not be shared
• Personal hygiene items, such as toothbrushes, soap, brushes/combs, and mouthwash, are kept in patient rooms; they should not be left in the bathroom where others might use them, and do not share them
• If clothes become soiled with blood or other body fluids, wash them in the washer/dryer on the unit; be sure to use a hot water cycle; ask nursing staff for help if needed
• Dirty or soiled areas on the unit should be reported to the staff

These rules are intended to protect patients and staff. Feel free to discuss questions or concerns with the staff.

Personal Boundaries

We ask that everybody be respectful of each others’ boundaries. No physical or sexual contact is permitted between patients or between patients and visitors.

The case manager works with patients to identify treatment goals, contain symptoms, develop plans to manage acute stresses, and help develop an aftercare plan. The case manager works with family members, significant others, and community clinicians that patients wish to be involved. Patients meet with their case manager each weekday except on holidays.

The psychiatrist is responsible for prescribing medications, helping with medical problems, supporting the treatment process, and collaborating with community medication prescriber. Patients meet with their psychiatrist each weekday and with a rounding psychiatrist on the weekend and holidays.

Each patient has a primary nurse and mental health specialist team. We encourage patients to take advantage of a staff talk on both the day shift and evening shift. This can help the patient to focus on how they are doing, provide education, and support skill development.

Other members of the nursing staff include the nurse director and administrative assistant. The nurse director is responsible for coordinating nursing services on the unit. The administrative assistant is responsible for tasks that allow the unit to function smoothly.

The expressive therapist runs the group therapy program. The unit offers a wide variety of groups designed to support understanding of symptoms, develop skills, and provide support for the completion of treatment tasks.

Our 21-bed, coed unit provides treatment to individuals who are overwhelmed and in crisis due to a range of difficulties, such as mood disorders, anxiety, post-traumatic stress, dissociation, substance misuse, self-endangerment, and suicidal ideation/behaviors.

The Dissociative Disorders and Trauma Inpatient Program has developed a model of treatment that is sensitive to the needs of trauma survivors. Control of symptoms and stabilization are goals of the inpatient stay, rather than the exploration of traumatic experiences.

Respect

Our treatment approach emphasizes respect, collaboration, and interpersonal relationships. Please remember that our attitudes and behaviors affect others and be respectful of other patients and staff, even if feeling frustrated.

Collaboration

Treatment planning is a collaborative effort between the patient and their treatment team. Active participation in the full range of treatment activities, including individual meetings and group programming, is expected and provide the most benefit during admission.

Safety

Members of the community are responsible for their personal safety, and we ask that patients refrain from behaviors that are harmful to themselves or others.

We strongly encourage patients to ask for help with any self-destructive impulses before acting and please let staff know of any potentially unsafe situations that may arise.

Interpersonal Relationships

Relationships formed on the unit can be intense. Remember that everyone is at the program to get help with their problems and that it is the staff’s job, not the patient’s job, to help other patients. It is important for patients to stay focused on their own treatment rather than on the treatment of others.

We ask patients not to discuss past traumas or self-endangering behaviors with other patients, individually or during group sessions.

Please maintain the confidentiality of other patients.

We recommend that patients do not visit the unit for the first month after discharge to keep focused on life in the community rather than on the Dissociative Disorders and Trauma Inpatient Program.

Program Structure

The Dissociative Disorders and Trauma Inpatient Program is a short-term inpatient unit with an average length of stay of up to one week.

Patients are admitted to the unit for many reasons, and each patient has an individualized treatment plan.

Patients are assigned to a treatment team who works with them during their stay. Treatment is focused on stabilization and safety management.

Our group program includes a range of therapeutic and activity groups using open discussion, art-based, movement, and educational formats.

Patients can find the group schedule posted in the hallway on the whiteboard across from the sign-out board.

We hope that patients find the group program helpful. We encourage patients to ask questions and offer feedback and suggestions about the program.

Group therapy provides group members with an emotionally safe place to talk about what is going on for them.

In group therapy, members can give each other support, insight, and acceptance. Sharing experiences and giving feedback to others can help reduce the sense of isolation that patients may feel. Participation in the group process can help to increase a sense of empowerment in the treatment process.

Group norms are a set of expectations based on a sense of mutual respect between group members. These norms are intended to establish a reliable structure so that group members can know what is expected of them and what they can expect from others during a group session.

• Be on time for the group: Remember the five-minute rule—joining the group five minutes into the start time is disruptive and distracting
• If patients need to leave early, inform the group at onset: Please let members know when leaving so that it is not misinterpreted
• We ask that patients do not discuss details of trauma, self-injurious behavior, or suicide attempts: Be sensitive about material and language that may be distressing to others
• Strive to create an atmosphere of mutual respect: No interrupting, side conversations, or physical contact between group members
• Be a good listener: Please turn off cell phone during groups to allow full attention to the group content and decrease disruption to the group process
• Please don’t bring food into the groups
• Come to groups dressed and ready to participate
• Respect the privacy of others: Group discussions are considered therapeutic and may be shared with the patient’s team if they are relevant to treatment; please use discretion when sharing material with others
• Patient participation supports the group process

We encourage and expect patients to participate actively in their treatment by attending groups. The following is a brief description of the intent and structure of each group. It is patient participation that ensures groups are relevant and meaningful to each individual.

Group Descriptions

Community Meeting

All patients are encouraged to attend this group, which offers an opportunity for the community to come together to get the day started.

Specific goals include introducing new patients to the community, allowing patients who are being discharged to say goodbye to the community in a formal way, and providing a place to discuss particular community issues, including any problems that have arisen on the unit.

Goals Group

In this check-in group, patients are given an opportunity to verbalize their short-term attainable goals around treatment and self-care. Feedback is encouraged, which provides additional support from peers.

PTSD

This group provides education and feedback about the symptoms of post-traumatic stress disorder and the management of these symptoms.

We use group discussion to facilitate a better understanding of how past traumatic experiences affect people in their present-day lives. Discussion also helps members explore and develop a broader range of constructive coping skills.

Stretch and Walk Groups

These groups provide a staff-supported environment utilizing movement to enhance physical health.

DBT Skills

Dialectical behavior therapy (DBT) combines cognitive and behavioral therapy with methodologies from various practices, including Eastern mindfulness techniques.

In this group, we learn and practice specific skills that are essential for managing emotional distress.

Mindfulness

Mindfulness is a state of active, open attention on the present moment. When you’re mindful, you observe your thoughts and feelings from a distance, without judging them as being good or bad.

Mindfulness is practicing living in the moment, which is the core skill of DBT.

This group offers a brief mindfulness exercise designed to cultivate awareness, reduce stress, boost immune functioning, reduce chronic pain, and lower blood pressure.

Art Therapy/Collage

The most important guideline for this group is that people are asked to “check their (art) critic at the door.” No talent or experience is required.

Art therapy integrates therapeutic techniques with the creative process to improve mental health and well-being. It is based on the belief that the creative process involved in artistic self-expression helps people to resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and self-awareness, and achieve insight.

In this one-hour group, people are given a theme and time to work, share artwork with peers, and give and receive feedback.

Open Art Studio/Creative Expression

This group offers patients opportunities to practice self-assessment by choosing what medium and method will be most useful and effective in the moment.

We use art, music, movement, and poetry to help people to explore personal potential and problems through non-verbal and verbal expression; gain insight; unblock and move forward; reconcile emotional conflicts; foster self-awareness, personal growth, and wellness; stimulate mental and physical activity; channel anger; and relieve depression.

Patients may join this 90-minute open format group anytime. Again: No experience or talent is required!

Trauma-Sensitive Yoga

This group is based on the basic yoga principles of connecting breath with simple yoga postures. The main objective is to help participants feel comfortable in their bodies.

In trauma-sensitive yoga, we focus on breath, movement, strengthening, stretching, and resting. Participants are in control over what they are doing with their body at all times, and the teacher is there to provide safe, professional guidance and to help students focus mindfully on particular dynamics (what muscles they are using, what it feels like to have their feet on the ground, what it feels like to breathe, etc.).

Modifications are demonstrated to accommodate a variety of abilities. Beginners are welcome!

Expressive Writing

This group is designed to offer patients an alternative means of expression through structured writing themes and exercises. The group both introduces writing as an expressive medium to novices as well as encourages more experienced writers to explore different topics and ways to utilize the medium.

Self-Assessment

Patients are given an opportunity to check in during this group. The focus is on developing awareness of thoughts, feelings, and physical sensations in the moment, which can be useful in managing safety issues.

Skills Workshop

This group focuses on creating individualized coping and crisis plans (CCP) for patients struggling with depressive symptoms, impulsive behaviors, and negative self-talk.

The CCP asks patients to identify thoughts, feelings, and body sensations at different levels of distress, then to identify strategies for coping that relate to each level of distress.

The specified format is introduced, and staff support is readily available. A variety of skills sheets are also available to address additional challenges. There are an initial check-in and time to work with staff support.

Health Issues

This group offers an opportunity for an informal discussion about specific health-related issues. Questions and concerns are encouraged.

Communication/Relationship Skills

Group members present current problems or impasses in one or more relationships and get feedback, suggestions, or problem-solving ideas about how to approach dilemmas in communication.

This group offers a forum to more effectively negotiate interpersonal relationships by speaking more directly to one’s thoughts, feelings, and wants. Patients are encouraged to share dilemmas and strategies from their own experiences.

This group often focuses on creating healthy boundaries and what makes a healthy relationship.

Symptom Management

This group begins with a discussion of stressors, common symptoms of stress, and stress-reduction techniques, followed by a brief relaxation directive.

This group provides a forum for patients to share their experiences, particularly their successes, in maintaining their safety.

The goals of the group are to improve self-assessment skills and patients’ abilities to effectively communicate to others the level of intervention they need.

Weekend Planning

The format of this group is as a check-in group giving patients an opportunity to share feelings and structures going into the weekend. Also, patients who attend this group are offered a variety of suggestions of activities to provide increased structure over the weekend when the group schedule is light and patients need to be more self-directed.

Topics include time management strategies, peer-facilitated groups, issues of maintaining safety and self-care, expressive arts projects, homework tasks, and unit activities.

Wrap-Up Group

This group provides an opportunity to wind down the day. A variety of topics are open for discussion, and time is allowed for individuals to share thoughts/feelings concerning treatment and goals as well as community issues.

Unit staff are available to answer additional questions. More information may also be found in McLean’s patient guides, including Guide to Arriving at McLean Hospital. Paper copies are available upon request.

Patients may also find this video about our admission process a helpful way to understand how it works. Watch now.