What is your fantasy, idealized treatment?

If you could design your own “treatment center”, with no regard to limits on finances or what seems “impossible”, what would find most helpful to you?

I am not sure how this topic came up this morning, but I ended up having a long discussion with my mom about what my ideal treatment would look like. It does not exist at this time, but it is based on my experiences both professionally and personally. A lot of it sounds impossible with today’s treatment models and financial limitations, but I think, at least for me, it would be hugely beneficial.

I have found I need a certain level of intensity to safely and effectively get through my issues, so I would want something that is residential, however I would want to keep my freedoms (access to my music, animals, nature, ability to leave if I need a change of scenery even if it means going with someone, access to my positive coping skills, access to my social supports and the community). I would want access to supportive and trained people at all hours of the day and night (because let’s be honest, most crises don’t keep themselves to a schedule, so if one arises, I want to be able to deal with it appropriately in the moment); a holistic treatment team (medical, psych, yoga, animal therapy, arts and expressive therapies, CAM) that takes my input into account and helps me implement my ideas (as appropriate and available); a safe environment where added supervision is available, but personal choice is also a key component; staff that maintains a level of compassion even if I get super annoying and needy; availability for staff to decompress and engage in self-care as needed; down-time for myself to regroup from dealing with something very heavy without the threat of having all the support taken away just because I seem better in the moment; people who are open to challenging me on my trouble points but also understanding of places I may be stuck; flexibility in treatment plans; openness to new ideas and new ways of doing things; limited judgements on how I present and a willingness to look at what may be underlying my symptoms/presentation; freedom from stigma around any particular symptom, behavior, or mood-state; people who listen to and hear what I have to say; people with patience around helping me figure stuff out; people to help me build a vocabulary and a method of expression for things I cannot adequately express; people who are willing to sit with me through challenging times, and gently insist that I get through the triggered symptom to find out what’s “on the other side” of it (not simply implement grounding at the first sign of distress, because I have recently found that there’s important stuff on the other side of a dissociative episode or a flashback); catering my treatment to me as an individual, and respecting me as an individual with certain likes and dislikes; going at treatment with “kid gloves” knowing that sometimes things will get way worse and way more challenging before they get better; having a treatment team that is ok taking over when my judgement goes south, but still open and receptive to what I am trying to communicate… Also an openness to “thinking outside the box” and coming up with new treatment ideas if the current ones do not work. Also I would include a transparency in all treatment methods, with access to everything by the client, and ultimate veto powers by the client.

Therapy sessions would be daily, and for maybe 90+ minutes to be able to tackle the harder stuff, then have the therapist available later in the day as needed to address what comes up. Arts/expressive therapies would be daily, animal therapy daily, visitors allowed daily with housing for family either on-site or nearby as needed, assessments to figure out what is helpful, and what might be helpful, organic treatment plan that evolves with new developments. “Family” therapy available (with whomever is involved in the person’s life), ability to return to treatment as needed, creation of “safe spaces” to help with processing things, personal choice around negative coping skills until the person is in a place to change them, but with the stipulation that they must be reported immediately and checked out as necessary, and taken on an individual basis, with constant monitoring and revaluation. I understand this is a huge liability and highly controversial, but it’s something I feel strongly that an element of personal freedom makes a huge difference in getting over it in the long run. Teaching accountability and responsibility around choices would be a huge component. I know I can walk away from something much easier if I have a choice around it than it I am simply told I cannot have it or cannot engage in it. It’s like the concept of thinking about a yellow school bus when someone tells you not to think about it; you will think about it more, and likely obsess over it. If negative coping can happen in a safe environment with buffers to ensure overall safety, I think it would go a long way to helping a person turn away from those negative coping skills in the long run.

It would also be standard of care to always look at every symptom, no matter how un-related it seems, and not discount any “medical” issues that may arise simply because I am there to work on psych issues.

I would prefer this to be with easy access to secluded nature and the beach, because that just makes me happy, but I guess anywhere with access to nature and water would be good…

It would be incredibly expensive, and incredibly intensive, but I think it would work for me. A girl can dream, right?

So, if you could design your ideal treatment based on what has and has not worked for you in the past, or what you have seen work or not work for others, what would it be?

6 responses to “What is your fantasy, idealized treatment?

  • 0sername

    Your ideas sound brilliant – if that ever comes into existence, I want to know about it!

    My fantasy treatment would be at a centre somewhere that is really easily accessible in times of crisis – no hoops to jump through, no referral needed as long as you’re already on the books somewhere (at the psych hospital), and reasonable single-occupant rooms for all inpatients. You could talk to a psychiatrist at least a couple of times a week (if you want to), and everyone would be assigned a personal psychotherapist to help stabilize them, and pave the way for further recovery. I agree with you about favouring an intensive approach – in this centre you’d see your psychotherapist every single week day, for longer than 50 minutes. These people would be trained in all sorts of types of therapy, so if say CBT isn’t working out for you, it’d be easy to switch, with or without changing therapist.

    I think one of the most important aspect of treatment in this centre would be the attentiveness, thoughtfulness, empathy and respect of all the staff for their patients. Ideally they’d all be approachable, and they should all be good listeners.

    And finally, each patient would be highly involved in planning their care.

    I guess mine’s pretty expensive too, but like you said, a girl can dream!

    • Samantha Jane

      I would totally include all of this too! I am trying to come up with a comprehensive plan on the off chance that I ever get to pitch it to someone, and maybe make it happen… I really like the idea of ease of access, because sometimes it’s just insane the amount of red tape you have to go through to get into an effective program. I want something I could access as needed, immediately, and without a long wait. I would also not want to be discharged just because I have to take a break ffrom the intensity. I tend to need that same level of care again after a few days, so the flexibilty around having a distraction would be great.

      • 0sername

        Absolutely – currently I’m an ‘acute’ case with the local crisis team, which means there’s a team of people who know who I am/a bit about me, and I can ring them 24/7 if I need to talk or need help. Why not extend that so I could go inpatient anytime, and stay on the books as an acute case when I feel I need some time out?

      • Samantha Jane

        I wish there was somethign like that around here… even just for the crisis response at home, but also being able to go inpatient as needed to a competant and helpful facility would be great.

  • brokenbutbeingrepaired

    Ideally, it`d be very similar to yours. Though…if we`re talking ideals, it`d be better to have that in-patient support at home.
    We sometimes have extended therapy sessions, and they are so helpful, but it makes us realise how much more is needed.
    The most important thing for us, therapy-wise is choice. Our therapists were chosen by us, not for us and we see them freely.

    Hmm…have lots of ideas about the perfect set-up, but they are a bit scattered just now, so will probably come back to this post 😉

    • Samantha Jane

      Choice is a huge component for me also, however I understand that my need for intensity makes it hard to seek out only one or even two people as supports. Ideally, there would be choice in therapist seen, and that switching is possible and encouraged if not the right fit…
      I’m looking forward to hearing your ideas. I would love to be able to come up with a portal and actually make it happen at some point (definitely will need help and support on this, but it would be great if it could gotten). I find the current stagnation in treatment options really frustrating.

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