Papers By Yellowbrick Leadership
Jesse Viner, MD, CEO & Chief Medical Officer
Yellowbrick is a private healthcare organization whose mission is to improve the lives of emotionally troubled young adults. The Yellowbrick Consultation and Treatment Center provides comprehensive and integrated outpatient diagnostic and treatment services. Yellowbrick Residence provides meaningful and pragmatically effective psychotherapeutic and rehabilitation treatment for those young adults who require a therapeutic residence as an anchoring context for personal growth. The treatment process within all Yellowbrick programs aims at assisting individuals to:
- Experience self respect while acknowledging personal limitations;
- Engage self directed responsibility within the context of community membership;
- Develop and maintain mutually sustaining relationships;
- Develop expanding competence required for meaningful and purposeful living.
Experience self respect while acknowledging personal limitations; Engage self directed responsibility within the context of community membership; Develop and maintain mutually sustaining relationships; Develop expanding competence required for meaningful and purposeful living.
Yellowbrick Residence utilizes these organizing principles to inform the work of staff and residents. A supported living experience in a semi-urban apartment provides the setting for treatment. Within this setting, individuals address and take responsibility for their lives – past, present, and future. In this context professionals provide intensive outpatient services tailored to individual needs through the Yellowbrick Consultation and Treatment Center.
Yellowbrick Residence is located on Sheridan Road, one block from Lake Michigan, in the City of Evanston on Chicago’s North Shore. Evanston is a vibrant and diverse community with a population of 75,000 comprised of strong and active neighborhoods, thriving commercial and retail businesses and restaurants, and home to many young adults including students at Northwestern and Loyola University. Public services and resources are excellent, and transportation to downtown Chicago by “El” is only blocks away.
Yellowbrick Residence is a 4 flat apartment building with 3 three-bedroom apartments and a fourth two- bedroom garden apartment with separate entrance where up to fifteen residents will live during their treatment. There are Residence Resource Staff available at The Residence on a 24/7 basis providing a mature, supportive adult presence. Additional community space is provided for group activities, leisure, and the office of Residence Resource Staff and administration. While the Evanston community and surrounding neighborhood are quite safe, Yellowbrick employs keycard locks on all street access entrances and each individual apartment, an alarm system for police, fire, and 911, and a sprinkler system for fire protection. There is ample parking on the well-lit and trafficked Sheridan Road.
Who Are The Residents At Yellowbrick?
Yellowbrick is prepared to work with a diverse population of individuals suffering from psychiatric disorders, developmental difficulties, and unsuccessful previous treatment experiences. Prospective residents and their families must demonstrate motivation for treatment and a financial commitment to a minimum of four months length of stay. Individuals who come to Yellowbrick are strongly encouraged to anchor their lives within Evanston/Chicago and draw on the continuing resources and relationships which Yellowbrick provides.
Yellowbrick is a potential treatment setting for individuals whose psychiatric difficulties impair daily functioning and/or derail developmental momentum. Many individuals discharged from acute care settings require the continuity of an extended therapeutic residence where they can apply previous progress and further develop their internal resources and support system in Yellowbrick’s “real time” treatment model. For many Yellowbrick residents, office treatment with brief or partial hospitalization interventions has been unable to sustain a level of self-integration and stability to enable them to create and implement a constructive life plan. Persistence of symptomatic behaviors often rigidifies into insidious chronicity and disability, leaving the individual at risk for estrangement from family and personal demoralization. Continued living at home under these circumstances further distorts developmental needs and strains family bonds already weary from the turmoil and pain of psychiatric illness. A limited number of individuals may require a long term commitment to living in a Yellowbrick Residence at a reduced intensity of care to sustain the highest level of function and well-being.
Yellowbrick is appropriate for a diverse range of psychiatric disorders who share basic impairments of self-regulation and self-integration. These include but are not limited to eating disorders, substance abuse, post-traumatic stress disorder, anxiety disorders and obsessive compulsive disorder, depression and bipolar illness, and some psychotic conditions. Personality problems related to loss, trauma or abuse, the emotionally distorting effect of learning or physical disability or childhood obesity, or other troubled experiences often affect a person such that treatment efforts that are not intensive, extended, and offering a spectrum of psychiatric, psychotherapeutic, rehabilitative, and community dimensions prove inadequate even when provided by skilled and experienced clinicians. Yellowbrick was designed to reach out and engage these individuals.
Yellowbrick is not suitable for all individuals. Developmental disorders with reduced intelligence or severe limitations in relationships would not benefit from Yellowbrick’s psychotherapeutic approach. Individuals with histories of committing sexual abuse or violence and any crime involving trespass of physical safety to another person will be excluded. Persons with a history of antisocial behavior and an incapacity for concern for others are not suitable for a setting which relies on the community relationships as a cornerstone for treatment. Destructive impulse control problems such as promiscuity, rage attacks, lying and deception, shoplifting and other theft, lack of commitment to abstinence from alcohol and substances will be excluded or in jeopardy of administrative discharge. Random breathalyzer and urine toxicology are employed. Anyone bringing alcohol or substances into Yellowbrick will be subject to a treatment review process involving residents, professional staff, and the Medical Director which may result in administrative discharge. This will also apply to any behavior or other contraband that if misused presents a threat to the safety or integrity of the Yellowbrick or Evanston community. Yellowbrick Residence prohibits smoking except in designated areas outside on grounds.
Professional, Community, & Individual Responsibility
Membership in the community is a responsibility and privilege for all residents and staff. The treatment community, involving all residents and staff, is available as a supportive but not supervisory resource. Admission is entirely voluntary and adequate motivation and capacity to make use of the treatment is evaluated within the assessment process. Residents are expected to attend all treatments, and to learn how to accept help and to invite assistance from others to diminish symptoms. However, the treatment community does not assume responsibility for residents’ choices. It is accepted that residents may have periods of symptomatic behavior. Through periodic treatment review, Quality Assurance, and consultation, including residents and staff, it will be determined if persistent symptomatic behavior represents an inability to further benefit from Yellowbrick at that time. Acknowledgement of this and parting with referral is preferable to efforts at coercive control of behavior and personal choice.
Personal safety is considered an individual responsibility with the role of professionals and the community being to provide support for the resident’s struggle to maintain their self-regulation. All explicit threats to safety will result in transfer to the Northshore University Health Systems Hospital Emergency Room for psychiatric evaluation. The Yellowbrick Residence community assumes no responsibility for individual choices or behavior resulting in self harm beyond that of an informed, involved Good Samaritan.
Yellowbrick is not licensed as a hospital and is not an acute care setting. While residents may be struggling with distressing experiences and problematic behaviors, Yellowbrick is not indicated for patients whose psychiatric or medical condition requires skilled or nursing supervision for behavioral control or safety. Medications are stored in the Community Room if medication support is required or a secure individual safe. Symptomatic behaviors are anticipated and will be active as a focus in treatment. It is required that these behaviors do not place the resident or others at risk for personal or medical safety. On site Residence Resource staff will communicate with professional staff to determine if residents require temporary referral to Evanston Northshore University Health Systems Hospital for assessment on an urgent or emergency basis. A Yellowbrick Residence Resource staff member will be on-site as an adult resource at all times. A senior leadership person is always on call.
The intent is for Yellowbrick to function as a normative community setting where residents aged 18 and older are fully responsible and active simultaneously in their treatment and their lives in the Evanston area. Experiences in the Yellowbrick and surrounding Evanston community are to be processed within the treatment. Professional staff and the Yellowbrick community provide an intensive, skilled, and supportive platform of relationships and growth opportunities as an alternative to the behavioral control required in other settings. The Yellowbrick culture encourages 3 hours a week of volunteer work in Evanston. Many residents will additionally be working or attending school part- time. The Life Strategies Program is scheduled into early afternoon with specialty services such as eating disorders, trauma recovery, and substance abuse.
Yellowbrick Treatment Program
- CULTURE AND PHILOSOPHY
- Psychiatric illnesses are complex, derived from and maintained by multiple (biological, developmental, psychological, systems, and cultural) sources and therefore require multiple interventions directed at several levels of interacting systems.
- Treatment relationships create a safe context within which to authorize, empower, instruct, and support the experience and capacity for owning and assuming self directed personal responsibility. Successful treatment requires the development of intimate, emotionally resonating attachments.
- Treatment is prescribed following careful collaboration with individuals and families resulting in comprehensive assessment including: psychiatric evaluation, neuropsychological and personality testing, medical/neurological studies, motivational assessment, family history and evaluation, functional life skills assessment, substance abuse consultation, eating disorder and nutritional assessment and other specialty consultations as indicated.
- Treatment is directed at developing competence in mindfulness, self- acceptance and expression, emotional and behavioral self- regulation, interpersonal relationships, educational and vocational skills, and the tools for daily living.
- Neuroscience research guides the pattern, rhythm, and content of Yellowbrick programming. Attention is paid to developing normative nutritional, activity and sleep patterns. Early morning interventions consist of individual support for developing effective self-organizational skills and patterns. Initial groups are designed for introducing gradual arousal, mind-body integration and a structured goal oriented cognitive approach to the day. As the program proceeds, groups and interventions become more interpersonally and emotionally intense. Later there are opportunities to process and metabolize the emotions themselves and their personal meaning. Evenings and weekends provide skilled support for developing the capacity to structure individual time, sustain inner vitality, socialize, and play.
- Individual psychotherapy and family psychotherapy provide a required private space in treatment. If prescribed, these are provided at the Consultation & Treatment Center by Yellowbrick or affiliated professionals other than Residence Resource Staff. Individual meetings with therapists are focused on the utilization of treatment towards achieving life goals. All communications within individual therapy are discussed openly with all professional staff. There are no special, protected, or confidential communications among residents and staff within the Yellowbrick community. Requests for privacy within communications in contrast to confidentiality will be honored on a prescriptive basis. All behaviors, interactions, and communications within the Yellowbrick community process are considered public domain and open for discussion. Beyond the Yellowbrick community, confidentiality must be maintained and the failure to do so is grounds for administrative discharge.
- Psychopharmacology treatment may enhance the capacity to learn and make optimal use of other treatments.
- Staff are recruited and retained on the basis of personal integrity, professional expertise, commitment to honest personal examination and growth, empathic compassion and collaboration within all relationships, and commitment to continuing education.
- VALUES AND GOALS
- Affirmation of the individuality and dignity of emotionally troubled individuals.
Develop self- awareness and acceptance to affirm identity and foster positive change.
Identify and build on individual motivations, interests, and talents.
- Assumption of personal responsibility for one’s actions. Necessity for personal competence.
Understand the historical and current origin of symptoms and experiences.
Learn and practice self-management.
- Necessity for initiating and sustaining honest and mutually supportive relationships.
Explore experiences and patterns in relationships.
Develop communication skills for self- expression, listening, empathy, collaboration.
Notice and effect change in recurring patterns of self-defeating behavior.
- Membership and participation in a diverse community as an anchor for personal growth.
Express individual needs and identity while contributing as a citizen of the community.
Experience the affirming and healing power of interdependent connectedness.
Respect for individual freedom, choice, open expression, and innovation. Intolerance for coercion.
Discover, develop, and protect authentic voice, passions, and ambitions.
- Treatment outcome is facilitated by working together on actual life experiences.
Practice new behaviors and face challenges while working to collaborate with support resources.
- Passionate professional commitment sustains the imperative of successful outcome.
Staff recruitment targets integrity, personal maturity, expertise, compassion, mutuality, collaboration, and personal growth.
- Affirmation of the individuality and dignity of emotionally troubled individuals.
Residents will be challenged with all the actual tasks of independent (with roommate) living but also supported with intensive skilled support and resources. Skilled senior clinicians will provide individual, family and group services addressed at promoting self-integration and improving skills in the areas of emotional regulation, interpersonal skills, conflict resolution, problem solving, coping effectively despite symptoms, and the capacity to access help from others. Specialized interventions are provided for eating disorders such as meal planning, supported meals, post meal processing, shopping, and dining experiences, and cognitive-behavioral and experiential group therapies. Yellowbrick’s Professional Staff have extensive experience and expertise with dual diagnosis substance abuse. The program actively integrates 12 step approaches into the daily life of the residents.
An educational and career services program beginning with motivational assessment and continuing through job readiness, interviewing, resume preparation, volunteer work, or apprenticing, and job placement with coaching is available. Yellowbrick has a full time professional staff, the majority of whom have 15 – 30 years experience working with troubled individuals, directing treatment programs, and serving as teachers, supervisors, and consultants. While Yellowbrick is not a treatment program for primary substance/ alcohol abuse, it is recognized that the emerging adult is an “at risk” population. Therefore, Yellowbrick actively facilitates and supports involvement in Evanston 12 Step meetings and linking with sponsors. Residents are supported with breathalyzer and urine toxicology monitoring and there is group programming directed at compulsive behavior disorders.
Art therapy, psychodrama, self-hypnosis instruction, yoga, martial arts, self-defense training, prescribed exercise, and fitness coaching and elective activities such as community service projects, educational or recreational outings, relevant films with discussion, music, and art studio, gardening or prescriptive board games provide additional rich treatment opportunities. An occupational therapist will assist in daily self-organization and management as well as individual and group planning, goal setting, and execution, and in developing life skills such as managing a budget. Each individual will be provided a bi-weekly stipend and will manage their account for purchase of non-staple foods, other routine items, and special events. A Registered Dietician will provide assistance with shopping, meal planning, supported meals, goals, and strategies for eating disordered residents, and health awareness. Staff and often other residents teach cooking and baking and assist in the preparation of routine meals, Sunday brunch, and special events.
Medical and laboratory examination
Neurological imaging studies
Psychiatric evaluation and psychopharmacology treatment
Neuropsychological and personality testing
Family history and evaluation
Motivational assessment and capacity to currently make use of treatment
Functional life skills assessment
Registered Dietician nutritional assessment
Educational and vocational assessment
Physical activity/exercise and wellness assessment
Individual Psychotherapy (3x/ wk)
Interpersonal Group Therapy (3x/wk)
Narrative Group (weekly)
Resident / Family Rounds (monthly)
Resident / Professional Staff Rounds (monthly)
Residence Community Meeting (daily)
Yellowbrick Community Meeting (weekly)
Yellowbrick Community Council (weekly)
Dialectical Behavior Therapy
Parents as Partners Workshop (monthly)
Family Psychotherapy offered through strategic partner Family Institute of Northwestern
- LIFE SKILLS THERAPIES
Mindfulness and Mentalization Group
Attachment Pattern Group
Healthy Relationship Group
Community and Transitional Group
Individualized case management for treatment and strategic life planning
Educational and vocational assessment and counseling
Functional assessment and intervention by occupational therapist
Individualized self-management and organization training
Individual and group self-hypnosis instruction
Personal goals and strategies development
Individualized nutritional case management
Residence business meeting, budgeting, and checking account management
Rotating assigned chores and responsibilities
Prescribed staff supported activity; example: grocery shopping for individuals with eating disorders
- SELF DISCOVERY, EXPRESSIVE, AND ACTIVITY THERAPIES
Art studio with professional artist
Supported cooking instruction
Hosting of Family Night Dinner and Open House Brunch
Journaling, blogging, and letter writing
Meditation room and outdoor garden
Mental health related films with discussion
Open house Sunday brunch
Outings: (ex.): Concerts, Museums, Millennium Park, sporting events, etc.
Training in self-hypnosis, meditation, and relaxation techniques
- NUTRITIONAL/EATING DISORDER
Registered dietitian evaluation and case management (All residents 30 days)
Mind-body Integration Group
Eating Disorder Art Therapy
Eating Disorder Interpersonal therapy Group
FIG: Food Issue Group with Registered Dietician
Daily journal review
Supported prescribed food planning
Cooking instruction by
Prescribed activity level
Medical monitoring including weight, labs, EKG (through affiliated Northshore University Health System – Evanston Hospital physician)
Cognitive/ behavioral symptom management
Dialectical Behavior Therapy
Staff supported meals
Post-meal processing and support
Supported grocery shopping and restaurant experiences
- SUBSTANCE ABUSE
To sustain abstinence, all residents are seen for evaluated for by alcohol/substance abuse difficulties and case management is initiated in accord with principles of recovery and relapse prevention.
Random urine toxicology and breathalyzer
Residence “Home” 12 Step Orientation and Meeting
12 Step meetings in community
- EDUCATIONAL & CAREER ASSESSMENT, PLANNING, TRAINING and PLACEMENT
Educational and Career testing and Assessment
Prevocational and job readiness skill development
Job search and analysis
Interviewing and negotiating skills
Mandatory volunteer work
Job placement and apprenticeships with 400 employers
- COMMUNITY OF EVANSTON
Individual volunteer work and Yellowbrick community special volunteer projects
Employment in local businesses; supported partnerships
Local colleges and universities for educational and cultural activities; Columbia, Loyola,
Northwestern, Oakton Community College
Transportation by “El” and Metra within 5 blocks; 20 minutes to the “Loop”
Evanston Public Library
Evanston Art Center
Restaurants, Coffee shops, Bistros
Private theatre, dance, music, and artistic experiences and opportunities
- PSYCHIATRIC CONSULTATION AND MEDICATION MANAGEMENT
Residents receive a comprehensive review of their previous psychopharmacology treatments and a medication plan is implemented and monitored.
Medications are purchased by residents from local pharmacies which are self administered with staff support as indicated.
The medication treatment for all Yellowbrick residents will be the responsibility of the Yellowbrick psychiatrist and will require transfer of this aspect of treatment from the previous psychiatrist, if applicable.
- 24 HOUR CRISIS EVALUATION AND INTERVENTION SERVICES
One or more Residence Resource Staff are available on site at The Residence 24 hours / day, 7 days a week working in consultation with Yellowbrick senior professional leadership on call.
- MEDICAL AND PSYCHIATRIC HOSPITAL SERVICES
Available through affiliate Northshore University Health System – Evanston Hospital and Northwestern Feinberg School of Medicine.
Health insurance policies and managed care companies vary widely in their coverage for psychiatric treatment. Though it is possible that some of the costs for treatment at Yellowbrick will be reimbursed under insurance, due to the specialty nature of Yellowbrick and it’s setting in the community, FAMILIES SHOULD EXPECT TO PAY THE ENTIRE BILL ON A PRIVATE PAY (CASH) BASIS Fees for treatment at Yellowbrick fall into four separate categories:
- Room and Board – This is unlikely to be covered as Yellowbrick is classified as an Intensive Outpatient Program.
- Intensive Outpatient Program (IOP) – This type of program is often covered or can be negotiated as an alternative to inpatient treatment which is usually twice the cost.
Ask your carrier about an “individual case agreement” option.
- Professional Services – Individual & family psychotherapy and psychiatric medication treatment. This is usually reimbursed by most insurance plans.
- Medications – Insurance plans vary and reimbursement would be unchanged from prior to admission.
It is wise to consult with your insurance company prior to admission and receive a written commitment regarding reimbursement for treatment at Yellowbrick. Yellowbrick can provide a “sample bill” for the insurance company to review. Our staff will also take initiative in assisting you in negotiations with insurance companies. If necessary, Yellowbrick can provide referral to attorneys experienced in such negotiations.
Yellowbrick requires a written financial commitment of a minimum four months length of stay. Payment for the first 60 days is due prior to admission and the remainder at 6 weeks.
At Yellowbrick, emerging adults find their way home.
If you or someone you know could benefit from the community-based treatment programs available at Yellowbrick, please contact Yellowbrick today at 847-869-1500.