Effective Outcomes for Mental Health Treatment at Yellowbrick
Yellowbrick, located on the North Shore of Chicago in Evanston, serves as a national mental health center of excellence specializing in the treatment of troubled adolescents, emerging adults and their families. Yellowbrick offers an integrated spectrum of specialized mental health and wellness services including expert consultation and assessment, supported living platforms, state of the art neuroscience, research-based psychotherapy strategies, and life-skill interventions; within a sober, supportive peer community making effective use of the multiple resources and opportunities within the Chicagoland area.
How to Use Mental Health Treatment at Yellowbrick
One of the main reasons that the Yellowbrick treatment program can be helpful is because it offers so many opportunities for human interaction. Part of the advantage of this is that there are chances for young people who are struggling to meet kindred spirits, to feel and be less alone, to make friendships, to find support, and to substitute human relationships for substances and symptoms.
What You Can Do to Help Make Treatment at Yellowbrick Work for You
Patients sometimes experience the community as “living in a bubble,” different from the real world in that peers and staff are more understanding and tolerant of people’s issues than they believe people in the “real world” are likely to be. Alternately, sometimes people experience the community as all too real, bringing up painful realities that they may have preferred to avoid facing or thinking about. The fact is that there is truth in both of these perceptions. YB is a place where people have a lot of empathy and understanding and tolerance for people’s struggles and at the same time, it is a program that asks people to learn to talk about their conflicts with others, their own inner world, their problematic behaviors.
In fact, our experience tells us that it is inevitable that whatever core difficulties a person brings to YB, these will emerge in the cauldron of community life. If a person has been lonely and has had difficulty feeling a part of things, these feelings of alienation are likely to emerge here at some point, in some fashion. If a person has had issues comparing themselves to others or with competitive feelings, these are bound to come up. If anger has been a problem, or if the way a person has expressed it has pushed people away, it is almost certain that this problem will be expressed in that person’s relationships here and so forth. We refer to this phenomenon as the person’s core enactment, which is a core repeating pattern which expresses important, and usually unacknowledged aspects of ourself that we haven’t been able to express in words.
Sometimes, when this phenomenon occurs, the patient (and his/her family) feels worried and discouraged. “This is a therapeutic community! Why am I still feeling this way? Why is this still happening?” The answer, though it may not feel consoling in the moment, is that all of us as humans have a remarkably tenacious tendency to repeat our own long practiced patterns of relating to others, to ourselves, to our own feelings, even if these patterns have led to disappointment, danger or destructiveness. We all bring ourselves and our core patterns with us wherever we go. In treatment this is actually an advantage. Having these patterns enacted in our midst gives us the opportunity to work with them in vivo, in real life, in real time.
Yellowbrick is a community and a treatment program that is designed to take advantage of the reemergence of these core troubles: as opportunities to witness them as they are occurring in our midst; to understand them more deeply; to see how they may have been a person’s adaptation to difficult circumstances; to help the person judge for themselves if these ways of being are getting them where they want to go; to help the person see and to learn alternative ways of coping or relating.
A note about feelings: While the therapeutic work at Yellowbrick frequently focuses on helping patients to recognize and to articulate their feelings, our goal is to assist the individual in bringing emotions back into their rightful place as a part of the understanding of the self, alongside the person’s values, their needs and wishes, their thoughts. We recognize the importance of emotions, but we don’t value them any more or less than we do the person’s ideas or their value system. Ultimately outcome is defined by a transformed experience towards relief of distress, but also the choices and actions that are derived from thoughts, feelings and values.
How You Can Take Best Advantage of This Treatment Opportunity
- Show up. It has been said that 90% of success is about showing up. If you can learn to get up and get in to the program even on those days when you don’t feel like it or when your thoughts are telling you to stay in bed, you will have won more than half the battle.
- Be willing. To try something that stretches your limits. To try something that someone else suggests. To accept an invitation. To ask for and take someone’s help.
- Be honest. About your thoughts, your feelings, your behavior. Lying separates you from the community and from yourself.
- Practice behaviors and ways of coping that are different than the one’s which got you here. Try something new or something that is opposite to your usual way of being, like to come closer to people when you feeling like running away or to treat yourself with kindness when you feel self-destructive.
- Connect. Allow yourself to get to know others and let them get to know you.
Test this proposition: If I allow myself to show my vulnerabilities I will feel safer and stronger than I do when I hide them.
Avoid avoiding. This place works best as a community and for the benefit of each individual when difficulties between and within people are confronted directly.
Don’t be willing to keep secrets, your own or anyone else’s.
Struggle with intention of as and have respect for the basis of staff recommendations, especially at the time you feel you “know better” or feel something else “is right”.
Working to Earn Secure Attachment
Many people who come to Yellowbrick have significant difficulties in their relationships with others. Sometimes these problems cause patients to isolate and avoid connecting, or to engage in destructive relationships, or to believe that their self worth depends on a connection with a romantic partner. Frequently patients report that they have a hard time trusting others; that is difficult to depend on others or to allow others to depend on them; that they worry about not being accepted; that they worry about being or ending up alone. A growing body of research points strongly to the fact that these kinds of difficulties have profound effects upon life satisfaction, self esteem, the ability to feel comfortable with intimacy and with independence: all core concerns for emerging adults. The literature also clearly indicates something that is extremely hopeful: it is quite possible to develop secure attachment as an adult and a therapeutic environment like Yellowbrick is well suited to facilitate this process.
Here are some examples of ways that you can help yourself to work on this dimension of your life:
- Working on your relationships by
- Practicing turning to others for comfort
- Improving your ability to set boundaries and limits
- Having less tolerance for being mistreated by others
- Working on your emotions by
- Practicing recognizing and tolerating your own feelings
- Practicing expressing what you feel
- Learning to access your “wise mind” which integrates feelings and your good judgment
- Working on your self by
- Moving toward taking charge of your own life by being more active and less passive
- Practicing compassion toward yourself
- Practicing tolerance toward your own vulnerabilities and limitations
- Actively grieving past losses and traumas
- Working to develop “metacognitive” abilities by
- Being curious about yourself and others
- Cultivating “beginner’s mind” which isn’t too judgmental, open to possibility, which considers options
- Developing a coherent narrative, your own life story, which helps you to make sense of who you are and how you came to be you
How to Make the Most of Groups at Yellowbrick
In general, group treatments are most useful when you allow yourself to be actively engaged in them. This might involve bringing your own personal issues forward, it might involve asking questions if you don’t understand something that is happening or being said, it might involve offering some support or other feedback to a peer.
Sometimes people say that they hesitate to offer feedback because they don’t have a ready solution to a problem that a peer is discussing. They feel, “If I don’t know the answer, then I have nothing useful to say.” It seems usually to be true that what is most helpful to a peer is knowing that he/she isn’t alone with his/her struggle and feedback that conveys “I’m here, I’m listening, I get it,” may be the most useful and supportive thing a person can offer.
Constructive confrontation: We may believe that the only way to be supportive of another person is to agree with them or to say something sympathetic. We may have been raised or have come to live by the credo “If you can’t say something nice, say nothing at all.” Our experience, both in treatment and in our own lives, tells us that often the most useful feedback is constructive confrontation, e.g., “When you do that it really worries me,” or “When you treat me this way, it really hurts me and makes me mad.” A friend tells a friend the truth about the effect of his behavior.
Complaining when things aren’t going well: When we have grown up in circumstances where our words, our feelings, our requests were ignored or seemed to make things worse, we may have learned to give up our voice, to think that asking for or complaining about something is useless or worse. Groups provide an opportunity to challenge that assumption and to practice using your voice to say what you need or want or to complain about what doesn’t seem fair or right.
Is it still worth talking if nothing changes?: In short, yes it is. Because speaking out helps us to know ourselves and our own values and opinions, even if the other person doesn’t “get it,” or change as a result. Because speaking out helps keep us from harboring hidden resentments or fears and keeps these from corroding us from the inside. Because even if others don’t change, when we find and use our own voice we change ourselves.
What is valuable about groups?
- The main value of group therapy isn’t about the advice you get from your peers or the group leader, though sometimes you do get good advice.
- Groups offer an opportunity to observe your own process, e.g., the emergence of your core enactment(s) (explained later in the handbook) and to be able to discuss this. This involves noticing the role you typically play in a group and your reaction to the roles others play.
- Put another way, groups provide repeated opportunities to notice your typical way of handling interpersonal situations and also provide many chances to try handling them differently, e.g., to speak out when you are hurt instead of hiding out, to confront a peer instead of seething inwardly.
- They provide the opportunity to work on learning to establish or to reestablish trust with others.
- They provide opportunities to learn how to address conflicts and differences with others.
- They provide opportunities to learn how to recognize and speak up in regard to your own needs and to learn how to balance these in relationship to others’ needs.
- Groups provide opportunities to learn to express the full range of one’s emotions, to be sad or angry or frustrated or joyful.
- Many people come to Yellowbrick with an intensely ashamed sense of themselves as bad, defective, damaged. We know that shame grows when it remains hidden and secret and that the antidote for the shame within us is bringing it into the light of day. Groups provide opportunities to speak about the shameful parts of one’s self.
How You Will Know if You Are Progressing in Treatment
We all hope that treatment will help every patient both to behave and to feel better. We know, though, that even in the most successful, best conducted treatment, progress is not linear but may happen in fits and starts, or involve periods of progress and regression, or may cause some people to feel worse before they feel better. These phenomena may make it difficult for a person, and for their family, to judge whether genuine progress is occurring. Here are some indications that a person is making progress:
- You know yourself better, even if the knowledge is painful.
- If you have been numb or cut off from your feelings, you are beginning to be able to feel a greater range and depth of feeling.
- If you have been overwhelmed by your feelings, then you may begin to feel a bit less overwhelmed by them.
- If you are attempting things which make you anxious but don’t overwhelm you.
- If you have tended to withdraw, then you may be a little more willing to come out of your room, or to let others know when you are having a hard time.
- If you are becoming more likely to use words to express feelings or needs, rather than retreating into silence or using actions to express yourself.
- You begin to feel connected to peers and/or staff and that others know you and you know them.
- You notice that your relationships with important others, including your family, are changing- this may be that they feel more genuine or real and that things are beginning to feel more resolved or it may be that, for the moment, the relationships are more tense or conflictual.
It may be apparent from the above signs of progress, why it is that sometimes a person engaged in deep treatment may feel worse before things improve: approaching those things that have been avoided, while an essential part of recovery, almost inevitably is uncomfortable or frightening or painful in some way. If a person has tended to avoid conflicts, then beginning to address these is likely to raise anxiety and discomfort; if a person has used drugs or alcohol to manage their own emotions, then being sober may leave a person with intense feelings that they may not yet know how to handle well; if a person has had a history or trauma and denied or minimized its impact, beginning to face what happened and the toll it has taken will, of course, be a painful process.
How Parents Can Help the Process
- Attend and participate in Parents as Partners weekends and activities.
- Parents are encouraged to reach out and seek support from Yellowbrick’s Family Liaison. Yellowbrick will not routinely initiate communication outside of scheduled Family Rounds or Family Therapy but rather encourages you to determine your needs for communication. The Family Liaison is free to speak with you about all information which is in the arena of “Public Behavior”. The Family Liaison is the exclusive parent contact for routine clinical communication.
- Become familiar with the concept of connected autonomy. This may require tolerating discomfort associated with limited communication or periods of symptomatic behavior as a means of self-expression as issues get approached in treatment. It is often the case that a period of separateness is necessary in order to reestablish connectedness to self from which emerging adults can then re-approach family relationships differently from prior maladaptive patterns.
- Looking at family history/relationships is not about looking for someone to blame. It is about helping the emerging adult , and the family as a whole, gain a better understanding of how your emerging adult has taken inside the experiences of their history, how he/she has integrated his/her early experiences into their self-concept and view of the world, and the narrative which the emerging adult has created that has shaped their relationship to themselves, others and reality. The unique configuration of this is known as the individual’s core enactment. Yellowbrick’s approach to psychotherapy focuses on identifying and working within the real-time reliving of the core enactment so as to free the emerging adult’s relationship to their needs and feelings and their ability to bring that forward effectively within their relationships and community.
- Family Rounds is a strategic planning session within which the emerging adult speaks with family regarding the experience of treatment. Areas of progress and struggle are noted. Issues which relate to patterns within the family are identified and addressed as needed. If indicated, a plan for family therapy is identified. Treatment planning, including decisions about transitions and length of stay are explored. Parents are encouraged to bring questions that may not have been raised previously with the Family Liaison, including questions about finances or other issues previously screened from their emerging adult. Family Rounds is attended by the Family Liaison, Advocate and Medical Director.
- Family Therapy sessions have the goal of helping the family to observe interactions and mutual influences in the present, improve communications each members’ experiences, feelings and needs and negotiate areas that require problem solving. While appreciating and honoring the understanding of the how the shadow of the past falls on current shared experiences, the emphasis is on improving communication and negotiated problem-solving.
- Everyone in the family may feel challenged and even threatened by change. It is helpful to anticipate family system changes as well as changes in the emerging adult and the other individuals in the family. Your emerging adult may be creating problems for the family, but it is not helpful to view them as the problem from a family perspective. Symptomatic behavior in an emerging adult often has meaning about issues within the family or about that individual’s relationship to the family as part of the process of separating towards connected autonomy. When any one member of a family changes, this inevitably leads to changes in the family dynamic, often ones that are disruptive at first.
- Parents often focus early in the treatment on the priority of behavioral changes in executive function and plans for continued education or career plans. Most of the emerging adults who come to Yellowbrick have had their capacity to maintain routine role performance crushed under the influence of disabling emotional struggles and psychiatric illness. It is often necessary for an extended period of time for work on symptomatic relief and the untangling of emotional issues within the core enactment before the emerging adult is able to sustain meaningful efforts in these areas of life critical for adult responsibility and functioning.
- Treatment can be frustrating, discouraging and at times even infuriating for parents. It may raise issues of trust with your emerging adult and with Yellowbrick Professional Staff. You are encouraged to express these painful moments in treatment and know that they often occur at moments of potential transformation and profound opportunity for change.
At Yellowbrick, emerging adults find their way home.
For more information, please contact Yellowbrick at 847-869-1500.