Minding the Brain Neuromodulation & Life Strategies PHP/IOP
Treatment at Yellowbrick is customized. Individuals whose psychiatric condition has persisted for several years and/or created safety risks and/or a period of incapacity to function within a developmental continuum have better outcomes with a more extended support platform and continued intensive treatment at varying levels of care to sustain an enduring recovery. While there is no minimum or maximum length of stay, Yellowbrick has created an 8 month/34-week treatment plan which has three phases:
a. Neuromodulation-Minding the Brain
b. Self & Skill Consolidation
c. Community Integration.
Yellowbrick’s experience is that most individuals require a minimum of 12 weeks to regulate their brain, restrain from defeating behavioral patterns and practice new adaptive actions, establish sustaining collaborative connections with staff, peers and parents, and initiate actions consistent with values, interests and ambitions. Yellowbrick’s most intensive PHP level of care is therefore organized around a 12-week neuromodulation curriculum. The groups listed below are specific to the Neuromodulation phase while the overall treatment plan during Neuromodulation also includes the remainder of the Life Strategies Program. Transition from The Residence to an apartment in Evanston supported by home visits often occurs successfully at the close of the Neuromodulation Phase of care.
Yellowbrick recommends for most individuals that there be a 4-week period of continued full-time programming following the Neuromodulation Phase with a shift to the full Life Strategies program within the Self & Skill Consolidation Phase. The next phase of treatment is an individualized 8-week extended period of Life Strategies IOP at a lower level of intensity. The last 8-week Community Integration segment of treatment involves individual and family work along with executive function and life-skill support while living in the community. Following transition from active treatment, Alumni in Good Standing are eligible for Tuesday and Friday night Community dinners, and Parents as Partners Sunday brunches with the Yellowbrick Community at no charge.
The above represents Yellowbrick’s efforts to provide several options in order to offer flexibility in response to the emerging adult’s clinical needs and the family’s varying financial circumstances.
NEUROMODULATION PHASE GROUPS @ YELLOWBRICK
BIOREGULATION OF BODY, AROUSAL AND RHYTHMS
Bioregulation of Body, Arousal and Rhythms is designed to explore the mind and body through the understanding of your body systems and how they affect one another. This group provides a fun, interactive, hands-on way to learn about the regulatory systems of the brain and body. This group will help provide a better understanding of how and why the Center for Clinical Neuroscience treatments relate and assist you in treatment; and it will provide additional tools for bioregulation outside of the group setting.
Interpersonal Effectiveness is a module of DBT that addresses how to change patterns of behaviors that interfere with the development and maintenance of healthy relationships. In this group participants will be offered focused education and practice of skills that can assist in identifying factors that interfere with the development of effective and mutual relationships, why they persist, and how they can be changed. The skill-sets to be discussed include: communicating and asserting one’s goals, maintaining self-respect, how to say “no” and tolerate hearing “no,” maintaining relationships, how to end destructive relationships, and how to build new, healthy relationships. Group members will be asked to participate in-the-moment by demonstrating skill practice through role-play, supportive worksheet, and group discussion.
INTIMACY, SEXUALITY AND DATING
This Group on Tuesday takes the same thematic course that the current Intimacy Matters II; the Friday Group follows that of Intimacy Matters I, intended to support the interests of those who identify as LGBTQI or as curious and questioning. Both Group sections address elements and dynamics that allow a relationship to develop and sustain intimacy, and how those elements and dynamics live within ourselves, given our own experiences with relationships. The change in title is to note that, while the group addresses intimacy in all types of relationships, some time will be devoted in particular to romantic relationships and sexuality.
This group explores mindfulness practices and how one can implement them in everyday life. The practice of abiding in awareness, non-critically and non-reactively, will encompass the heart of the group. Through practical exercises including meditation, visualization, and physical awareness, group members will cultivate the state of mindfulness. Reflections on the practices and discussion around how to bring them out of the group and into one’s own routine will be key to expanding mindfulness from an isolated activity to a lived experience. Group members will be encouraged to practice mindfulness each week outside of the group and bring those experiences back in for discussion. The group is appropriate for beginners and experienced practitioners of mindfulness.
Primarily a discussion group focused on different dimensions of self and identity. Each week a different aspect of self-identity is discussed. Group members will be given recommendations for how to explore that week’s particular topic further in their treatment that week.
THE JOY FORMULA
Drawing from the field of positive psychology and extensive clinical research on the connection between joy, resiliency, and health, this group will explore how cultivating positivity can bring about healing and thriving. This playful and engaging group will include creative and mindful exercises, educational information on the connection between joy and health, and activities to support personal goals toward a positive outlook on life. Even those who currently feel that joy is out of reach can benefit from practicing exercises related to gratitude, loving-kindness, and hope. This group will actively enliven the brain by practicing positivity and hopefully find that joy is accessible to all.
LIFE STRATEGIES PROGRAM GROUPS @ YELLOWBRICK
Treatment within LSP is directed at helping the emerging adult develop self-acceptance and expression, emotional and behavioral self-regulation, satisfying interpersonal relationships, educational and career skills, and life skill competence. Guided by skilled, experienced and compassionate professionals who are dedicated to accountability and outcome, Yellowbrick addresses the complex developmental needs of emerging adults.
The LSP members receive additional professional services within the Consultation & Treatment Center. These services are individually prescribed and evolve as the emerging adult evolves in treatment.
The intent of the LSP is to facilitate developmental processes of identity integration, self-regulation and life skill competence support for engaging in school, work, and in community service is viewed as essential to the treatment process. The model incorporates the surrounding Evanston and Chicago community as an essential component of the Yellowbrick treatment experience.
Group Program Descriptions
- Educational Discussion
- Specialty Programming
I. EDUCATIONAL DISCUSSION
ACT is a model of psychotherapy which uses the practice of mindfulness to help group members learn to become more objective observers of their own emotional experience. This allows for greater flexibility in dealing with various stresses of life and the normal psychological pain they can engender. ACT encompasses six core principles:
- Cognitive defusion: techniques to spend less energy and effort trying to change or prevent spontaneous private mental experience.
- Acceptance (or radical acceptance): welcoming all thoughts, regardless of their negative or positive content.
- Being present: openness to contact with the immediate moment
- Observing the self: becoming aware of oneself as a consciousness with the capacity to observe spontaneous thoughts, feelings and sensations.
- Values: identifying what is important to the observing self
- Committed Action: following one’s values and behaving according to them.
By practicing mindfulness meditation, in the group and on a regular basis outside of it, members learn to separate their observing selves from the various thoughts and feelings their minds offer them. This makes it more possible to decide and behave according to one’s values, rather than fusing with thoughts and feelings and acting on them automatically or impulsively. Didactic presentation, mindfulness meditation exercises, and intragroup practice of core ACT principles are all part of this group.
Attachment styles and associated coping patterns are developed from infancy and beyond as mentalizing occurs in our earliest relationships and our life narrative unfolds. This occurs at the neurobiological and relational level with experience directly forming brain organization. Emerging adult brains are developmentally open to structural change through changes in relating. In this group members learn about the attachment process and identify their primary attachment style. Discussion focuses on how it developed and is reinforced in relationships in the present. Further focus on coping styles and self-regulation offers members opportunities to work on challenging and strengthening personal patterns. Group members set and regularly review progress on concrete behavioral goals toward achieving earned secure attachment. The ultimate goal is to improve upon problematic attachment patterns and promote the maintenance of healthy relationships.
Community and Career Transitions group is designed to meet the needs of individuals preparing to transition from the Residence to independent living. Members are encouraged to talk about how they envision their future (career, school), and discuss past educational and vocational experiences to build insight into current needs. Related cognitive, social and emotional topics are discussed. The seventeen week curriculum covers a range of topics designed to promote successful transition out of the Residence/LSP and into the community at large.
Yellowbrick offers 2 elective options on a 12 rotating basis that are chosen by the community at that time. Suggestions come from peers and staff. Topics thus far include: perfectionism, guided meditation, anxiety management, dating & intimacy, creative writing, therapeutic improv, sexuality and shame resilience.
This group focuses on strengthening the emerging adult’s core life competencies. Group members identify barriers creating resistance to change as the first step towards self-efficacy. Applying that knowledge, members actively engage in activities designed to foster personal responsibility, motivation, and commitment. This group combines didactic, discussion, and experiential modes of learning.
Mind Matters group offers cutting edge education about the brain and connects this information to practical implications. Participants are encouraged to be curious about their brains and how daily habits such as diet, exercise, sleep and social interaction affect their brains. In addition to learning how to best care for their brains, members also learn about the impact of mental illness, substance abuse and other destructive behaviors. The education component includes discussion and practice of mind exercises such as mentalizing and meditation as additional tools for healthy mind/brain functioning. Information from the latest neuroscience findings is included.
In this interpersonal process group the focus is on relationships among members as well as the content of what is discussed. Many of the skills learned in other Yellowbrick formats are practiced in this relational group. Participants share their own experience and hear how others approach similar issues and problems. Those in the group receive vital support and encouragement while also being challenged by peers and staff. Each emerging adult in the group can try out new ways of experiencing themselves and others in a safe, supportive environment, as well as learning how they are perceived by others.
This group begins each day of Yellowbrick’s intensive group programming. In order to maximize individual’s capacity to benefit from the day ahead, members are guided to ground themselves in the present moment and identify what approach to their day will benefit them the most based upon their current needs. Out of this self exploration each member clarifies and shares with their peers an intention for the day that helps guide them as they participate in the group program.
This process group is divided along gender lines and focuses on both content and relationships among members. Discussion centers around the influence of gender roles, life experience, same gender friendships, intimate relationships, gender identity, and self experience. The group also focuses on educational aspects of sexuality, physiology, history of gender roles, and health as they arise. Relationships between members of the group are explored in a safe environment which allows others to reflect on their relationships within the here and now and perceptions of self and others in the group.
Narrative or storytelling is a natural extension of mentalizing. Reflections on present and past of what may be fragmented emotions, thoughts and behaviors are organized into a coherent self-story. This allows critical experiences to be integrated into a life story rather than persist in fragments that may contribute to anxiety, disconnection and other psychiatric symptoms that interfere with functioning. It contributes to the formation of identity and gives meaning to experiences that may stand alone in time. Multiple meanings may be constructed about experience as the facilitator leads the process of deconstructing individual narratives through careful questioning. This process helps the individual distinguish the self from his or her problems. Group members are encouraged to be active listeners and to provide feedback and support.
This group closes each day of Yellowbrick’s intensive group programming. Members are guided to reflect on the days experiences and identify important learning experiences or positive themes. This both consolidates the day’s events and activates their frontal lobes, the part of the brain that is charged with emotional regulation and determination of the personal meanings of experience.
This twice weekly meeting is the only group within Yellowbrick which is required as the issues under discussion involve or affect everyone within Yellowbrick. The Community Meeting is focused on affirmation and acknowledgement of individuals and relationships both for their positive or problematic contribution within the community process. It is chaired by the Community Chair and the Vice-President for Clinical Operations. Absence leads to being ineligible for Yellowbrick payment for meals at Community Dinners Friday and Saturday night and the possibility of being placed on Jeopardy Status.
Art Therapy provides a safe and structured environment where individuals can explore emotions with both traditional and non-traditional media. Emphasis is placed on the creative process rather than the product. Unconscious feelings and internal conflicts may be brought to the surface and resolved symbolically. The art therapist facilitates dialogue with one’s own art. The therapeutic value offered by meditation on art is generally an infusion of imagination and awareness rather than a specific answer. It is the role of the art therapist to help find comfort in this. Art provides an experiential versus a verbal experience in which healthy solutions to problems, increased self-esteem and self-awareness may be found.
As emerging adults move toward greater independence it is critical to have opportunities for informal social connection. Connections Group is one of a number of places within Yellowbrick where this occurs. This group meets daily during the lunch hour and is comprised of people with and without eating disorders. For individuals who struggle with eating disorders, eating itself may cause anxiety, and often requires skilled support and accountability. Eating with others may pose further difficulties. The emphasis is upon making this usually challenging part of the day easier for these individuals while providing nourishment in a non-threatening supportive atmosphere. For those without eating disorders it provides a relaxed social networking opportunity. Participation offers a forum to get acquainted outside of the therapeutic environment while making connections with one another.
The purpose of the Community Council is to enhance communication among the patient, professional and administrative members of the Yellowbrick Community and ensure that issues important to the mission of Yellowbrick are addressed in a timely and effective manner. This meeting is attended by elected representatives from the patient community, the Director of the Residence and the VP of Clinical Services, but also invites all within the Yellowbrick community to participate. It is co-chaired by the Community Chair and the Vice-President for Clinical Services. The Council is part of the official administrative process within Yellowbrick as it is asked to consult to the Directors Group on administrative decisions regarding program development and policy and procedure. Recommendations from Council are discussed at Yellowbrick’s Directors Meeting and the Yellowbrick Community Meeting.
Every emotional experience has a bodily component. In traditional psychotherapy the focus is primarily on word-based thinking. Narratives alone can keep therapy at a surface level and deeper emotional trauma may remain unresolved. An over-emphasis on logical, linguistic, linear and literal thinking may tilt the balance of our minds away from the important sensorimotor, holistic, stress-reducing, image based self-regulatory functions of our non-verbal modes of processing experience. This group focuses on turning toward the body with mindful awareness of here-and-now sensory experience. This opens the pathways to integration and deep emotional healing becomes possible. Yoga instruction either individually or in groups assists in the development of a centered sense of self, mindfulness practice, and an affirmative, empowered relationship to one’s body. While universally useful, this approach is especially effective for individuals with histories of trauma, eating disorders and somatization.
III. SPECIALTY PROGRAMMING
The Substance Abuse Services Program is designed to meet the needs of individuals with a history of substance abuse or problematic use of drugs and/or alcohol. Yellowbrick’s relational model emphasizes the primary importance of interpersonal relationships for mental health. We understand that individuals with substance abuse have replaced their primary attachment to individuals with a relationship with the drugs/alcohol. This group helps individual’s identify the needs they have in relationships and obstacles to engaging effectively interpersonally. Members are encouraged to participate in evening IOP consists of 3 hours of group treatment divided into 3 interrelated components.
ASP Mindfulness is an experiential group that group rotates seventeen weeks of art therapy and seventeen weeks of separate men’s and women’s yoga.
ASP Education & Discussion Group helps members understand their relationship with substance abuse and the effect it can have on all areas of their lives. This group rotates seventeen weeks of two curricula. The first focuses on the powerful relationship between shame and substance abuse. The second focuses on the principles behind the 12 Steps of Alcoholics Anonymous. Relapse prevention techniques are discussed and Twelve Step participation is strongly encouraged.
ASP Interpersonal Group Therapy provides an open forum for members to explore the experiences and feelings associated with substance abuse and the struggles that are often associated with early recovery. This group promotes creating a sense of safety within which peers can share their fears and struggles and work together to try and find meaning and fulfillment in life without mind altering substances. In this interpersonal process group the focus is on relationships among members as well as the content of what is discussed.
Substance Abuse Services Program More Information
The Eating Disorder Program consists of 3 ½ hours of group treatment that are part of the Eating Disorder Service. The group treatment is divided into three interrelated components.
EDP Experiential Group alternates seventeen weeks of Art Therapy and Yoga. These therapies (described earlier) emphasize the importance of accessing emotions through non-verbal experiences and emotionally arousing techniques, which focus on the relationship between the body, self, and the eating disorder.
EDP Symptom Management Group/ Peer-Supported Meal offers an opportunity for the group to eat together with the Registered Dietician. The goal is to have an enjoyable and successful meal experience; socializing, receiving and offering support as indicated and enacting individual food plan goals. Symptom management goals from the previous week and the experience of efforts to achieve them are discussed. DBT and other effective strategies are reviewed.
EDP Interpersonal Group Therapy explores the experiences within oneself and relationships that contribute to the origin and sustenance of the eating disorder. Patients discuss their relationships both within and outside the group and their feelings about their struggles in treatment.
Eating Disorder Program More Information
This evening group IOP is available separately for men and women who have experienced interpersonal trauma involving violence and/or the extreme or persistent violation of emotional, physical, or sexual boundaries. Within the context of the latest neurobiological understanding of trauma and traumatic attachment, the impact of trauma on the body, and the psychology of mindfulness, this group focuses on how trauma influences one’s self and interpersonal relationships in the present. Based upon the research of trauma expert Bessel van der Kolk, this group adheres to an interpersonal focus format with the addition of techniques for managing sensorimotor aspects of traumatic memory. The group is divided into 3 interrelated components.
Trauma Recovery Mindfulnessis an experiential group that rotates seventeen weeks of yoga with seventeen weeks of art therapy.
Trauma Recovery Education & Discussion Group teaches the Becoming Safely Embodied skills developed by Deirdre Fay.
Trauma Recovery Interpersonal Group Therapy provides a forum for the development of increased safety as issues related to trauma are explored and identified as they arise both in content and within/between the interpersonal relationships in the group.
Issues specific to men and women are addressed in the education/discussion component, as they arise in the interpersonal group and via the separation of all group components.
Trauma Recovery Program More Informaton
At Yellowbrick, emerging adults find their way home.
For more information, please contact Yellowbrick at 847-869-1500.