Posted by antennastoheaven on July 8, 2013, at 0:19:08
In reply to Is partial hospitalization right for me?, posted by antennastoheaven on June 6, 2013, at 3:48:43
I've been going to the program for over three weeks now. I was on PHP (5 hours a day) for two weeks, then dropped down to IOP (3 hours a day). Although I'm doing better than I was when I started this thread a month ago, I'm tired of going to the program and think I might drop out.
I'm OK now mainly because of medication. Unfortunately it's mostly just the same medication I was on a few months ago, which makes me functional but still leaves me unhappy; I did get some better ADD medication, though. The psychiatrist is unreliable, which has been an annoyance. The last time I saw her, the discussion was abruptly cut short, so I didn't have a chance to ask about when she might discharge me. During the previous week's visit, I said I wanted to get an effective ADD medication before finishing, and now I have that.
I don't get much out of the group sessions. My previous comments about not being able to relate to other group members still hold true. I haven't gained much of anything from hearing other patients talk about their issues. I've participated in group and tried to talk about my issues, but the feedback I get isn't very valuable - many times the only helpful commentary I get is from the group therapist. Educational content is minimal, and not very in-depth... the CBT topics we discuss are things I have already learned. I gain much more from weekly individual sessions with a therapist and using online resources and discussion forums.
I have not met all my treatment plan goals and don't expect to no matter how long I am in the program. This doesn't seem to matter, because it doesn't seem like treatment plan progress is ever reviewed by the staff... patients self-report progress every week, but there is no feedback from the therapists and no actual revisions to the treatment plan seem to be made. The only time I have talked to a therapist about progress in the program is when they are re-authorizing my stay with the insurance company, and the treatment plan has never come up during that time.
I've already mentally checked out from the program. I thought about it a lot this weekend and came to the conclusion that it's not helping. I really don't want to go at all anymore. I'm not sure if I can hold out until Thursday, which should be the last day my insurance company has authorized, and would be the first day I could be discharged since I should see the psychiatrist on Wednesday. Right now I'm considering telling them I am done when I go in tomorrow. My main concern would be with the insurance company - they will receive discharge information and will know that I dropped out. Would they do anything if I quit on my own? I suppose they probably would not authorize another intensive outpatient/partial hospitalization program in the future. My regular therapist and psychiatrist would also get notified that I dropped out, but this is less of a concern, as long as the psychiatrist will still write a note saying it's okay for me to go back to work. If I don't quit tomorrow, I do not intend to stay past Friday, as I'm expected to return to work in a week. I could extend my leave and disability if I felt there was value in it.
I now question whether I should have been referred to the partial hospitalization program in the first place. My depressed mood at the time I entered was the direct result of a medication I had started a month earlier; discontinuing that medication and going back to my previous medication was all that I needed to be functional again. The program was useful in giving me structure and responsibility during the time I was adjusting medications, but it only took me a few days to become functional once again. The core component of the program is group therapy, and I don't think this is effective for me due to personality (schizoid) and my specific depressive symptoms. I think my therapist should have been able to predict that I wouldn't get much out of the program; maybe she did, and wanted me to go to a higher level of care anyway. The program is not a good value for me given the high cost, and I think the money spent on this program would have been better used on TMS (if only the insurance company would pay for it) or more frequent individual therapy.
poster:antennastoheaven
thread:1044771
URL: http://www.dr-bob.org/babble/psycho/20130309/msgs/1046756.html