Dissociative Disorders and Trauma Program at McLean Hospital (2023)

trauma care

Patients stay in the program from three to seven days. The hospital stay is short and focused on acute stabilization and treatment of seizures and psychiatric disorders.

Follow-up planning begins immediately after admission.

Visitors are allowed according to program rules. Visiting hours are seven days a week from 2 to 8 p.m.

Please contact the patient's treatment team for more information. See below for more detailsvisitorbook page.

The nurse's station can be reached at 617.855.2512. Patient phone numbers are 617.855.3392 and 617.855.3372.

Patient phones are switched on between 7am and 7am. and 11 p.m. The use of mobile phones is also prohibited during these times. Limit phone calls to 10 minutes. Family members are asked to provide the treatment team with an unblocked number that is available during business hours.

Patients can talk to medical staff through emergency calls from 11:00 p.m.

As a courtesy to others in the unit, please keep quiet when talking on the phone.

When you answer a call, just say "hello" and you'll get a message if the person is unavailable. Please do not share patient information. It is important to protect the privacy of other patients - callers may not know they are calling a hospital ward.

Patients are allowed to keep and use their cell phones and other devices, subject to certain guidelines to avoid disrupting the program and other patients. In order to respect the privacy of all patients, no photographic equipment or recording devices are permitted.

If the patient's cell phone has a camera, he can only use the phone's functions. We ask patients to sign a contract on the use of mobile phones upon admission, in which they agree to this. When using the camera function, the patient must not use his mobile phone for the rest of the stay.

The use of personal laptops is limited to free time when there are no group sessions, even if the patient does not participate in the group. When you are constantly preoccupied with the "outside world," you miss opportunities for healing.

Cables for mobile phones, music players, laptops, etc. are kept in the nurse's station from 21:00 to 07:00. Patients should exercise personal safety and avoid cables. Patients are responsible for these items, so please do not leave them visibly unattended or in public places.

Our patients are admitted to the department with strict restrictions. A sharp object is any object that can cause damage, by itself or otherwise.

Examples include scissors, nail clippers, tweezers, cell phone and computer chargers, headphones, and other cables or tapes. Hair dryers are considered hot. All makeup or beauty products in glass containers are considered spicy. We do not allow razors, but electric razors are fine. Flat irons and curling irons are not allowed on site. We keep thread and needles in the office.

To ensure patient safety, the following items are not permitted in the unit: alcoholic beverages, medications/medicines, plastic bags, guns, knives or other sharp objects, matches/lighters, glass bottles, mirrors and glass frames.

Life in a ward with 20 other patients can be stressful. In order to maintain a safe treatment environment, it is essential to follow ward policies and maintain respectful relationships with each other and staff.

Important information

Patient wristbands must be worn at all times to ensure proper identification and administration of all medications.

Control

Each patient should see an appropriate staff member for screening every 15 minutes or more often as clinically indicated. The auditor is only responsible for audits and is not available for other activities, including employee interviews, during this period.

Checks take place throughout the night. Staff wear lenses and must see patients' faces to ensure patient safety.

Smoking

Smoking and possession of smoking materials is prohibited at all times. We offer nicotine replacement therapy and other help to quit smoking. Electronic cigarettes and vaporizers are not allowed.

Families should avoid bringing cigarettes or other smoking materials to patients.

property

Any packages or luggage brought in by patients or visitors will be checked by staff for security measures.

Patients are strongly advised not to bring items of sentimental or monetary value to the hospital. We cannot accept responsibility for personal belongings, including money.

Unit permissions and checkout table

• Level 1 (space limitation): the patient must remain in the unit
• Level 2 (out of ward with staff): The patient can leave the ward in groups with a member of staff

Patients must sign out each time they leave the ward and state the time of departure, destination and estimated time of return. If the patient cannot return at the agreed time, please call the department at number 2512.

space work

Nursing staff assign rooms based on the clinical needs of the individual and the unit as a whole. You can change your room at any time during your stay.

Patients are asked to socialize in the common areas and not be with each other in the rooms.

Patient rooms must be neat and clean. Fresh bed linen and towels are available in the closet. Soiled sheets and towels can be thrown into laundry bags next to the bathroom and shower.

dress code

All patients are expected to be changed by 9am on weekdays. For hygiene reasons, entry to the unit is not allowed. In general, sunglasses and hoods are not allowed in the unit. Do not wear hoods in bed.

meals

• Breakfast: 8-8:30 am
• Lunch: 12-12:30 p.m
• Dinner: 17:00 - 17:30

If there is a treatment-related reason why the patient cannot attend a group meal, they can notify the medical staff to arrange for the meal to be rescheduled. Patients have to clean themselves in the kitchen.

meds

It is the patient's responsibility to come to the doctor's office at the agreed appointments to take the medication:

• In the morning: 8-9 hours
• Lunch: 12:30-13:30 in the afternoon
• Afternoon: 16:30-17:30
• Night: 20-22 hours

Try to avoid asking for medication as needed during shift change reports (6:45-7:30, 2:45-3:30). and 10:45-11:30 am.

infection control

Simple precautions are needed to prevent the spread of infection and to avoid contact with blood and other body fluids (saliva, urine, feces, and vomit) that may contain germs.

• Wash your hands thoroughly after using the toilet, touching wounds, blowing your nose, or before eating or handling food
• Cover your mouth when you sneeze or cough. Use a tissue and be sure to throw used tissues in the bin
• Use only your own fork, knife, spoon, straw, cup, plate, etc. and avoid sharing food or drinks with anyone. Any food or drink that has been touched or partially eaten should be thrown into the waste container
• Personal items such as make-up, earrings, razors, nail clippers and clothes should not be shared
• Personal hygiene items such as toothbrushes, soap, brushes/combs and mouthwash are kept in patient rooms. They must not be left in the toilet where others could use them and must not be shared with others
• If clothing is stained with blood or other bodily fluids, wash it in a washer/dryer. Make sure you are using a hot water circuit. If necessary, seek the help of medical personnel
• Dirty or contaminated areas of the unit should be reported to the staff

These rules are for the protection of patients and staff. Please do not hesitate to ask the staff any questions or concerns.

Personal boundaries

We ask everyone to respect each other's boundaries. No physical or sexual contact is allowed between patients or between patients and visitors.

The case manager works with patients to determine treatment goals, manage symptoms, develop acute stress management plans, and help develop a follow-up plan. A case manager works with family members, key caregivers, and doctors that patients want to see. Patients meet with their case manager every working day except public holidays.

A psychiatrist is responsible for prescribing medications, helping with medical problems, helping with the treatment process, and working with local prescribers. Patients meet with their psychiatrist every weekday, and with another psychiatrist on weekends and holidays.

Each patient has a senior nurse and a team of mental health professionals. We encourage patients to take advantage of staff lectures during the day and evening shifts. This can help the patient focus on their performance, enable education and support skill development.

Other members of the nursing staff are the head of nursing and an administrative assistant. The head of nursing is responsible for the coordination of nursing services on the ward. The administrative assistant is responsible for tasks that ensure the smooth operation of the unit.

An expressive therapist runs a group therapy program. The unit offers a variety of groups designed to increase understanding of symptoms, develop skills and provide support in completing treatment work.

Our 21-bed student unit offers treatment for people who are depressed and in crisis for a range of difficulties including mood disorders, anxiety, post-traumatic stress, dissociation, substance abuse, self-harm and suicidal thoughts/behaviour.

The hospital's Dissociative Disorders and Trauma Program has developed a treatment model that addresses the needs of trauma survivors. Symptom control and stabilization are the goals of hospitalization, not exploration of traumatic experiences.

Respect

Our therapeutic approach emphasizes respect, cooperation and interpersonal relationships. Remember that our attitudes and behaviors affect others and respect other patients and staff even when we are frustrated.

Cooperation

Treatment planning is a collaborative effort between the patient and their treatment team. Active participation in the full range of treatment activities, including individual sessions and group programs, is expected and provides the greatest benefit upon admission.

Safety

Community members are responsible for their own personal safety and we ask patients to refrain from behavior that is harmful to themselves or others.

We strongly encourage patients to seek help with self-destructive urges before taking action and ask that you inform staff of any potentially dangerous situations that may arise.

Relationships

Relationships that develop in unity can be intense. Remember that everyone in the program gets help with their own problems and that it is the staff's job, not the patients' job, to help other patients. It is important that patients remain focused on their own healing, not on the healing of others.

We ask patients not to discuss past trauma or self-threatening behavior with other patients, either individually or in group sessions.

Please maintain the confidentiality of other patients.

We recommend that patients stay off the ward for the first month after discharge so that they can continue to focus on living in the community and not on the Dissociative Disorders and Trauma program.

program structure

The program for dissociative disorders and trauma is a short-term inpatient unit with an average length of stay of up to a week.

Patients are admitted to the department for a number of reasons and each patient has an individual treatment plan.

Patients are assigned to a treatment team that will care for them during their stay. Treatment is focused on stabilization and safety management.

Our group program includes a variety of therapy groups and activity groups that use open formats of discussion, art, movement and education.

The patient group plan can be found in the hallway on the board opposite the exit board.

We hope that the patients will find the group program useful. We encourage patients to ask questions and make comments and suggestions about the program.

Group therapy provides an emotionally safe place for group members to talk about what is happening to them.

In group therapy, members can provide each other with support, insight, and acceptance. Sharing experiences and giving feedback to others can help reduce the sense of isolation that patients may feel. Participating in a group process can help increase a sense of self-determination in the healing process.

Group norms are a set of expectations based on a sense of mutual respect between group members. These standards are intended to provide a reliable structure for group members to know what is expected of them and what to expect from others during a group session.

• Be on time for the group: Remember the five minute rule - joining the group five minutes after the start time is annoying and disruptive
• If patients need to leave early, let the team know at the start: Please inform members when leaving to avoid misinterpretation
• We ask patients not to discuss details of trauma, self-harm or suicide attempts: be sensitive to material and language that may upset others
• Try to create an atmosphere of mutual respect: no interruptions, side-by-side conversations or physical contact between team members
• Be a good listener: turn off your mobile phone during a group session to give your full attention to the group content and avoid disrupting the group process
• Do not bring food to groups
• Come to the groups trained and ready to participate
• Respect the privacy of others: Group discussions are considered therapeutic and may be shared with the patient's team if relevant to treatment. Be discreet when sharing material with others
• Patient involvement supports the team process

We encourage and expect patients to be actively involved in their treatment by participating in groups. A brief description of the purpose and structure of each group follows. Patient involvement ensures that groups are relevant and meaningful to each individual.

group descriptions

community meeting

All patients are encouraged to participate in this group, which provides an opportunity for the community to come together and start the day.

Specific goals include introducing new patients to the community, giving discharged patients an opportunity to formally say goodbye to the community, and providing a space to discuss specific community concerns, including any issues that may arise regarding the station.

Target group

In this drop-in group, patients have the opportunity to express their short-term goals for treatment and self-care. Feedback is encouraged, which ensures additional peer support.

PTSD

This group provides education and feedback about PTSD symptoms and managing those symptoms.

We use group discussions to facilitate a better understanding of how past traumatic experiences affect people in their current lives. Discussion also helps members explore and develop a wider range of constructive coping skills.

Stretching and walking teams

These groups provide a staff-supported environment that uses exercise to improve physical health.

DBT skills

Dialectical Behavior Therapy (DBT) combines cognitive and behavioral therapy with methods from a variety of practices, including Eastern mindfulness techniques.

In this group, we learn and practice specific skills needed to deal with emotional stress.

attention

Mindfulness is a state of active, open attention in the present moment. When you are conscious, you observe your thoughts and feelings from a distance without judging them as good or bad.

Mindfulness is the practice of living in the moment, which is a core competency of DBT.

This group offers a brief mindfulness practice aimed at increasing awareness, reducing stress, boosting immune function, relieving chronic pain and lowering blood pressure.

Art therapy/collage

The main guideline for this group is that people are asked to "check their (art) critic at the door." No talent or experience required.

Art therapy integrates therapeutic techniques into the creative process to improve mental health and well-being. It is based on the belief that the creative process of artistic self-expression helps people resolve conflicts and problems, develop interpersonal skills, manage behavior, reduce stress, increase self-esteem and confidence, and gain insight.

In this hour-long group, participants are given a topic and time to work, share artwork with peers, and give and receive feedback.

Open Art Studio/Creative Expression

This group offers patients the opportunity to exercise self-assessment in choosing the tools and methods that are most useful and effective at that moment.

We use art, music, movement and poetry to help people explore personal potential and issues through non-verbal and verbal expression. insights; Unlock and move on. to reconcile emotional conflicts; they promote self-confidence, personal growth and well-being. Encouraging mental and physical activity. channeling anger; and relieves depression.

Patients can join this 90-minute open group at any time. Again: No experience or talent required!

Traumasensible Yoga

This group draws on the fundamental principles of yoga to combine breathing with simple yoga postures. The main goal is to help participants feel comfortable in their bodies.

In trauma sensitive yoga, we focus on breathing, movement, strengthening, stretching and rest. Participants are in control of what they are doing with their bodies at all times, and the instructor is there to provide safe, professional guidance and help students focus carefully on specific dynamics (which muscles they are using, how it feels to have their feet on their body). floor, how it feels to breathe, etc.).

Mods are proven to be good for a variety of abilities. Beginners are welcome!

Expressive writing

This group aims to offer patients an alternative way of expressing themselves through structured topics and writing exercises. The group introduces writing as a medium of expression to beginners and encourages more experienced writers to explore different topics and uses of the medium.

Self-esteem

Patients will have the opportunity to check in during this group. The focus is on developing awareness of thoughts, feelings and physical sensations in the moment, which can be helpful in overcoming security concerns.

Competence workshop

This group focuses on creating individualized coping and crisis plans (CCPs) for clients struggling with depressive symptoms, impulsive behavior, and negative self-talk.

The CCP asks patients to identify thoughts, feelings, and bodily sensations at different levels of distress and then to identify coping strategies associated with each level of distress.

The specified format has been entered and staff assistance is immediately available. Various skill sheets are also available to complete additional challenges. There is an initial sign-up and time to work with staff support.

health problems

This group provides an opportunity for informal discussion of specific health issues. Questions and concerns are welcome.

Communication/relationship skills

Group members present current issues or impasses in one or more relationships and receive feedback, suggestions, or problem-solving ideas on how to resolve communication dilemmas.

This group provides a forum for more effective negotiation of interpersonal relationships by addressing one's own thoughts, feelings, and desires more directly. Patients are encouraged to share dilemmas and strategies from their own experiences.

This group often focuses on creating healthy boundaries and what makes a healthy relationship.

Symptom management

This group begins with a discussion of stressors, common symptoms of stress, and stress reduction techniques, followed by a brief instruction on relaxation.

This group provides a forum where patients can share their experiences and especially their successes in ensuring their safety.

The team's goal is to improve patients' self-assessment skills and ability to effectively communicate with others what level of intervention they need.

weekend planning

The format of this group is a drop-in group, giving patients the opportunity to share their feelings and structures over the weekend. A variety of suggested activities are also offered to patients participating in this group to provide structure on weekends when the group schedule is busy and patients need more self-control.

Topics include time management strategies, peer-led groups, safety and self-care, expressive art projects, homework, and group activities.

Integration team

This group offers an opportunity to end the day. A variety of topics are discussed and time is given for individuals to share thoughts/feelings about treatment and goals, as well as community issues.

If you have additional questions, the employees of the department will be happy to help you. Also see McLean's Patient Guides for more information, includingA guide to getting to McLean Hospital. Paper copies are available upon request.

Patients may also find this video on our intake process helpful to understand how it works.look now.