Jump to content

Any good - private inpatient intensive CBT/ERP Treatment ?


Recommended Posts

Has anyone any experience of intensive inpatient CBT/ERP programmes please? Are they any good. How could it work alongside with the NHS programme - could it even? Should we see how the NHS goes and hold the intensive one in case its needed later?

The reason for asking is despite our son at 18 recently disengaging with his CBT/ERP (after 5 out of the 14 funded sessions wed waited since December till May to start these ) treatment and frankly not being able to focus very well on much without being distracted by his thoughts, he still hopes to be able to return to school in September 2014 and attempt to start his A level course for the third time, having started his lower 6th twice ( once in 2012; second time in September 2013) and having to stop on both occasions after a few weeks due to his poor mental state. He is a very bright chap and wed like if we can to help him hang on to this ambition but equally we recognise that this may not be possible and hell have to change his future pathway. At this stage I am focusing simply on getting him well as without this he cant od very much at all hes been pretty much stuck at home for 2 years and has become reliant on us for giving him experiences outside the home all friend ad hobbies etc have stopped.

He has just had to change his therapist as it wasnt working. Cross fingers the new one will work. But with September school start only 7 wks away his plan doesnt seem very plausible unless miracles happen.

However I know at home that with persistence we do get somewhere in getting him to understand and talk about what is happening to him its very hard work and can be upsetting for us all . So goodness knows how the therapists will manage!

Our son likes action he is impatient for results but struggles even talking about his obsessions so it s very hard indeed for any doctor or therapist to get very far very fast even to simply understand how the OCD works for our son so that they can design the ERP etc. (his OCD is mostly but not entirely mental and is pretty much all day constant). And our son finds it terrifying to do the homework etc . So it may just be he just isnt ready to really do the CBT/ERP at all .

Anyway we wondered if we can somehow supplement his NHS 1hr/wk CBT /ERP with an intensive inpatient programme to get him better for September. This would be for 11 nights (or possibly over 3 or more weeks but this needs to be planned in advance). It includes 20 hours of therapy over the 2 weeks plus a therapy assistant and relevant occupational therapy for exposure tasks and some group work as part of the community in the residential unit. Its not cheap - but neither will be my son living at home with us for the rest of his life and his life being wasted.

I made some good headway today with my son showing him the stories others have shared with me about how they wished they had done their CBT/ER sooner. So I am hopeful he will this time engage with his CBT /ERP which is why it makes we think maybe the intensive programme could be worth- while.

I dont want our son to lose out though on a slot in the NHS sausage machine as he may need it long term!!

Any thoughts gratefully received. Thank you.

Link to comment
Guest paramoregirl

Hi there,

I'am 32 but had inpatient treatment at cygnet health godden green. They have a special adolescent unit there as well but I was on the adult ward. It was very good, I couldn't fault them. I was there for just under a month ( I had private health insurance then). I think it's pretty expensive but check out their website. I had an excellent psychiatrist.

Link to comment

Hi Littlefoot,

Anyway we wondered if we can somehow supplement his NHS 1hr/wk CBT /ERP with an intensive inpatient programme to get him better for September. This would be for 11 nights (or possibly over 3 or more weeks but this needs to be planned in advance). It includes 20 hours of therapy over the 2 weeks plus a therapy assistant and relevant occupational therapy for exposure tasks and some group work as part of the community in the residential unit. Its not cheap - but neither will be my son living at home with us for the rest of his life and his life being wasted.

Would you feel comfortable saying who's providing the intensive treatment you're thinking about?

That's really what it comes down to tbh with you, if it's somewhere like The Priory I shouldn't imagine you'd have any problems with the level of expertise and care provided, but there have been some horror stories where the intensive treatment's been abysmal via the private sector and actually set the person back in their recovery.

Hal

Link to comment

Can I just ask though, I think your son has been under the Maudsley? Im not sure there is going to be anything better in the private sector. My son talked about going into the Priory several times, but his psychiatrist (who was based there) said that the problem is you would have therapy for some of the day, but the rest of the time you would probably be left to your own devices and this was the worst thing for OCD. Some places have day therapy where you spend several hours a day there, perhaps that would be an option?

Link to comment
Guest paramoregirl

Yes where i was we had a min of four hours therapy every day ( varied from group, one to one, cbt, psychotherapy, dealing with anxiety, anger management, art therapy, physical exercise, trips out. We were always kept busy most of the time. The worst times were weekends though as nothing would be on so without visitors you got bored very quickly. I wish i had the money to go back to godden green. I really feel like i would benefit from going again x

Link to comment

Thanks for all this info.

It is at the maudsley ARDU unit is south london - under Dr Veale and Simon Darnley - has 20 hours therapy over 2 weeks ( possibly over 3 wks depending on ??? ) , a therapy assistant and relavnt occpational therapy for exposure tasks and some group work as part of community in the residential unit. Does this make a difference to anyones views please?

As we live so close we've been told he can come home at night .... not sure about the weekend daytime - a question to ask along with the time spent 'doing things' as I'd agree with paramoregirl nothing to do and no computer he would really struggle with his OCD .... mind you his PC fuels the OCD so not having it would be exposure itself! Does exposure therapy stop at the weekend - wil staff be off so basically it's a 5 day week job with the staff and 2 days tackling it on your own?

so overall sounds like I need to ask much more specific questions asking about how the time is spent. with 20 hrs therapy - if it is only over 10 working days then that's only 2 hrs per day and a lot of time to kill the rest of the time!

Let's see.

thanks

Link to comment
  • 2 weeks later...
Guest olivcart

Hi littlefoot,

Having read your posts there are many similarities in my son's situation. He is not at school at the moment but I am hoping he will be able to access school in some form in September although I think this is probably not going to happen. He is not engaging with CBT at Camhs and they have told him to have a break but he really just does not want to go. I was wondering if you have given up on the school thing for now or whether I should be more proactive in trying to get him some schooling - nobody seems to bother because he is in the sixth form.

Link to comment
Guest Annabel

Hi 1Littlefoot,

I'm really sorry to hear about your son. He must be very determined to want to go back to school (I'm in a slightly similar situation- going back to university for a third attempt [having had to leave twice due to OCD] of the 3rd year of my degree and I'm unsure if I'll cope).

I spent twelve weeks at the ADRU with NHS national commissioning group funding. There was one private patient there while I was there- he was at the unit for a fortnight and had more therapy sessions per week than the rest of us (we had 2-5 sessions of CBT per week whereas he had 14).

I wouldn't worry about your son having too much spare time- they try to keep you occupied with occupational therapy classes - pottery, cooking, art, play-reading, meditation and group classes (assertiveness, recovery and a weekly general community group) alongside CBT homework and tons of questionnaires to assess your symptoms!. There's also a dog that one of the housekeepers brings in if he feels like going for a dog walk and he could always pop into the local town for a coffee or to the community centre if he has space between therapy sessions. In the evenings patients sometimes go out for drinks, watch films or order take-aways.

I would say though that CBT at ADRU is much like CBT anywhere else- you have to be well enough to cope with it and 100% determined to follow their plan. I wasn't really and think I felt that they could have done things a bit differently there to cope with people who struggled more with therapy but c'est la vie.

Hope this helps!

Edited by Annabel
Link to comment

hello olivcart

sorry for delay in coming back to you. I can feel for you. IT's where we have been for some time ... but now are making some progress.

At least for now. and it's always .."for now'. I am learning to take one day at a time. but I am still doing everything I can to find ways forward for my son as you'll see on my endless posts .there's a point for my son in them all.

Re school we have found camhs next to useless. Their only interest was hoping he would stay at school since doing anything near normal is a help to combatting OCD. since he was at a very high performing school and started being ill there long before he was a diagnosed they just wanted him out . so we had no help there either.

the upshot is that we have tried to persevere on his behalf by getting him into a private school but this also bombed as he was ill.

so what are we doing? Our focus has been to 1) try to get him accept the diagnosis and buy into treatment 2) keep him occupied and his mind active in any way we can e.g . online tutorials - can have a personal live tutor and write just as you would face to face; physical activities - just helping round the home ; cooking - getting him to think about and plan the menu; etc ... reading the newspaper; involving him in conversation.... anything to keep his mind ticking and focusing and concentrating.

I researched and found that to get much help you have to go down the statementing route - it's all very complicated . I'd say spk to OCD UK or OCD action and Young Minds (quickly before he's 18) and Mind - i asked the legal questions about what the state was obliged to do as well as the practical what can be done before having to flex muscles and take a legal route.My take was to avoid any statement /disability label as long as possible as it has big consequences to life eg insurance/work .... I think good advice from our GP. get the school onside and get them to work hard and make suggestions - they are obliged to.

there is financial help and I think that legally there is an obligation to provide a certain level of education in hours .... but it's not straightforward at all to get ... you need to ask the right questions to the right people.

For now I have abandoned this route and am focused on doing all I can to get him to manage the OCD believing everything else will fall into place.

I have abandoned a belief in the normal routes and have an open mind that education can happen at any time as long as he is well.

That said we are braced for him returning to private school and crossing fingers. we are doing this as the school was his junior school and he felt happy there. If this fails I don't know what to do ..... adult education college , apprenticeship etc .... not at all what we ever imagined.

hope this helps a bit. keep asking .... you'll build your own picture of what is possible.

keep in touch - we can share. I'll try to dig out the stuff I got - and paste in to this page.will need the weekend to dig it out.

if you put your query into the sources i said they came back within days.

good luck

littlefoot

Link to comment

thanks Annabel.

we've decided to go ahead with the assessment at the unit - they'll show us around too. my son sees the chance of intensive therapy to really nail OCD on the head ! the very fact he has said this ( at least yesterday - may change tomorrow) is a huge step forward.

i spoke with one of the therapists and I was very impressed. If he could get her I reckon he'd crack it!

will let you know so thank you for the insight as it's helped reassure us that it is indeed very intense.

LIttlefoot.

Link to comment
Guest olivcart

Thanks for your advice littlefoot. It is helpful to know that there are others out there going through the same problems as you - although it's something that we could all do without. I will see what advice OCD UK can give me re his schooling but like you I am beginning to think that the most important thing is to get them well and education can take place later. My son is also bright and hopefully that will stand him in good stead later on. I do hope your son can move forward with the intensive therapy he is having.

Olivcart

Link to comment

olivcart,

i don't know what you were thinking re level of education but I came across this article - worth looking at all the links too - and it has reassured me further that if our son does want to go on to unie etc he can ..... even if he doesn't do a levels at all! will need good batch of GCSE's :

http://www.theguardian.com/education/2013/aug/19/how-to-get-into-university-without-alevels

All sorts of things are possible - where there's a will there's a way! May be harder, longer, and not the norm so will need more explaining but it can be done.

I spoke to a young man who was struck with OCD at !7 -literally over night - he was hospitalised etc .... so really bad. but now he has managed to get back on his feet, take exams, get a job, have a long term relationship..... it's not the way he wanted .... but he says he"s a better person for it - more empathetic to others . he said he'd have otherwise done an office job - and been pretty much oblivious to others. would have earned more money but he no longer values that as much and is happy and healthy and no longer on medication.

I hope that helps a little bit more.

have a good weekend.

Link to comment
Guest olivcart

Littlefoot

Thanks for that link - very interesting. As I think school is probably too difficult a mountain to climb at the moment as my son won't engage in therapy at the moment and just gets angry if I try to bring up the subject. it does give me hope - not that university is necessarily an aim at the moment but it is good to know that there are ways and means if you work at it. the helpline said that I would have to wait until he really wanted to tackle his OCD and engage with therapy - that camhs don't always get OCD very well and that the transition to adult services might help with a different therapist - all that would need to be exhausted before he could be referred to a specialist centre. However until he wants to do it we can't move forward in that sense - he just thinks that all therapists are full of empty promises and won't go anymore.

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...