A partial hospital program is sometimes also called a day program. You spend the day at the hospital, but then go home to sleep.
My first partial hospital program was right after my first hospitalization. I lasted two days there.
This is the program that I mentioned in my post about how they sent me someone else’s records.
The social worker in my hospitalization set up the intake at the partial hospital program for me.
I told her two requirements I had for it:
1. It needed to be an adolescent program
2. I did not want to do DBT
When the social worker informed me it was set up, she told me my requirements had been met.
When I arrived on the first day, I quickly learned neither request had been fulfilled.
I realize now that avoiding DBT in this type of program is likely an impossibility, but I’d have appreciated her being upfront with me about this. To be fair she probably didn’t know the program contained DBT. But the reason for this is probably because she didn’t put any effort to find out.
My request for an adolescent program was reasonable. I was 19. My inpatient hospitalization had been with adolescents (their cut off was age 21).
There was a group of about 6 others in the program. I was by far the youngest. Most were old enough to be my parents.
I was very uncomfortable. I listened to people complain about their children and spouses. I couldn’t relate.
At my intake meeting a ‘No Harm Contract’ was presented.
‘No way’, I said ‘I will self injure if I want to and forcing me to sign that just will force me to lie. I’d rather not need to lie.’
The contract was pushed aside to be reevaluated in the future.
I left that meeting with the understanding that I had in no way suggested I would refrain from self-injuring.
I was very angry and aggressive (verbally, not physically). Largely because I was stuck at this partial hospital program because I’d been kicked out of school and possibly also in a small part because of a bad reaction I was having to Celexa.
I was under the impression that successful completion of this program was necessary to help my return to school. Despite despising the program, I felt I needed to stick it out.
The first day was a Friday. That weekend I returned to the school to move everything out of my dorm room.
Most was removed Saturday. Sunday morning I came to retrieve the last few items and discovered another person sleeping in what had been my bed and a large bong in the bathroom.
Monday I returned to the partial hospital program. The first day I had left my sharp items at home. I wasn’t sure what I was getting into (would my items be searched?) and decided it was in my best interests to leave them at home. Monday, the second day, I came prepared with a swiss army knife in my pocket. This seemed fine based on my experience the first day.
Inpatient hospitalizations are under-structured. Too much time with nothing to do. Partial hospital programs are over-structured. One group after another. Spending the entire day dwelling on problems, because the structure prevents one from going out and doing anything enjoyable.
I was frustrated with the way the people leading the groups spoke down to us, as if the depression meant we were cognitively challenged.
During the lunch break I made a few little tiny cuts on my leg. Very minimal, close to zero blood draw.
In the afternoon I had a daily check-in meeting with a social worker. As a side note I mentioned cutting a little during lunch. I didn’t think it was a big deal to mention. I’d never agreed to the no harm contract.
I was transported into an office with another woman (someone with a higher level of authority). She demanded to see what I’d used. I handed over the knife.
A lecture proceeded in a disgusted tone, wondering how I could have possibly thought it was acceptable to bring a “weapon” (aka a small swiss army knife) into a hospital.
She demanded to see the cuts.
I refused, explaining they were minimal and did not need medical attention.
She argued that because I had done it “on the premises” she had to see them.
I continued to refuse.
“I’d have to take off my pants to show you”, I protested.
She seemed unconcerned.
I was scared and eventually intimidated into giving in.
I tried rolling up the pant leg to show the cuts, but as I’d suspected the leg wouldn’t push up far enough.
I unzipped, pulled down my pants and showed her the cuts.
I felt very violated.
“Well there’s not too much damage this time“, she huffed.
That was it. The last straw. I announced I was leaving the program.
She bombarded me with questions assessing my current suicidal risk, trying to trick me into saying something to allow them to keep me there.
I didn’t fall for it.
My knife was returned and I went home.
I still didn’t have a therapist. While making phone calls to find one, many therapists refused to see me on the basis that I’d not properly completed the partial hospital program. I only was able to get into therapy (although this was my fake therapy, because anything I said was at risk of being reported back to my school) eventually when I left out the bit about the incomplete partial program.
There is just one thing Im not clear on.
Wht the anti DBT ? which is similar to Rational Emotive T or cognative Behavioural T which as far as I know works on behaviour and thaught process
Yea, that’s a topic that needs its own post. Short version. I was in DBT at one point and hated it. Also not a CBT fan. Basically nothing with ‘Behavior’ in it.
Yep looking forward to reading your Take on CBT ,DBT ,or rational emotive T
As some one who has had experience in both as a client
Dear goodness, what an experience. At least you had the balls to stand up to the people in the hospital. I am shocked at the lack of compassion…honestly, that type of response would make me want to kill myself.
I hate myself for giving into them though. I should have stood my ground.
I can understand your story TOCPM, and have seen that sort of approach in the medical field.
Compliance or the battle lines are drawn. A complete and total misunderstanding of what a no harm contract is meant to be. But as the person said above you do seem to be a very determined character, so good for you.
It’s interesting to hear other’s perspectives on this. I’ve been viewing it all these years as a total defeat and had been ignoring the parts where I stood up for myself.
I just found your blog, and am looking forward to reading back entries and hearing more about your experiences. I’m impressed at your ability to stand up to the hospital!
i understand about the DBT thing. A couple of years ago i was an inpatient at “Very Expensive and Useless”, a Matriarchy (UGGGGGGGH!!!!!!) somewhere in Texas and had s o m e DBT there…i hated it too. Basically the best part was making fun of the acronyms.
“PLEASE MASTER” “YES MAN” Hee.