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Compass Young Adult Program
Treatment details & clinical protocols
By choosing a program that specializes in treating the special developmental needs associated with young adulthood, patients receive treatment specifically designed with their unique issues in mind. Staff members are experts in recognizing and helping patients manage the difficulties in transitioning into young adulthood.
Members of the treatment team work with the young adults in the program to help them navigate from having difficulties with self-esteem and development to a position of self-worth and empowerment.
Treatment approach
The Compass Program is based on treating the whole person. Treatment team members strive to understand and treat each individual on medical, psychological and social levels.
Often, young adults who enter our program have either not fully developed or have lost the healthy life and coping skills they need to function effectively. Using a rehabilitation model of treatment, our staff blends therapeutic approaches to teach and coach the use of adaptive skills. We also work with the patient to regain their sense of self and help them rekindle their potential and manage their symptoms.
Individualized treatment planning and treatment are essential to this program. A customized treatment plan allows each patient to capitalize on their strengths while they work on targeted symptoms among peers and experienced clinical staff.
For young adults with substance abuse issues, Compass integrates the 12-step addictions treatment model with traditional psychiatric interventions. Treatment for psychiatric disorders focuses on the effects that emotional difficulties have on navigating adulthood.
In all cases, Compass emphasizes the teaching of life management skills, coping strategies and social rehabilitation. Patients learn how they can function more effectively within their community, as part of their family and for themselves.
The treatment goals are to form personal and peer alliances that will empower patients to take responsibility for their recovery, minimize relapse potential and focus on life skills.
Treatment team
Upon admission, patients are assigned a multidisciplinary clinical team consisting of a primary clinician, psychiatrist, rehabilitation specialist, substance abuse/addictions counselor, when appropriate, and nursing staff. Patients are considered full participants in their treatment team.
Since Menninger is a teaching hospital, psychiatry residents of the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine have the option of choosing an elective rotation at The Menninger Clinic in their fourth year of education. Residents have the opportunity to experience the Menninger tradition that emphasizes focusing on the whole person—the individual patient’s physical status, social abilities and psychological state. Patients assigned to a resident are seen by both the resident and staff psychiatrist.
The primary clinician keeps in touch with the patient’s family and referring professional about the patient’s progress and discharge planning.
A utilization review manager also is part of the clinical team, ensuring that needed services are provided and allocated in a manner to effectively improve or eliminate any identified problems.
Assessment
Each patient receives a thorough medical, emotional, developmental and social diagnostic assessment. These evaluations help the treatment team integrate an appropriate blend of individualized therapeutic interventions to meet the young adult’s needs.
The team also considers patient and family history, since it is important to understand each patient in the context of their family and its history.
Team members share assessment findings during a diagnostic conference in which the patient’s diagnoses and clinical understanding are communicated along with an estimated length of stay, which correlates with the treatment goals. These findings are then shared with the patient.
The staff continues to assess the patient throughout their stay. Progress is reviewed on a weekly basis with the patient.
Core treatment program
All patients participate in treatments to help gain confidence, build skills and practice behaviors. The Compass Program features:
- Group therapy
- Individual therapy
- Skill-building groups
- Family therapy
- Specialized dual diagnosis groups
- Relapse prevention groups
- Discharge planning groups
- Medication therapy
- Therapeutic activities and recreation
Individual & group therapy
These therapies are central aspects of treatment and are provided by program staff. In order to facilitate an integrated treatment program, the patient's primary clinician serves as his/her individual therapist. A team of primary clinicians, social workers and nursing staff leads each group psychotherapy session.
Individual therapy provides the opportunity for in-depth understanding of a patient's problems and attention to problem solving through the developing relationship between the therapist and patient. It is sometimes the development of this basic trust that allows the patient to address deeper and more difficult issues.
Group therapy provides patients with the opportunity to share their issues and receive support while also providing the same to peers. Every patient’s situation is unique, but also overlaps with problems of others. Group therapy provides a sense of commonality of problems and experiences and allows patients to explore their issues in a safe and supportive environment with others in similar situations. Group methods range from psychoeducational to therapy and skills development.
Skill-building groups
Groups, such as anger management, interpersonal effectiveness, depression group, are part of the core program, to focus on issues such as social skills and relationships.
Therapeutic activities and recreation
The activity therapist coordinates an active program of recreation and skill-building activities that focus on work, play, learning and creativity—all integral components of everyday life.
Specialized programming
A wide range of specialty services, including disabilities assessment and neuropsychological assessment, are available, as needed, through collaboration with other specialty programs at The Menninger Clinic. Specialized programming is available for:
Patients with substance abuse issues
- Substance abuse evaluation
- Individual substance abuse counseling
- Substance abuse educational groups
- 12-step group treatment
- Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) groups
Patients with impulsive and anger management issues
- Anger management group
- Trauma group
- Dialectical behavior therapy (DBT) group
- Interpersonal relationships group
Medication philosophy & treatment
The use of medication, if needed, is discussed in detail since patients need to make the ultimate decision about what they put in their body.
A psychiatrist is a member of the treatment team and works with patients and other treatment team members in establishing the most effective medication regimen. Medications are used only when necessary and are based upon an appropriate diagnosis.
Upon admission, the patient meets with the psychiatrist for an initial assessment of medication needs. The medication regimen is reassessed through weekly medication rounds. Patients receive education regarding medication, intended effects and side effects so they can participate in monitoring and are prepared to assume responsibility for it after discharge.
Milieu therapy
The milieu is the supportive, therapeutic environment in which the staff work with patients on repair difficulties in relationships that can be applied during treatment and upon return to the patient’s family, work and community. The milieu provides structure, education and support.
A consistent routine is maintained, which fosters predictability and trust. Milieu structure assists patients in containing negative behavior and provides opportunities to remediate the behavior through staff and peer feedback and modeling.
A milieu is considered therapeutic when there is an environment that provides a sense of membership and belonging. Patients work with peers and with staff to take responsibility for the welfare of others in their community and the community as a whole. The therapeutic community provides a set of values and norms for behavior with the expectation that community members will participate in activities, value one another as individuals and learn to care not only for themselves, but for their peers.
The objective of the therapeutic community is to provide a safe, nurturing environment in which patients can develop a sense of trust in staff and other patients in order to share and scrutinize their problems, feelings and beliefs. The milieu provides the patient with an opportunity to integrate new and positive experiences, practice new skills and gain self understanding. Activities include a weekly community meeting, patient leisure activities and daily group activities.
Family involvement
Family involvement with the Compass patient is particularly important because, developmentally, young adults are struggling with how to become independent and still remain members of their family. On the Compass unit, we recognize that family members of patients are also experiencing distress. It can be very stressful to have a family member experiencing psychiatric illness and not know how to help them. In working with families we provide education about diagnoses and treatment options for families' loved ones.
Additionally, it is important for the Compass treatment team to understand the patient in the context of his/her family and the family's history. For this reason, the patient's primary clinician gathers a full family history from core family members.
With the patient's permission, the Compass staff will establish and maintain regular contact with family members to ensure as smooth a transition as possible for the patient's return to family life.
A family workshop is offered during treatment. Additional educational materials are provided to the family as needed.
Discharge planning
Discharge planning and relapse prevention strategizing are integral components of the Compass Program. Because the goal of treatment is to help the patient reenter society, discharge planning is an ongoing process.
From the beginning of treatment, the patient works as a member of the treatment team to set treatment goals, define where he/she wants to be when he/she leaves the program and establish an effective discharge plan that meets his/her needs. The team teaches patients to recognize potential triggers to relapse and to find ways of managing their symptoms to avoid slips.
In addition, the Compass treatment team works with the patient’s outpatient therapist to help set up a discharge plan to manage symptoms. If a patient does not have an outpatient treatment team or is in need of additional services, the Compass team will work to help the patient set up and implement a plan prior to discharge.
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