Intensive Outpatient and PHP Choices

[Anonymous]

My 11-year-old DS is having increased difficulties with depression and anxiety causing struggles getting through the school day. It started with somatic symptoms and has blossomed to him expressing feelings of worthlessness, conflicts with peers during lunch/recess, and eventually him locking himself in the bathroom at school and refusing to come out. After the last event, he shared that he "didn't want to be around anymore" so we're taking it seriously and are considering Intensive Outpatient or Partial Hospitalization day programs. We are deciding between a few programs and wondered if anyone had recent experiences with any of the following:

Dominion PHP (no waitlist, in-person, 8-2:30pm)
Discovery Mood and Anxiety IOP- Columbia (short waitlist, in person starting next week, 3:30-6:30pm)
Pathlight Mood & Anxiety Center PHP- Baltimore (no waitlist, in-person, 9-3:30pm)

Inova, Adventist, and Shephard Pratt do not currently have programs for 11-year-olds. We want to help him in any way that we can and are struggling with sending him back to school before we get him stabilized. Funnily enough, at home he's happy and we're not experiencing any issues behaviorally. He has a diagnosis of ADHD, Anxiety, and depression and has been seeing a therapist weekly, and his psychiatrist every 6 weeks.

I've heard good things about Discovery, but he would be in a group with age ranges from 11-16 whereas at Dominion he would be on the pediatric floor with children up to 12. I've read mixed reviews on Dominion, and I'm not quite sure he needs a PHP program. Pathlight would be a shot in the dark and also the farthest from home. I haven't heard it mentioned on this board frequently. Thanks for any insight!

[Anonymous]

Hard no to Dominion.....there is a reason there is no waitlist. Have you looked at Embark? Have heard good things about Discovery.

[Anonymous]

In addition to Embark at Cabin John, Newport Academy in Rockville has a program, but I'm unsure of the ages. It's hard when they are young. Thinking of you, OP.

[Anonymous]

Anonymous wrote:In addition to Embark at Cabin John, Newport Academy in Rockville has a program, but I'm unsure of the ages. It's hard when they are young. Thinking of you, OP.

OP: Thanks so much for your kind words. Unfortunately, Embark starts at 12 and Newport at 13. I think we will try Discovery IOP, fingers crossed.

[Anonymous]

Discovery is your best bet. You won’t always have a choice—we’ve done many inpatients at Dominion but try not to do PHP there.

[Anonymous]

Is your child already on medication? I can’t tell from the first post OP.

[Anonymous]

Since he is already with a therapist and psychiatrist, those people should be able to offer their recommendations for his care. Taking things very seriously is good, but working with the treatment team you already have is the first step to finding something that works for your son.

What do those people say?

[Anonymous]

Anonymous wrote:Since he is already with a therapist and psychiatrist, those people should be able to offer their recommendations for his care. Taking things very seriously is good, but working with the treatment team you already have is the first step to finding something that works for your son.

What do those people say?

OP: We are with the Chesapeake Center and his therapist is out this week, we have an appointment with his psychiatrist next week but this feels urgent, and most places have waiting lists, so I'm trying to be proactive.

[Anonymous]

Anonymous wrote:Is your child already on medication? I can’t tell from the first post OP.

OP: Yes he's on an SSRI and Guanfacine.

[Anonymous]

OP, you really need to talk to the psychiatrist urgently. This is an after-hours, don't-have-an-appointment situation but your If your kid is expressing suicidal ideation -- "I really don't want to be around anymore" -- that's a do not pass go, do not collect $200 scenario and the safest place for him is an inpatient unit -- which you get to after going to an ER.

My teenager did two tours at Dominion inpatient, one two years ago and one a year ago. She then went to Newport PHP after the first one and Dominion IOP after the second one. I agree with PP that Dominion IOP is a hard no -- the therapists are young and inexperienced and we left after less than a week (but we had a back-up plan) -- but the inpatient was what she needed at the time, as unfun as it was. I don't have experience with the Dominion PHP, but if it's staffed by the same people as the IOP, then also hard no.

Please do call the psychiatrist first thing tomorrow -- it's good to be proactive but you absolutely need professional guidance on this and you absolutely need to keep your kid safe.

[Anonymous]

Reviews of treatment places are not always the best gauge. The places that work for people are great. The place that doesn’t is awful. What we have learned is the work they do AND you do is what matters. It really doesn’t matter the facility. They all use the same approach.

[Anonymous]

Anonymous wrote:OP, you really need to talk to the psychiatrist urgently. This is an after-hours, don't-have-an-appointment situation but your If your kid is expressing suicidal ideation -- "I really don't want to be around anymore" -- that's a do not pass go, do not collect $200 scenario and the safest place for him is an inpatient unit -- which you get to after going to an ER.

My teenager did two tours at Dominion inpatient, one two years ago and one a year ago. She then went to Newport PHP after the first one and Dominion IOP after the second one. I agree with PP that Dominion IOP is a hard no -- the therapists are young and inexperienced and we left after less than a week (but we had a back-up plan) -- but the inpatient was what she needed at the time, as unfun as it was. I don't have experience with the Dominion PHP, but if it's staffed by the same people as the IOP, then also hard no.

Please do call the psychiatrist first thing tomorrow -- it's good to be proactive but you absolutely need professional guidance on this and you absolutely need to keep your kid safe.

OP: I did call his psychiatrist and they can’t get him in until next week. Frustrating, especially since we pay quite a bit and it’s not covered by insurance. I’ve talked to several places and most have agreed that he’s not a danger to himself. He’s happy as a clam at home, it’s school stressors and reactiveness to rejection from peers at school that prompt these big feelings for him. He’s at home for now but that’s not sustainable forever and he needs to finish out 6th grade.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, you really need to talk to the psychiatrist urgently. This is an after-hours, don't-have-an-appointment situation but your If your kid is expressing suicidal ideation -- "I really don't want to be around anymore" -- that's a do not pass go, do not collect $200 scenario and the safest place for him is an inpatient unit -- which you get to after going to an ER.

My teenager did two tours at Dominion inpatient, one two years ago and one a year ago. She then went to Newport PHP after the first one and Dominion IOP after the second one. I agree with PP that Dominion IOP is a hard no -- the therapists are young and inexperienced and we left after less than a week (but we had a back-up plan) -- but the inpatient was what she needed at the time, as unfun as it was. I don't have experience with the Dominion PHP, but if it's staffed by the same people as the IOP, then also hard no.

Please do call the psychiatrist first thing tomorrow -- it's good to be proactive but you absolutely need professional guidance on this and you absolutely need to keep your kid safe.

OP: I did call his psychiatrist and they can’t get him in until next week. Frustrating, especially since we pay quite a bit and it’s not covered by insurance. I’ve talked to several places and most have agreed that he’s not a danger to himself. He’s happy as a clam at home, it’s school stressors and reactiveness to rejection from peers at school that prompt these big feelings for him. He’s at home for now but that’s not sustainable forever and he needs to finish out 6th grade.

One of the biggest challenges with this age is that they mask a lot. If he is expressing suicidal ideation, I guarantee you he is not happy as a clam at home. I know you were just saying that as an expression. But as a parent who had been continually blindsided when our DD gives us the impressions and cues different from her internal reality, please be on guard for suicidal ideation triggers at home too.

[Anonymous]

I'd be very careful about putting a child that age with much older teens. They can learn a lot more negative things and it can be a disaster.

[Anonymous]

Anonymous wrote:I'd be very careful about putting a child that age with much older teens. They can learn a lot more negative things and it can be a disaster.

OP: That’s my worry as well especially given his age. It’s my one concern about the program at Discovery. I just connected with Heartwood in Bethesda that has a middle school IOP program that seems like it might work for him. Fingers crossed because it’s by far the closest to home.