Menninger is a leading psychiatric center dedicated to treating individuals with mood, personality, anxiety and addictive disorders, teaching mental health professionals and advancing mental healthcare through research.

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.

Most of the young adults who enter our program have had significant prior treatment experiences. Many have had previous hospitalizations, residential treatment, rehabilitation, or, at the very least, outpatient treatment. It is common for our patients to enter treatment feeling discouraged because of a failure to make significant gains or have been able to sustain progress. Our purpose is to make a difference that will involve progress and help patients feel that they have direction for what needs to happen after they leave Compass in order to continue the progress they achieve here. Patients should leave Compass with a sense of accomplishment and hope about the future.

Individualized treatment planning and treatment are essential to the program. A customized treatment plan, developed in consultation with the patient and other family members, is critical to success and a vision shared by everyone involved.

For young adults with substance abuse issues, Compass integrates a 12-step addictions treatment model with approaches informed by a comprehensive psychiatric point of view. This includes program-based addictions interventions as well as supervised community support groups. So, the patient with psychiatric problems and substance abuse issues participates in treatment that addresses and integrates these co-existing needs.

In all cases, Compass emphasizes the teaching of life management skills, coping strategies and the development of social skills. Patients learn how they can function more effectively within their community, as part of their family and as young people growing towards independence.

Treatment team
Upon admission, patients are assigned an interdisciplinary clinical team consisting of a psychiatrist, psychologist, social worker, rehabilitation therapist, substance abuse/addictions counselor, when appropriate, individual psychotherapist and primary nursing staff. Patients are encouraged to fully participate in their treatment planning and review.

The psychiatrist coordinate sthe patient's treatment and is the primary link to the patient's feferring professionals about the patient's progress and discharge planning. Family members and local treaters are considered important members of the team. The social worker is the point of contact for family members, provides family therapy and coordinates the post-discharge wellness plan for continued treatment and community support.

Patients on Compass are involved in intensive and concentrated treatment. They form treatment relationships with a wide variety of mental health professionals who work to provide a diverse, but integrated experience for the patient.

Assessment
Each patient receives a thorough psychiatric, 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.

Team members share assessment findings in order to get an integrated picture. Diagnostic understanding is a dynamic process, and the team share information regularly to update its view of the core issues and other important information. Increased understanding leads to changes in treatment approaches. This process includes input, of course, from the patient, family and involved local treaters.

Core treatment program
All patients participate in treatments to help gain confidence, build skills and practice behaviors. The Compass Program features:

• Core team review with patient twice weekly
• Psychiatric medication evaluation and treatment
• Treatment coordination led by the team leader
• Group psychotherapy
• Individual psychotherapy
• Psychoeducational groups
• Skill-building groups
• Family communication and treatment
• Specialized dual diagnosis program
• Therapeutic activities and recreation
• Relapse prevention groups
• Discharge planning process

Individual & group therapy
These therapies are central aspects of treatment and are provided by program professional staff. Individual therapists are selected based on patient needs and therapists' areas of expertise; their work with the patient is integrated into review of the treatment. A team of various clinicians, including psychiatrist, psychologists, social workers and other qualified professionals 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.

Psychoeducational and Skill-building groups
Groups, such as Dialectic Behavior Therapy (DBT) skills and social skills groups focus on emotion management, interpersonal effectiveness, and self-esteem. Other groups such as Coping with Trauma, Mentalizing, Self-injury, Body Image and Perfectionism groups focus on specific problems and areas of functioning.

Therapeutic activities and recreation
The rehabilitation specialist 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 psychological testing, eating problems consultation, obsessive-compulsive disorders assessment and neuropsychological assessment, are available, as needed.

Patients with substance abuse and other addictive behaviors

• Substance abuse evaluation
• Individual substance abuse counseling
• Substance abuse educational groups
• 12-step group treatment
• Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) groups

• Coping with Trauma group
• Dialectical behavior therapy (DBT) groups
• Social skills and Roles & Relationships groups
• Assertiveness training

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 the team leader of each treatment team and works with patients and other treatment team members in establishing the most effective medication regimen. Medications are prescribed in collaboration with the patient and are based on an appropriate diagnostic understanding of the patient' s issues.

Upon admission, the patient meets with the psychiatrist for an initial assessment of medication needs. The medication regimen is reassessed through twice-weekly psychiatric team rounds. Patients receive education regarding medication, intended effects and side effects so they can participate in monitoring and are prepared to assume appropriate responsibility for their part in medication review after discharge.

Milieu therapy
The milieu is the supportive, therapeutic environment in which the staff work closely with patients in support of their growing therapeutic alliance and on issues and difficulties that emerge.

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 the patient's 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. The patient's team leader 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 encourage growth in family relationships and 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 is encouraged to serve as an active member of the treatment team to set treatment goals, define desired outcomes, 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 aftercare treaters to help set up a discharge plan to promote stability and continued progress. The treatment team works to insure a well articulated and communicated safe, reliable and effective aftercare plan.

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Menninger is a leading psychiatric hospital dedicated to
treating individuals with mood, personality, anxiety and
addictive disorders, teaching mental health professionals
and advancing mental healthcare through research.

The Menninger Clinic | 800-351-9058 | 713-275-5000 | Houston, Texas
Affiliated with Baylor College of Medicine and
The Methodist Hospital in the Texas Medical Center
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