Located in midtown Manhattan at Columbia Doctors on at 51 W. 51st Street between 5th & 6th, the Day Program is designed as an adjunct to ongoing private, individual treatment. It is well suited to individuals who have had to interrupt their educational or professional pursuits because of mental illness and/or addiction.
This level of care often prevents the need to abandon such pursuits completely and may preclude the need for inpatient hospitalization. Our goal is to help individuals return to work or school at their best possible level of functioning.
The individuals we help have a course of illness in which many of the following factors are present
• At least one treatment-resistant major mental illness (mood, anxiety, substance abuse and/or psychotic disorder)
• Maladaptive interpersonal behavior, often involving and affecting the family
• Major functional impairment in multiple life roles (e.g., work, home life, school)
• Behavior that jeopardizes physical health or safety (e.g., substance abuse, abnormal eating, or suicidality)
• Demoralization about whether more treatment can help
• Lack of meaning in life as well as confusion as to aspirations and goals for the future
• Lack of communication among family members with negative cycles of interaction
Several of these factors are commonly seen in the individuals found in traditional, office-based outpatient settings. However, the more of these that are present, the more likely that integrated treatment such as that offered by Columbia’s Day Program will have unique value.
Concerns Of Our Patients, Their Families
With over thirty years of experience serving patients in crisis we are sensitive to the concerns of patients, families and referring clinicians. Our staff attempts to ease these concerns, and if our program is indicated, to facilitate quick and seamless entry into treatment.
Our patients often worry that they will never get better, and that others will stigmatize them if they find out about their condition and treatment. They may fear that employers will not hire them and prospective partners will not date them, and that marriage is out of the question. They worry that if they give up accustomed but familiar ways of coping with pain, such as substance use or self harming behaviors, that they will lose control and suffer from panic, depression or loss of control. Patients at times worry about becoming a burden on their families and becoming dependent forever.
Our families may worry that their child will never “function on their own in society”. They often fear that they have the financial burden of treatment but that they will be marginalized or blamed for their child’s lack of progress. Families fear that the patient and family will be stigmatized. Parents are concerned that previous treatments have failed and that nothing will help. Parents may feel guilty, that they have somehow caused their child’s illness or have passed on genes that have made him or her ill. Families fear that professionals will reveal “family secrets” and be insensitive to privacy and confidentiality. They fear that without help their child will deteriorate and in the worst case self-destruct or commit suicide.
Intergrated Treatment Model
Integrated treatment defines the current standard for optimal evidence-based mental health care. Such treatment requires concurrent consideration of each patient’s full array of psychiatric and non-psychiatric health care needs. Integrated treatment does not prescribe a rigid approach of treating all conditions at the same time; nor does it require sequential treatment. Rather, programmatic integration dictates that there be an individualized, comprehensive, agreed upon and well-communicated treatment plan with a consistent and well coordinated method to implement that plan.
No less important than patient-centered care processes are the clinical components of each patient’s treatment plan. Staff clinicians have both broad general expertise as well as extensive experience in a variety of specific family, individual, and group interventions for treating severe mental health, substance abuse and general health concerns. Importantly, the clinical philosophy underscores the importance of utilizing patient’ strengths to improve social, occupational and educational functioning as opposed to targeting only symptom reduction. Attention to developmental issues (specific to phase of life) is another clinic priority. To that end patients join one of three tracks: college, young adult, and adult.
Assessment and Beginning Treatment
If our staff and the patient conclude that the program would be helpful, we set up an appointment for the patient and family to attend a multi-family orientation group. When a patient is accepted into the program, he or she is assigned a coordinator who will discuss treatment issues with the patient, family, and outside clinician. The coordinator will meet with the patient early in his or her stay and regularly while in the program.
Individual referring therapists continue to see their patients while they are in the program; if a patient needs a therapist, we can provide referral to experienced clinicians. Clinical coordinators meet regularly with patients to review schedule, goals and clinical progress; in addition, coordinators communicate with individual therapists. As our program is located within the Columbia Doctors multispecialty practice, we can refer patients quickly to physicians and dentists who can address other health needs. When appropriate we serve as liaison with schools and employers to advocate for patients and to assist with specific educational and career goals.
Our group therapists have expertise in the following techniques: cognitive-behavioral (CBT), dialectical behavioral (DBT), motivational (MI), psychodynamic, interpersonal, life skills, psycho-education and mindfulness. We address symptoms and self-defeating behaviors encountered with every psychiatric diagnosis and focus particularly on the causes of treatment resistance and failure. Every week we offer over one hundred groups, thus providing scheduling flexibility so that patients can maintain involvement in school, work or other activities.
Groups foster sharing and hopefulness, teach planning and accountability, encourage confrontation of fears and appropriate risk taking and enhance sensitivity to others and compassion. They enable members to learn about the impact they have on others, to acquire new social skills and adaptive behaviors and to consider peers’ solutions to common problems and challenges.
Groups question members’ isolation and pessimism, challenge their blaming others and lying and confront examples of intolerance and insensitivity. They enhance self-esteem by reducing preoccupation with personal problems and presenting opportunities to understand and help others.
WHY WE INVOLVE FAMILIES
Having a family member struggle with a major mental health problem is almost always a time of crisis for families, and illness experienced by one person in the family affects all persons in the family. Parents often feel demoralized about whether more - or any - treatment will be beneficial for their child and the young patient with a long treatment history may feel equally discouraged.
Communication between family members often breaks down and the illness creates troubled interaction patterns among family members that exacerbate the problems rather than healing the conflicts.
We include the family upon intake, during clinical crises that may arise and at the time of discharge planning. We devote careful attention to issues of autonomy and privacy for the patient as well as family members.
Our treatment approach always assumes a strengths-based perspective and we work with each family to locate the resilient responses to a complicated course of illness. We build an alliance with families and help families navigate the boundaries of loving support and treatment confidentiality. We help families step out of a problematic cycle of interaction into a positive cycle that supports treatment and family well being, and as well, enhances family experiences of closeness and compassion.
- Betty Jeanne Kass, LCSW, Director
- Jack Tuchman, LCSW, Associate Director
- Ann Axel, LCSW
- Chiara Battistello, LCSW
- Anja Behm, LCSW
- Jessica Benson, PhD
- Josh Berman, MD
- Peter Bergman, LMSW
- Mary Brewster, PhD
- Michelle Brill, LMSW
- Brian Clinton, MD
- Sheyla Delvecchio, MA
- Karen Frieder, PhD
- Len Genduso, LCSW
- Enid Gertmenian-King, LCSW
- Tiffany Herlands, PsyD
- Frederic L. Kass, MD
- Erica Kovacs, PhD
- Jennifer Lee, PhD
- Jonathan Liss, PhD
- Alice Medalia, PhD
- Melissa Nesle, LCSW
- John O’Leary, PhD
- Heather Paley, LCSW
- Shulamit Sabag-Cohen, PhD
- Laura Travaglini, LMHC
- Jack Tuchman, LCSW
- Robert Watson, PhD
- Evelyn Attia, MD
- Eric Marcus, MD
- John Clarkin, PhD
- Alice Medalia, PhD
- Eric Collins, MD
- Maria Oquendo, MD
- Frederic Kass, MD
- Barbara Stanley, PhD
- Jeffrey Lieberman, MD
Referrals may be made by patients, family members, therapists, or treatment facilities. Frequently, the Columbia University Day Treatment Program is recommended as part of a comprehensive discharge plan following hospitalization. To schedule an appointment, make a referral, or for further information, please call 212-305-6001.
ColumbiaDoctors - Midtown
51 West 51st Street
New York, NY 10019