In treating mental health problems there are different levels of care. These levels include (in increasing intensity and amount of support): outpatient, intensive outpatient/partial hospitalization, residential, and inpatient. The lingo can get a bit confusing so here are a few quick definitions.
I am currently in residential treatment. College with OCD was becoming very hard to handle and I needed to have more time to devote to exposures. Before I entered the program I didn’t really know what to expect. I want to share my experiences so far so if someone else is considering entering residential treatment they can make a more informed decision. I should note, however, that every program is a little different and this is just my experience.
What is a typical day like?
Every day is a mixture of ERP (exposure and response prevention therapy), psychoeducation groups, and free-time. The day is very structured to keep us productive and to help us develop normal routines, especially a more normal sleep cycle. Here is a schedule for how a typical day goes:
8:45-9:00 AM set a goal for the day
9:00-10:00 AM psychoeducation group (example topics include mindfulness,
CBT for OCD, and ACT)
10:00-12:00 AM exposure and response prevention
12:00-1:00 PM lunch
1:00-2:00 PM psychoeducation group (example topics include treatment
motivation, relapse prevention, and sleep)
2:00-4:00 PM exposure and response prevention
4:00-11:00PM dinner with staff and the other residents, free-time
11:00pm curfew to be in your room (On the weekend this is extended to
During the week you also meet with your behavioral therapist three times. Two nights each week we eat out and have some sort of social outing that we agreed upon, such as going to a museum, seeing a movie, etc.
How much freedom do you have?
The structure and rules can be intimidating at first, but you get used to it fairly quickly. Even though a good portion of the day is scheduled for you I still feel like I have a great deal of freedom. During exposure time I get to choose what I want to work on. In the evening, I have plenty of free-time to read or call friends. We are not locked in and I can leave the house, as long as I’m back before 11. It’s also common to leave the house for an exposure or to take a walk for behavioral activation. Sometimes I even go to a dance class!
Is it intense?
Yes it is intense, but it is also manageable. They wouldn’t push us to do more than we can handle. Four hours of exposures a day does get tiring, but I try to keep in mind why I am here and all that I can gain by working hard. There is also a great deal of support available. Staff is accessible 24 hours a day to assist with exposures or to just talk. During exposure time staff if there if you have questions, want help deciding what to work on, or if you want someone to sit with you while you do the exposure. Additionally, being around other people with OCD who are doing their own exposures helps. We can relate to each other, which is comforting and motivating.
Can you have fun?
Yes, you can absolutely still have fun when you are in treatment! In fact I think it’s critical to have fun in the evenings after a long day of exposures so you are ready and motivated again the next day. To have fun I watch movies, play Wii with the other residents, read, and do art, anything to have a little relaxation time. Also, the two social outings a week are great ways to take a break and get out of the house. I’ve loved visiting local restaurants and going bowling, among other things.
Hopefully this provided some clarity about what residential treatment is like.