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Inpatient Treatment For Ptsd

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And I would absolutely give serious thought to admission under a fixed program for ptsd if it was on offer, because it's very different to your standard admission:)

Very much agreed.

@FauxLiz
To know... Trauma programs here in the states are often booked months in advance (if not longer). As in, the very first possible opening may well not be for 6+ months. And that's before taking insurance into account, which can mean needing to jump through about 30 hoops of fire to get it paid for, and saving for deductibles & copays.

So researching what programs look like the best fit? Best done early. You can always turn down or defer a spot once it opens up. Just because you're researching, or taking the first steps? Doesn't mean you'll be admitted tomorrow. ((Even if you wanted to be)). The very very lengthy wait times will give you time to arrange time off work, babysitting, bills paid in advance, new insurance if necessary, etc.

ETA

Also... Even in 'At Will' States (meaning you can be fired for any or no reason whatsoever, for those not stateside), it is usually very very common for companies to not just allow for but encourage 30 days inpatient alcohol treatment. Many even allow for 60-90. Alcoholism is very well understood in corporate culture. While PTSD Treatment is not Drug & Alcohol Rehab? If your company has rules in place for -at a minimum- holding your job for 30/60/90 days of Drug&Alcohol treatment? Or even better contributing 10k or 20k directly to it, or paid time off, or any of the other bells and whistles a lot of big companies do? Breathe easy. Because that same policy will extend to other inpatient psych sabbaticals in the fine print. So you may very well not have to give up all of your vacation & sick time, if they have paid time off for Drug&Alcohol treatment!!! :D Go through your employee handbook / through Human Resources to find out your company policies.
 
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I have done two specialized inpatient programs that were geared for specifically PTSD (and only PTSD.) Both programs provided access to computer and phone to stay in contact with friends and family on a regular basis. Both required a 14 minimum commitment but did allow people at any point to request discharge and if they could prove they could stay safe to themselves (i.e. were not in danger of imminently killing themselves) they would easily discharge the patient within 72 hours at the patients request.

I would highly recommend considering programs that are specialized for PTSD or for a specific PTSD related problem (for example, a trauma informed eating disorder or rehab facility) - after talking to them and getting a feel for how they handle things. I would recommend them for folks who are not yet in a life a death level of danger (and for those who are) but who are struggling all the same to function in life as well as they want to and need some time to do get away and do some serious work within the container that can be a specialized trauma unit.

I would not recommend a general or acute inpatient unit, or any unit that does not have trauma trained staff, unless someone was in danger of ending their lives or harming others or simply and completely unable to function. Those kinds of facilities are excellent for keeping people alive for awile, but tend not to be as good at skills work or trauma work, which is the work needed to sustain stability after discharge. If the facilities you are looking at are general psych units, and you are not actively sucidial or homicdial, and you are looking at a place near where you live, would actually suggest looking at partial hospitalization programs. Many general psych units offer partial programs or IOPs, and they tend to be more focused on effective skills work in IOP/partial hospitalization programs than inpatient ones.

General psych units in the US will not general keep patients longer than 5-7 days. There is a huge push to get people in, get them on meds, and unless they are violently hallucinating or about to kill them self or someone else, get them out as soon as possible with sometimes a referral to outpatient services. it may be different where you live (and I highly suggest calling the hospitals and seeing what they tell you) but general units are good for crisis management, but they are very very very unlikely to keep you for more than a week, let alone 30 days --- unless it's a specialized program, in which case, 30 days is a pretty typical stay. Most all of them give you the right to leave voluntarily if admitted voluntarily unless a danger to self or others (as already explained) if it's really just not the right place, even if you have only been there a few hours.

For me, I decided to do specialized inpatient work because there are no good IOP programs near where I love that take my insurance, and because trauma therapy as an outpatient was triggering me too much to benefit from it. I was sliding downhill... I wasn't sucidial or homicdial or anything, but I also wasn't stable enough to be able to handle outpatient work. The first program I went to was specifically for people with PTSD but didn't do any trauma processing work in groups. They were all about stabilizing and skills work. It was perfect for me at that point. The second program that I went to a few years later was also for people with PTSD (and often accepted people as a step down from general inpatient units or rehab or eating disorder centers) and did do a lot of trauma processing work in groups and individually, along with skills work. It was hard in a different way, but also worth it.

If I had not done the programs I did, I think it was inevitable that I would have been eventually forced to resort to doing a general inpatient unit in order to keep myself alive. I went when I was many steps before that happening --I found that some of my peers there were also there not because they were sucidial but because outpatient work wasn't enough on it own to make progress and they too needed some time to recharge and learn some new ways to handle and process.

I have heard of and talked to some programs that intentionally cut off contact with outside family and friends but for me that was too hard, so I found programs where outside contact is allowed to some degree. I did have to travel out of state for both programs, but for me, it was worth it. Frankly, it helped me commit more to the work.

Once in the programs, they fe ally had me busy enough that it wasn't as hard as I thought it would be to be more distant from he outside world. I also enjoyed getting to know the other clients there - most of the fellow traum survivors there were pretty neat people.

I also came to like the fact that I was a little more disconnected from the outside world by choice. I got to spend time really digging in to do the work.

It's paid off dividends immensely. I would do it again if I needed it.

I would not go to a general psych unit unless my life depended on it (and if it did, then I would go and expect a short stay.)
 
I have had the courtesy when I was doing EMDR work and lost any facsimile of norm balance... of my T initializing double sessions per week with large home reading, and follow-up homework/journal. Because I was an divorced Mom and due to needing income in order for us to eat (plus no child care)...this intensity of focus supplemented inpatient care or support that I needed. It took several months to re-regulate and some out of pocket expense to cover the frequency because of insurance. He worked on a sliding scale and allowed payments for this special time.

There are options...it is not always either or scenarios, so perhaps address your T to explore radical acceptance or DBT and double dip in sessions until it is mutually decided you are somewhat back to balance. As well many avenues extend beyond the brick and mortar confinement. There exist support through courses and groups on-line with specific focus such as meditation, DBT, ect.

I do not totally adhere to "providence will provide" thinking of your T - concerning your child-care! In some circles that is considered magical thinking and might slow down my consideration for intake as well. *:hug:s if you accept.* Often a Mom feels more prone to discover herself when she knows her child(ren) are safe and not facing the same danger that she might have faced...so long ago. Best of wishes in your decision and recovery.
 
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My therapist has recommend three locations that I have been researching. Two that I have found have specialty areas for trauma (I am guessing due to the high veteran population in the area) the third my therapist has had another patient attend successfully that was dealing with both trauma and substance abuse issues. This seems to be the one that he is most comfortable with recommending to me but the one I am least comfortable with as my research seems to show that it is primarily a substance abuse recovery center.

I won't deny that I tend to lean heavily on alcohol and pain medication for a chronic pain condition when I absolutely need to disengage from the world but I would in no way place that as my primary issue and know I need a place where they will understand my chronic pain condition in addition to the ptsd and not just tell me that sobriety from all substances will help/resolve my issues.
 
I went to a inpatient/residential program for 4 months. I really had no choice after 2 hospitalizations and72 hour holds in 3 weeks due to trying to end it all. I did not have a job or a child so I cannot comment on that part, but it was the best thing that happened to me. I went kicking, screaming and angry...I found hope to keep going on and great skills and ways to manage life....it does not make things go away, but helps you learn how to live and manage. I hope that you get some peace in what is right for you.
 
You have to do the research:-
All of the above.
But, if you cannot ensure your child & future will be safe, don't do it.
Failing to plan is planning to fail.
I failed to plan. Don't try that one.
Sorry Providence is not planning. Nor does Providence help with all the fall out.
 
As a single parent that has spent her life isolating to protect and do not have a close relationship with my family so I don't have a lot of support for taking care of my child and I am torn.
Don't have "a lot of support'? Do you have a safe means for your child to be cared for that is maybe not ideal but is safe? Or is your therapist really pushing for just whatever to happen? Let angels come down or something... ? Because that would be advocating for possible child neglect, or not being able to be admitted at all, or having your kids taken into foster care while you get help.

It actually changes things based on what you mean by not a lot of support for the child.
 
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@Justmehere is so right.

My children had to go into child foster care because I needed urgent treatment re PTSD
Both were 'taken' from their schools, kicking & screaming & manhandled into car's by total strangers.

I was told later, "it looked like a child abduction scene'. Because I had no one, to care for them at all. They suffered terribly because I was their only parent & had told them over & over, never go with strangers ever!

The repercussions were long & lasting. So, if you have some not so ideal (support) rather than no support... well, don't count on Providence to help out.

I am not saying there are not a load of Foster Carers out there, who do the best they can.

But, a Dr who is risking your treatment vs your child in the randomness of a State run system AND your ability to return to your career, which underpins your ability to provide for your child & you in the future on some whimsical notion of Providence stepping in. IMHO is too risky.

For year's later I had to reassure my children, YES mum would be picking them up! Just getting them to trust me & all the other fallout they suffered... you cannot imagine.

To top it all off, after begging my Dr to release me from the 'program'. I did not get the treatment I needed, dropped out of all therapy of my own volition because the foster system dropped the ball & could not accommodate my children, they were handled from one stranger to another. Till the State ran out of options & rang me in hospital to tell me to go & pick them up from their dam office!

So, I know you are looking at places for treatment & it sound's like you do need trearment, but lots of options have been already suggested.

But, at the end of the day, please consider what you really do have in terms of options for your child, your future and type of treatment available. Don't trust a Dr who placates you with the Providence 'theory'.

Also, you are leaning on alcohol & drugs for pain relief. I don't know your circumstances but, you say this is not the real problem. So you are not leaning towards Alcohol -Drug rehab programs. This is for you to decide, I don't know your causation of pain nor the meds you are taking for this.

But, please consider this. Alcohol & pain meds are not good things to mix. If your pain is so severe is it not possible to see a Pain Management Dr., because he may well have some good recommendations for more appropriate treatment or medication? It's worth a try if you haven't been down that path.

I just worry about you relying on both. It's not I am suggesting you stop alcohol. I don't know how much you rely on it. Or, if you can stop. They don't hand out meds with alcohol for a really good reason. But I don't know what meds you are taking.

Please consider not mixing them though because so many people have chocked on their own vomit from this cause, in their sleep.This is a big risk.

I know you need help. I truly hope you can find it. The right kind of help too.
Take care. I wish you all the best.
(blackemerald1 sigh's & take's herself off to sleep)
 
Thank you everyone for the input. I can't tell you how good it has felt this past week to be able to be honest with others that have similar experiences about where I am and know that I am not alone in this world.

Black Emerald, Justmehere, and Recovery4me you and I are all on the same page I have never bought into my therapists belief that when I am ready Providence will take care of the logistics. For one thing the events in my life have taught me to leave nothing to chance. Though I have two children one is in college and therefore relatively protected from the horrors of the court system if I don't make sure I have things in place before I do this. My other child is just completing their sophomore year of high school with two full months left before the end of the year and I would not risk a disruption to their classes, activities or every day life. I am a single parent but that is because I was awarded full custody in a divorce case a decade ago from an emotional, mentally and physically abusive ex-husband that abandon the kids and I and moved 1200 miles away. I would never risk putting my child at risk of a custody battle where their father could say I was an unfit mother and jeopardize his health safety and welfare even though they are only 18 months away from being a legal adult.

I won't let my child end up in foster care for one night so between the two of us we are identifying parents of his friends that I am comfortable with letting in a bit. Part of what has triggered a significant deterioration in my ability to function over the past 6 months comes from a chronic pain condition that I mentioned earlier that after 26 years I have had three of my doctors inform my primary care physician that they have run out of treatment options to get the condition under control (yes that included a PM specialist that said he could assist with one of the ancillary conditions but that he did not believe it contributed to the primary pain condition and there was nothing he could or was willing to do to help). They have all recommended that I see a specific specialist in the area for my pain condition and I am trying but I received my first referral to him in December and at that time was told that if he decided to take my case it would be 18 months on the wait list before a new patient appointment opened up, that means June of 2017.

BlackEmerald, you expressed concern about mixing alcohol and pain medications. I am very well aware of the warning labels on the medications. However, in spite of having dealt with this condition for the past 25 years, having tried every therapy, medication both on and off label, procedure, alternative medicine possibility, PT, therapy as one doctor told me it was psychosomatic, undergoing invasive brain surgery which caused other functional and physical challenges literally the only relief I get in any condition is from opiods for which my doctors are willing to write me a prescription for a total of 30 doses a month and this is a schedule 4 med not exactly the stuff that the news stories are screaming about. So when I say I abuse what that means is that some times when I am putting in a 15-18 hour day a single dose is not going to control my pain enough to be able to even function at work so I understand the consequence of having to give up a weekend dose and get through the work day. I then use alcohol on the weekend to escape that constant pain that I had to make a choice about earlier in the week.

FridayJones, you mentioned talking to the HR department at my work, well that is rather difficult. We don't have one. The way our organization is structured I report directly to a board of directors, I oversee all other staff and myself and one other employee share HR responsibilities. If there was a clause in the personnel handbook as you mentioned trust me I would know it as I am in the process of updating it as my two predecessors didn't touch it or update it in the last 20 years and trust me there is no money to assist with payment for treatment.

Sorry this is so long but I wanted to answer as many questions/concerns that had been raised as I could
 
Ok, well you're pretty much backed into a corner!

You sound like you have tried a lot. And are considering all angles.

Can you ask your Dr for a better pain medication? Can you tell him that you need 7 days relief from your condition... that your pain is not a 9 to 5 phenomenon & you have pain on weekends & overnight too? S4 Drug or not, if you are in serious pain 24/7 does he know about the hours you work, your responsibilities, your alcohol 'compensation' on weekends?

It seems you have two serious issues. Chronic pain not being resolved & CPTSD taking you down. I am so sorry.

Neither Dr seems to be very practical in their approach.

When you have smothered serious pain & CPTSD for so long. Something is going to give/break. (Albeit, you have put your children before yourself) Mother's do this), (and Father's too)...especially coming from the background you described.

So, I guess you have to decide which 'condition' is going to break you first & fastest?

Can you ask your Dr for better, not necessarily stronger drugs for 7 days relief at a time? And return every week to refill, depending on you stopping the alcohol?

Can you abstain from alcohol if he did this for you? Because I am certain your children both want you well again, for their future's. And, I hope you do too!

Sound's like you have a totally crap work situation too.Can you stop working such crazy hours for a set time, so you can get this pain & CPTSD back into the ballpark?

Can you get surgery Interstate? What would your recovery period be like & for how long? Can you take leave from work for this?

Of course being dependant on S4 drugs is not going to go down well in a Psychological sense or setting nor, will the compensation with alcohol!

I am asking more questions because you have to make a move/decision. Particularly as either condition could worsen & your body & brain will not sustain you in this vicious cycle for ever. And not only will one or both hit/worsen. You risk too much!

Sorry, @FauxLiz I am probably being no help at all.
Just throwing around possibilities.
 
I work with kids who have been traumatized by the foster care system, so please know, I really intimately understand how awful the system can be. I also know how parent who is overwhelmed with their own stuff and who is from time to time using stub antes to disenfranchise the world can actually be very detrimental to a child's development as well.

I admire how well you are thinking everything through and I'm so glad you are reaching out for input and advice on how to evaluate things and make these decisions.

Like your therapist said, the choice is yours (for now) and at the end of the day, it is essential that it is you that makes this choice for you, and as a good momma, you make the choice that is best for your kids too.

She is saying this because she knows that even the very best treatment won't work unless you are committed to it and that you have made the choice to really invest in it.

And it is an investment. It is an investment in your life and healing. It is an investment in your family. It is an investment in the long term reduction of pain from the trauma. It is an investment in becoming an even better employee than you are now (and I think you are doing one hell of a job already with all in your plate!)

You have done so much with so little, I'm excited about what you could do with some support and healing under you.

I love that you are identifying parents who are willing to take care of your kids while you are gone. I hope that you do what you can to get that squared away as soon as possible... because I think that once that is squared away, your reasons to go far out weigh your hesitations to go.

I strongly advise you to not get stuck on the work situation too much. There are solutions (and other ways to excersie your rights under the FMLA)... What you can do is call a good employment law attorney and get a free consult even over the phone on what you can do to ensure your job is there for you when you get back. I don't want to give more detailed advice on this because I don't want to get it wrong, but no matter how loosey goosey your HR dept is, you are still protected. It's really a matter of notifying even your one supervisors with a doctors letter (or note from your therapist) that you have a legit reason to excersie your rights to take leave and request they have your position available to you upon your return. (And no you would not have to get into diagnostic details or hospitalization details.) again, a phone call to an employment law attorney can lead to the best advice on how to write that letter.

Those are details that can be worked out, if/where you are ready to commit to doing this treatment and the work that it will take.

Plus, if your goal is keeping your job, treatment is all the more of an important idea: even if your workplace has not said anything yet, I am sure they are beginning to notice that you are struggling to keep up with it all. Eventually the drug and alcohol use will also take a greater toll and even interfere with your ability to assess if you are even keeping up or not. You already know that what you are doing now isn't working, and something has to change for it to work better. You describe consequences of your PTSD and substance use already that may lead to job loss and much worse problems anyhow. So the reasons to go in terms of your job far outweigh the reasons not to go.

As far as the pain medicine component, you have already indentifed two trauma focused facilities that you ae more comfortable with than the dual diagnosis treatment facility. I agree with you that sobriety alone is absolutely not a solution to all your problems (it never is) and a good rehab facility would understand that and many rehabilitated are now treating trauma and addiction at the same time. A good trauma unit will also know that sobriety is essential to healing over the long haul from trauma. The mind and body can not heal when checked out from the wild through substance use. Such use of meds and alcohol actually biochemically makes symptoms worse (even though I know it doesn't feel like it is making symptoms worse.) A good trauma unit understand all the many ways every most survivors with PTSD try to escape the pain - by substance use or through isolation, self injury, negative self talk, etc, etc.... And that part of healing from PTSD is giving up those ways of avoidance and finding healthier ways to replace those bad coping skills with better ones, so that they can get through the process of the resolving the underlying trauma.

Doing solid trauma treatment will invole getting sober, and maintaining sobriety will involve addressing the trauma as well that you are trying to handle by using alcohol and pain meds to escape the world and that pain.

And you done a great job finding two trauma focused facilities that will help you work through all of this. You gave already done that good work and found places you are ok with.

Once you have child care set up, the only reason I see for not going is that you are not yet ready or willing. No treatment at any facility is going to work until you are ready to make the commitment to go and do things that will be hard and uncomfortable. You will have to be willing to give the staff some level of control over things like medications and etc. and you will not always grew with them or make the same choices of you were not there - and that's why you are there. To do something different. To heal. For very good reasons.

Your therapist appears to be respecting that this is your choice and the very real reality that you have to be ready to go. I also think she may have said providence will provide because she knows you do have some options for your kids care and she is more trying to help you let go of the reasons to not go.

Let's be real, it's scary to dive into trauma work and letting any hospital have any kind of control over anything, even the very best facilities and for the very best reasons.

After I was set up to go to inpatient care the second time, I lost my sh*t because I was so scared of doing the work there. My dog care fell through. My small job has some issues that came up that threaten loss of the entire company I had set up and run myself. I solved those because I was committed enough to go. Then my suitcase broke, and I told my therapist I couldn't go... because you know, my suitcase zipper broke. I had to have my clothes (she agreed I couldn't go with only the clothes I was wearing) bur now in my head I was convinced I couldn't do it. My therapist said a phrase similar to "providence will provide" that taken out of context seemed like a terrible thing to say. In context, it wasn't really that bad. She was actually trying to get me to get the job done to make it work and stop coming up with reasons to not go, but to finally get it done. She reminded me of my reasons to go, and told me to hold on to those... And in a way, she was right. Once I recentered myself around my good reasons to go, I got the job done to get a new suitcase... I got the job done to rearrange my commitments to my job and other people. I had care for my service dog worked out within a hour too.

I know, a suitcase is not childcare - and childcare is essential while a suitcase is not at all. Like at all.... But this kind of thing, where people think of lists and lists of solvable reasons to not go happens all the time. All the time. Serious legit reasons far more important than a suitcase or even dog care.... all very solveable reasons.

My therapist and the treatment center said they see people suddenly sabotage themselves all the time just before they make the real heart commitment to go, and they tend to do the same when transitioning to leave. So much that really well seasoned trauma folks familiar with the voluntary inpatient process for 30 day programs say that they expect it to happen. They said that once someone is really connects to good reasons to go, and the reality that what they are not doing is not working (and is risking jobs, being their for their families, their well being, and they need more support than what they have right now to change things around to deal with the pain the deep and real pin of the trauma....) once people connect and hold on to those reasons, sufferers will suddenly pull out all the stops to do what needs to be done so that all the things that need to be in place are in place and invest in their long term relief and recovery.

So unless your therapist is engaged in magical thinking and is a bit of a clueless dingbat (those therapists are out there - I have run into them myself), she might be thinking it's time to go now, before it's much harder to go, for your sake and for the sake of you being able to care for your kids, because she knows you do have some reasonable possibilities for the safe care of your kids, you do have some options to address not losing your job, etc, etc... And she sees you going as the best option to live the life you want to live.

She is hopefully a safe person who knows you and can see the situation from the outside, and really wants you to pull out the stops, when you are ready, to get the arrangements made... because remember, she has first hand experience of how beneficial these programs can be at long term change and reduction of the pain from trauma so people can do their jobs, maintain family relationships, etc etc over the long haul so much better than they can do now.

She hopefully is someone who sees the bigger and long term perspective and is hopefully not a dingbat advocating for child neglect.

You are a good mom to worry about your kiddos care and being a single mom is really hard. You are a strong and wise and compassionate survivor and I think you are doing a great job at thinking through everything. Really, I'm quite impressed.

Maybe another way to look at this that this is a time for you to go get resourced to be able to handle the really intense stressors of being a single mom even better than you already do. You deserve some support to get through this. No matter what treatment path you choose, I will be real that they will ask you to make hard choices. You will not like or agree with all of them, but if you hold on to the very good reasons to make this investment in your healing, those issues won't be has hard to get through and you will be more able to focus on the main thing: healing from what you have been through.

Rhis is all to say that as YOU make this decision, good to focus on what could be reasons to *not* go and what may not work out...

but it's also very important to look at reasons why you should consider going.

Don't lose sight of those reasons. Even if you decide not to go, the positive reasons to invest in change are essential to pull through the hard steps ahead.

My heart goes out to you! :hug:s to you if you accept them.
 
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