Assessment Philosophy

The primary focus of Bridge House is to help residents and family members better understand the underlying reasons for behavioral, emotional, academic, social, vocational, and functional issues leading to impairment in day-to-day adaptation and functioning. We seek to understand these issues through the application of scientific, social, medical, and observational strategies. These strategies will help clarify diagnostic issues as well as provide new or elaborated information to enhance treatment, academic, vocational, and other types of life planning. It will also inform medication use when needed. Each Bridge House resident is the “owner” of their confidential information through this process. All treatment and assessments are conducted on behalf of the Bridge House resident and confidentiality will be strictly enforced. While some of our residents will have participated in assessments prior to arriving at Bridge House, there may still be unanswered questions that can be clarified through the comprehensive assessment process at Bridge House. Often, prior assessments were conducted when the resident was in a time of crisis, inappropriately or over medicated, abusing substances, or not engaged effectively in the assessment process. At Bridge House, we seek to initiate the assessment process once the resident is feeling stable, clean and sober, eating well and getting enough rest. As residents engage in normative daily activities rather than during a crisis time in a hospital, we are able to gain a more clear picture of their level of functioning . Our commitment is to allow residents the time necessary to stabilize and then to conduct a thorough holistic assessment with them over a period of weeks rather than hours. Encouraging our residents to engage in activities of daily living will enhance the assessment outcome as they experience successes and challenges during the observation period. This comprehensive approach to assessment will provide unparalleled future guidance for the resident, his or her family, the Bridge House treatment and diagnostic team, and future service providers.

Individualized Approach

Each individual arrives at Bridge House with their own story and their own set of circumstances, values, and goals. Because of this, a generic set of tests and evaluation procedures will not be administered to all residents. As part of the initial phase of assessment, the treatment team will determine if any testing was previously conducted and the circumstances under which it was undertaken. This will aid in determining the type of tests and assessments which will be utilized at Bridge House and allow for a highly customized assessment process. Additionally, as we learn more about a resident’s history and observe their response to stressors and activities of daily living at Bridge House, initial assessment strategies may be modified to suit new therapeutic or vocational goals.

Stabilization Phase

During the initial phase of a resident’s stay at Bridge House, the focus is on stabilization so that an accurate assessment may be conducted. Many residents come to Bridge House in acute distress, which may require a period of days or weeks to overcome. During that time, residents will be kept safe and will be supported as they acclimate to the Bridge House setting and culture. Every effort will be made to help the resident settle in and feel comfortable with the daily routine, staff members, and peers.

The focus will be on eliminating stressors that have contributed to the resident’s difficulties. Peace, serenity, healthy eating and activity, and predictable living will be paramount during this transitional phase. Social detoxification from the effects of drugs, alcohol, and electronics will be undertaken while the resident is in a safe and supportive environment. Chef-prepared fresh meals will be served while daily exercise regimens, yoga, meditation, Yoga Nidra, and weekly massage therapy will be introduced, all creating an ideal backdrop for physical and mental health and healing.

Assessment Phase

Once the resident and their treatment team agree that enough stability has been achieved, various types of assessments will be facilitated by the Bridge House Medical and Clinical professionals who will be looking at all areas of health and functioning. This testing will be overseen by the Director of Diagnostic Services. A broad range of tests and assessments can be administered, and each resident’s particular circumstances will guide the development of the test battery utilized. These tests and assessments will be chosen to help the resident and treatment team gather information quickly and will be utilized to guide the observational components of assessment as the resident begins reengaging in day-to-day activities on the Bridge House campus and in the community. With the resident’s permission, clinicians within appropriate specialty areas will spend many hours with the resident, family members, and prior treatment, and academic providers gathering background information. Empirical data will be gathered through the use of written and hands-on tests with the psychologist and other professionals. It will be essential for the Bridge House Medical and Clinical Team to get to know the resident as a whole person and to learn about what led them to their current circumstances. The goals is to provide the resident, family, and treating professionals with a comprehensive history of the resident and an understanding of how the resident’s issues have developed; the most accurate diagnosis possible; and a clear path for treatment of the issues interfering with the resident’s ability to function as adaptively as possible. While accurate diagnosis is important, the primary focus will be on gaining an understanding of the resident as a human being with a unique history, personal strengths, future goals, and aspirations.

Diagnostic Formulation

What does it mean to be you? A meeting will be planned with each of our residents, about two-thirds of the way through their Bridge House experience, and this will be the topic. The treatment team who has been working with each resident will come together to share verbal feedback with the resident and with significant others for whom the resident has given consent. This allows the resident to have clear communication about assessment results and an opportunity to ask any questions of the psychologist and other team members. The goal will be to articulate what is going on for each person, why it is going on, and most importantly, what to do about it next. The Bridge House Medical and Clinical Team will be available throughout the remainder of the resident’s stay at Bridge House for further consultation. These findings will also be provided in a thorough written report.

Bridge to Health Report

Throughout each resident’s stay at Bridge House, a comprehensive Bridge to Health Report will be compiled. This document will summarize assessment results from each clinical discipline and will include the psychoeducational evaluation, psychiatric evaluation, occupational therapy assessment, dietetics evaluation, and any other formal assessments which were conducted during the resident’s stay. It will also contain a comprehensive psychosocial history; any diagnostic indications; a summary of milieu assessments, observations, and interventions; and a comprehensive set of recommendations for ongoing care as the resident transitions from Bridge House to another setting. This comprehensive document will provide the resident, family members, and treatment providers with guidance as the resident continues to progress in self-reliance and self-sufficiency. In addition, each resident will write their own Bridge to Health Plan in which they are able to summarize what they accomplished while at Bridge House, and they can outline a plan for their future.

Transition Planning

The Bridge House process is anything but a race to a diagnosis. Once the Diagnostic Formulation meeting has occurred, the real work begins. Success at Bridge House does not translate to success beyond Bridge House if we cannot provide a seamless transition to what comes next in the lives of each of our residents. We carefully curate a transition plan based on all the information we have learned about an individual and take the time to ensure adequate understanding and acceptance of the recommendations.

For many of our residents, the Transition Planning phase of their Bridge House process is pivotal in the journey toward independence and in determining the level of support most appropriate upon program completion. By strategically and safely creating opportunities for responsibility and independence, the residents and their team gain firsthand insight into how they engage with the world around them. With this detailed understanding, the treatment team can assess the barriers residents face and identify where further guidance or support is needed. This individualized approach to assessment and planning for the future ensures that residents are given the best possible opportunity to succeed when they leave Bridge House.

Read more about the Transition Phase here.

Continued Care Program

Since its inception, Bridge House has prioritized helping people identify the most appropriate long-term support systems to continue their healing and optimize their lives after completing the Bridge House program. The goal for most Bridge House residents during the Transition Planning phase of the Bridge House process is to identify resources outside of Bridge House that meet their needs. Occasionally, whether because of a complex mental health presentation, compounding medical issues, or other factors in a resident’s history, an appropriate next step simply does not exist within the existing continuum of care in our country. Bridge House’s Continued Care Program, founded in 2025, provides an alternative in these cases, to allow residents to access the support they need to live their lives in the most successful way possible.

Bridge House’s Continued Care Program takes place on site at Bridge House in specific areas of the property designated for this purpose, as well as in homes directly adjacent to the main campus. Those enrolled in this phase of Bridge House participate in highly individualized programming, which includes therapy, psychiatric and medical support, and activities as appropriate. In some cases, residents volunteer in the community, play in community sports leagues, or work part-time jobs; they may be able to have their own cars or take public transportation, with or without staff support, depending on their capacity and safety needs. Some residents will be enrolled in the Continued Care Program for six months to a year as they practice integrating back into the larger community, while others may be enrolled with us for the long-term, with each case depending on the individual’s needs.

Bridge House’s Continued Care Program is very small and individualized and is intended to serve residents who have completed initial stabilization, assessment, and treatment at Bridge House and for whom no more appropriate external options exist. Applicants who have not been through the Bridge House assessment phase will not be considered for this level of care.