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 assessment is conducted on behalf of the Bridge House resident and confidentiality will be strictly enforced. While some of our residents will have participated in assessment prior to arriving at Bridge House, there may still be unanswered questions which 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 conduct an assessment when the resident is feeling stable, clean and sober, eating well, getting enough rest, living in as “normal” an environment as possible, and committed to the process. Assessment will be conducted as residents engage in normative daily activities rather than during a crisis time in a hospital. 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.
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 his or her response to stressors and activities of daily living at Bridge House, initial assessment strategies may be modified to suit new therapeutic or vocational goals.
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 which 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.
Once the resident and his or her treatment team agree that enough stability has been achieved, various types of testing will be conducted by the Bridge House Clinical Psychologist and other clinicians within appropriate specialty areas. 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, the psychologist 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. It will be essential for the psychologist to get to know the resident as a whole person and to learn about what led them to their current circumstances. The goals for the psychologist are 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.
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 psychologist 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.
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 equate to success beyond Bridge House if we can not provide a seamless transition to what might be next in the lives of each of our residents. We carefully curate a transition plan, based on all of the information that we have learned about an individual, and take the time to allow for adequate understanding and acceptance of the recommendations.
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.
Each Bridge House resident is the “owner” of his or her confidential information. As such, no interviews, debriefings, or communications will be conducted with anyone outside of Bridge House personnel without the express written consent of the resident. All treatment and assessment is conducted on behalf of the resident and confidentiality will be strictly enforced.