Bio Behavioral is one of the few treatment facilities in the country offering intensive out-patient treatment for anxiety, mood, and obsessive compulsive spectrum disorders. Our intensive program was established in 1978 and has continued to expand and improve over the years. We found that intensive programs work better than weekly sessions for many individuals and unlike many other programs patients receive individual rather than group treatment.
When is an intensive program necessary?
An intensive program may be recommended to those who have tried individual therapy in the past and did not attain their goals. In addition, it may be recommended for those who are severely impaired in their daily life, eg. Can not get to school, work, take care of themselves or their homes etc. Others may need to achieve their goals during a set time period in order to return to their daily life; for example, students who want to start or return to school, others who want to reduce distress immediately to be able to remain in their jobs or perform their daily responsibilities.
Who qualifies for intensive treatment?
We accept children, adolescents, and adults into our intensive program. Individuals who typically enter this program have tried traditional weekly therapy with minimal gains or require more frequent sessions due to the severity of their illness and difficulty functioning in daily life. Disorders typically targeted in our intensive program include: obsessive compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding, social anxiety, trichotillomania, self injurious behavior, panic disorder with agoraphobia, and depression. Children and adolescents who are having significant difficulty attending school regularly or have stopped attending school are also candidates for the program.
What is the first step?
Every incoming patient at Bio Behavioral initially meets with either a licensed psychologist or psychiatrist for a consultation appointment. Our clinical team then reviews the case in order to design the most appropriate treatment program. Recommendations may include follow-up neuropsychological assessments, medical evaluations, as well as psychological and/or psychiatric treatment.
If intensive treatment is recommended, the individual’s specific needs are taken into account when developing a treatment plan. The frequency of treatment depends on many factors, including the functioning level of the patient and the severity of the illness. We recommend a minimum of four weeks of treatment in order to achieve therapeutic goals, although patients often extend their stay to meet further goals. Sessions can range from 90 minutes to six hours per day, again based on a number of factors, such as level of functioning. Neuropsychological assessment is recommended for most of our intensive treatment candidates to help us plan the most effective treatment program.
Who will be treating me?
Once session frequency is determined, patients are assigned a treatment team who are either licensed or assistant psychologists, post-doctoral fellows (individuals who have earned their Ph.D. but have not taken the NY state licensing exam), behavior therapists (individuals in doctorate programs who have already earned a master’s degree and completed all of their academic coursework for the doctorate degree except for their doctoral thesis) as well as psychology interns (individuals in doctorate programs who have already earned a master’s degree and are completing their training at our Institute). Non-licensed staff are extensively trained and supervised by licensed psychologists. All of our staff have training is child, adolescent, and adult populations. Most hold a certificate in school psychology and therefore are familiar with learning issues and school problems.
Your treatment team meets weekly and communicates daily in order to maintain the continuity of treatment.
What is a typical day in the program?
A specific program is developed depending on the specific problem. All treatment strategies are based on the latest research findings and patients are educated about what is effective treatment and why. Psychoeducation is an important component of any program. Previous treatments may have failed due to inappropriate treatments for the disorder. Some of the specific cognitive behavior treatment approaches we use are the following; exposure in vivo or in imagination, exposure and response prevention; behavioral activation, interoceptive cue exposure, cognitive strategies, three and a half box technique (for hoarding), dialectical behavior therapy etc.
All session time is spent one on one with a therapist. Treatment is conducted in a variety of settings, which may include public places, the individual's home, and any other locations specific to the problem. Everything is done at a pace that the individual is capable of tolerating and all strategies are initially done in conjunction with the therapist. Many programs outside of Bio-Behavioral have the individual spend a lot of time on their own trying to do assignments given by the therapist. These programs emphasize groups and sometimes meet with individual therapists to review the homework assignments. At Bio-Behavioral we believe strongly in practicing assignments with the individual and instructing them during the session as well as challenging all maladaptive thoughts as they occur. Of course, 'homework' and outside assignments are also given. After the initial four weeks, the treatment team re-evaluates in order to determine the continued frequency of treatment. At this time, the number of sessions or daily time may be reduced according to the needs of the patient. Medication and nutritional supplementation may be employed at the same time as the behavior therapy. Cognitive therapy is employed to promote more logical thinking about coping with anxiety and life difficulties in order to build insight, motivation, and feelings of self-efficacy. In addition, cognitive therapy is used to challenge "over-valued ideas" or strong beliefs in the fears themselves. Individuals are taught to examine their own system of beliefs for extreme and illogical ideas which may be contributing to extreme emotional reactions. They are then instructed in methods of countering such ideas and replacing them with more moderate and sensible ones. The goals of the integrated treatment are to eliminate compulsive and ritualistic behaviors; eliminate obsessive thoughts and teach coping skills where such thoughts cannot be entirely eliminated; end phobic avoidance of people, places, objects, or social situations; and promote a balanced lifestyle consisting of satisfying social relationships, productive work, and sufficient nutrition and exercise.
What happens after I’ve completed the intensive program?
Maintaining one’s gains and preventing relapse is a highly stressed aspect of our program. Research and our clinical experience suggest that follow-up therapy is a crucial step towards recovery. In our program, we recommend that patients continue their treatment on a less frequent basis after completing the intensive treatment. Patients may do weekly sessions for a period of time and then decrease sessions to every other week and so on. We offer follow-up phone sessions for our out of state patients. The slow reduction in treatment allows patients to practice the newly learned skills while still being monitored by our staff for any possible indicators of relapse. We recommend that patients maintain some level of contact with our staff for six months to a year for maximum long term gains.
Patients also may return at a later time for a "booster" program which typically consists of daily sessions for a shorter duration of time (typically 2 weeks) in order to regain the progress achieved during the initial intensive program.
How will my family be involved?
Bio-Behavioral strongly believes that family involvement is an integral component of therapeutic effectiveness. We therefore recommend that family members meet with the treatment team to provide relevant background information and learn techniques to best support their loved one’s progress. The intensive program consists of family sessions within the first week of the program and regularly throughout the program. Phone sessions can be scheduled for family members not present. The level of family involvement is determined on a case by case basis.
Where can I stay for the duration of the program?
Bio Behavioral is conveniently located in a suburb of Long Island easily accessed by train from Manhattan (a 30 minute ride on the Long Island Railroad) and near major highways. There are a number of local motels as well as extended stay facilities in neighboring towns. Our staff will be happy to provide you with a list of options and make the process as convenient as possible.