Fact Sheet (PDF)
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Hill Center for Women
Welcome to the Hill Center for Women at McLean:
DBT Solutions for Borderline Personality, Trauma, and Related Disorders
Offering Both Partial and Residential Acute Care
The Hill Center for Women at McLean offers psychiatric and psychological services for women with histories of trauma and related disorders, borderline personality disorder, mood disorders, and anxiety disorders.
Our staff are experts in applying dialectical behavior therapy (DBT) to the treatment of trauma. Intensive dialectical behavior therapy (DBT) helps women to overcome self-destructive, impulsive behavior and to regulate their emotions. We emphasize empathy, compassion, collaboration and empowerment to help women build new strength and find new resources to regain command of their lives.
The group-based treatment program is designed for women who need more structure and intensive treatment than can be received from an outpatient program. The program offers both short-term residential and partial hospital levels of care.
Who We Serve
Woman from throughout the United States, Canada, and other places in the world come to the Hill Center for treatment. We serve a wide range of women, in acute crisis or in otherwise destabilized situations, who are motivated to work hard in a therapeutic environment that employs dialectical behavior therapy (DBT) as the primary intervention.
We aim to provide a safe, supportive, and empathic environment that also challenges women to function at their highest capacity, encouraging empowerment with skills and knowledge, and ultimately increasing their autonomy and a sense of connection and meaning.
Although our program is for people in acute situations, those who come to the Hill Center have the ability and willingness to work with us collaboratively and to remain safe, sober, and medically stable while in treatment. This requirement supports the important therapeutic work undertaken by each person and ensures a living and working environment that feels safe to all of our clients. The individuals who do best and go through our treatment program successfully are those who can work collaboratively with others and meet our safety standards and policies.
Individuals with severe psychosis, severe eating disorders or those who are medically unstable will be served best by other McLean programs. Individuals with secondary substance abuse will be considered on an individual basis. We generally require a period of sobriety prior to admission.
"You've gotten me through times and feelings I didn't think I could get through."
"I am grateful for the time and opportunity I was given in the program. I feel like I am journeying outside of the darkness now. Life has begun to bud and I feel the sun on my face."
"The program is first-class, a wonderful place to practice newly learned skills, regain self-esteem and face problems."
"The feedback from other clients within the program was so helpful and the enthusiasm from staff continues to inspire me."
"The program was extremely helpful. It gave me time to relate feelings to events and to make choices in how I respond."
Our Leadership and Staff
Our leadership and staff are comprised of dedicated, compassionate and creative clinicians who have been highly trained in the areas of trauma and DBT. Many of our staff have attended DBT intensive training and have extensive experience running DBT groups. Several of our staff have received additional training and have many years of experience working with specific clinical problems, including dissociative disorders, eating disorders and substance abuse.
Sherry Winternitz, MD, Clinical Director
Milissa Kaufman, MD, PhD, Medical Director
Andrea Killam, LICSW, Program Director
The Hill Center for Women at McLean offers a comfortable setting that includes residential bedrooms on the upper floors and rooms for group treatment, dining and relaxing on the main floor. In recent years, a newly renovated kitchen and dining area, general building upgrades, and a peaceful meditative garden space have enhanced the Center's atmosphere.
Most residential bedrooms are shared with a roommate. Bathrooms are shared with other residents on the floor. Bed and bath linens are provided, but women are welcome to bring their own linens if they desire their own personal items. Women cook dinner and eat together. Other meals are less formal and organized. All food is provided.
Assessment and Care
At the Hill Center, women receive comprehensive treatment from a multidisciplinary staff. We have staff from diverse disciplines and backgrounds, including psychiatrists, psychologists, nurses, social workers, art therapists and mental health counselors.
Assessment and care includes meetings with a case manager (one to two times weekly), regular attendance at several groups daily (including weekend and evening groups for residents), psychopharmacological management and consultation, educational and vocational rehabilitative groups, and art therapy. Additionally, clinical care is provided for those with eating disorders.
We support families and couples in our treatment. Family and couples meetings are quite important for those who have conflicts in or who are feeling inadequately supported by those relationships. We hold these meetings as indicated and respect clients' wishes around any involvement, while also emphasizing the importance of open communication, psychoeducation and intervention with families.
Group Schedules and Daily Structure
We provide both residential and partial levels of care. Our partial hospital program runs Monday through Friday. Groups begin at 9 am and end at 2 pm. Clients can expect bi-weekly meetings with their case administrator and meetings with psychiatric or nursing staff as needed. These individual meetings may happen during or after group time. Some clients may receive additional specialized individualized meetings, as needed for particular clinical problems.
Clients in the residential program attend all of the above components of treatment alongside our day clients, and they also weekend groups from 9 am to 12 pm and evening groups. Those in residence have access to staff 24 hours a day. Residents cook and eat meals together and participate in chores at the house, fostering a sense of community and reinforcing the importance of self-care and independent functioning.
During free hours, clients are encouraged to resume normal life activities outside the confines of the program. This gives them an opportunity to increase positive experiences, practice their skills, and re-connect with important parts of their lives. Clients often socialize informally with each other or visit with family members outside of scheduled programming. They are also welcome to attend any relevant self-help groups on campus that are open to the community.
Length of Stay and Continuity of Care
Clients stay, on average, two to three weeks. Slightly longer stays are sometimes possible if clinically indicated, depending on funding for such treatment. Clients may utilize either or both the partial and residential programs during an episode of treatment. Inpatient units are also available on grounds in the event a client requires a higher level of care.
If a client does not have adequate outpatient resources, we will work with the client to try to establish some referrals for additional care after they leave the program. During their stay, our teams work with clients to communicate and collaborate with outpatient treatment teams.
Admission and Referral
For information, please call our admissions coordinator, at 617.855.2595, Monday through Friday. Although phone contact is preferred, prospective clients may contact the program via e-mail at email@example.com.
To apply for admission, please fax a referral form to 617. 855.3738, so as not to delay the process. Referrals from treating therapists or psychiatrists are strongly preferred and may facilitate the admission process.
We will review the written referral materials to determine preliminary appropriateness for the program. If indicated, we will then proceed to an intake interview. The time it takes to schedule an intake and arrange for an admission can vary depending on our waiting list.
Payment and Insurance
McLean accepts many private insurance and managed care plans, Medicare, and Massachusetts Medicaid. Insurance benefits must be ascertained by our financial department. If benefits exist, this does not ensure individual authorization for treatment, which is clinically determined by the insurance company at the time of admission and based on each insurance company's standard for "medical necessity."
The program draws its strength from several schools of investigation: Dialectical Behavioral Therapy skills training developed by Marsha Linehan, PhD; clinical studies of trauma and recovery by James Chu, MD and other McLean Hospital researchers; and extensive work on the psychology of women conducted at the Stone Center at Wellesley College.
About Borderline Personality Disorder and Trauma
Borderline personality disorder (BPD) is a longstanding pattern of impulsive and self-destructive behavior, emotional dysregulation, problematic interpersonal relationships, intense fear of abandonment, and identity disturbance. These difficulties emerge from a combination of temperamental vulnerability and an invalidating environment.
Childhood trauma can be thought of as one extreme form of invalidating environment that also induces terror and alters the nervous system and thus can exert its own damaging impact on one's capacity to regulate emotions, independent of or in addition to temperament. There is tremendous overlap between those who are diagnosed with BPD and those who report trauma early in their lives. Trauma can thus produce either post-traumatic stress disorder, characteristics of BPD, or a combination of both.
Post-traumatic stress disorder involves a combination of re-experiencing symptoms (e.g., nightmares, flashbacks, intrusive memories of traumatic events), avoidant symptoms, and hyperarousal symptoms (e.g. anxiety, hypervigilance to one's surroundings, difficulty sleeping). Interpersonal trauma is also highly disruptive to the development of safe, trusting relationships. Furthermore, trauma can exacerbate the tendency to dissociate (various forms of removing oneself and disconnecting from a very disturbing experience, either emotionally or mentally). Dissociation can become a problem of its own that requires treatment.
Given the interrelatedness of these problems and diagnoses, we treat all of them at our program, as well as some additional problems that may commonly co-occur, including mood disorders, anxiety disorders, and eating disorders.
What is Dialectical Behavior Therapy (DBT)?
Dialectical Behavior Therapy was developed by Marsha Linehan as a treatment model for those with borderline personality disorder, though it has been widely used with people who have other illnesses in recent years. This treatment uses a combination of cognitive-behavioral techniques and mindfulness principles to help people gain better control over their impulsive self-destructive behavior, and to allow for a different way of managing intense feelings. Cognitive-behavioral strategies involve examining problematic thinking patterns and self-destructive or ineffective behaviors and replacing these with more effective coping strategies. Mindfulness practices are drawn from meditation and involve learning to focus the mind's attention on one thing in the here and now, while letting go of judgments.
There are four skills modules taught in groups: 1) Mindfulness, as described above. 2) Distress Tolerance helps to tolerate feelings and survive emotional crises. 3) Emotion Regulation teaches about emotions, their functions, and how to decrease their volatile intensity. 4) Interpersonal Effectiveness teaches strategies for interacting with others in ways that are most likely to achieve goals.
Individual coaching is also an important element of DBT and involves frequent review of homework, diary cards, behavioral analyses of target (problem) behaviors and assistance with maximizing the effective use of skills.
DBT is a highly collaborative endeavor that requires a readiness and openness on the part of a client. It involves a great deal of work and a level of commitment that may differ from other forms of therapy. It is problem- and solution-focused and emphasizes dialectical thinking (holding seemingly opposing ideas in mind simultaneously). A fundamental dialectic is that of validation and change (i.e., we work to understand and appreciate a client's perspective to the fullest extent possible, accepting the client where she is, while also pushing for change).
For information about the program, please call (617) 855-2595 or e-mail us at firstname.lastname@example.org.
About McLean Hospital
U.S. News & World Report named McLean America's #1 Hospital for Psychiatry in 2013 . McLean Hospital is the largest psychiatric facility of Harvard Medical School, an affiliate of the Massachusetts General Hospital and a member of Partners HealthCare. For more information about McLean visit us on www.facebook.com/ McLeanHospital or follow the hospital on Twitter@McLeanHospital.