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ADOLESCENT DUAL DIAGNOSIS RESIDENTIAL SERVICES

Welcome to The Landing at McLean(R) Hospital. For Help and Information Call 877-412-3445.

Adolescent Dual Diagnosis Residential Services

Adolescent Acute Residential Treatment (ART)

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Program Overview
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Welcome to The Landing at McLean® Hospital

The Landing at McLean® Hospital is a six week dual diagnosis residential treatment program combining intensive and transitional programming for adolescents and young adults through age 19 who are struggling with co-occurring substance use disorder and psychiatric illness such as ADHD, anxiety, depression and bipolar disorder and require extended care.

The program is especially designed for adolescents who are prepared and motivated to attain a more complete level of recovery. It is also helpful to those who would not be ready to step down to partial or outpatient care after two weeks in an acute residential treatment program and would require further residential treatment. An extended length of care helps adolescents consolidate the skills acquired during treatment and integrate this learning for when they return to home life and the community.

The program offers a full range of services, including assessment and consultation, individual therapy, group therapy, skills training, psychoeducation, psychopharmacology and family therapy.

The Landing program encompasses two phases of care:

The initial phase is two weeks long and focuses on stabilizing adolescents who are in acute crisis due to substance abuse and psychiatric issues. Adolescents can be referred to the program from home or any level of care, including inpatient, partial and outpatient.

The transitional phase is two-to-four weeks long and is designed to help adolescents go further in their journey to recovery.

Our Leadership and Staff

Our clinical management team is comprised of child and adolescent psychiatrists, clinical psychologists and clinical social workers with extensive experience in the treatment of adolescents with substance use disorders and other complex psychiatric illnesses.

  1. Ranna I. Parekh, M.D., Medical Director
  2. Jessica Feinberg, LICSW, Director of Clinical Services
  3. John Rodolico, PhD, Director of Adolescent Addictions Training, Senior Addictions Consultant
  4. Cynthia Kaplan, PhD, Associate Clinical and Administrative Director, Child and Adolescent Programs (CAP)

A multidisciplinary staff of child psychiatrists, psychologists, clinical social workers, nurses, recreational therapists, clinical educators and mental health specialists are trained and experienced in a wide array of treatments, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing, contingency management, and psychopharmacology. Staff members have experience working with patients from diverse cultural and socioeconomic backgrounds.



Setting and Program Life
The Landing at McLean® Hospital

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Our residential dual diagnosis programs are located on the second floor of East House, one of several historic buildings on the McLean campus. Though McLean Hospital is located only minutes from Boston, its setting offers a pleasant, peaceful environment that enables adolescents to focus on improving their mental health.
The program facilities offer:

  1. comfortable bedrooms;
  2. common areas for groups and conversation;
  3. a fully equipped kitchen; and
  4. access to a fitness facility with state-of-the-art equipment and basketball court located on the McLean campus.

The programs operate in an unlocked setting, maximizing each individual's responsibility and capacity for self-control. Groups and structured activities involve skills training, team building, preparing meals and recreational therapy. These pursuits enhance daily living skills, build self-mastery and esteem, and provide a sense of autonomy and membership in a community.

Parents, click accommodations for information on overnight places to stay in the area.



Assessment

Upon admission, each adolescent meets individually with a psychiatrist and case manager for an initial assessment that includes diagnostic evaluation and treatment planning. The evaluation takes into account biological, psychological, and social strengths and vulnerabilities. The treatment plan includes plans for medications, if indicated, as well as goal setting, skills training, family interventions, and aftercare planning.

When needed, additional specialty consultations are available in neurology, eating disorders, personality disorders, Asperger's disorder, and trauma. Following any specialty consultation, the multidisciplinary clinical team develops an individualized treatment plan that includes the recommendations of consultants.



Length of Stay

The average length of stay at The Landing is six weeks, with approximately two weeks of that time spent in the initial phase of treatment and four weeks in transitional care treatment. The Landing's extended length of care is for adolescents who would benefit from additional support and skills training prior to transitioning back into the community.



Treatment Approach

Our goal is to help adolescents become and remain drug and alcohol free while treating any co-occurring psychiatric illness and maintaining a steady developmental course. Many adolescents do not enter treatment willingly. We use a motivational approach to work through ambivalence about change. This serves to empower adolescents and families.

We specialize in treating adolescents through groups—educational experiences and group therapy that focus on strengthening important relationships, fostering coping skills and impulse control, and creating and implementing relapse-prevention plans. Adolescents attend these groups daily, five days a week. We use multiple modalities, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational interviewing (MI), 12-step facilitation methods and contingency management.

All adolescents in the program receive a diagnostic evaluation by a child and adolescent psychiatrist. The results lead to specific treatment plans that may include medication. For adolescents prone to self-destructive behaviors, including self-injury and suicidal ideation, DBT and CBT are used to help them develop the coping skills to deal with emotionally overwhelming circumstances, interpersonal conflicts and self-destructive urges.

Additional components of treatment include case management, classroom-based skills training, individual and family meetings, expressive music and art therapies, skills coaching, group and milieu therapy and recreational therapy. During the transitional phase of care, adolescents attend specialized groups designed to help them put their new skills to use. They also go out into the community to attend 12-step meetings, volunteer, and use their newfound skills outside the program.

For more information, click About Our Treatment Methodologies.



Parental Involvement

Because parental involvement is critical to the initial and ongoing success of treatment, parents are involved in treatment at each step. To enhance involvement, we communicate closely with parents throughout the course of their child's stay.

Parents participate in the initial evaluation, subsequent family meetings, weekly parent support and skills groups, and discharge planning with the clinical team. We encourage all parents to attend these skills training groups because adolescents make more effective use of treatment when they and their parents learn the same skills.

Parents are allowed scheduled daily visits after 3pm and all-day weekend visits. These visits furnish opportunity for adolescents and families to practice new skills and behaviors.



Program Components

During the initial phase of residential care:

  1. Each adolescent undergoes an assessment of his/her substance use and co-occurring psychiatric illness, taking biological, psychological, and social strengths and vulnerabilities into consideration. This allows the clinical team to develop an appropriate treatment plan that meets the specific needs of that individual.
  2. Skills training modules are introduced during classroom time and are reinforced through group exercises.
  3. Each adolescent meets with a child and adolescent psychiatrist for psychopharmacologic consultation.
  4. Adolescents participate in therapeutic passes with family members on evenings and weekends.
  5. Individual time during evenings and weekends is available to complete schoolwork. School-appointed tutors may meet with the adolescents on the unit.
  6. Weekly parent support group and family meetings are available for parents.
  7. Recovery mentoring/skills coaching are available on weekdays during group hours.
  8. Adolescents work with their clinical team and families to develop relapse-prevention and crisis management plans.

Click here to view the "Typical Daily Schedule" during the initial phase of residential treatment.

During the transitional phase of care:

  1. Based on the initial assessment of substance abuse and psychiatric illness, as well as progress thus far in the program, adolescents work with their clinical team to develop treatment goals to help ensure a successful transition back to the community.
  2. With a focus on consolidation and generalization of skills, adolescents at this point in treatment participate in exposure exercises and have opportunities to put skills learned in classroom and groups into action.
  3. Staff psychiatrist continues to be available for ongoing psychopharmacologic consultation. In addition, the clinical team works with the adolescent to help increase medication compliance.
  4. In addition to continued therapeutic passes with family during evening and weekend hours, adolescents participate in field trips incorporating fitness (hiking, ropes course, rock climbing, bowling, etc.), cue response training, AA meetings and community service.
  5. In addition to the continued opportunity to meet with school-appointed tutors, tutoring may be available at an additional cost to further assist with schoolwork if needed.
  6. In addition to a weekly parent support group, parents participate in weekly parent education and multi-family groups. Parents meet with their child's clinical team twice weekly and have the opportunity to write an impact letter to their child. Parents are also introduced to contingency management.
  7. Because adolescents are participating in exposure exercises, coaching for recovery mentoring/skills is available 24/7 during the transitional phase of care.
  8. With a focus on transitioning to the community, adolescents participate in enhanced aftercare/transition planning. This plan may include assistance with transitioning back to outpatient treatment or aftercare program, to school, to afterschool activities/jobs/social activities, to 12-step meetings, or other community services.

Click here to view the "Typical Daily Schedule" during transitional care.



Advancing Cognitive Skills / Supporting Education

For all adolescents, cognitive skills are supported and expanded through task-oriented goal-setting groups. Students struggling with issues related to substance abuse, anger management, emotion regulation and trauma utilize specific curricula that help them work toward recovery.

Adolescents may use daily room time and time on the weekends to work on school assignments. Tutors provided by the school may come to the program to assist adolescents in completing their work. Regular contact with local educational agencies is encouraged. Private academic tutoring is also available for an additional fee.

For longer-term options, McLean offers a therapeutic day school on campus, The Arlington School.



Admission / Making a Referral

For admission or to make a referral to The Landing at McLean® Hospital, call Sarah Hunt at 617.855.2804 or Gale Norway at 617.855.2816, or call us toll free at 877.412.3445.

Please let us know that you are calling about The Landing so we can send additional information that is needed (including clinical and financial requirements).



Discharge and Aftercare

Substance abuse and psychiatric illness may be chronic conditions that require continued attention over time. We emphasize continued treatment to increase resilience and functioning after the acute phase is resolved. The treatment team works closely with patients and families to develop appropriate referrals and aftercare plans. Based on clinical needs and progress made during treatment, the treatment team may recommend that continued partial care treatment take place at McLean Hospital or at another program. If a longer term therapeutic school or residential treatment, other than at McLean, is being considered, we offer an onsite educational consultant who has toured over forty programs across the country.

For adolescents who have completed residential care and are ready to return to school and their community, the treatment team collaborates with adolescents, parents, schools, outpatient treatment programs, and community agencies to foster a smooth transition back to home.



Payment and Insurance

The Landing is primarily a self pay program. However, insurance will often reimburse for the initial residential phase of treatment. If coverage is denied, the private pay rate for the initial phase is $750 per day. The transitional phase of treatment is self pay. The cost is $900 per day. Insurance or other third party reimbursement is not accepted for this portion of treatment.

Families and others interested in our programs should contact their insurance carrier, employer or McLean patient accounts at 617.855.3311

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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.

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12.2013