Jump to content
CrazyBoards.org

Recommended Posts

My therapist has been trying to convince me to go into a DBT intensive outpatient program. I have been avoiding it because I am agoraphobic (I don't ever leave the house alone) and it's a hassle in terms of getting there. My disability attorney convinced me to do it because she said it would be very helpful for my case. I am scared though. 

Anyone have any experiences with IOP they want to share, good, bad, or ugly?

Share this post


Link to post
Share on other sites

I don't know how your IOP program is structured. The most helpful aspect of it for me was that I could express a problem I was having and then one of the therapists/social workers could help me right away with it (getting my pdoc to call me, placing me in a certain group therapy etc...) The major problem for me was that all of the talks and exercises are geared towards the majority of the people in IOP who are usually stressed about work or sad about a loved one dying or something similar. I am not minimizing their issues but there was no one to relate to about mania and psychosis or anything like that. I did not feel comfortable sharing in the group setting. 

Share this post


Link to post
Share on other sites

I've been in IOP four times. Three were CBT and one was DBT. The CBT IOPs were helpful but also hard for me. They were very process-oriented and I found it really difficult to be exposed to other people's pain without being triggered. I had to get up and leave the room a lot. And similar to what Ceremony said, there weren't a lot of people in the room who could relate to what I was experiencing, so I felt a little uncomfortable sharing. There were definitely benefits as well: structure, the support of a pdoc and a tdoc, a small sense of community (even though it was also a little alienating), etc.

DBT was a better fit for me. I did it for a year and half. I would still be in it if I could be. People may moderate it differently, but in my experience it was not process-oriented, it was run more like a class aimed at teaching DBT skills. I was told this is because in part DBT is designed to work for people who may be easily triggered and/or are highly sensitive. The people in my DBT group also had similar histories and dxs to me. We would learn a series of skills and keep track of our progress working with them. In group we would discuss our experiences with what we had tried and ask the group leader questions about how the skills worked. 

Share this post


Link to post
Share on other sites
25 minutes ago, CeremonyNewOrder said:

The major problem for me was that all of the talks and exercises are geared towards the majority of the people in IOP who are usually stressed about work or sad about a loved one dying or something similar. I am not minimizing their issues but there was no one to relate to about mania and psychosis or anything like that. I did not feel comfortable sharing in the group setting. 

Sorry you didn't feel comfortable sharing. I am worried about not fitting in too. I was in group therapy for anxiety that was like that - everyone's problems seemed, I don't know, I guess less severe than mine. I had the opposite experience the one time I was inpatient. I guess I'll just have to see what it's like. Hopefully it will be helpful for me, and if not, at least it will help my disability application.

Share this post


Link to post
Share on other sites

it takes time to get comfortable,a plus is knowing others out there suffer like u, u have some "peers" and are not alone, you also see a doctor at least 1x a week for med adjustments, thats a HUGE bonus, it took me 10 weeks in IOP but it got me liveable, im still all messed up lol and need therapy and cant shake the depression and sleep issues, and some things are coming back but i think its med relted, anyways give it a shot, they help

Share this post


Link to post
Share on other sites
13 hours ago, CeremonyNewOrder said:

I don't know how your IOP program is structured. The most helpful aspect of it for me was that I could express a problem I was having and then one of the therapists/social workers could help me right away with it (getting my pdoc to call me, placing me in a certain group therapy etc...) The major problem for me was that all of the talks and exercises are geared towards the majority of the people in IOP who are usually stressed about work or sad about a loved one dying or something similar. I am not minimizing their issues but there was no one to relate to about mania and psychosis or anything like that. I did not feel comfortable sharing in the group setting. 

This. 

I actually asked to leave IOP because I couldn't relate to anyone there. They all had minor depression or anxiety issues. I don't want to minimize their issues either but I don't know how else to say that. No one had psychosis or mania. I didn't share anything because I felt like a freak! Well when I tried to leave the Dr put me in the hospital the psych ward! Which I didn't appreciate at all! 

Now I basically do IOP continuously and indefinitely at my county mental health clinic. I do group therapy twice a week. Individual therapy weekly. Pdoc depends on how I'm doing. At least monthly though. I meet with my case manager at least monthly. Etc. 

Share this post


Link to post
Share on other sites

Yeah your experience highly depends on the group you are put in and how severe your symptoms. I'd think it would be more difficult if you are dealing with psychosis, hallucinations, delusions,  panic disorder, agoraphobia, social anxiety...I think there are more groups where people deal with straight up depression/general anxiety.

You mention doing a DBT program, which I did and I found to be excellent (it was given through a private practice psychiatrist though, not in a hospital). It was very structured, a small (8 person) class where you are given worksheets and practice different skills, mindfulness meditation, do "homework exercises" and talk about about how the skills went each session, and other group members provide feedback. I liked that it was more of a structured class with hands-on techniques/skills, and less an "open forum" type discussion where you just go around the circle and talk/analyze our feelings or whatever. It felt more useful and productive and less pressure on each individual to disclose your personal history.

Edited by Blahblah

Share this post


Link to post
Share on other sites

I've had a wide range of experiences.  I agree with the general consensus that a lot of times it's oriented toward depression and anxiety.  That said, in mine there have been a decent number of people who were coming off a hospital stay, so there was at least that similarity/severity.  At the most recent one I was a part of, there were others dealing with PTSD, but none with bipolar disorder.  I had to make up my own mood rating scale because there's was designed for depression.  But it was still reasonably worthwhile--it gave me something to do and some skills.

One place that I went to had a heavy focus on art therapy and other expressive therapies.  That said, it also had OT, a weekly mindfulness thing, and some general skills-related sessions periodically.  In that one, I met with the psychiatrist two to three times per week, though they said I was too drug-dependent and not skills-oriented (I'm sorry, but I can't mindfulness myself out of mania).  I also ended up in the hospital fairly shortly after that experience, as the medication that they had put me on sent me manic. 

The other didn't have nearly as much in terms of types of therapies and was more geared at giving people something to do.  I'm sure they called it (and billed it) as therapeutic, but I didn't see a ton of therapeutic work going on.

Share this post


Link to post
Share on other sites

Everyone who has experienced being psychotic while in IOP hit the nail not he head for me. I felt the odd one out and I kept trying to leave anyway because I was certain I wasn’t sick anymore. It just seemed like a big waste of time to me. Nothing to help me combat the psychosis. 

BUT... I think if it is depression or anxiety you struggle with, it offers a lot of constructive exercises for dealing with that.  

Share this post


Link to post
Share on other sites

Thanks for the insight, everyone. It's been helpful. It sounds like it can be a real mixed bag, and depends on the program you get.

Right now my big problems are severe depression and anxiety. I am not struggling with psychosis or mania (although I have in the past), but I can relate to concerns about what level the people the other people are at. I recently quit group therapy for anxiety because it seemed like everyone else's anxiety was much "less severe" than mine. I didn't want to share because I felt like a freak. On the other hand, my one inpatient experience (when I was a teenager) was the opposite. They put me in the adult ward for the night (no adolescent beds) and I felt like everyone around me was much more seriously mentally ill than I was. It's important to have a good fit.

I guess I'll wait and see. My therapist put in the referral today. I hope I will get a lot of it of it to help me, but if I don't, I'll just keep reminding myself that it will help my disability case, and at least that's something.

Share this post


Link to post
Share on other sites

I’m not sure where you are but if you are in the US make sure the outpatient program is in network with your insurance, absolutely sure (two opinions if you can), because you can get stuck with a big bill. I contested mine because I was told it was in network by the program and supposedly the insurance company told them it was too, but it wasn’t and I ended up with the hospital trying to charge me around 24 grand (I didn’t have to pay in the end but it was a LONG process to get there). I will always double check something like that now, not just ask at reception and depend on the answer given to me. I will personally make sure myself by calling the insurance company directly. 

  • Like 1

Share this post


Link to post
Share on other sites
1 minute ago, saintalto said:

I’m not sure where you are but if you are in the US make sure the outpatient program is in network with your insurance, absolutely sure (two opinions if you can), because you can get stuck with a big bill. I contested mine because I was told it was in network by the program and supposedly the insurance company told them it was too, but it wasn’t and I ended up with the hospital trying to charge me around 24 grand (I didn’t have to pay in the end but it was a LONG process to get there). I will always double check something like that now, not just ask at reception and depend on the answer given to me. I will personally make sure myself by calling the insurance company directly. 

Thanks. This is a really good point. I forgot to even ask because I was so nervous when I called. I know the hospital takes my insurance, but I will double check on the program specifically. 

Share this post


Link to post
Share on other sites

My experience with an IOP was super positive, though I've heard IOPs vary.  I would try to get a sense of the particular program's reputation before committing.  DBT skills, when I remember to use them, are SO helpful.  Regarding agoraphobia (I'm in hiding right now), I took low dose Ativan before attending.  I'm going to use a combination of medication and DBT skills to take my dog for a walk (not easy for me).  You're brave for looking into this.  I see this was in February.  Did you end up doing the IOP, @Byron-Black?    

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now


  • Similar Content

    • By Inanlae
      Mine is radical acceptance.  It centers me.  I had a ring made, with the initials "RA" to remind me.  Honourable mention to "ride the wave" and "opposite to emotion action."  More reminder rings to come.
    • By cgarcia134
      My new therapist recommended another therapist that deals with PTSD and other issues. PTSD because of loss of many family members. I mentioned to her that I can't recall many memories from my past, let alone a few weeks ago like general conversations. I can't even remember the first time holding either of my daughters. My parents fought a lot when I was younger. I know that it happened, even physical fighting, but can't remember in detail. Willing to pay whatever the cost to find out why I am the way that I am including taking expensive Latuda. 
      Has anyone had a breakthrough with dealing with their bipolar and depression? Anyone ever get some answers from a professional? I'm worried that if I don't tackle these issues now, how can I be a better parent, a better person or even consider marriage? My boyfriend thankfully is very supportive, but doesn't live with me. I'm tired of the days that I wish my life was over when I am truly blessed or times that I feel my life has slipped on by without any progress. 
    • By Blahblah
      Have any of you have had a longterm therapist becoming less & less available? I feel like she is subtly trying to get rid of me... I've seen her for a year & a half (for a long time was every week, and lately every 2 weeks and she was flexible). And now, seems I can only get in every 4-5 weeks...
      I chose her because I can walk to her office in 5 mins and she accepts low price/sliding scale. It's fine as a sounding board, But honestly, its not helping me, I'm avoiding trying to find someone else, because it's so difficult to find someone that you connect with where it doesn't take 40+ minutes out of your day to travel there...I'm not severely depressed, just the same anhedonia, no motivation, interest and general unhappiness/dissatisfaction no matter what I try or do.
      Just thinking out loud.. How long would you keep seeing a therapist if you genuinely like the person (and feel comfortable) but after a year, never leave with any insights really..she simply doesn't do CBT or behavioral therapy, only talk (well, it's mainly me talking the entire time and her asking a few hypothetical questions to think about at the end.) Out of the many therapists I've had, all of them have been underwhelming and usually expensive. I feel like quitting because after all these years I seem to be getting very little out of it :-(
    • By neptune93
      For too long, I was doing horribly. Multiple hospitalizations, mostly for PTSD and bipolar depression. Well a few weeks ago I started therapy with a great therapist that accepts medicaid. Her office has a giant window that looks over Lake Michigan and that almost makes me happier than the therapy itself. Well anyways, we've been doing standard talk therapy and CBT and the more I talk, the more my issues seem less important. The arguments with family, the anger at my landlord, etc. They just seem less important and don't bother me anymore.I haven't been to a therapist in a year and a half because I thought it was pointless and didn't help but I guess I never found the right therapist (with an awesome view while pouring my guts out.) I also switched from geodon to seroquel 150mg so that is helping too. I am able to drink coffee again without panic and anxiety. I am gaining more interest in things like video games, reaading, coloring. Whereas before I couldn't even shower or brush my teeth. I just stared into space for hours. I really hope this lasts. I've never felt so normal in awhile. I've stayed at depression centers for weeks and months, ptsd trauma center for over a month. Nothing did it. Maybe this is just a fluke and eventually it will peeter out, but I'm hoping for the best. Wish me luck!  
    • By 3xEmonkey
      When my psychiatrist quit, I had no idea. I was assigned another one, who will very likely leave me. It's one of those programs where the doctors are all residents. I walked in, and the lady at the desk told me the doctor left. Wasn't a big deal. I see the psychiatrist for meds. As long as the meds work, all she needs to do is write prescriptions. I do like that she's nice.
      So now my counselor quit and I only cry when I think about it. Five years. I had her before either psychiatrist. She closed the doors. No more patients. Doing her own thing now. That's awesome. She referred me to another whom she knows personally and met while working together. I'm sure because she's sure I'll be fine.
      But I was already perfectly fine and dandy, and didn't really see the need for her to leave and for me to see a new lady. What am I supposed to do? The appointment is scheduled. This woman is, as long as we get along, my new counselor. It's a whole new person I am supposed to trust off the bat, and confide in. I'm supposed to assume she knows what she's doing. We're starting on our third date here, and I'm the only one in the relationship freaking out. 
      If you've done this before, what's the easiest way to start over? I know she's a different person, and it will be like starting from scratch for me. Old counselor sent her notes and talked about me. I'm going in blind and she is not, but it's not about her.... so, okay? 
×