Why You Do NOT Get Individual Therapy at a Behavioral Health Hospital
Created by: Michelle Luszczewski LCSW, LCADC on
I spent my practicum during my master’s program and subsequently obtained my clinical hours for licensure at a behavioral health hospital, also known as a psychiatric hospital. One of the biggest misconceptions about a behavioral health hospital is that you will receive one-on-one therapy while you are there. In reality, it is harmful to conduct individual therapy during such a short time frame. No real processing or progress can be made during a 3-7 day stay in a hospital for mental health treatment. While you are at a behavioral health hospital, the main therapeutic option provided is group therapy. Group therapy typically includes psychoeducation on topics such as coping skills, emotion regulation, different mental health diagnoses, the importance of continuing medication, the value of attending therapy, and other relevant topics.
Individual therapy does not take place at a psychiatric hospital because there is not enough time to build a client-therapist relationship, unpack the history of events that led to hospitalization, or ethically de-escalate the years leading up to the situation in which someone presents to the hospital. When admitted to a behavioral health hospital, a client is there for crisis stabilization. If you are having thoughts of suicide, harming someone else, thoughts of homicide or have an inability to care for yourself the behavioral health hospital is there to keep you safe during the crisis and address the current symptoms.
My director at the time explained that a behavioral health hospital is similar to an emergency room at a hospital. When you go to an emergency room with a medical condition, such as a broken arm, the emergency department provides tests that support a diagnosis and offers treatment options, such as splinting, casting, or surgical intervention if needed. Once the emergency department completes its treatment (e.g., applying a cast for the broken arm), they refer you to your primary care doctor or a specialist for follow-up care. The emergency room addresses the urgent situation and then refers you for ongoing treatment. It does not become your primary care doctor, nurse, or laboratory.
At a behavioral health hospital, a patient is admitted due to a mental health crisis. During the patient’s stay, they meet with a therapist, nursing staff, and psychiatrist. If the patient requires medication, the psychiatrist (a doctor who has completed medical school and specializes in mental health) will prescribe medication. The time spent at the hospital is used to initiate medication and monitor for any adverse reactions during the first few days of treatment. The therapist meets with the patient to gather information on their needs and works with the psychiatrist to develop a discharge plan. The therapist also provides group therapy at least once a day. Programming can vary depending on the hospital. The behavioral health hospital where I worked did not require attendance at group therapy as part of the discharge requirements.
Once you and the psychiatrist determine that there are no adverse reactions to the medications, the doctor will discuss how much longer your stay will be before discharge. Upon discharge, you are typically provided with a 2-week prescription for your medication, along with appointments scheduled with a psychiatrist or psychiatric nurse practitioner (who can prescribe medication) and a therapist.
It is essential to carefully review all of your discharge paperwork to ensure you understand your appointment dates and times. These appointments are arranged to ensure you do not run out of medication and can continue addressing your mental health concerns with a therapist. I suggest asking questions before leaving the hospital if there is any confusion or uncertainty about your scheduled appointments.
Looking for help or support in a judgement free zone? Schedule an appointment with Michelle by calling (702) 527-8362 or by emailing evokeinsighttherapy@gmail.com