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by Mandolin Porter, LCSW-R
I would like to share with you what is often considered the “hidden jewel” of mental health treatment. Continuing Day Treatments (CDTs) are defined by the NYS Office of Mental Health website as programs that “provide adults with serious mental illness the skills and supports necessary to remain in the community and or work toward a more independent level of functioning. Participants often attend several days per week with visits lasting more than an hour.” CDTs are considered the highest level of outpatient care prior to inpatient hospitalization.
CDTs, however, encompass so much more than this simple definition. Often seen as an outdated treatment model, CDTs, in my experience, have been an incredibly powerful intervention for a diverse target population. In honor of World Social Work Day, I would love to share some insights on how serving an intergenerational population has built a sense of well-being unmatched in other treatment models.
CDTs serve adults 18 years of age and older. Individuals tend to have diagnoses such as schizophrenia, bipolar disorder, borderline personality disorder, and post traumatic stress disorder. Often faced with an ACE score of four or more, these individuals are faced with much adversity.
They attend this program up to five days a week, for four hours a day. They participate in four group therapy sessions, have access to a psychiatric nurse practitioner, registered nurse, and regular individual appointments with their assigned individual counselor. Groups focus on symptom management, communication skills, meditation, physical health, and more.
The magic of this program, more so than that plethora of interventions listed, is the use of the milieu model. Clients have the time to connect with peers in between groups and build healthy relationships. They are given a safe space to practice use of skills that help them to remain independent in the community.
Clients in the CDT I work for range from age 20 to 82. This diverse age range has allowed meaningful relationships to form in the program that have been healing in ways that a prescription or a therapeutic worksheet could never provide.
Younger clients often look to older clients for mentorship, guidance, and wisdom. Older clients then step into these roles with a sense of purpose and reason. You will regularly hear of a friendship forming between those who may have a 30-year age gap between them. This intergenerational group celebrates successes together, mourns losses together, and faces trials together.
The staffing at this program is also intergenerational, with employees in their twenties to sixties. This unique makeup provides an opportunity for clients to connect and form healthy therapeutic relationships with staff across the lifespan. Clients often come to us with prior negative interactions with past providers, and CDTs become a space where trust unites this community.
In my 13 years of clinical practice, the most effective treatment I have had the honor of witnessing is the power of community. CDTs utilize a milieu approach to allow clients to form communities they often don’t have elsewhere.
Mandolin Porter, LCSW-R
Mandolin Porter, LCSW-R, has worked for more than a decade at Cortland County Mental Health in CNY. As a senior mental health clinician, she is responsible for managing the Continuing Day Treatment Program, as well as running intimate partner violence and sex offender treatment groups and seeing clients for individual therapy in the outpatient clinic.