By Emalee Gillis, NAMI Spokane Blog Editor.
According to James Fisk, the Behavioral Health Manager at RISE, the RISE program serves a need that exists in the gap between inpatient care and traditional therapy. RISE services are intensive and are focused on building skills. Clients spend four and a half hours a day at the facility for typically three to five days a week for six to eight weeks. When you consider traditional therapy is one hour-long session a week, a normal day at RISE equals nearly five sessions of traditional outpatient therapy. In a five-day week, that number goes up to six months of traditional counseling. If a client attends five days a week for six weeks, he/she has been exposed to the equivalent of two and a half years of traditional counseling. Not surprisingly, clients who participate in the RISE program consistently report a dramatic positive change in their ability to manage their mental health upon completion of the program.
The program is divided between three groups of clients that are each served separately, 13-17 year-olds, adults 18 years and older, and pregnant and new moms 18 and older. The RISE program is offered by Providence.
The focus of RISE is on skill building. Clients build skills in five areas: emotional regulation, mindfulness, distress tolerance, interpersonal effectiveness, and the middle path. An example of a skill built that is related to emotional regulation is learning to accumulate positives. Many clients have major depression and tend to look for bad things that happen in the day. RISE therapists help clients see how a specific event might be looked at as a positive instead of a negative. They also encourage clients to actively look for and celebrate positives which improves mood.
In one aspect of mindfulness, RISE therapists help clients develop a nonjudgmental stance. RISE clients who have experienced trauma or had a lot of negative talk directed toward them often view themselves in a negative light. For example, if you forget your kid’s lunch, does that make you a bad parent? Therapists encourage participants to remember all the positive things they did as a parent that day and to view the forgotten item as a mistake any good parent could make.
One of the skills built related to distress tolerance is useful for clients who engage in self-injury. Self-injury generates relief from emotional pain, but it is not a positive coping skill. Therapists encourage clients who are feeling a desire to cut themselves to instead take an ice cube and place it on the body part that they want to cut. This helps relieve the pain in a healthier approach.
In interpersonal effectiveness, clients learn techniques like how to have a conversation that will more likely result in getting their needs met. Skills related to the middle path move away from all-or-nothing thinking and help clients keep things in balance and on a continuum.
Clients are also exposed to creative applications where art is used as a tool for therapy. They also get regular blocks of time dedicated to learning psychological approaches to positive mental health. Individual therapy is also provided where therapists discuss what specific skills the client used recently, how the skill worked, and whether another skill might have been more effective in the situation. Medication management is also part of the program. Clients also hear a presentation by NAMI Spokane on how NAMI’s support groups might benefit them after their participation in the RISE program ends.
For school-aged children, RISE works with school counselors to get workload accommodations and homework accommodations. The school counselors usually know these kids because they have behavioral concerns due to untreated mental health conditions and often have school avoidance issues. School attendance typically goes up after participating in the RISE program.
Clients at RISE can have a broad range of mental health diagnoses including depression, anxiety, PTSD, borderline personality disorder, attachment disorder, schizoaffective disorder and schizophrenia. According to Mr. Fisk, therapists in the Spokane area often make the most frequent referrals to RISE because they can see how, without coping skills to manage the intense emotions that come up in outpatient therapy, their clients struggle to make as much progress as they can. This is where RISE’s intensive skill-based approach might be the best answer.
An intake process ensures that there is a good match. If a person has active hallucinations, the intake person would likely recommend that the potential client wait till they are more stable so they can appropriately participate in group sessions. RISE sometime admits people who haven’t gone through traditional therapy first. RISE takes all insurance.
Mr. Fisk recommends that anyone thinking they might benefit from the program go through the simple intake process. The benefits could be life-changing. For more information call 509-252-6446.
James Fisk is the Behavioral Health Manager at RISE. He oversees the clinic and supervises all therapists. Previously, he worked as a therapist at Frontier Behavioral Health.
Emalee Gillis is a writer and blog editor. She is the author of the memoir Adventures on the Path to Living Well with a Mental Illness and has a related TEDx Talk.