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Emotional Wellness Blog

The Adult Intensive Outpatient Program for Depression and Anxiety

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Greg Schramka, PSYD
Psychologist - Aurora Psychiatric Hospital

At Aurora Psychiatric Hospital is specifically designed to help individuals through times of extreme fear, severe depression and anxiety. More than just a matter of prompting people how to "weather the storm," this intense program teaches powerful, practical ways to respond effectively to any type of emotional distress, especially major crises, such as the loss of a job, health or relationship.

This program uses "behavioral activation," a research-supported therapy that views depression as a painful, life-disrupting experience that makes sense within the context of a person's life. A major focus of behavioral activation is on educating patients about the role of avoidance in depression and the ways that people naturally resort to it to escape stressful events and depressed feelings. Common avoidance behaviors may include staying in bed and withdrawing from friends, exercise or other normal routines. Avoidance as a persistent, long-term strategy for coping with depression keeps the problem going as it tends to block addressing important life problems, limits one's contact with antidepressant experiences, and leads to additional problems, such as bill collection notices, unintended weight gain and loneliness. These, in turn, can become new sources of depression.

A major goal of this treatment is to help people re-engage in their lives by breaking patterns of avoidance that are maintaining or worsening depression. We collaborate with patients to identify personally meaningful activities, and then strategize with them to find ways to initiate engagement in those experiences regardless of their mood. We focus on what actions need to be taken to address important life problems, as well as on those activities that might provide a sense of meaning, enjoyment or accomplishment. We also emphasize what they need to do to help manage their lives more effectively, even when this means doing things that might not be enjoyable, such as paying bills, working on taxes or tending to housework – things that are frequently avoided when people feel depressed. Activation in these important areas is what puts people back into greater contact with antidepressant experiences to help them overcome depression over time.

OutpatientDuring Intensive Outpatient Program group sessions, which meet three times a week for three hours, participants identify and share meaningful short-term goals. Making goals public within the group enhances commitment to activate oneself and creates accountability. Participants then report their progress the following session, gaining a sense of accomplishment from what they have done, as well as encouragement and motivation from the group.

There is something very powerful about taking action in small and gradual ways to begin to reverse the cycle of depression and avoidance. It may sound like a simple idea, but the reality of it is that it is far from easy. We understand how difficult it is to start to become active again when you've been depressed. Therapeutic strategies are needed to make it happen.

The Intensive Outpatient Program features components of other research-supported treatments, such as dialectical behavior therapy and exposure therapy, which can be helpful in treating additional clinical conditions besides depression. For example, distress tolerance skills derived from dialectical behavior therapy can enhance coping for those individuals who have difficulty experiencing emotional distress without responding in an impulsive or even self-destructive manner, which tends to make highly stressful situations worse.

Who is the program for?
The Intensive Outpatient Program provides an alternative for individuals in need of longer and more frequent treatment sessions than can be provided with once-a-week individual outpatient therapy. The program is especially helpful for those struggling with severe depression or anxiety and who are using impulsive or avoidant coping strategies.

Program days and times

Morning program

Monday, Wednesday and Friday
9 a.m. to Noon
Facilitator: Greg Schramka, PsyD

Monday, Tuesday and Thursday
9 a.m. to Noon
Facilitator: Mark Jensen, MSW

Afternoon Program

Monday, Tuesday and Thursday
1 p.m. to 4 p.m.
Facilitator: Greg Schramka, PsyD

Monday, Wednesday and Friday
1 p.m. to 4 p.m.
Facilitator: Mary Pelman, LPC

Evening Program

Monday, Tuesday and Thursday
6 p.m. to 9 p.m.
Facilitator: Mark Jensen, MSW

Referral process

To schedule an appointment to be assessed for admission into the Behavioral Health Intensive Outpatient Program, please contact Central Scheduling at (414) 773-4312. If you are looking for additional information or have questions about our programs, please call us at (414) 454-6675.