Picking up on a theme from our Pride Month blog, we want to talk about traumatic treatment and therapy practices. This discussion may be difficult, and it may be uncomfortable, but it’s necessary to address how treatment itself can be potentially harmful for patients regardless of their primary diagnoses.
By addressing treatment trauma head-on, we hope we can help end the practices that do more harm than good.
What is treatment trauma?
There are a number of practices that have been, and still sometimes are, used in the treatment of mental health and eating disorders that are clinically shown to traumatize patients when they occur. From patently denying the lived experience of a patient in therapy to abusive treatment in facilities, stories of traumatic treatment practices pervade mental healthcare.
A traumatic history
Dating back to the days of Bedlam, the asylum in London founded in 1247, anti-therapeutic treatment has been an unfortunate, but well-documented, part of the treatment of mental illness. Just a handful of these abusive types of historical treatment include:
- Forced sterilization
- Unwarranted electroshock treatment
- Forced insulin shock
- Days and weeks in shackles
- Isolation of non-violent patients
When we add to these the fact that many people were institutionalized for reasons other than medical need (including women considered “free thinking,” and those in opposition to influential people), it seems shocking that change did not happen in our field sooner.
We owe the beginnings of change in mental healthcare to the investigative work of Nelly Bly, an investigative journalist who went undercover into New York City’s Blackwell Island asylum in 1887. While there, Bly experienced and reported on abuses including inedible food, long periods of isolation, forced silence, and a lack of protection from the cold.
As Bly wrote:
“Take a perfectly sane and healthy woman shut her up and make her sit from 6 a.m. to 8 p.m. on straight-back benches, do not allow her to talk or move during these hours … give her bad food and harsh treatment, and see how long it will take to make her insane. Two months would make her a mental and physical wreck,”
While we’ve thankfully moved largely past the days of beating patients and forced lobotomies, and away from the institutionalization of the majority of mental health patients, some of the types of treatment that Bly experienced still exist in some facilities.
The current state of affairs
As Health Affairs published in a 2018 article, “Recent investigative journalism has provoked public concern about instances of alleged abuse, negligence, understaffing, sexual assault, inappropriate medication use, patient self-harm, poor sanitation, and inappropriate restraint and seclusion.”
A very recent lawsuit against a residential treatment center in Utah alleges a wide array of abuses and traumatic experiences. According to the Salt Lake Tribune, the lawsuit filed by 26 of the former patients of the facility, alleges that program staff:
- engaged in harmful group therapy tactics,
- shamed young people for expressing their sexuality,
- put clients in painful physical restraints
- gave them unneeded medication.
The lawsuit also “alleges that the program engaged in a “referral scheme,” where it would pay education consultants to recommend its program to parents with children who were struggling in traditional school settings.”
While the facility denies these allegations, there is a history of similar treatment at other facilities in Utah and beyond.
Why is this happening?
At the current moment, we see treatment trauma falling into at least one of three categories: bad programs, bad actors within programs, and a misalignment in the philosophies of the program and the client.
Bad programs are not necessarily deliberately bad. They often start as well-intentioned programs, and then somehow the treatment philosophies get watered down over time, or the wrong leadership gets put into place. Sometimes, as with the centers in the Utah lawsuit, a lack of oversight and regulation leads to a series of disastrous decisions in service of the financial bottom line.
Bad actors can happen nearly anywhere. Though every program takes steps to ensure that they are employing only the best staff, sometimes bad actors slip through. And whether tis a result of opportunity or inadequate supervision, sometimes red flags are missed. It’s at that moment that a program MUST respond as thoroughly as possible. But as history shows, facilities sometimes are more concerned with their own interests than their clients’.
Occasionally there is a mismatch between what a program offers and what a client needs. This may be a client with religious trauma sent to a religion-centered program. Or it may look like a client who needs strict guidance to understand their behavior being sent to a less-restrictive program. These misalignments in treatment can cause trauma.
Help for recovery
There are many challenges that treatment trauma poses for recovery. When an individual is bullied, shunned, or in the case of one story from the Utah lawsuit “forced to sit and listen as one person after another berates her,” their path to wellness becomes so much more complicated.
Not only do these patients need to overcome whatever challenges they may have faced when they entered the previous treatment, but care and time must be taken to address that trauma as well. Trust must be restored in the entire process of mental health or eating disorder treatment.
At Galen Hope, we have had the chance to work with a number of patients who have encountered trauma in prior treatment. We are encouraged by their reports of “night and day” differences in the care we offer.
Galen Hope founder and President Amy Boyers thinks that one key step that parents, clients, and providers, can take to immediately help improve this scenario is to develop a keen sensitivity to the past trauma of the client, and to understand that many come to treatment in a fragile mental state. Such a state, Boyers says, can also result in a client perceiving trauma from otherwise careful treatment.
Boyers suggests that it is vital that clients and their families know who the leadership is at a facility, and that they have access to them when needed. Transparency in leadership and philosophy is an essential part of how we operate at Galen Hope.
In keeping with our mission to provide a community of integrated wellness, Galen Hop offers a weekly community meeting where clients, staff, and our leadership can engage in transparent and open communication. We discuss what is working, and what we can do better. We address concerns and applaud successes. And we take client suggestions very seriously and integrate them wherever possible.
Treatment trauma is an ongoing conversation at Galen Hope, and in our industry. It is a topic that we will revisit in our blog. Please subscribe to our newsletter to be a part of this conversation.
THE ROAD TO WELLNESS STARTS BY SEEKING HELP. TODAY.
Built on the principles of assertive community treatment, Galen Hope is an eating disorder and mental health treatment center offering individualized treatment options that include Intensive Outpatient (IOP) and Partial Hospitalization Programs (PHP). As a “Community of Integrated Wellness,” we pride ourselves in fostering a thoughtful and meaningful care experience that can guide our clients on their road to recovery and increased quality of life, regardless of diagnosis. Galen Hope currently offers separate, age-specific programming for female and transfeminine adolescents ages 12-17 and adults 18 and up, as well as a gender-specific programming for males and transmasculine individuals with eating disorders and primary mental health diagnoses.
To learn more, or to join our community for integrated wellness, please contact us today.
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