IOP, as it’s called, can be thought of like a “recovery” menu.

Juliet Nelson, dialectical behavior team leader at the Bert Nash Center, left, and Eunice Ruttinger, Adult Services director, head up the intensive outpatient program at the Center. IOP includes group and individual therapy and skills training for people who are going through a mental health crisis.

Included on that menu is a whole range of mental health services that are available, depending on the client’s needs.

The intensive outpatient program (IOP) at the Bert Nash Community Mental Health Center has been helping Douglas County residents since 1997 — and keeping them out of state and private hospitals whenever possible.

“IOP is a program that is in lieu of being in the hospital,” said Eunice Ruttinger, Adult Services director at the Bert Nash Center. “The program is designed for those individuals we are trying to help divert from going into a hospital or individuals who have not been responsive to other treatments.”

That was the case with Teresa Treanor of Lawrence. She spent two weeks at an inpatient facility in another state, but came back feeling more depressed.

“I went directly to Bert Nash and was able to get better quality therapy and be at home after the three hours per day for six weeks in IOP,” Treanor said. “So I could actually live my life in the comfort of my own home with my husband and dogs and be with my family; with help a phone call away.”

IOP is preferred to hospitalization, said Bert Nash team leader Juliet Nelson, for numerous reasons.

“Really, hospitalization hasn’t been shown to be that effective for individuals in the long-run,” Nelson said. “It can be necessary to prevent someone from doing something really impulsive like killing themselves. But in terms of actually helping someone learn skills and learn how to be in the community while they’re integrating those skills, hospitalization doesn’t work well, because it’s kind of like a lousy vacation. You come back and you have your same issues, in addition to a big hospital bill.”

People who are going through the intensive outpatient program learn new skills, based on another acronym — (DBT) dialectical behavior therapy.

DBT is what is called an evidence-based practice. DBT was developed by noted psychologist Marsha Linehan and targeted people who were in need of intense services because they were self-harming or suicidal.

The research base, including randomized controlled trials and outcome studies (including data collected at the Bert Nash Center), continues to grow in favor of DBT for a number of different disorders, even beyond those that involve self-harm or suicidal behaviors.

“Evidence based means there has been specific research on the outcomes,” Ruttinger said. “We have evidence that shows us that this is a practice that works for people.”

The Bert Nash Center’s DBT program has also been expanded to include adolescents, ages 12 to 18, and their parents. Multifamily skills training groups include parents and their adolescents so families learn the skills together.

“The reason it was expanded so easily is it’s a comprehensive program,” said DBT team leader Nelson. “The skills are appropriate for a variety of different diagnoses. In fact, they are useful for anyone.”

There are four primary skills that are taught through DBT: emotion regulation, distress tolerance, mindfulness and interpersonal effectiveness.

“These four skills sets cover areas that are commonly problematic for people struggling with psychiatric issues,” Nelson said.

The intensive part of the intensive outpatient program comes from the frequency of skills-training groups and the number of services offered.

“People will be in group therapy twice a day, you’ll also have an individual therapist you will see at least once a week, and then you have the availability of coaching calls,” Nelson said.

Group therapy is an important component of the intensive outpatient program. Typically, there are 10 to 12 people on the intensive outpatient roster at any given time, who are at various stages in the program.

“Generally people find the groups supportive and non-confrontational. The format is a bit like a classroom, with the topic of study being self-regulation and recovery. It’s also a good way to connect with other people who are in pain,” Nelson said. “That’s something I hear all the time, ‘I had no idea there were other people who feel the same way I do.’ With depression and other mental health issues, people feel so much shame and are often isolative. That’s the fabulous thing about the group process. It shows people they are not alone.”

The intensive outpatient program at Bert Nash runs for about a month. Then there is a step-down process where the frequency of therapy groups will scale down over a four-week period. Upon completion of the intensive outpatient program, people can continue to receive services on an ongoing basis through the outpatient dialectical behavior therapy program or other outpatient services as appropriate.

People who enter the intensive outpatient program are dealing with a serious mental health crisis. These are tough cases, and timing is critical.

“We get a lot of referrals, because people understand that this is immediate, that they can get in very quickly,” Nelson said. “With crisis situations, you really have to work fast. We don’t like for anybody to have to wait for this service.”

For information about the intensive outpatient program at the Bert Nash Center, call 785-843-9192 or email talktobert@bertnash.org.

Jeff Burkhead is Communications Coordinator for Bert Nash Mental Health Center. Contact him at jburkhead@bertnash.org.