A warm, supportive therapeutic community with a skills-based program achieves social and vocational success for residents.
Schizophrenia and Psychotic Spectrum Disorders
Schizophrenia and Psychotic Spectrum Disorders are serious mental illnesses affecting thought processes, emotions, and behavior. Symptoms may include paranoia, severe and unpredictable mood swings, hallucinations, delusions, disorganized thinking, and bizarre behavior. Untreated psychosis results in more severe symptoms, hospitalizations, social problems, and poor health, including a shorter life expectancy. Our dedicated staff create a safe and accepting environment in which medications are essential in combination with individual and group psychotherapy. When provided in a therapeutic community, these measures contribute to a total immersion learning environment that helps residents decode the social, family, and emotional impact of their symptoms. Helping restore emotional balance, building resilience against future breakdowns, and identifying triggers of stress are crucial in breaking the cycle of emotional collapse. In time, many individuals with psychotic disorders can achieve recovery with meaningful social interaction and occupational functioning.
Treatment-Resistant Bipolar Disorder
Treatment-Resistant Bipolar Disorders are complex, hereditable illnesses marked by extreme mood swings lasting more than a few days and without a clear external triggering event. Manic phases of the illness present as sleeping very little and feeling energized—often with reckless behavior, excessive spending, and hypersexuality. Depressive phases can last months and present substantial risk for suicidality. Adults with treatment-resistant forms of bipolar disorder typically need mood stabilizers, psychotherapy, family therapy, and vocational rehabilitation services to help reverse damaged familial and social and relationships and restore optimal functioning.
Borderline Personality Disorder (BPD)
Borderline Personality Disorder (BPD) is a severe mental illness marked by great difficulty regulating emotions, impulsivity, suicidality and self-harm, impairment in relationship functioning and social cognition, affecting the ability to read people and their intentions accurately. In more serious cases, it is common for individuals to have multiple psychiatric diagnoses. Fortunately, there are several effective treatments for BPD including mentalization-based therapy, an attachment-based therapeutic approach that helps the individual co-regulate emotions and restore healthy mentalizing to improve decision-making and relationship functioning. Medications can be helpful in reducing symptoms, but the front-line treatment is psychotherapy and social engagement. At Monarch, we specialize in individual and group mentalization-based therapies, including the unique Mentalization and Attachment Priming Seminar, developed by Dr. J. Christopher Fowler, Monarch’s Executive Clinical Director, and implemented both at Monarch and Houston Methodist Hospital.
Treatment-Resistant Depression (TRD)
Treatment-Resistant Depression (TRD) is in a special class of depressive disorders that rarely respond to medications or therapy alone. When depression persists despite normal treatment, those suffering become disillusioned and may blame themselves for lack of a positive response. Suicidal ideation and substance use are all too common responses to such situations and complicate the lives of the affected. Combatting TRD requires multimodal treatment including medication augmentation strategies, neurostimulation, intensive psychotherapy, and behavioral activation (exercise, social activity, work, and volunteerism). Our affiliation with Houston Methodist Hospital’s psychiatry department allows for second opinions and rapid referral for neurostimulation services if deemed appropriate.
Treatment-Resistant Obsessive-Compulsive Disorder
Treatment-Resistant Obsessive-Compulsive Disorder does not respond quickly to evidence-based treatment approaches such as exposure and response prevention (ERP). The intensity of exposures in briefer treatment programs can be overwhelming and cause increases in anxiety, obsessional thoughts, and compulsive behaviors in some individuals. Monarch’s slower-paced approach allows individuals to modulate exposures and rely on staff who help them co-regulate intense emotions generated by the hard work of ERP.
Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder is a persistent condition of autonomic hyperarousal following traumatic event(s) that may last months or years. Sounds, smells, images, memories, and associations with traumatic events can trigger severe flashbacks, nightmares, and frightening memories of the trauma. Avoidance of situations that bring back memories of traumatic events, hypervigilance, anxiety, and depressed mood can rob affected individuals of their quality of life. Treatment includes trauma-informed psychotherapy as well as medications to manage symptoms.
Treatment-Resistant Anxiety Spectrum Disorders
Treatment-Resistant Anxiety Spectrum Disorders develop when symptoms persist despite evidence-based medication and therapy. Multimodal treatments are needed including higher doses of medications, augmentation strategies, neurostimulation, and intensive psychotherapy, plus behavioral activation such as exercise, social activity, work, and volunteerism. Our affiliation with Houston Methodist Hospital’s psychiatry department allows for second opinions and rapid referral for neurostimulation services if deemed appropriate.
Suicidal Ideation and Self-Harm
Suicidal Ideation and Self-Harm exist within many psychiatric disorders and can be both dangerous and frightening for families and their affected loved ones. While there are several effective psychotherapy modalities, Monarch’s mentalization-based approach restores physical and emotional stability by creating a sense of interpersonal safety in the community. Expert staff help with co-regulating intense emotion, modeling curiosity about suicidal states of mind, and encouraging residents to identify meanings and patterns that precipitate suicidal states. Monarch utilizes the protocol “Core Principles in Treating Suicidal Patients,” which was written by its Executive Clinical Director, Dr. J. Christopher Fowler.” The modality is taught in medical schools, residency programs, clinical/counseling programs, and in advanced seminars for seasoned clinicians.
Co-Occurring Substance Use
Many adults with severe mental illness use substances such as alcohol and drugs to deal with the pain of their disorders. This type of self-medication interferes with effective pharmacological management and psychotherapy. Monarch works with residents who struggle with intermittent substance use but who do not have a primary substance use disorder. Monarch encourages complete abstinence and supports AA/NA, Smart Recovery, and Refuge Recovery meetings; we also consult with licensed chemical dependency counselors to augment our treatment. Utilization of anti-craving medications can help residents fight urges to use as they find more meaningful activities and learn new strategies for dealing with strong emotions and internal conflicts that drive substance use.