My Mental Health Journey Through an Intensive Outpatient Program – Part 34

Well, I finished my intensive outpatient program (IOP) today. It’s a day earlier than I expected, but I’ll talk about that later. For now, I was customarily early, but the fourth to arrive. These new group members are something else.

It was a big group today, so check-ins took all of the first hour and half of the second hour. My check-in was fine. I talked about going to my parents’ for dinner last night and watching the UCONN game. They won. Then, I talked about how nervous I am to be leaving the program. As I said yesterday, it’s time, but man is the real world a scary place.

Our first activity, it wasn’t really a tool or a skill, was saying something we’re proud of and talking about it. Normally I would have struggled mightily with this one, but today was my last day, so I said that I was proud of successfully completing my IOP. It feels like a cheat, but it’s true. We talked about how it is an accomplishment. Many people start programs like this but never finish them. It’s funny, I can completely see dropping out, but I also can’t imagine dropping out. It’s intense, but it’s also safe. I’m glad I stuck it out.

Our second topic was “Creating an Exposure Hierarchy”. Sometimes triggers are unavoidable. We used the example of a car crash on the way to work. It’s not like you can never drive again or never go to work again, but driving, or specifically driving at the scene of the accident, can be quite triggering. One way to make this easier to handle is exposure therapy. That is exposing yourself to triggers little by little in a controlled environment until you are ready to tackle the real thing. The activities chosen should be safe, controllable, specific, and repeatable. Safe is obvious. In the car accident scenario, you could start by talking about the crash or listening to the music that was on when the crash happened. It’s safe because you’re not even in a car. It’s controllable because you can stop at any time if it gets to be too much. It’s specific and directly related to the trauma. And it’s repeatable. They don’t recommend doing something once and being done. Start with something easy, do it a few times, and move on to something a little harder.

We ended the day on my farewell. As mentioned earlier, I graduated today. We went around the room and everyone said a few words. Mostly good luck and congratulations and things like that. Most of the remaining group didn’t know me that well. I was the last of my original group left. But it was a nice little ceremony. I also got a certificate of accomplishment and a coin. The coin says, “I’m worth it” on one side and, “Recovery never stops. Neither do we,” on the other. I’m not sure what I’ll do with the certificate, but I can see myself carrying around the coin to use as a grounding tool.

Now to get back to graduating a day earlier than expected. It turns out that my insurance only covered my IOP through today. That’s why I was shorted a day. One day isn’t really that big a deal, but it’s frustrating that decisions like that can be made by insurance rather than the clinician.

So, I’m all done. I think I’m going to write one more of these to sum up everything I’ve gone through, but thank you to those of you who came along for the ride. It’s been an interesting experience. I know I’ve learned a lot. Hopefully I’ve helped someone else, if only a little bit.

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