Inpatient or Outpatient?

It’s really too bad that when you are going through a crisis you often have to make crucial decisions. It’s the worst time to have to do this because, well, you are going through a crisis…..who thinks clearly at this time??

For us, the decision to send Dan to a residential program for OCD during the summer almost seemed like a no-brainer at the time. Just to clarify: Dan was technically not an inpatient. He entered the program voluntarily and could leave if he wanted to.

Anyway, back to the no-brainer part. The residential program Dan was accepted into is world-renowned, highly regarded, and intensive. They assured us Dan would improve enough to successfully return to college that Fall, which was his goal. Dan was not only willing to go, he wanted to go. He couldn’t wait to go! So why on earth wouldn’t we send him, especially when that was what all of the experts recommended?

In retrospect, I think we should have found a Partial Hospitalization Program (PHP) which is basically the same as a residential program aside from one very important fact: you go home at night.

In regard to the residential program, I really thought that as Dan’s parents, our relationship with the staff would be one of collaboration. You know, all of us working together to help Dan. But that was not the case. Dan was over eighteen and considered an adult. The fact that he was a nineteen year old suffering from severe OCD and not really in the best condition to be making life-changing decisions did not seem to matter.  Not only were we not consulted when decisions were being made, we were often not even informed of these decisions. So it was fine for us to pay for Dan’s treatment; we just couldn’t know anything about it. And when we did press for information, we were often regarded as pushy, overbearing parents.

So this is something to be aware of. The bottom line is these residential programs know their stuff in regard to OCD. But we know our son. And it is the whole person who needs to be treated. Why not work together?

Has anyone out there had experience with residential programs? What are your thoughts?

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6 Responses to Inpatient or Outpatient?

  1. Jennifer says:

    I agree–there is a total neglect of the whole person. Moreover, I was also treated terribly as a parent–while my son was having adverse reactions to experimental medication for OCD. Moreover, I am a trained mental health professional and have worked on inpatient units. There is a definite prisoner vs prison guard mentality that can erupt easily in such places and professionals are quick to blame parents. They call them overly enmeshed, etc. etc. The problem with OCD treatment is that yes, ERP is the method of choice; unfortunately, these therapists attack everything from this viewpoint and often miss the big picture and whole person. It’s so frustrating. They think everything is OCD even when it’s not.

  2. ocdtalk says:

    Wow, I feel as if you are me talking four years ago. You know your son, and your input should be valued and respected. I am so sorry you are going through this……….

  3. Treacy says:

    I wish I had found your blog earlier. My son was in a inpatient facility. He too was so happy to go. Although I don’t feel it was a total waste of money because they helped my son get his medication stable. He was self medicating. We had the same issues you had. We are starting to understand more about OCD and hope are Son has success in overcoming this disease.

    • Thank you for sharing Treacy. I think it is such a positive sign that your son is willing to get help as this is not always the case. I wish him and your whole family all the best on the road to recovery and hope to hear from you again.

  4. Susan says:

    My son has suffered from OCD since he was in elementary school. I was able to detect it early because I suffer from OCD. He has been in treatment for years with an OCD specialist and is on medication. However, we found that as he got older and the academic stress increased, his OCD intensified because of his fear of failure. He was able to do well in a small and nurturing high school and with the help of tutors that would help him prepare for exams in order to calm his fears. Although homework was never an issue, he would become wrought with anxiety over exams. He is now a student at a rigorous liberal arts college in New England (his choice) and was able to survive his first year with great difficulty, but after his first semester this year, became depressed and was unable to focus. His fear of failure became all-consuming. The therapist at his school thought it would be advisable for him to take some time off to do something other than academics in order to gain perspective and mature. We would love to send him on Outward Bound or a service program overseas, but he does not think he could do it. Another thought is a residential program, but after reading your post above, I am wondering if it would make more sense to do a partial hospitalization program. There is an excellent treatment center outside of Boston that has both options…hopefullly, we could secure a spot there. Do you have any further thoughts? Thanks you for this wonderful website.

    • Hi Susan, Thanks for sharing. It’s unclear to me from your comment whether your son has ever engaged in exposure and response prevention (ERP) therapy to fight his OCD. It is the first line psychological treatment for the disorder and if he is willing to put in the work, it can give him his life back. Whether it is best that he does that through a residential program or partial hospitalization program depends on so many factors. I’m not a therapist, but if you want to “chat” more about this feel free to email me at:

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