S.A.F.E. Alternatives - Self Abuse Finally Ends

S.A.F.E. Adult Intensive™ Admission

S.A.F.E. ALTERNATIVES® Adult Intensive™ is a comprehensive treatment program for patients 18 and over who engage in repeated self-injurious behavior.  The multidisciplinary treatment team uses individual, group and family therapies, to support and empower individuals to make healthy choices in dealing with emotional distress.

Program overview:

• The program operates 7 days per week for approximately 30 days.
• Intake screening at no charge
• Individual, group, milieu, and family therapy
• Impulse control management
• Education and support
• Medication management
• Case management
• Collaboration with referring professionals
• Aftercare planning

Treatment Team:

• Psychiatrist
• Clinical Therapist
• Registered Nurse
• Behavioral Health Support staff
• Expressive Therapists

The treatment program is approximately 30 days long.  It is a voluntary program so prospective clients are assessed for motivation.  Group topics include communication, role play, relationships, trauma, body image and all other issues underlying self-injury.  Clients learn to distinguish thoughts from feelings and how to verbalize those feelings.  They will also learn to use various logs to manage their impulses.

On admission, patients sign a No-Harm/Safety Contract agreeing to refrain from any self-injurious behaviors for the entire length of treatment. This includes traditional forms of self-injury such as cutting and burning, as well as less traditional forms such as restricting food or fluid intake.  If someone engages in any form of self-injury while in the program, the treatment team will determine if a written warning, probation, or discharge is warranted.

Client Responsibilities

• Actively participate in all groups
• Complete sixteen writing assignments
• Complete two role plays
• Actively participate in individual and family sessions
• Address all forms of self-injury, including food and nutrition issues
• Identify alternatives to self-injury
• Find an outpatient therapist for ongoing treatment
• Follow their individualized treatment plans
• Abide by all terms specified in the No-Harm/Safety Contract and hospital policies

Funding

Many commercial insurance plans and Medicare will pay for this treatment.  Each insurance company has its own criteria for admission and each policy has its own unique package.  The financial counselors of the business department will assist in determining individual policy coverage.  You will be responsible for the hotel costs and your outpatient medications.

Admission

1. A pre-admission screening is performed by an intake counselor for all prospective patients.
   
   Call 800-DONTCUT^® (366.8288) for an appointment or write info@selfinjury.com
   
   The screening will take place over the phone and is approximately one hour long. We will work with you to schedule it at a time that is convenient for you. The following information will be asked of you:
1. Brief history of self injury and previous treatment
2. Clinical symptoms
3. Medication list
4. Outpatient therapist and psychiatrist name, phone number, and fax number
5. Insurance data
6. Motivation for treatment assessment
7. Discharge plan
2. We will contact your outpatient therapist by phone or fax to make sure he/she:
• Is in agreement regarding placement within the S.A.F.E. ALTERNATIVES® Program
• Intend to consult with the treatment team and provide follow up after your discharge
You or your therapist may download the Therapist Consult form and send it back to us when it is completed or the therapist may call (800.366.8288) and give us the information verbally.


3. Insurance benefits will be verified by the financial department.  A financial counselor will call to discuss your benefits and let you know if there will be a co-payment due. The insurance company will not have given its approval at this point.
4. A precertification will be completed prior to admission in most cases.  We will call the insurance company to get approval for your admission.  Most insurance companies will work with us but it is important to think about what you will do in the slight chance there is a denial.  We will talk with you about this before you come to the program.

Items to have ready on the day of screening:

• Name, phone, and fax numbers for your outpatient therapist and psychiatrist.
• A list of your medications along with the dosage and times you take them.
• Your insurance information.  If you have the card with you , you can read us the information.  You will be asked to fax a copy of both sides to the financial office.  If the insurance is in a name other than your own (e.g. a spouse or parent), then we will need the insured's birth date, social security number and employment information.
• An e-mail address or fax number where we can send you some information.
  

Admission for those who are currently in another hospital:

We can begin the admission process while you are in another hospital.  We will need to gather the same information stated above.  The case manager at the hospital you are currently at can help to facilitate the process.  We will fax a portion of the screening form to your case manager and when it is returned, along with your current records, we will review all the information with you and get a history of your self-injury.  The remainder of the admission process is the same.

Readmissions:

There are times when life brings changes or you change and you find it necessary to seek readmission to the S.A.F.E. ALTERNATIVES® Program.  This process is a little different.  We will want to know what changes have occurred, how you followed your discharge plan, and what you need to work on during this admission.  You may download the attached Readmission Form, answer all questions thoroughly and mail or fax it back to us.  We will then contact you to review your answers and assess your individual situation.  The remainder of the admission process is the same.

What to bring when you are ready to come to the program:

This list may not be exhaustive, so please direct any questions you may have to the treatment team. During the admission process a member of the treatment team will inventory your personal items. Some contraband items will be placed in a bin for you to check out when needed, others will be placed in storage until your discharge (e.g. hair dryer, curling iron, make-up, razors for shaving, etc...).  Avoid bringing valuable items, however in the event that you do they will be secured according to hospital procedures.  Smoking is allowed at designated times and only in designated areas.

Non-residential clients will be given a designated area to secure valuables (i.e. purse) and contraband items (such as a sweatshirt with a drawstring) during programming.  You may wear shoes with shoe strings, pants with belts and drawstrings if you will be keeping these items on your person at all times. 

You will need:

• 5-6 changes of comfortable, casual clothes.  Note that the temperature on the unit varies seasonally so layers are recommended. (Laundry facilities are available)
• Personal toiletries, including lip balm
• Phone card for long distance calls
• Journal, folders, paper, pens, etc. to organize group worksheets and assignments (no spiral notebooks or 3-ring binders)
• Medications:  a 15 day supply of medications in the original containers and a multi-dose pill container.  Also bring money or your insurance card in case there is a medication change prior to or during your outpatient stay.

Optional items:

• Stationery and stamps to last 30 days
• iPods or MP3 players may not be used while inpatient, but can be utilized while in the outpatient portion of the program.
  
• Music (nothing graphic about sex, death or violence; nothing you have ever injured to)
• Favorite "G" or "PG-13" videos to share. (Note: Please put your name on electronics, CDs and videos for identification purpose)
• Your copy of Bodily Harm.  Many patients have peers sign their books before they graduate.  Copies can be purchased on the unit for $15.

Please ask about our restrictions on cell phone use, to be determined by facility.

The S.A.F.E. ALTERNATIVES^® Program will have a group room for its exclusive use with a lock. In this room, S.A.F.E. clients may keep and use (when not in group) iPods, headphones, and CD's.

Please do NOT bring:

• Cameras or cell phones with cameras
• "R" rated videos
• Stuffed animals (while you are here, we want you to learn to sit with uncomfortable feelings and verbalize them instead of "stuffing" them away)
• T-shirts that are sexually or verbally explicit, or deemed inappropriate by staff
• Cropped tops (bare midriff)
• Metal objects, razors, nail clippers
• Any item that could be used as a weapon
• Shoe strings, belts, and drawstring clothing items
• Any items that contain offensive material
• Heavy, bulky or valuable jewelry

Violating the contraband policy may be considered a violation of the No-Harm/Safety contract.