Program for Assertive Community Treatment (PACT): Dr. Ross Ellenhorn on MHNR

Join our host Kristin Walker as she interviews Dr. Ross Ellenhorn of Dr. Ellenhorn and his former partner, Dr.  Madhavl Prakash, founded Prakash Ellenhorn, now Ellenhorn, with the goal of  synergizing their expertise and experience to create a private, state-of–the–art PACT program.  Not only will you learn about Ellenhorn, a facility that embraces a holistic and psychosocial perspective, but you will also learn about the man that runs a vibrant, energized organization that is innovative,  flexible, thoughtful, and provides individualized treatment planning for clients .  Dr. Ellenhorn is the first person to receive a joint Ph.D. from the prestigious Florence Heller School for Social Welfare Policy and Management and the Department of Sociology at Brandeis University. After the interview, you will understand that this first won’t be his last.


How does  Ellenhorn’s treatment approach differ from other models?

Ellenhorn’s  “whole person” model aims to help people recover not only from the disruption caused by psychiatric experiences, but also from social losses. We focus on psychosocial rehabilitation and recovery, the evidence-based best practices in clinical treatments, recreational and group experiences, thorough diagnostic investigations, vocational/educational counseling, best practice approaches to people with co-occurring addiction and psychiatric issues, and help with daily activities in the community. We provide these services through a model that is comprehensive, flexible, mobile and focused on empowering our clients as the leaders in their care. As a PACT program, Ellenhorn is a “single source” model of treatment. This makes us unique among typical community-based services. Instead of providing only one component of a person’s treatment and referring-out for other services, we offer a full range of rehabilitation and treatment resources delivered by a multidisciplinary team.

What is PACT?

Ellenhorn is a Program for Assertive Community Treatment (PACT) team, providing integrated, comprehensive, multidisciplinary care. PACT is the most widely tested model of psychiatric community care for persons with severe and persistent mental illness. It is endorsed by both the National Alliance for the Mentally Ill and the National Institute of Mental Health as a highly effective evidence-based treatment, and as a “best practice” in community mental health. Research on PACT programs reveal that they are effective in decreasing hospital rates, improving employment outcomes, stabilizing and reducing psychiatric symptoms, and increasing sobriety.

You have an in-depth holistic assessment to help understand your clients’ needs. What is the importance of such a thorough intake process?

Many of our clients choose to use our in-depth holistic assessment. This consists of many assessments, each addressing a facet of a complex individual. Included are neuropsychological and psychological tests, psychiatric and neurological exams, and assessments of physical wellness, family dynamics, substance use, spirituality, social/developmental issues, and educational and vocational experiences. When necessary, a patient consults with specialists in particular areas. This helps a client and his or her family reach a greater understanding not only of the client’s clinical picture, but of their social situation as well, that is, how they function in the world. Our multi-faceted assessment provides a stable, thoughtful and holistic picture of their situation. Indeed, it reflects the person so thoroughly, that it provides a base from which they can seek and receive the right kinds of interventions throughout their lives. Our assessment guides us in planning treatment. Once it is complete, the client’s team meets and develops a comprehensive, multidisciplinary treatment plan based on multiple factors drawn from the assessment. We call this plan, “The Roadmap to Recovery.” The Roadmap to Recovery forecasts life-goals the team feels they can achieve with the client.

Can you further explain your psychosocial approach to treatment?

This means that we are as focused on ameliorating the ravages of stigma, loss of social role and institutionalization, as we are focused on treating psychiatric illnesses. At Ellenhorn autonomy and mastery are coupled with symptom reduction as our primary goals for our clients. Focused on individual empowerment, we treat our clients as autonomous agents in their lives, and thus deserving of an individualized outlook. We help empower our clients by appreciating their unique struggles and strengths. This individualized approach is the very counter-definition of institutional care. We do not provide care in bulk. We contour our care to the individual needs of our clients. We often say at Ellenhorn that our clients come with a wide-range of psychiatric issues, but they all suffer from one serious complaint: losing their dreams. Their lives interrupted by their illness, they feel like life itself has failed them, or that they, themselves have failed at life. Accordingly, hope, the struggle over hope, and the means to recover a sense of hope are central parts of our work. It is our job to dream of possibilities with our clients, to seek out and find these opportunities, and, in the end, to help our clients achieve their greatest potential.

Your treatment team is mobile, can you talk about how this benefits your clients?

We provide most of our services in our client’s homes, communities or at our residence. Aside from psychosocial support, vocational counseling, nursing, psychiatric visits, and non-pharmacological therapies, we provide direct support for our clients in regards to activities of daily living. These supports include; transportation to appointments, medication organization, medication monitoring, home organizational help, side-by-side cleaning, legal advocacy, assistance in applications for entitlements, help with basic hygienic responsibilities, coaching on sleep hygiene, substance abuse monitoring, including testing, daily behavioral planning, and accompaniment to leisure activities.

In addition to traditional treatments such as psychiatry and nursing, you have many experiential modalities.  Can you tell us about those?

We offer a variety of non-pharmacological therapies. These include Individual Psychotherapy, Art/Expressive therapy, Mindfulness and Meditation, Biofeedback, Peer Counseling, L.E.A.P. Education, Wellness Recovery Action Plan (WRAP), Cognitive Behavioral Treatment (CBT), Dialectical Behavioral Treatment (DBT), Narrative Therapy, Motivational Interviewing for Addictions, Substance Abuse Counseling, Couples Counseling, Family Therapy, Parent Coaching, Spiritual Counseling, and Ellenhorn’s Value-Driven Module Planning.  We also have QUEST.

What is the QUEST Program?

QUEST is a unique and exciting component of Ellenhorn that helps clients stay physically and mentally active, explore new horizons, and form friendships in a natural setting – all while receiving the degree of support each needs. QUEST reduces isolation, promotes self-esteem, and points to a meaningful future. Participating in QUEST can mean visiting a museum, hiking in the woods, learning to kayak, growing vegetables on a working farm, grooming horses, or training gentle, affectionate dogs. Clients engage with the outside world in a positive way, discover the city’s treasures, and find strengths and interests within themselves that build self-confidence. Staff are right at hand to help clients work through any issues that arise. We see clients make significant progress through participation in QUEST. Clients can choose from three types of activities: excursions, work at Hybid Farm, and participating in the canine group.

Trained as a social worker, sociologist and psychotherapist, Dr. Ross Ellenhorn has spent the last two decades dedicated to the work of helping individuals suffering psychiatric symptoms find the psychological and social means for remaining outside the hospital.  He created the first fully operating intensive hospital diversion program in Massachusetts, and created and led one of the first Assertive Community Treatment teams in the commonwealth.  Along with his former partner, Dr. Madhavi Prakash, he created Ellenhorn, an intensive, and holistic outreach program, serving clients in the Boston area.  Ellenhorn aims to serve clients, who are typically perceived by mental health professionals as appropriate for hospital care, outside the hospital, in their own communities.  Dr. Ellenhorn has given talks and seminars throughout the country, and has provided consultation to numerous mental health agencies and psychiatric hospitals on the subjects of hospital diversion, psychosocial rehabilitation, patient careerism and the PACT model.  His book, which addresses parasuicidality, psychiatric hospital recidivism and techniques for diverting hospital use, was published by Springer Publishing in 2007.  He is a graduate of the UCLA School of Social Welfare and the first person to receive a joint Ph.D. from the prestigious Florence Heller School for Social Welfare Policy and Management and the Department of Sociology at Brandeis University.

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