One step at a time
Therapists Sandy Alicea and Linda Seraphin

Therapists Sandy Alicea and Linda Seraphin fine-tune a game, which is similar to Jeopardy!, created for the new outpatient therapy program at St. Lucie Medical Center. PETER GORMAN PHOTO

Program CARES to help patients cope after leaving hospital environment


For families and patients struggling with the seemingly endless circle of inpatient and outpatient treatment for the many and varied forms of mental illness, a new program through St. Lucie Medical Center known as CARES (Compassion, Accountability, Respect, Enthusiasm and Support) will soon be able to help provide relief for those who are suffering.

Some patients have had difficulty with stepping down from the inpatient unit with its 24-hour care to meeting one hour a week with a therapist as outpatient follow-up. Many therapists began to think that more intermediary steps are needed to help their clients function in society. Thus, the idea of the intensive outpatient program was born.

CARES offers an 8- to 10-week opportunity for intensive follow care after hospitalized patients have been discharged. Clients will meet in groups three days a week, Monday, Wednesday and Thursday, for three hours each day. The CARES curriculum provides a three-pronged effort to help clients adjust to problems or frustrations in their lives. The clients will work through process groups where they will discuss a common topic with which they are dealing. With the therapist acting as a facilitator, the clients will discuss the problem and create their own resolution. They also will have psychotherapy groups with therapeutic intervention in a crisis situation. Lastly, they will have psycho-education groups where guest speakers along with the therapists will address issues for all of the clients such as medications and their importance, coping skills and other aspects of managing their illnesses.

Headed up by Katy Maxemow, director of outreach and business development at St. Lucie Medical Center, the new program is staffed by Sandy Alicea, a licensed clinical social worker, and Linda Seraphin, a licensed mental health therapist. Maxemow said there is a program at HCA’s other St. Lucie County hospital, Lawnwood Regional Medical Center in Fort Pierce, that has been in existence for about a year. She said the intensive outpatient program should be up and running soon in the Port St. Lucie Medical Plaza, adjacent to St. Lucie Medical Center.

A Navy veteran, Maxemow is excited that HCA Healthcare, the parent company for Lawnwood Regional and St. Lucie Medical Center, is seeking to arrange a working relationship with the Department of Veterans Affairs so local veterans suffering from PTSD (post-traumatic stress disorder) will be able to take part in this helpful program.

“Linda has a big passion for substance abuse therapy,” Maxemow said, “and Sandy’s husband is a first responder, a firefighter, so she likes to work with first-responders.”

“They have all of these images burned into their brains which make it difficult to sleep,” Alicea said of first responders like her husband and veterans. “My role is to educate you and help you cope with PTSD or any illness.”

“There are nurses who could benefit from IOP (intensive outpatient program), but I also see a need for support groups, which are different from IOPs,” Maxemow said.

“As adults, they are not getting the help they needed as children – preventive measures,” Seraphin said. “Children with ODD (oppositional defiant disorder), which occurs with a lot of children suffering with ADHD (attention deficit/hyperactivity disorder), can be taught different coping skills. The difficulty in dealing with their lives can lead to sociopathic behaviors in later life.”

The CARES program, though, can only serve clients between 18 and 88 years of age and cannot accept Medicare clients, due to the requirements under the government health insurer.

This program is designed for someone who has tried on their own to step down from inpatient level of care, Maxemow explained, or someone who has found that one hour per week of individual therapy is not enough to help them cope.

There is a shortage of inpatient beds in the county and HCA is in the process of adding 12 beds to its inpatient unit at Lawnwood. The staff at CARES said the beds are full 100 percent of the time, adding that it can take four to six months to get an outpatient appointment in the area, and although inpatient services are provided, there is not much help available once they are released. The therapists at CARES work with the patients in the medical center and are a familiar face they see once they are released. Although not all insurance companies will pay for the intensive outpatient programs and some companies don’t include HCA facilities in their network, the CARES staff will refer a client to another facility their insurance company might accept.

“If they have a referral and need to come into the IOP,” Alicea said, “we will call the insurance company and if they won’t cover our services, but might cover something else, we will call the client back and let them know.”

Ready and willing to help those who need their services, the CARES staff stated their goal is to reduce the rate of psychiatric hospitalizations, to educate clients as to their diagnosis and help them learn how to manage their symptoms, and to provide support to their loved ones.

For more information on the CARES program, call Maxemow at 335.4000.

See the original article in the print publication

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