Our Approach
Unprecedented Person-Centered Care Within a Holistic Evidence-Based Team Approach
At Ellenhorn we seek to empower our clients and help them regain a sense of voice and control in their lives.
This focus is as rooted in our wish to be humane as much as it is rooted in our knowledge that such an approach routinely produces the best therapeutic outcome. Research shows that collaborative relationships in which a person seeking help controls and guides treatment are the most effective therapeutic relationships—more effective, in fact, than any particular therapeutic model.
The Why
Our beliefs
We believe that standard treatment for psychiatric issues is often conducted in a vacuum in which the person being treated is removed from his or her real life. Such an experience can damage a person’s confidence as they come to see themselves as defined by illness, derail them from pursuing their life goals, rob them of a sense of purpose and disrupt their connections with others. In fact, we see abundant evidence that these social injuries are as devastating as a person’s psychiatric symptoms.
For this reason, we actively support clients in pursuing their goals as a core part of treatment, which helps them return to their most deeply desired educational or vocational track, regain their rightful role in the world and recapture their belief in their own ability to realize their dreams. Ellenhorn firmly believes that doing so prevents potentially devastating social injuries from happening, and helps people heal from previous damage.
The Who
Individuals we help
Our teams are extensively trained by leading experts in working with:
- Experiences of psychosis and what some professionals label as schizophrenia
- Disordered experiences of the self, and problems in relating to others that are often associated with personality disorders.
- Painful events of mind mood, like depression, anxiety and bipolarity.
- Co-occurring substance use and other problematic habits
- Individuals who feel disconnected from traditional treatment models and want to stay integrated within their communities while receiving care
While we are highly trained in serving individuals navigating complex and often acute experiences of mind, self and mood, all of our clients have one thing in common: they are reluctant to engage in treatment, particularly in traditional, group, or milieu-based settings. Too often, professionals label such individuals “difficult to engage.” At Ellenhorn, we see things differently, believing that the current modes of providing treatment are actually difficult to engage in. That’s why we take a novel approach to care. Our mobile, multi-disciplinary teams wrap care around the individual, meeting them where they are—both physically and in their recovery journey. By focusing on real-life goals and social inclusion, we offer a collaborative and personalized path forward, helping individuals rebuild connections and regain agency in their lives.
The How
Our model
Most Ellenhorn clients are treated while living independently in the community, though a small number do stay in one of our residential programs. Ellenhorn’s staff-to-client ratio of one to two combined with the fact that each of our psychiatrists holds a deliberately small caseload allows us to provide what is often called a “hospital without walls” approach. Such an approach allows us to successfully treat people who were once viewed as needing care within an intensive outpatient, residential or even hospital-based treatment program and allow them to live and participate in the community and be supported by all the nurturing ingredients of real life.
Ellenhorn’s time-tested and evidence-based treatment model, called the Program of Assertive Community Treatment (PACT), is endorsed by both the National Alliance on Mental Illness (NAMI) and the Substance Abuse and Mental Health Services Administration (SAMHSA), as the prime model for both psychiatric and psychosocial recovery.
The Program of Assertive Community Treatment (PACT) is an evidence-based model designed to support individuals with severe mental-health challenges through intensive, community-based care. Often referred to as "a hospital without walls," PACT ensures that clients receive comprehensive support without needing to be institutionalized. At the core of PACT is a multidisciplinary team approach that combines psychiatric care, therapy, case management and social services to address both clinical and practical needs.
At Ellenhorn, we focus the PACT model on accessibility and flexibility. Our teams hold small caseloads, which allows them to devote significant time to each client and maintain frequent communication. This allows us to provide rapid, responsive care when clients face crises or changes in their lives. With 24/7 access to psychiatrists and the integration of wellness and psychosocial programs, Ellenhorn’s use of the PACT model ensures that clients receive holistic, person-centered treatment in the context of their daily lives.
Ellenhorn is committed to providing whole-person centered care that acknowledges the complexity of psychological suffering. Our multidisciplinary teams address clients' diverse needs by recognizing their strengths and fostering a collaborative partnership in treatment planning. This strengths-based approach empowers clients as they navigate challenges and treats them as resourceful individuals striving for positive change.
We understand that effective treatment occurs beyond traditional office hours and settings, and by delivering services in clients’ homes and communities we ensure that our support aligns with their everyday lives. Our teams meet regularly—often daily—to discuss each client’s unique circumstances and allow us to adapt treatments as needed.
Our mission transcends mere treatment; it’s about helping clients reintegrate into their social environments and pursue fulfilling lives. By centering care around individual experiences, we empower clients to take the lead in their journey toward recovery, and promote personal agency and meaningful engagement with the world.
At Ellenhorn, we believe in the healing power of home. We know that, even when facing serious psychiatric challenges, people recover best in their own homes and surrounded by supportive neighborhoods.
We help clients who are able to live independently find and furnish their own residences and manage daily tasks. We view helping individuals rebuild their social roles while living independently as a key part of treatment, and our team is there to support them every step of the way.
For those who need additional support, we offer a variety of housing options, including Brackett House in Arlington, Mass., and our partnerships with supportive-living programs in New York City and Los Angeles. These environments provide stability, personalized care and 24/7 staffing where needed.
At Ellenhorn, assessment and treatment aren't separate steps—they happen simultaneously from day one. Our assessment process is a collaborative, ongoing journey designed to build a comprehensive understanding of each client’s needs. We gather information through traditional methods, like psychological testing and medical record reviews, and through the therapeutic relationships we develop. This helps us create a personalized Roadmap to Recovery that aligns with each client’s dreams and goals.
Unlike static, one-time assessments, ours evolve alongside the client. This ensures that treatment plans remain dynamic and responsive to changing needs and focus not only on symptom management, but on life goals, social connections and community involvement as well. By working closely with clients from the start, we help each person take charge of their recovery in a way that reflects their values and aspirations.
The What
Practices we use
Psychosocial rehabilitation focuses on restoring a person’s sense of independence, purpose and connection. At Ellenhorn, it forms the foundation of our model, which blends psychiatric care with social support to help clients rebuild their lives beyond mental-health challenges.
We believe in learning from the source. That’s why our clinicians train directly with the originators of leading therapeutic models, ensuring fidelity to evidence-based care.
While Ellenhorn therapists and clinicians use many collaborative therapies, we primarily focus on the following four powerful treatment styles, which we use not only as tools for promoting change in clients, but also as a productive treatment path for a given client. Here’s what that means: Since we view each client as a unique individual with their own needs, we don’t believe any client fits within a cookie-cutter treatment “track” or “protocol.” At Ellenhorn, a client’s treatment path is completely personalized and always evolving.
Ellenhorn is a national leader in Integrated Dual Disorder Treatment (IDDT), a model endorsed by the Substance Abuse and Mental Health Services Administration (SAMHSA) as the primary evidence-based best practice for treating co-occurring psychiatric events and problematic substance use. Our IDDT program was reviewed and approved by its founder after training with the creators of Motivational Interviewing.
All too often, co-occurring programs that describe themselves as “evidence-based” supplement psychiatric work with a substance-abuse add-on, or add a mental-health component to substance-abuse work. Their “evidence” is in the techniques they use, and yet significant research shows that this piecemeal approach has little effect. True co‑occurring work is based on the premise that problematic substance use and psychiatric disturbance are two parts of a single complex syndrome and must be treated simultaneously using a truly integrated approach. Co-occurring treatment is not simply a matter of using the right technique. It requires a system of care that balances the two issues at once and utilizes a multidisciplinary team that is in constant communication. IDDT is just that kind of system—and more.
IDDT teams provide high-intensity multidisciplinary outreach services that include substance-abuse treatment, psychiatric care and a focus on clients’ educational, family and/or career goals. IDDT doesn’t simply integrate treatments, it focuses on integrating a person into the world that surrounds them. Working closely with clients to create meaningful futures fosters real human connection, and a sense of purpose and hope—profound medicine for both psychiatric issues and problematic substance use.
Part of IDDT services include the use of motivational interviewing. Motivational interviewing was developed for counseling people engaged in problematic substance use, and is based on a nonconfrontational partnering relationship between counselor and client, in which the client is respected as the agent of change.
Mentalization-Based Treatment (MBT)—which helps individuals better understand their own and others’ thoughts and emotions—is at the core of Adaptive Mentalization-Based Integrative Treatment (AMBIT). MBT is a highly effective therapeutic approach for people struggling with interpersonal relationships and attachments to others. The term mentalization refers to our ability to accurately understand the intent and mental experiences of others, and to correctly understand our own intentions and thoughts. We all mentalize and feel in sync when we interact smoothly and successfully with someone. We also sometimes fail at mentalizing and lose track of our mind, the meaning behind our feelings and behavior, and/or misunderstand others.
Adaptive Mentalization-Based Integrative Treatment (AMBIT) is a way of organizing care that is specifically modeled around attachment issues. Typically, Ellenhorn provides clients with a multidisciplinary team of clinicians who each offer help in a specific area of a client’s life. That means that clients form relationships with each member of the team, but it also means that the demand to create collaborative relationships with each team member may cause undue strain for someone whose issues are related to connecting with and trusting others. With AMBIT, we provide this same team, but one member is designated as “key clinician” and has the majority of contact with the client. The goal is to form one strong collaborative relationship that can then be used to form others within the team.
People with significant attachment issues tend to mentalize poorly in a chronic manner. This inability to perceive the experiences of others, or to grasp what’s happening in their own minds, often leads to persistent conflict and hurt. Mentalization-based treatment works to increase the client’s awareness of their emotions and how they impact their ability to be curious about their and others’ minds.
We are the only accredited AMBIT training center in North America, and our training comes directly from its founders at the Anna Freud Center, ensuring the highest level of expertise.
Ellenhorn was the first U.S. program trained in Open Dialogue by the creators of the model. Open Dialogue is as much a way to organize care as it is a therapeutic approach. Open Dialogue teams are highly flexible, typically work on an outreach basis in people’s homes, are multidisciplinary and stay with a person for the duration of treatment.While our whole-person assessment relies somewhat on the input of clinicians, the Open Dialogue process is an alternative to formal assessments. As a new client participates in weekly discussions with their team, they gain self-understanding about their challenges and dreams. This self-knowledge enables a client to design their own “Roadmap to Recovery” treatment plan that determines the nature of their treatment and helps establish life goals.
We often use Open Dialogue to help people experiencing what professionals call “psychotic experiences.” Perhaps these individuals hear voices, see things we can’t see or have thoughts that don’t match what others believe. In Open Dialogue, a shared meaning and vocabulary for this experience is developed.
Open Dialogue is centered on the “network meeting,” which typically takes place with the client, their family and at least two clinicians. The aim of the meeting is to develop a dialogue that gives voice to all concerned. It is a way of working and having conversations that aims to create a space for many voices as equals. Dialogic practice is based on the belief that change occurs when all voices in the room are heard and understood.
Research on Open Dialogue shows that the method has a significant impact on decreasing psychiatric distress and enabling clients to return to social roles. When people engage in Open Dialogue, we have seen a decline in the duration of the psychosis, a subsequent decline in people matching the diagnostic criteria for schizophrenia and a 73 percent return to full employment or schooling, all with minimal use of antipsychotic medications. Ellenhorn clinicians are graduates of the first class of Open Dialogue training in the United States, which puts us at the forefront of the movement.
Interpersonal and Social Rhythms Therapy (IPSRT) is a collaborative form of care for people experiencing extreme mood events, specifically individuals who have been diagnosed with bipolar disorder or depression. IPSRT places the tools for better control of mood in the hands of our clients as we work alongside them as they navigate their recovery. The foundation of IPSRT centers around the belief that problems in the circadian rhythm exacerbate manic depressive and major depressive symptoms. This psychotherapy focuses on helping a person identify and maintain the regular routines of everyday life, including sleep patterns. Equal attention is also given to interpersonal and social issues that may affect daily routine.
IPSRT is designed to teach skills to reduce the frequency of relapses that are caused by stress, social difficulties and inconsistency in circadian rhythm. IPSRT therapists work with clients to understand the importance of circadian rhythm and daily routines—eating, sleeping, etc.
When combined with psychiatric medicine, IPSRT has been proven to reduce both manic and depressive experiences, to make essential gains in achieving a person’s targeted life goals, and to assist in a person’s ability to be consistent in maintaining daily routines.
What makes good psychiatry good? For one thing, good psychiatry demands a trusting relationship between the prescriber and their client. To find the right therapeutic dose, and to avoid the all-too-common event of over-prescribing medications, psychiatric appointments must be collaborative, a space in which the minutiae of a client’s experience, in regard to both their symptoms and medication side effects are freely discussed. That’s where trust comes in, since such open and attuned connections can’t happen without it, but trust isn’t all of it: hope needs to be in the room, too. People are not motivated to change if they don’t have a dream about where they are headed.
Trust, hope, a collaborative spirit and a team approach are what we consider the central “medicine” of psychiatry that exceeds any pill in efficacy. And yet today we live in a world in which psychopharmacology is increasingly becoming isolated and transactional: a mechanical act of writing prescriptions. It’s thus no wonder that the United States outranks any other country in the use of psychotropic medications. At Ellenhorn, however, we take extra-pharmacological ingredients seriously, and work tirelessly to combine them with a multidisciplinary team approach and the high level of contact and accessibility associated with concierge psychiatry.
Ellenhorn uses the Program of Assertive Community Treatment (PACT) model of care, often called a “hospital without walls” because it combines the multidisciplinary team approach of a hospital with regularly scheduled communication. In fact, our doctors participate in daily team meetings modeled on hospital “rounds.” This is the exceptional approach to psychiatry we practice at Ellenhorn. If you’re curious about our metabolic psychiatry program, Accord, click here.
Our psychiatrists hold very small caseloads, which allows them to devote significant time to the individual care of clients, gives them significant flexibility in regard to crisis situations or changes in their clients’ lives, and ensures their ability to stay in constant communication with their teams and attend family meetings, etc. Each of our psychiatrists is on call 24 hours a day.
At Ellenhorn, every client begins with a wellness assessment, which helps guide their personalized Roadmap to Recovery.
Clients following our IPSRT path also complete an IPSRT assessment and are assigned a wellness-program leader who becomes an integral part of their care team. This leader focuses on physical health and wellness in general and daily rhythms, such as sleep, in particular. To ensure that treatment is aligned with the client’s daily routine, all multidisciplinary team visits are reviewed by the wellness expert. For example, psychotherapy appointments may be scheduled in the morning to help the client establish a healthy wake-up time, while medication visits are planned for early evening to ensure the client goes to bed at an appropriate hour.
Integrative recovery is a client-centered approach that addresses the physical, emotional, mental, social, spiritual and environmental influences on health and well-being. At Ellenhorn, we blend Eastern concepts with traditional therapeutic practices to expand our clinical repertoire and enhance our work with clients.
Our wellness clinicians partner with each client and their care team to create a personalized program that integrates mind, body, spirit and community into the treatment process. The program complements each client’s Roadmap to Recovery with wellness-enhancing practices, which empowers clients to become independent and supports their ongoing healing and psychosocial recovery.Every client’s overall wellness is considered an essential part of their Roadmap to Recovery. Some clients are ready, able and willing to dive into integrative wellness practices—and some aren’t. Regardless of their readiness and/or ability, each client’s lifestyle, nutrition and resiliency affect their ability to partner with their team in clarifying and working toward their psychosocial goals. These aspects of wellness are often the foundation of recovery and are followed closely by the wellness clinician on the team throughout treatment. We meet the client where they are, find the starting points and build from there.
Program and community offerings
- Weekly Meditation Group
- Individual Trauma-Informed Yoga
- Treatment-Plan Consultation with Wellness Clinicians
- Cognitive Behavioral Therapy for Insomnia
- Interpersonal Social-Rhythms Therapy
- Circadian-Rhythm Therapy
- Biofeedback
- Aromatherapy
- Meditation and Mindfulness Skills
- Yoga
- Acupuncture
- Massage Therapy
- Reiki
- Nutritional Assessment
- Mindfulness-Based Stress Reduction
*These activities may be offered internally by the Ellenhorn team or referred to external, community-based providers. The PACT Team, in collaboration with the client, will work together to determine which wellness services best compliment individual psychosocial-recovery goals.
How they work together
At Ellenhorn, we take a whole-person approach that goes beyond diagnoses. We design personalized, evolving treatment paths based on each client’s unique experiences, strengths and needs. By using multidisciplinary therapies and incorporating life roles like work and family, we empower clients to heal, grow and reintegrate into their world.
