The Lodge Program

The Lodge at Silver Hill is an intensive residential treatment program for adults experiencing symptoms related to psychosis, such as changes in thinking, perception, difficulty communicating, social withdrawal, or a decline in functioning.

These symptoms can be persistent and related to many underlying diagnoses such as schizophrenia, schizoaffective disorder, substance-induced psychosis, bipolar disorder, and depression, and can be complicated by comorbid anxiety disorders, trauma, autism spectrum disorders, cognitive decline, and/or substance use disorders.

The Lodge Program is focused on providing comprehensive and individualized treatment in a safe and supportive environment with the goal of helping you regain mental clarity and reconnect to your life.

The Lodge Program is a variable-length treatment program (recommended minimum of 6 weeks) focused on treatment of psychosis and other persistent psychiatric symptoms. The program is informed by CBT for psychosis (CBTp) principles and offers exceptional evidence-based treatment modalities for individuals struggling with psychosis.

The program begins with a comprehensive evaluation and assessment of symptoms including social and cognitive functioning, followed by a combination of medication management, individual and group therapy, and life skills support, as well as family engagement, support, and education. Therapeutic modalities include: CBTp, social skills training, interpersonal therapy, leisure and life skills, art therapy, music therapy, pet therapy, exercise and movement-based therapy, cognitive skills training, and extensive psychoeducation related to medications, treatment adherence, and the connection between mental and physical health.

Cognitive Behavioral Therapy for psychosis (CBTp) is the core therapeutic modality at the Lodge Program. It is an evidence-based psychotherapy that helps patients manage distress related to psychosis symptoms. CBTp does not aim to directly change the content of hallucinations or delusions. Instead, the goal of CBTp is to shift how a person relates to, interprets, and manages these experiences. Key components include:

• Collaborative Formulation: The therapist and client build a “problem list” to identify specific issues and track triggers.
• Normalization: Therapists validate the client’s distress while reframing psychotic experiences as extreme versions of normal human responses.
• Coping Strategies: Patients develop actionable behavioral and cognitive techniques to handle symptoms and reduce their impact on daily life.

Research over the past three decades shows that CBTp leads to concrete improvements including:

• Decreased severity of positive symptoms (e.g., paranoia, hallucinations)
• Reduced distress, anxiety, and depression caused by psychosis
• Improved social functioning, motivation, and quality of life
• Reduced risk or length of hospitalizations

The Lodge Program is designed for people experiencing psychosis, thought disorders, and mood disorders (including bipolar disorder and depression with psychosis). As one of few intensive residential programs in the nation dedicated exclusively to treatment of psychosis, our program is the best next step for adults (ages 18+) leaving an inpatient psychiatric unit of a hospital or acute care facility. The Lodge can also be a good alternative to hospitalization earlier in an illness or episode.

Research consistently shows that earlier initiation of evidence-based treatments for psychosis, plus support for maintaining treatment adherence, help to decrease frequency of future hospitalizations, as well as decrease the risk of treatment-resistance and long-term cognitive impairment associated with prolonged psychosis. The Lodge offers the necessary structure, support, and time for both medication management and intensive therapy to target symptoms that interfere with social and cognitive functioning in order to return to a meaningful and productive life at home or in the community.

The Lodge team has expertise working with individuals:
—  experiencing first-episode psychosis
—  who have not responded to previous treatments
—  with a history of medication adherence challenges or hesitancy
—  who may benefit from initiation of clozapine or long-acting injectable medications

Participants at the Lodge are welcomed into our warm white clapboard house on the east campus of Silver Hill. The Lodge house has a full kitchen, living room with grand piano, lounge room, outdoor backyard with gazebo, and seven double bedrooms (two beds each; private rooms may be accommodated at additional cost).

Some programming takes place within the residence, while meals and other programming are conducted in other locations on campus. All patients have access to Silver Hill wellness facilities and offerings, including gym, massage therapy, meditation, and more.

The day begins with morning breakfast, self-care and ADL support, chores, and a Community Meeting. It continues with a range of daily programming through evening, including individual therapy and medication sessions, meals, opportunities to reflect, and downtime. Groups within the Lodge Program are led by experienced Silver Hill team members expertly trained in the treatment and care of individuals experiencing psychosis.

A typical weekday schedule for Lodge residents includes a mix of:

• CBTp-focused Therapy and Skills Groups
• Psychoeducation Groups, including medication education, exploration of meaning of medications and aligning treatment with values, exploring challenges with adherence, and symptom education including normalization and education regarding the experience of psychosis
• Social Skills and Interpersonal Therapy, including process groups
• Creative Arts Therapy, including art therapy and music therapy
• Exercise and Movement Therapy
• Life Skills, Leisure, and Cognitive Health Groups, including horticulture, pet therapy, grocery shopping and cooking groups, trivia and games groups, healthy minds groups
• In-House Group Programming, including community meetings, goals review, and more
• “Homework” to practice new therapeutic skills and reinforce meaningful learnings

Residential Counselors (RCs) are located within the Lodge House 24/7, lead and participate in programming activities, and are available at all times for support and needs.

Psychiatrist-Led: All Silver Hill residential programs are led by board-certified psychiatrists expert in their fields. All work full-time during the week at their respective intensive residential programs are involved in all aspects of care. We also have 24/7 psychiatrist (physician) coverage during overnights and weekends.

Family Education and Partnership: The Lodge program staff works closely with patients and families to determine appropriate levels of family involvement throughout treatment.  Family meetings with the whole treatment team occur regularly to update families on progress, provide psychoeducation and support, and make ongoing treatment recommendations.

The growing family therapy program at Silver Hill offers opportunities for family therapy when recommended by the treatment team.

Following treatment at The Lodge, we work closely with patients and families to develop a consistent aftercare program supporting healthy, safe, and meaningful lives after discharge (including work, relationships, education, and increased integration in family life).

To learn more about The Lodge program, refer a patient for admission, or find out if it is right for you or a loved one, please contact Senior Admissions Coordinator, Barbara Carlson, LCSW, LADC at 203-801-2243, Silver Hill Admissions at 1 (866) 542-4455, or complete the contact form below.