Understanding Common Challenges Families Face During and After Residential Mental Health Treatment

“Getting Michael to go to treatment was a full-time project for me,” Angelika says, “And when he finally went, I thought that would be it—problem solved! But it was more complicated than that.”

Michael is Angelika’s husband, whose struggle with bipolar disorder had begun years earlier, his depression and hypomania coming in waves that left him struggling to stay afloat. “I knew something was very wrong pretty early in our relationship, but I loved him and I made it my mission to get him help,” Angelika tells me. Michael, however, was slower to come around. When he was depressed, he did not have the energy or motivation to see his psychiatrist. When he was hypomanic, things were great and putting an end to that intoxicating energy was the last thing he wanted; elation seemed like the hard-won reward after months of sorrowful lows. But as his mood episodes grew in intensity and frequency, his bipolar disorder threatened to derail his career and permanently damage his relationship with his family and friends. By the time even he could see that treatment was the only way forward, his needs had outgrown the outpatient care he’d initially refused.

But getting her husband residential help wasn’t the end of the road. “When he agreed to go to treatment, I felt like I had won a war,” Angelika remembers. “I was ecstatic. In my focus to get him into care, I never considered that treatment wasn’t an end, but the beginning of new and unfamiliar challenges—both during treatment and when he came home. There were relapses. There was anger. There was resentment. I needed to learn how to bring my expectations in line with reality, how to heal myself, and we needed to learn how to communicate and cope together.”

Whether someone has an extensive history of outpatient care or is seeking treatment for the first time, residential mental health treatment can offer an ideal environment in which people can begin the healing process in a safe milieu free from everyday stresses. But clients aren’t the only ones who will go through a healing process; for families of people in psychiatric distress, residential care marks a transition point at which you start a new journey, both individually and collectively. By understanding some of the most common challenges families face during and after treatment, you can be better prepared for the changes that lie ahead.

Residential mental health treatment gives clients the time and space they need to start recovery in an environment entirely devoted to their care and gives you the assurance that your loved one is in a warm, safe environment. The time away also gives you opportunities to start examining the impact of your loved one’s illness on your own life and relationships.

This can be emotionally overwhelming, and it is imperative that you seek out your own sources of support to process the difficult feelings that may arise during this time. As the Dr. Jeanne Segal and Melinda Smith write, “Dealing with a loved one’s mental illness can be painful and isolating. Make sure you’re getting the emotional support you need to cope. Talk to someone you trust about what you’re going through.”

The treatment program you choose can help you connect to specialized individual therapists and support groups to help you examine, understand, and address what you are experiencing. This is the best gift you can give yourself, as it allows you to nurture and strengthen yourself regardless of the outcome of treatment.

Some residential treatment programs offer family and couples therapy during treatment to support both of you as you enter this new phase, which can be invaluable for opening up a healthy dialogue, learning coping and communication skills, and mending your relationship within the context of residential treatment. You should also be invited to participate in continuing care planning to ensure that your family member’s ongoing care is appropriate for both them and for you, and that you have a meaningful picture of what life after treatment will look like.

The return of your loved one after residential care can be a thrilling moment, but it is also a highly vulnerable time for all of you. Many families find that they have unrealistic expectations of both themselves and their loved ones following intensive treatment; it is easy to want to believe that everything is all better now and your work is done.

However, it is vital to understand that there will be setbacks along the way and to set yourself up for success by continuing to see your individual therapist as well as enlisting a family therapist to build on the work you have done in residential treatment. Finding a family therapist with experience helping families after residential care is one of the most valuable steps you can take to set the stage for a healthy and productive homecoming.

The best treatment programs recognize that relapse can and does happen. In addition to your family’s continuing care plan, you should also create a relapse plan that details how to identify relapse and take action. This may include reaching out to the treatment program itself, or working with individual and family therapists to get you back on track. Being prepared for setbacks helps you not only ensure that your loved one stays safe and healthy, but prevents you from internalizing and blaming yourself for relapse.

Even with extensive, 90-day treatment, your loved one may experience relapses, and you may find yourself slipping into your old, unhealthy behavioral patterns, leading to anger, resentment, and disappointment—both toward yourself and your family member. It is important to resist expectations of perfection and to learn to forgive yourself and your loved one for setbacks. The foundation you have laid during their time in treatment through individual therapy and support groups will have fortified you and allow you to weather these storms, practice your new skills, and grow into your new circumstances with compassion, love, and kindness.

You are never alone in the challenges you face during and after your loved one’s time in residential mental health treatment; millions of families across the country have been in your shoes and have used this time to strengthen themselves and their relationships. Learning how to prioritize your own well-being will give you the resiliency and practical skills you need to cope with the transformations you will undoubtedly experience. As such, the treatment program you choose should support not just your family member, but you and your family as a whole as you make your way out of the storm. In doing so, you will be better prepared to help your loved one and deepen your bond throughout the recovery process while creating a strong network of resources you can use to buoy yourself whenever you need.

Bridges to Recovery offers residential treatment for people struggling with mental health disorders as well as substance abuse and eating disorders. Our comprehensive curriculum is designed to support families to create sustainable change and lasting wellness. Contact us for more information about our innovative program and how we can help you or your loved one start the journey toward healing.

Image Source: Unsplash user Thomas Kelley