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Intermediate Care Programs

Program Descriptions

Brandon Markel, Psy.D., MBA, ACT
Director of Intermediate Care Programs

Typically patients attend the program 5 days a week. The length of stay ranges from 3-8 weeks. Each patient is on his or her own treatment plan and there is no required length of stay. Patients may discharge at any point when they feel they are ready; however, we ask that there is a detailed discussion of treatment progress prior to discharge. We measure treatment progress using evidence based assessments.

The intensive therapy programs at Portland Anxiety Clinic (PAC) are designed to help individuals suffering from anxiety and depressive disorders. Our specialized treatment programs are focused specifically on the use of evidence-based treatments to help individuals who suffer from OCD, social fears, panic, traumatic stress, tics, body focused repetitive behaviors (BFRB’s; like hair pulling and skin picking), depressive symptoms, and other anxiety and mood related conditions.

Exposure and Response Prevention

The IOP program at Portland Anxiety Clinic specializes in providing Exposure and Response Prevention (ERP) therapy for youth who are having trouble attending school. Many children and adolescents who are having trouble attending school struggle with mood and anxiety symptoms that manifest as school refusal behavior. School refusal behaviors may include physical complaints (stomachaches, headaches, fatigue, soreness) and emotional outbursts when leaving the home and/or arriving at school.

Oftentimes, the child or adolescent feels better when they are allowed to stay home, but their symptoms typically reappear the next day. Some children with school refusal may attend school, but avoid their classroom throughout the day by taking extended bathroom breaks, frequently requesting to visit the nurse’s office, or showing up tardy to classes. Other symptoms of school-avoidance include temper tantrums, crying spells, and panic attacks before, during, or related to school. Our goal is to help youth return to the classroom by providing them and their families with strategies to manage their mood and anxiety symptoms and school refusal behaviors.

Intensive Outpatient Programs (2 hours per day)

The highly specialized anxiety track utilizes Cognitive Behavioral Therapy (CBT) with an emphasis on Exposure and Response Prevention (ERP), Habit Reversal and Stimulus Control (HRT/SC), Behavioral Activation, and other evidence-based methods and is suited for adults, adolescents, and children. This supervised individualized intensive program provides a structured day using evidence-based practices to systematically manage the underlying challenges associated with hard to treat anxiety and related conditions. Patients are given the opportunity to face their fears at their pace in collaboration with treatment staff so they are better able to function at work, school, socially, and within their families.

Partial Hospitalization Program (Typically 4 hours per day): Coming Soon!

The partial hospital level of care is ideal for individuals who suffer from anxiety, depression, OCD, trauma, BFRBs, and/or related conditions who require more intensive treatment. Typically an individual enrolled in the partial program will attend a combination of exposure based therapy and skills training groups. This program also requires individuals to meet with a prescriber once a week during program hours.

Our Staff

Our experts include psychologists who specialize in evidence-based practices (such as CBT) and highly trained graduate students to enhance treatment outcomes. Our team of well-trained and compassionate practitioners foster an environment to help our patients achieve successful results.

The emphasis and goal of our IOP programs, using evidence-based treatment, is to provide stability to each patient so they can gradually transition to a lower level of care, usually outpatient.

Conditions we treat:

Our Outcomes

The most common condition we see in our program is OCD; however, we do see all anxiety and depressive conditions. Typically most patients start to see some changes after 8 to 12 sessions in the program but there are many individuals who have a variety of circumstances in their lives that may complicate treatment and can delay gains. Each individual who enters the program is unique. Experiencing a full benefit from the program often requires individuals to follow their treatment plan and actively collaborate with their primary therapist on progress.

We use a variety of evidence-based measures to identify progress during the course of treatment. The industry standard measure for OCD is called the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The graph below illustrates the average scores of a sample of individuals who have completed our program and their symptom scores prior to entering treatment until they have been discharged.

The Y-BOCS scale has a maximum score of 40 (extreme range). The accumulated average score of individuals who enter our program began at 24 (severe range). Prior to discharge patients are given the same scale again to show their progress. The accumulated average score at discharge from the intensive outpatient program for our patient sample falls in the mild symptom range at a score of 13.

Individuals who may benefit from our program include:

The Portland Anxiety Clinic’s Intensive Outpatient Programs are not appropriate for patients who are actively suicidal, who are currently addicted to/actively using drugs and/or alcohol, or are actively engaged in eating disorder behaviors (including food restriction, binge/purge, excessive use of laxatives, etc.). 

We are affiliated and active members of the International OCD Foundation. We have received training in evidence-based treatment by the Trichotillomania Learning Center, Tourette Association of America, and the Interpersonal Psychotherapy Institute. Dr. Markel holds certifications from the Academy of Cognitive Therapy and the American Academy of Experts in Traumatic Stress. 

If you are interested in learning more about our IOP program please contact our intake line at 503-894-9630.

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