Let's Talk About Bridges' 35th Anniversary
Cami Smith:
Welcome to Centra Scripts. Here we talk about health, wellness and practical tips for your everyday life. I'm your host Cami Smith.
Cami Smith:
Hi, and welcome to Centra Scripts. I am here with a team from our Centra Bridges Treatment Center and we're celebrating the 35th anniversary. When is the 35th anniversary?
Dr. John Hendrickson:
I guess, technically, it was in June.
Cami Smith:
It was in June, but we're celebrating all year long.
Dr. John Hendrickson:
Right. We're going to, I think, have a celebration sometime in August.
Cami Smith:
I love that. Okay. So as we're anticipating the celebration, we want to give you a little bit of an inside view of the history of Bridges, some of the big moments in accomplishments and amazing things that have been accomplished treating children who have gone through traumatic experiences. But you all can speak to that much better than I can, so I'm going to let them introduce themselves and we'll start on the end with Dr. John Hendrickson.
Dr. John Hendrickson:
Hi, I'm John Hendrickson. I'm the medical director. I'm a child and adolescent psychiatrist at Bridges Treatment Center. I joined Centra in 1997, so I recently celebrated my 25th anniversary with Bridges. And when I joined in '97, Bridges was 10 years old and, at that time, was just opening its third cottage, which was known as Ivy Cottage. And so, I joined Dr. Shilling, the previous medical director, to try to expand the census there at that time. Subsequently, we got as big as five cottages and 102 beds. We're working considerably smaller than that presently. But that's my story and how long I've been there. I have not been there as long as these other two gentlemen, so they can tell you more of the early history than I can.
Cami Smith:
All right.
Cray Callahan:
Wow, early history. I'm Cray Callahan, the principal of the school program at Bridges. Obviously, the kids live there and they have to go to school there. I started there in January 1990, actually working in one of the two cottages at that time. We only had Chimney and Cedar, and I was working third shift, working on my master's in special education. And I did not know that I would stay at Bridges that long after I completed my master's, but a teaching position became available. The director at the time said, "I hear you have a teaching certification." And I said, Yes," and I rolled into a position and have been there ever since.
Cami Smith:
The rest is history. Wow. All right, and Mark.
Mark Bosher:
Yeah, I'm Mark Bosher. I started at Bridges back in December 1992, but I came for a little bit different reason. I loved fishing and I called Aaron Ruley up, who was one of the therapists at Bridges at the time. And he was getting ready to leave for Michigan, and I said, "Do you guys have a place there?" So I jumped on board and started fishing at the lake, and really enjoyed that whole feature of being able to get some of my dreams met. I started as a therapist doing individual therapy, as well as family therapy. And it has been a love of my life. I've really enjoyed working at Bridges the whole entire time. I've got lots of different aspects that we did while we were there.
Mark Bosher:
When I started, we were just leaving from a substance abuse program, so I started doing group with kids that had codependency and dual diagnosed, and that was very challenging to do that. I'd worked up in Charlottesville, in a hospital that treated the same types of kids as well. It's been very, very unique in the whole process of coming on board and enjoying my practice there.
Cami Smith:
Wow. Well, it sounds like each of you have had a very rewarding experience at Bridges. So let's rewind a little bit, and could one of you, maybe we can start with you, John. Can you tell us what is Bridges? For those who are watching, who've never heard of Bridges before, what's some context of what the facility does. What is your purpose?
Dr. John Hendrickson:
Sure. Well, bridges is what we call a psychiatric residential treatment facility, which means, as Cray said, the children live there. The children who are placed in our facility typically have been through a lot of previous treatments for various mental health issues. They've typically had the gamut of outpatient treatment, intensive in-home therapy services, typically multiple acute psychiatric hospitalizations, and haven't really gotten to where they need or want to be. So at that point, they often get referred to Bridges for an extended period of treatment as a resident living there, attending school there, eating there, sleeping there, going to school there. So that's what Bridges does. And as Mark already mentioned, they receive individual therapy there. They get group therapy. They get family therapy. We do psychiatric assessment, medication management. We can do psychological evaluations.
Dr. John Hendrickson:
That's just the range of services that are offered. Kids do go home on therapeutic passes, typically as their treatment progresses, to test the waters and things at home with their families. But they do have recreational activities as well. They have outings. What else am I forgetting? That's pretty much the gamut of the services that we offer.
Cami Smith:
Wow. That's pretty extensive.
Dr. John Hendrickson:
And the average length of stay is about six months currently. It used to be a little longer, but right now it's about six or seven months.
Cami Smith:
Okay.
Dr. John Hendrickson:
It's a typical length of stay.
Cami Smith:
So many questions come to mind immediately. And you've just answered my first one, what is the typical length of stay? But would it be accurate to say that entering Bridges is the last option. It's like we have tried everything. We have been all in, and this is now the decision we need to make, still a good option, but the last option.
Dr. John Hendrickson:
Sure. It is one of the last steps in the road of, if you were to lay it out as a course, or a continuum of treatment. Bridges is one of the highest level, tertiary levels of care, that we provide in mental health. And a lot of our kids come from various placements. Some of them come from families. Some of them come from foster families. A lot of them are in the foster home system. Some of them have been adopted and are having issues around adoption, and assimilation into their families, and that sort of thing. So there's really a gamut of issues that we deal with at Bridges.
Cray Callahan:
Well, I guess one of the things I'm looking at, we serve kids ages six to 17, as a matter of fact. It's hard to believe that some kids, at age six or seven, have to come to residential treatment, but they do. Therefore, our school serves grades K to 12. We currently have four teachers on staff. Again, like John was saying, our census is not what it used to be in the early days, but we've adjusted and the program is... Because we've seen a lot of different trends in this field in all of our years. It gives anywhere from 102 kids to the COVID unfortunate time period of 20 kids.
Cami Smith:
Wow. How many kids can you house? How many beds did you say that you have?
Dr. John Hendrickson:
It's around 40 right now, but the census has been staying in the mid-twenties lately. We did get as low as 11 or 12 last winter in the height of COVID. We've had a few COVID outbreaks over the recent year, year and a half, which has obviously been difficult to manage as everyone has had that difficulty.
Cami Smith:
I'm sure, yeah.
Dr. John Hendrickson:
Many aspects of healthcare and other industries, of course.
Cray Callahan:
And they all live together, so it's been a challenge.
Cami Smith:
Close quarters, yeah.
Dr. John Hendrickson:
Very close quarters.
Cami Smith:
So you mentioned... What did you call the each facility or each building?
Dr. John Hendrickson:
Cottage.
Cami Smith:
The cottage.
Dr. John Hendrickson:
Yeah.
Cami Smith:
What does that setup look like? So they live in cottages, and then, I'm assuming, the school is another building. But what is the campus physically? What's the experience?
Dr. John Hendrickson:
How many acres is it?
Cray Callahan:
I think we have around 11, 12 acres on Leesville Road in Lynchburg.
Cami Smith:
Okay.
Dr. John Hendrickson:
Yes.
Cray Callahan:
Many people don't know where we're located, but it's 11 or 12 acres and multiple buildings. The kids live now, currently, in two different cottages. The school and therapeutic offices are in another building.
Cami Smith:
Okay, so there's two cottages that the students live in.
Dr. John Hendrickson:
Right now, yeah. Two of our previously occupied cottages are now the Autism and Developmental Center, so they're functioning as an outpatient autism assessment center, not part of the residential program, but it is on campus with us.
Cami Smith:
Okay.
Dr. John Hendrickson:
But we do have a soccer field. We have playgrounds. We have a courtyard. We have a picnic area, where we have cookouts sometimes.
Cami Smith:
Fun.
Cray Callahan:
A gym.
Dr. John Hendrickson:
Yeah.
Cami Smith:
I've seen the playgrounds. We've been on the facility for my son visiting the Autism and Development Center. They always want to go in the playground, so the playgrounds are great. I'm sure that's a big hit, especially for your younger patients. Now, do you typically get very young patients
Dr. John Hendrickson:
Down to six?
Cray Callahan:
We do.
Dr. John Hendrickson:
I'm trying to remember what our current youngest is.
Cray Callahan:
Seven.
Mark Bosher:
Seven.
Dr. John Hendrickson:
Yeah, we have a seven year-old right now. But we do get them that young. We tend to focus, and for whatever reason, a large number of our referrals are around the prepubertal 10 to 12 age. We do really well with that population.
Cami Smith:
Okay.
Dr. John Hendrickson:
So we have a large number of kids in that age range. We have fewer older adolescents right now, but we do get some younger kids, as well.
Cami Smith:
Okay. So celebrating 35 years, that's huge. That's going to be a fun celebration, and I think of really rewarding celebration, when you think of all the lives that you've been able to touch over the years. What have been some of the highlights for you guys as you've been there for so long? What are some moments that stick out to you or something along those lines?
Cray Callahan:
Well, for me, is when we get those invites or notifications that students are graduating.
Cami Smith:
Okay.
Cray Callahan:
Working with them in the school program, that they struggled in their public school. They've struggled with services, as John's mentioned, through therapeutic day treatment services and so forth. And they come to us and we get that notification that they are graduating, which really does feel wonderful.
Cami Smith:
Yeah. That's so encouraging to hear.
Dr. John Hendrickson:
Yeah. And we do have a bell on campus that the kids have the opportunity to ring at the time of discharge. So anytime a kid is getting discharged and goes and rings the bell, that's a pretty peak moment in any kid's treatment. Typically, the family's there to pick them up, and they get to go out and there's just a little informal ceremony when they ring the bell and get some applause, and get recognized for all the hard work that they've put in their treatment and in therapy, and for all the progress they've made. And that's the time that, I think, we most appreciate. How far kids have come and we remember how things were when they arrived there, just the amount of progress they've been able to make, and that we have been able to offer them some help.
Cami Smith:
Yeah. That's incredible. What about you, Mark?
Mark Bosher:
I think, for me, it's getting a call and you hear a kid say that they're doing well. They're using their skills or family is also a part of it. And family members will send cards and let you know, give you updates on how kids are doing. And you get the appreciation from the families when the treatment has been successful. I had one youngster, that youngster called for about 15 years every month saying, "I'm still looking at the facts when the thoughts are paranoid," which was a logo that he had to use in treatment. So it's always nice to hear that they're still using things that are part of what you taught them in their coping strategies.
Cami Smith:
Yeah. Very influential in their lives, I'm sure. So at the end of treatment, what does that reintegration, you mentioned the ceremony, but what is it like for these patients to be sent out? How are they prepared to integrate back into, whether it's general education, or just into the family unit? What does that look like?
Cray Callahan:
Well, each child has an individual plan of care.
Cami Smith:
Okay.
Cray Callahan:
Areas of need, areas of focus are identified with goals, short term objectives. And we look at a child progressing through the treatment plan, meeting the goals, like you said, going on therapeutic passes to practice those skills at home. And then looking at the transition, hopefully, hopefully the home, hopefully the foster homes, some to group homes. We discharged many kids over the years to group homes.
Cami Smith:
Okay.
Dr. John Hendrickson:
And discharge is really about connecting them all with the services they're going to receive after they leave. Cray does a great job coordinating the educational placements with the local educational authority. And we're making sure that they're set up with their aftercare providers, whether it be an outpatient therapist, an in-home therapist, a psychiatrist. We make sure that they have all those appointments and services lined up after they leave.
Cami Smith:
Okay. So there's a plan in place, and that's got to be encouraging for families who are watching this, who maybe are thinking this could be a fit that there is a plan to step into the program. It sounds like there's a lot of community when they are there within the facility. And then also for them to step back into their life. It's not just, "You've got the tools. Here you go." There are some things that are taken with them and even a plan in place for after they leave. That's encouraging to hear. After 35 years, what are some goals moving forward, or some things that you've learned over the 35 years, that you want to implement in the future?
Dr. John Hendrickson:
One thing we're looking at is obtaining the official designation of being a psychiatric qualified residential treatment program, which allows that we are taking care of things like providing trauma informed care, which we do, but there are certain ways you have to prove that you're doing that.
Cami Smith:
I see.
Dr. John Hendrickson:
And apply for that official status, so that's one of the things we're hoping to gain. And increasing the incorporation of families' involvement. There's a family's first movement to increase the amount of time that families are involved, whether visiting or with therapeutic passes, or just coming to campus for activities. Unfortunately, for the past year and a half or two, COVID has put a lot of limitations on the abilities of families to visit and come on campus, but things are opening up at this time. Fortunately, we're going to be able to move forward with some of those plans. Because it really is about getting the families engaged and keeping them involved in the treatment of the kid.
Cami Smith:
Yes. And that's important, I think, to state for this who are listening, this is not a separation in all ways of the child from the family unit. It is just a way for the family and the child to move forward, staying connected as much as possible, but in an environment that's going to be suitable for treatment. Okay. That's helpful.
Mark Bosher:
And, typically, what you'll do is you'll meet with the families and set up therapeutic passes. And they will have their goals set up. And they'll go home for a day or two, and you get back in family, and go over how things went, and collaborate with them on modifications that they need to do to make things better. And so, we got past goal sheets that we will use. And most of the parents will fill out how things went, and we just keep focused on trying to make the changes that are needed.
Cami Smith:
Okay. What other goals do you think you would see or you hope for Bridges in the future?
Cray Callahan:
Well, as John mentioned, the QRTP status and increasing training, I guess, for all staff in the trauma informed model of care. It's one of the certainly big trends in our profession at this point, so we'll be working on getting the staff training for that and making the official, I guess, application.
Cami Smith:
Okay.
Cray Callahan:
Hopefully.
Dr. John Hendrickson:
Sure. Another of the challenges we're facing is, as across so many industries, there's been a fair amount of turnover during COVID and afterwards. So we have been talking recently about how many of our staff are young and fairly new. So we're working on training them and getting them the tools that they need to provide the therapy services and the support that the kids need while they're there. So that's kind of a challenge, as well as something we're looking to continue improving as we go forward.
Cami Smith:
Yeah. And I think it's also pretty incredible that these caregivers have an opportunity to learn in such an incredible environment, especially with... It sounds like your patients are great. It sounds like there's a lot that they can glean from, and share from, and grow through along with the patients. Well, one thing that I know that we're doing in August is there's going to be some celebration. What is that celebration going to look like?
Dr. John Hendrickson:
That's a good question. I don't know what-
Cami Smith:
So maybe we won't talk about the celebration.
Dr. John Hendrickson:
Yeah. I don't know much about the details of the celebration, not much has actually been announced. This podcast is actually the first concrete thing that we've talked about doing as part of this 35th anniversary celebration. So we don't really know much about the details of the actual celebration as it may be at this point.
Cami Smith:
Okay. Well, one thing I know we can tease a little is we've got some pictures that we're going to put out on our social channels, and it's a pretty thick book that's got 35 years of representation from Bridges. So before we close out, I do want to talk a little bit, and I know it's a very intensive process, but for those who are thinking this could be a great fit for my family, or for this child in my life. How would they go about doing that? Visit your website, get the ball rolling from there?
Dr. John Hendrickson:
Yeah. Visiting the website is probably the best. They can call Bridges. We have an admissions coordinator who can direct them to the community agencies that they may need to speak with to coordinate the admission and referral process.
Cami Smith:
Okay.
Cray Callahan:
Yeah, because the referrals come from community-based organizations usually. Sometimes the school systems make referrals to us. And just a side note is that, we have served kids, children, adolescents, over my 32 plus years, from probably almost 90% of the counties and cities and throughout the Commonwealth. Our kids have come from the beaches to the mountains and all in between.
Cami Smith:
Wow. That's incredible. So it's not just our local community. There's larger [crosstalk 00:20:38].
Dr. John Hendrickson:
No, it's all over Virginia right now. We're not currently admitting kids from out of state, but it's every part of Virginia, every corner of the state.
Cray Callahan:
It is.
Cami Smith:
Yeah. Well, I'm excited for the work that you all are doing, and happy 35th anniversary.
Dr. John Hendrickson:
Thank you.
Cami Smith:
We're going to put a link in the description for those of you who want to know more about Bridges. And we're also going to throw out some pictures, so that you can see a little bit of the history on our social channels. And so, be sure to check that out and thank you once again for joining us on Centra Scripts.