Mental Health Levels of Care: PHP, IOP, Outpatient Therapy, and Psychiatry
How to know which level of care is right for you, with Calvin Klint, MD, Associate Medical Director at Compass Health Center — Northbrook.
Moving through a mental health crisis can be challenging, and figuring out the right level of care can feel just as overwhelming. According to Calvin Klint, MD, Associate Medical Director of Compass Health Center – Northbrook, finding that path often starts with an honest conversation with yourself—and the courage to reach out for support when you need it.
Understanding the levels of care in mental health treatment can help you identify the right next step. In this in-depth discussion, Dr. Klint helps bring the continuum of mental health care to life, offering a clearer understanding of how treatment can evolve from psychiatry and therapy to more structured levels of support. He explores how PHP, IOP, and outpatient care differ, and how each can play a meaningful role at different points in a person’s life.
Dr. Klint also reflects on the value of collaboration throughout treatment—between clinicians, care teams, and patients themselves—and how that shared approach can help people feel more grounded, even in moments of uncertainty. Above all, Dr. Klint speaks to what he often sees in practice at Compass: that while taking the first step into treatment can feel overwhelming, many people discover over time that life becomes not only more manageable, but also more hopeful than they imagined at the start.
This interview has been lightly edited for grammar and flow. The speaker’s original meaning and intent have not been changed.
Q&A
Britt Teasdale (BT): Tell me about your background as a psychiatrist and what brought you to Compass.
Calvin Klint, MD (CK): I’ve always loved math and chemistry. After graduating college, I worked as a chemist for a short bit. While there, I loved the science but didn’t find the in-person interactions I was looking for. We sat around the lunchroom and no one talked; it was very isolating. I was sharing with one of my friends who was in medical school, and he said, “if you love science and you love people, medicine is the way to go.” So I changed my career path.
When I started medical school, I wanted to be a surgeon or an emergency medicine doctor. It wasn’t until I did my psychiatry rotation, which was something I’d never been exposed to, that I saw how much time providers got to spend with their patients and how drastically lives were changed.
I then did my residency at Cleveland Clinic in Cleveland, and while there, I had minimal experience with PHP or IOP. It wasn’t just something we did; we didn’t have a strong PHP or IOP presence—there were a lot of consults and academic medicine instead.
I found Compass randomly as I was looking for jobs. I learned about the free-flowing care for patients and the immersive aspect of an individual therapist, a family therapist, and group therapy all working together and I really loved the collaboration. I believe that in order to really make a difference, it takes a village—it takes many people with different expertise coming together. So that’s what led me to coming here, and I’ve loved my experience. I genuinely love my job. My wife laughs because, come Sunday night, she notices that I sit here a little bit excited, and she’ll say, “Work doesn’t start until tomorrow. It’s okay. You can relax.”
BT: It sounds like you landed in the perfect specialty for you. How long have you been with Compass?
CK: I’m coming up on four years in August.
I’ve always been in Northbrook since coming over here. I’m an over-18 psychiatrist, but about a year ago I took over the role of Associate Medical Director, so I’m helping out with the under-18 side in different ways.
BT: When people think about mental health treatment, they often picture weekly therapy or occasional psychiatry visits—maybe a monthly check-in with their psychiatrist. How do you define outpatient care, or anything where you’re not staying overnight somewhere?
CK: Outpatient care is a broad umbrella term that encompasses many different facets. At its core, you just don’t stay overnight. If you can leave at the end of the visit, it would be considered outpatient care. Within outpatient care, you have your traditional outpatient visits, which is the way we typically think about meeting with a doctor or therapist for 30 minutes to an hour, once every week or once every few months. There are also more immersive parts of outpatient care, where you’re there for a longer period of time, like IOP or PHP. But at the end of the day, you’re still able to return home, take care of your responsibilities, and potentially work. It’s a way to integrate mental health treatment into your daily life.
BT: Where do intensive outpatient programs and partial hospitalization programs really fit within that broader continuum of mental health care?
CK: IOPs and PHPs are the middle ground. They’re the in-between—between more lenient or flexible outpatient care and more immersive inpatient care. Patients in an IOP or PHP are present for a prolonged period of time, and it’s suited for individuals who are struggling to a larger degree. It can keep patients from using the most restrictive levels of care, like inpatient units or residential care. These patients tend to benefit from a higher level of accountability, closer monitoring, and a more immersive treatment experience. But the purpose is the same- to allow you to live your regular everyday life, as best as you can.
BT: If someone is reading or listening to this, what are some signals that that person or their caregiver can take into account—thinking, “Oh, maybe the PHP and IOP level of care is what might be right for me”? What are some signals?
CK: One of the things that I tell my patients is, “How do you know whether a tree is good? You check the fruit.” I have patients who have done a lot of outpatient care like seeing their therapist weekly and adjusting their medications over many years. We can get distracted by our daily problems that are readily in front of our eyes. Patients and providers should occasionally step back and question, “How have I been doing over the past year or five years? Am I making progress in this area?” Sometimes the answer is no. The person is still struggling with social anxiety, still having a hard time maintaining a job, still struggling with finding a hobby, or developing positive habits. Even though they’ve given outpatient care a good shot, these issues remain.
In that regard, if you’re still struggling, it may be time to increase the intervention by doing something more immersive. It is a somewhat logical conclusion to honestly admitting that the current approach isn’t working.
BT: I think a lot of people believe, “If I’m really struggling and day-to-day life is really hard, or I’m seeing my teen and they’re not able to really function anymore,” they immediately think, I need to take them to the ER or I need to take them to the hospital. Can you speak a little to that, and maybe when they could actually call somewhere like Compass, or a PHP or IOP instead of just automatically going to the hospital?
CK: We always think about the emergency room as that ultimate life raft—that’s drilled into us with every TV show and movie that’s out there. When somebody’s sick or they’ve fallen or are having a heart attack, it’s right to the ER. We have the same thought with mental health crises, and it’s not the most accurate approach because the ER isn’t designed for treatment; they’re designed for stabilization. In fact, most people who have been to the ER realize there are long wait times and limited interventions, especially from a mental health standpoint. Unless there’s an acute safety concern, the options are limited.
Mental health is long-term work as patients try to improve their mind and life. On the other hand, the ER is trying to keep visits as short as possible. Patients need to talk with somebody who can thoroughly listen to their story and guide them through what they need and then provide accountability as they move to the next step. If you have an outpatient therapist or a psychiatrist, you can reach out to them. Compass is another great option—we’ve done a good job of intervening to get care to patients faster, knowing that that gap between when they need help and when they’re able to receive help is such a vulnerable state.
So even reaching out to a place like us and saying, “Do you think I’d be a good fit?”—we’d be able to give advice and get you in as soon as possible. The worst thing someone can do is not to struggle, but to struggle alone and for a prolonged amount of time.
BT: That’s such a good point—being able to get that support as quickly as possible. At our different locations, we’re often able to get folks started within 24 to 48 hours. Can we dig into the differences between IOP and PHP? Those terms, “partial hospitalization program” and “intensive outpatient program,” can seem a little daunting. I’m hoping you can bring them down to earth a little bit for us.
CK: Acronyms are always scary when we don’t exactly know what they are. Even what these acronyms represent—they’re historical terms: intensive outpatient program, partial hospitalization program—can have some intimidating aspects. Instead, what those two terms differentiate are the two tracks of how we treat patients. PHP—partial hospitalization program—is our most immersive way to manage patients. They’re here for a longer amount of time, and it’s designed to help patients stabilize. They’re going to see their team more frequently, receive a couple of extra groups, and have more one-on-one time while in the program. It’s very useful for people who are trying to understand all the problems they’re dealing with and how to get their feet back underneath them.
And IOP—intensive outpatient programming—is our less immersive form of treatment. Patients are here for the morning program, from 9:30 to 12:30. They’re still checking in with their team, having one-on-one sessions with their psychiatrist, their family therapist, and their individual therapist, but there’s a lot more time spent in groups. They have more hours of the day left to their own devices—if they want to volunteer, start working out, resume work in some situations, or manage home responsibilities. It provides a natural reintegration back into their everyday life, and they can use the morning part of the program as a form of accountability—to ask, “How are we doing? How did the previous day go? How are we working on our goals?”—while also managing that gradual transition out of the program.
BT: I’m glad you touched on the different facets of care for both. Let’s dig into group-based care a little bit more. If someone’s unfamiliar with that style of therapy—being in a group with others—or maybe a parent is a bit hesitant to have their child or teen in a group setting, can you speak to that and why it’s such an important part of IOP and PHP programming?
CK: At our core, we are a group-based program—that is the bulk of what we do. The good work that we do, a lot of times, has its true foundation in what happens in those group rooms. Individuals who are struggling are with other individuals who are struggling, and that breeds so many positive aspects. There’s a shared commonality—this idea that we are all human and we are all going through it together.
It’s one thing to struggle, but mental illness in and of itself is very isolating. Whatever it is—anxiety, depression, psychosis, substance use—it makes you pull within yourself. You feel misunderstood. There’s a lot of guilt and shame, and just walking into a room knowing there are six other people, eight other people, twenty other people who are dealing with the same thing takes a bit of the weight off your shoulders. Patients say, “I’m not alone. I’m not misunderstood by everybody.” That’s the common humanity part of treatment.
There’s also the difference between what I would call mental health knowledge and experiential wisdom. Any therapist or psychiatrist can teach you what we know from working with patients and from the studies we read. But there’s also a different kind of impact that comes from a patient who has experiential knowledge. If one person struggles with panic attacks, hearing from someone else who has also struggled with panic attacks describe what’s worked for them, how they sought help, how they were able to learn coping skills—that experience, coming from a non-professional who’s in the same boat, carries a lot of weight.
BT: To see yourself in someone else’s shoes—even if your experiences aren’t exactly the same—that can feel so comforting. What about parents who are a little bit worried about that for their child or teen? For example, “I understand the common humanity part of it, and I understand being able to relate to one another, but what if I still have some hesitation?” Especially for parents who may think, “I don’t want my child exposed to others who are struggling. Could that impact them negatively?” I’m sure we get those questions. How do we respond to those concerns?
CK: I think it’s a misconception that by putting people together who are going through something similar in a room, they’ll bring each other down rather than build each other up. It loses sight of the main premise that we are a voluntary program—everyone who walks in our doors is trying to get better. They’re taking time away from their life, their family, their job—things they’re building for their future—in order to really work on their mental health.
The model of using people who are struggling to help others—we see it as one of the anchor points of AA, which is one of our best approaches to treating sobriety. You also see it in schools where a group of peers are together in the same room, trying to cover the same material, with the hope that through collaboration, they’ll all grow.
There’s something about community that—especially in this modern world, where we’re lacking it in so many ways—can be incredibly powerful. To have a community of individuals who understand you and can share in this slice of your life—the mental health part—is a powerful and beautiful benefit.
A big part of being here is what I’d call a tiered system of patients. You have the person who comes in for their first or second day, who’s brand new and everything feels overwhelming. But they’re also sitting next to someone who’s been in the program for a bit—they’re starting to make changes and experiencing the difficulties of trying to live a new life with a new mindset. And they’re also alongside people who are nearing the end of their time at Compass—who have overcome and achieved. All three of those people are able to talk together and work through things, taking on a shared sense of ownership in impacting one another and being part of the solution. It’s this ever-revolving wheel where everyone fills a role that’s needed.
BT: That must feel comforting to a degree as well. To think, “Wow, maybe on my first day I feel so overwhelmed and nervous, but I can see someone who’s nearing the end of their treatment and they seem like they’re doing really well. That could be me.” Let’s talk a little about psychiatry and how it fits into our treatment model as well. I know all our programs are psychiatrist-led and part of our treatment teams. All patients go through a psychiatric evaluation once they start program and have regular check-ins. Can you dig in a little bit to how psychiatric care fits into all of our programming and how it supports all of the treatment modalities while someone’s in program?
CK: With PHP and IOP, we view it as three legs of a stool—the three legs that support the weight of getting the patient better. One of the legs is group therapy: learning skills and being exposed to material in a classroom-like setting. Another leg is individual therapy, which includes individual therapy and family therapy—working on integrating those skills on a one-on-one basis. And then the last leg is psychiatry.
I think people often pigeonhole psychiatry as medication management, which is very important and a bulk of what we do. But psychiatry is also about diagnosis—really figuring out what is going on. Usually when people come in, they’ve already been diagnosed with and treated , but the reason they need PHP or IOP is that they’re still struggling. Many times, the diagnosis needs to be refined, something else needs to be added, or something has been misconstrued or misunderstood, and that’s why treatments haven’t been effective.
Also, outside of medication management, we’re all trained in our own forms of psychotherapy. Compass’s PHP and IOP programs are heavily involved with DBT, ACT, and CBT. While psychiatrists are well-versed in those schools of therapy, there are also other approaches that help round things out. We draw attention to other aspects to consider, like brain pathology, data and research, interpersonal functioning, and the science of healthy habits.
For many of my patients, medication is just a small part of what we do in our visits. We also serve as accountability—building up the things we know are healthy for them: physical exercise, diet, hobbies, friendships, a passion, some sort of life purpose. Those are the kinds of things that can grow in one-on-one visits.
BT: How do those psychiatrists work within the treatment teams? I know there’s such a team-based approach to our patients’ care and that throughout their time at Compass, treatment plans are adjusted. There are conversations going on daily amongst the treatment team so that everyone can support the patient in the best possible way they can. Could you speak a little bit to that?
CK: The peek behind the curtain is that there’s a remarkably high level of collaboration. We are always talking, whether it’s as a group or as individuals—the psychiatrists, the family therapists, the individual therapists, and the group therapists—knowing that everyone has a different perspective on what they’re seeing.
We are also always trying to chip away, to different degrees, at what we can solve for the patient and who is best equipped for it. With multiple people on a treatment team, you’re going to have slightly different relationships. The north star is the same for all of us in what we’re shooting for: for a patient to be able to function in the life that they have. And yet we all get to use our specific training, skill sets, personalities, relationships, and backgrounds to chip away at these problems.
In certain ways, it’s more comfortable for me to have the conversation about a patient’s substance use, whereas the family therapist is really going to focus on their dynamic with their father and getting that restored. The individual therapist may be talking more about group overall and building hobbies on the outside. And we’re hearing how they’re doing from the group therapist and how they’re integrating with everybody else.
Sometimes we’re all unified, working on the exact same problem; sometimes we’re allocating what we’re doing. But it’s always this multi-headed approach to try to figure out how best to get the patient where they want to be, and how best to help them achieve their goals.
BT: And how does that differ from outpatient therapy or outpatient psychiatry? How does that model really change?
CK: Modern mental healthcare is very siloed, where an outpatient psychiatrist sees the patient and typically it’s just pure med management. An outpatient therapist will also work with the patient, but a lot of times communication between providers is difficult. People are overbooked, and there isn’t protected time for communicating or getting in touch with other individuals.
So a lot of times when you’re treating a patient, you end up being on an island, which is difficult because there are certain problems that require parts of treatment you aren’t able to access. As a therapist who is not aware of what’s happening with medication, it’s hard to know if the meds are being optimized or what you should expect from them. As a psychiatrist who may only see the patient once a month or once every three months, it’s hard to really dig into their hobbies, their social connections, or how fulfilled they are feeling at work. That lack of communication is a tough thing, and it actually provides a barrier to patients getting better.
BT: Let’s discuss medication management specifically. You said maybe you’re seeing an outpatient psychiatrist monthly or every few months, and you’re getting that medication management. How does that differ when you’re in a PHP or IOP level of care, specifically for medication management? How does that look?
CK: I believe that PHP and IOP care is best suited for medication management. In mental health, we rarely have quick fixes. Our meds take time to settle in. Our antidepressants and anti-anxiety medications have a time course that we’re looking at in weeks instead of days. In that sense, being able to start a medication and follow up with a patient multiple times in a week gives you the ability to check for side effects early on. You also have the advantage of knowing you’re going to closely see the patient for a couple of weeks to monitor how they’re responding to treatment.
Outpatient care, especially with providers being as busy as they are, makes it hard to get in quickly when you have a medication side effect. It’s hard to promptly manage things, pivot, or make larger changes or cross-taper between medications.
On the other hand, the most immersive form of care—the inpatient unit—is where patients can be monitored 24 hours a day, but admissions are often very short: three to ten days. Most of the medications started there won’t have their full effect until a couple of weeks after discharge.
Taking the time in IOP and PHP is a nice privilege for medication adjustments. My patients know that I’m always 45 feet away and if anything comes up, they have access to me.
BT: And so you’re able to really get them started on medication, adjust those medications, reevaluate what’s working and what’s not working, and this is all kind of done in real time.
CK: Absolutely. We’re a fresh set of eyes, as well. People normally think the answer is to add on more meds, but in reality, for 50% of my patients, the first half of their time in program is actually coming down on their meds little by little. Things have been added on slowly without looking at the big picture. Patients can be taking seven or more different medications, and when you ask, “What are we using this for?”, they don’t know.
How meds were described to me was: “Imagine you are the CEO walking through your brain, and you ask each medication, ‘What’s your job here?’—if a medication said, ‘I help with depression,’ or ‘I improve motivation,’ you’d keep them. Whereas if you looked at a medication and said, ‘What is your job?’ and they said they didn’t know what they are doing, they’d be fired or replaced quickly.”
A big part of what we do is figuring out that right balance. In addition, we help patients by asking, “How much of what we’re dealing with is a medication problem?” It seems strange, but a lot of times we assume that medications can solve more than what they’re designed to do.
When I have patients come in for the first time, I ask, “What are the problems that we’re dealing with? What are we trying to work on?” Then I’ll get a long list: “My anxiety has been a little bit higher than what I want. I have panic attacks every now and then. My job just isn’t fulfilling. I’ve always wanted to have a career that I really believe in. And my family relationships aren’t good.”
Once we get a brief lay of the land, I’ll ask, “Which of these problems are we going to try and medicate?” It seems like a goofy question, but sometimes we just assume that if my medications were good, I would love my job and feel fulfilled. In actuality, no matter what dose of Prozac you take, your boss will always remain your boss and function in the way that they do. No medication can restore family relationships. No medication can make us not be a picky eater.
But there are things that medications can do for us. And we use that as part of treatment while also using the other resources of Compass—individual therapy, coping skills, and lifestyle changes—to really instill change. When people do a treatment like IOP/PHP, they’re focusing on the neurochemical and also the psychological part. They actually end up taking fewer medications because they’re able to support their own mental health through other means.
BT: That’s so interesting to think that someone can come into Compass taking too many medications and you can actually adjust and refine and figure out what is necessary and what’s going to help them thrive—and that it’s actually less than what they came in with. How about for folks or parents who have never taken medication and are a little bit hesitant, like, “If I start a PHP or IOP, there are psychiatrists, there’s medication management, I’m going to have to do that.” We know that’s not the case—it’s not automatically like you’re going to be prescribed a medication if you’re in a PHP or IOP. But sometimes there’s that fear, right? Can you speak to that, please?
CK: Some of my favorite patients are the ones who want to avoid medication at all costs. There are a lot of different reasons behind it—either they’ve got medical problems and are already on other medications and don’t want to add more complexity, or there’s skepticism toward psychiatry or pharmaceutical companies, or just skepticism toward the mental health field.
I really love working with patients who do not want to be on medication because you get to partner with them, and you know they’re going to be motivated to solve their problems in other ways. I think there’s maybe an overreliance on medication in certain situations, so instead, when I have a patient come in who says, “I don’t want to be on medication; I’m a little skeptical of this or I’m strongly averse to it,” what I’ll say is, “What do you believe in? And let’s lean into that.”
If it’s religion, exercise, hobbies, socialization, or coping skills, I’ll say, “Let’s start with the things that are most aligned with your values, your ethics, and your goals, and I’m going to serve as accountability, support, and your biggest cheerleader through all of that. You and I—let’s keep medications as Option K, and we’re going to start working through Options A, B, C, D, and E first.”
What I’ve found is that a lot of times either:
- the patient is correct and they didn’t need medication from the start, which is all the better, or
- they start making improvements—going to sleep earlier, improving their diet, trying to be more diligent with coping skills—but they notice there’s still something left on the table. There’s still something that, no matter how much they’ve changed, they can’t quite bring down their anxiety, mood symptoms, or trauma symptoms to where they want them.
At that point, because I’ve partnered with them and they’ve been able to enact the changes they wanted without anything being forced, people arrive at the idea of medication with much greater alignment, saying, “I do think something more is needed. Now we’ve arrived at Option K. Let’s give medications a shot.”
The nice thing about it is, first, it keeps the doctor-patient relationship strong. And second, you know you’re medicating a small part of the problem because everything else has already been optimized.
BT: Sounds like you have a really holistic approach to patient care, which is so great to hear and is such a highlight of the PHP and IOP model because psychiatrists are really able to accomplish that within that setting, which is really cool.
CK: With each patient, it’s always interesting to see who the most important part of their team is. The team-centered approach is phenomenal, and I love each part of it. For some patients, family therapy is what carries the bulk of the treatment, through rectifying family relationships, resolving marital conflict, and pushing them from divorce to reunification. Sometimes it’s their relationship with their individual therapist. Sometimes it’s just being in group, learning the skills, and forming a community. For people who have been isolating for a long time, they finally realize what it’s like to be known and affirmed. Sometimes it is medication.
There are so many ways to skin a cat in mental health, and that’s why I love working here: we can always start with what the patient values most. Nothing is required. Nothing is forced. Instead, we get to partner with them. Because we are a temporary program, what I want is that by the time they’ve completed our program, they know their own values, they know what they need to do, and that’s the knowledge that will keep them not just healthy while they’re at Compass, but for the decades after they leave our program.
BT: And you made such a great point that at the core of our PHP and IOP programs is an individualized, personalized approach. It’s not one-size-fits-all. It’s, like you said, at the beginning when you speak to a patient: “What are your values? What are your goals? What are you looking to accomplish here?” It’s not, “Okay, this is the prescribed course of treatment and you’re just going to follow it.” I think that will feel really comforting for people to hear.
I would like to get into also a difference between outpatient therapy or psychiatry versus PHP and IOP’s ability to treat co-occurring disorders at a high level. So if someone is struggling with trauma symptoms as well as mental health and substance use, we can do that concurrently, at the same time, in our programs. Or if they’re struggling with OCD and trauma—or whatever they are struggling with—we’re able to do that all under one roof concurrently. Can you speak to how that impacts a patient’s treatment outcomes and their trajectory in general?
CK: When people first come into Compass, at my first meeting, I’ll start the conversation and say, “Tell me what brought you in here. What can I do for you today?” They’ll usually list off two or three things. I know from the get-go those two or three things are what’s at the forefront of their mind, but in enough time, that laundry list of problems will continue to grow. It’s not even about the most important thing—at some point you’ll have smaller or medium-sized problems that come up, and sometimes new larger problems that the patient didn’t even know they were struggling with emerge.
In PHP and IOP, you are immersively in a patient’s life, so you get to see all that they’re dealing with—their strengths and their weaknesses. People can’t get better until they resolve a lot of these things. There are these hang-ups where your mood could be better, but if you don’t have something to do with your better mood, it’s not a better life. Our north star is functionality: can you live your life and enjoy your todays while also appreciating your yesterdays and looking forward to your tomorrows?
With that, Compass has realized that we need to be broad in our approach. One of the misconceptions about Compass is that we just treat depression and anxiety, or that you need to have a certain level of severity in the symptoms you’re dealing with, when in actuality the problems that keep us from enjoying our life are far more complex and immersive. Sometimes it is treating those mood symptoms, but also trying to reconcile the trauma you experienced, or those parts of your childhood that you were never able to open up and put to rest. There’s also accountability for substances and accountability for enacting other changes.
You see somebody every single day while you’re here, so it’s easy to say, “Between now and when I see you at 9:30 tomorrow morning, what are you going to do that’s aligned with your values, and how can we support you with that?” And knowing that tomorrow I’m going to ask about it, you’ve got that little bit of pressure to follow through on what we’re talking about.
Compass has created different programs that patients can utilize to best serve them, whether it’s our trauma program, our substance use track, our chronic pain program, or our OCD program—and patients can oscillate between them. It’s very common to have a patient who comes in and says, “Trauma is the main thing I need help with,” and they start in that program. But as their trauma symptoms are reduced, it becomes more apparent that, “I didn’t realize I was using marijuana as more of a crutch than I wanted. I’m having a hard time walking it down.” They may then switch from the trauma program over to our substance use track.
We are an open playground for you—use us as much as you can, knowing that as the patient and team get to know each other, it will become clear what the next best step in treatment is.
BT: Thank you so much for going over the different programs and how they can work together. I think that’s such a differentiator for folks who are seeking the PHP and IOP levels of care. We really do specialize in those areas and can treat them concurrently—you don’t have to go to different locations. You can just be under one roof. We take the complication out of it.
Unfortunately, in our mental health landscape today, there’s still a lot of shame that comes with asking for help, and more so at the PHP and IOP level of care than reaching out to an outpatient therapist, which is thankfully more normalized over the years. But there’s still some shame associated with it, right? So how would you respond to someone who feels they should be able to manage their symptoms or manage their life with weekly therapy alone, but is struggling to come to terms with the fact that they may need more support and feels like they’re a failure? How would you speak to them?
CK: One thing I’d encourage to anyone who’s struggling is to be honest with yourself. Take a moment and look at your life. “Where am I satisfied? Where am I having some difficulty?” and be broad in your understanding of yourself—your self-worth, your body image, your understanding of your strengths and weaknesses, and whether you feel like you’ve achieved the potential that you believe. Your relationships, your friendships, your role, your vocation, your career, how you’re impacting the world around you—be honest with yourself and see what’s going well and what’s not going well.
And take a point in time and say, “On this day, at this time, this is how my life is going,” and then try to make a change. If through outpatient therapy or intentional effort you’re able to make progress, a higher level of care may not be needed. But a majority of individuals never take that larger viewpoint to realize that they’re dealing with the same problem year after year after year. The mask of the day that they’re wearing might look a little different, but some of these tendencies are the exact same, and it’s been hard to make progress.
In that sense, PHP and IOP, in my mind, is the idea that “you’re going to lose some time to gain some time.” It can seem immersive to come in for six weeks, eight weeks, twelve weeks, but I promise that with the patients that we work with, those twelve weeks can stop years or decades of continued struggle. And the functionality patients have when they leave our program allows them to derive so much more fulfillment and success in what they then turn their attention toward.
It’s multimodal—one of those things where you’re not investing in just a very specific problem. When they leave program, I want my patients to be better fathers, better mothers, better employees, better friends, better neighbors, and better lovers of themselves. It’s something that plants seeds and produces a great harvest across so many paradigms of life.
BT: Thank you so much for saying that. That was a wonderful way of describing what progress can look like when someone is in the right level of care for their needs—to become a greater lover of themselves. I love that. What does progress tend to look like when someone is in the right level of care? How quickly can that happen? What can their day-to-day look like?
CK: Progress is never linear. It would be easier if it were. If you’re at the right level of care, things will start to change. Things will start to change in the sense that you may see tangible benefits—someone is going to bed earlier, they’re doing a better job of maintaining their daily responsibilities, they reached out to a friend they were thinking about for a long time.
Sometimes the tangible benefits aren’t as clear, but you’ll get the intangible ones—you’ll just feel better. “I woke up this morning and I didn’t have that cloud hanging over me,” or “my movement throughout the day—I don’t have to give myself as much of a pep talk to get out the door.” Barriers that were present in the mind seem to be shrinking down.
It doesn’t take long if it’s the right treatment with the right intentionality at the right time—a matter of days or weeks will prove that this was the right answer. A lot of treatment at Compass, in my mind, is a momentum game. The first change is always the hardest— coming in and figuring out what’s the first thing we can do differently. But once someone makes that change and they feel the benefit of it, they’re a little more willing to make that second change.
All of a sudden, a couple weeks go by and they’ve made 10 or 12 changes and they feel all the positive fruit from it. They’re coming in and saying, “Dr. Klint, here’s the next thing that I think we need to focus on. What would you say? Here’s my plan for how I want to enact a change. Do you think this is a good plan or not?” It’s a momentum game, and it starts with that first step.
For patients, one of the hardest things they’re going to have to do is just walk through the door. That’s what I’d encourage anyone with—that’s the biggest, toughest step. Once you’re here, you’re going to have a whole support system around you, and we’ll slowly build up those changes together.
BT: Thank you so much, Dr. Klint. That was really fabulous. I think you touched on so many important facets of our care at Compass and just PHP, IOP, and mental health in general. Thank you so much. Is there anything that I didn’t ask that you wanted to touch on?
CK: One other thing I would say is, for individuals who are curious, just reach out to us. Just give us a call. It’s low stakes. More information helps—just figuring out who we are, what we’re about, and what our patients experience. The unknown is one of the scariest things, but a lot of times it’s a shadow on the wall; it doesn’t carry the weight or isn’t actually something that’s as bad as what we chalk it up to be. Be willing to do something different. It’s a tough thing being in the world today, and there are resources that are designed to help.
BT: That’s such an important point—that even if they’re unsure what might be best for them, just reaching out, whether it’s to us or to a school counselor or to an outpatient therapist, just to start that conversation can make the wheels start turning. This was a great conversation. Thank you so much, Dr. Klint. It was really lovely to speak with you this morning.
Bios
Dr. Calvin Klint, MD, is the Associate Medical Director for Compass Health Center – Northbrook. With over 8 years of clinical and leadership experience in mental health, he has dedicated his career to partnering with patients to help them build a future they believe in. Leading the psychiatry department for PHP and IOP programming at Compass in Northbrook is a fulfilling opportunity for Dr. Klint to connect with patients and support them in taking ownership of their recovery through a collaborative, strengths-based approach.
Britt Teasdale is a writer, photographer, and creative strategist. As Associate Director of Brand Management & Content at Compass Health Center, she has spent nearly a decade shaping narratives that translate complex clinical ideas into stories that resonate, reduce stigma, and help families access care. She holds an MFA in Creative Nonfiction Writing and began her career in journalism. She also co-hosts Compass’s forthcoming podcast, You Only Know What You Know.
