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INTENSIVE OUTPATIENT PROGRAM / PARTIAL HOSPITALIZATION PROGRAMS

Introduction

Since 2008, Direction has provided mental health care to adolescents in the Greater Nashua Area. As the only program of its kind in the region, we offer a much-needed “intermediate” level of care for teens who have needs that are too complex to be effectively managed in an office outpatient setting, but do not reach the threshold warranting inpatient hospitalization. We offer an alternative for outpatient providers, emergency rooms, school guidance counselors, primary care physicians, parents, and other local agencies seeking mental health care for their patients, students, clients, and children. To date we have treated over 3,000 kids and their families.

For some teens, Direction serves as the point of entry to psychiatric care. For others who already are engaged in treatment, it provides crisis stabilization when outpatient treatment alone is insufficient or ineffective. For those kids who do require inpatient level of care, it serves as a step-down program to provide smoother transition back into the community. It appeals to parents, patients, and other providers because of its ability to provide a wide array of services in a relatively short period of time. It appeals to insurance companies for the same reasons, and because it accomplishes its goals in a more cost-effective way.

The Facility

In January, 2021, Direction moved to a the Millyard Technology Park. Our program takes place at a newly-renovated 4000-square-foot suite, located in converted mill space in Downtown Nashua. This site has a reception area, several large group spaces, several offices, a bathrooms, and a kitchenette.  And the foosball, pingpong, and airhockey tables are all good selling points to the kids.  

The Treatment Team

Duncan Gill, MD, is Board-Certified in Child and Adolescent Psychiatry as well as General Psychiatry. Unlike many other similar programs, he is on-site in Nashua during program hours 5 days per week and actively involved in our clients’ care.

Victoria Lee, LADC, is the program Director.  Her extensive experience working with residential kids enables her to form connections with even the most "difficult" teenagers.  

You can learn more about our staff here.

Admission to Direction

Kids come from hospitals, emergency rooms, schools, homes, and pretty much everywhere else.  We don't need any particular formal "referral" -- just give us a call.  

The programs are paid for by the vast majority of insurances.

Level of Care

The Intensive Outpatient Program (IOP) operates 3 hours per day, between 3 PM and 6 PM, and the Partial Hospitalization Program operates 5 hours per day, between 1 PM and 6 PM.  

Program Structure

Group therapy forms the core component of treatment in Direction’s IOP and PHP, and is led by Victoria. Over the years, we developed a model of group therapy called Wholeistic Education (WED) which you can learn more about under the menu "Resources".  

We provide both Parenting Groups (currently over Zoom) and do individual work with families.  

The Medical Director provides medication management to those kids for whom it is appropriate. One advantage of his strong presence at the program is that it allows him to closely monitor medication effects and respond quickly with changes when indicated. Essentially, it allows him to manage medications in a manner more similar to an inpatient psychiatrist, and to provide more intensive psychiatric services than many other programs provide.

Program length of stay is variable, and dependent on each client’s own particular clinical needs, but generally is a few weeks. Clients generally attend the program 5 days per week, though frequency of attendance may be reduced as clinically appropriate.  Clients who attend the PHP often step down to the IOP afterward.  


Discharge planning begins upon admission to ensure suitable aftercare arrangements are made prior to completion of the program.

Direction usually has between 10 and 20 kids attending each day.

Transportation

Transportation to and from the program must be provided by the family, though some children are able to drive themselves.