Creating Lasting Change Through Therapeutic Community: An Interview with Dr. Karlyn Pleasants
Dr. Karlyn Pleasants understands complex mental health needs. As Executive Clinical Director at Hanbleceya, she seeks to create holistic health through a therapeutic community. Here, you have the opportunity to nourish relationships and experience Hanbleceya’s unique emotional scaffolding approach, supporting you as you gain the skills and confidence to transition toward independence. Through a comprehensive array of therapies, a warm, welcoming community environment, and significant family involvement, you can finally move from “I can’t” to “I can.”
When you are struggling with a mental health disorder that has not been resolved through outpatient or even short-term inpatient care, it can be difficult to know where to turn next. Despite the proliferation of public awareness regarding mental illness and the expansion of mental health services in the past two decades, it can still be difficult to find resources if you need intensive, longer-term care for a complex mental illness. At Hanbleceya, we have a long history as a place where you can experience effective and focused care when other treatment options have failed to give you the stability, skills, and personal growth you need to live a healthy, independent life.
Dr. Karlyn Pleasants, Executive Clinical Director at Hanbleceya, understands the unique challenges faced by people who have been unable to make and sustain meaningful changes despite previous treatment attempts. Trained as a clinical psychologist, she has gained a rich clinical background treating people with complex diagnoses, including thought and mood disorders, substance use disorders, eating disorders, and anxiety disorders. In this interview, she shares her thoughts on the innovative approaches taken by Hanbleceya and why the program continues to serve as safe, supportive space for people living with mental illnesses to find healing, empowerment, and purpose.
Holistic Health Through a Therapeutic Community
Hanbleceya was established in 1979, and originally served people living with schizophrenia through a residential, community-based treatment model. From this singular focus, Hanbleceya has since broadened its horizons and today acts as a long-term, multi-level residential treatment option for people struggling with a wide variety of mood, psychotic, and anxiety disorders, as well as co-occurring substance use disorders and addiction. But even as the breadth of its offerings has increased, its founding philosophy of working from a therapeutic community approach remains intact.
“Our primary specialization is working with individuals and families where someone has a significant mental health issue,” Dr. Pleasants tells me. “The folks who come here are typically people who haven’t successfully launched into adult living. They tend to be extremely dependent and reliant on their families, whether it’s financial support, transportation, or connections to the world.” Addressing these complex issues requires more than just the psychiatric stabilization offered by many mental health treatment programs; it requires a holistic framework that combines tailored psychiatric care with skill-building to move clients to a place of emotional and practical self-sufficiency.
Hanbleceya’s innovative approach folds in all aspects of your life and care while you are here, from deep investigation into the roots of distress to learning how to maintain your own living space, build relationships, and keep a job. Residents live together, eat together, attend group therapy together, socialize with each other, and are responsible for household chores that benefit the group as a whole. Through this therapeutic community, everyday living becomes an opportunity to work toward your goals within a supportive milieu in which you are held accountable for your actions and encouraged to grow as a person. As Dr. Pleasants explains:
The therapeutic community model is based on the notion of people coming together and being part of a family, rather than patients in a treatment center. Everyone participates not only in their own process, but in the treatment process of everybody else who is here. We believe that people get better in part by participating in the recovery of other people and by giving back; that is part of the process that helps people learn how to develop and live a fuller life. It helps build a sense of collective responsibility that they don’t come here with.
Indeed, one of Hanbleceya’s core tenets is that people who come here do treatment, rather than receive treatment. Active participation in the process is key, and there is a strong expectation that people help each other according to their emotional and practical means. As you gain stability and skills, you are able to take on more senior roles and serve as role models for others, increasing your sense of ability and responsibility. “This isn’t just a place to come, get what you need, and leave. You are here to help yourself as well as participate in others’ healing processes.”
Experiencing life in a therapeutic community can have profound benefits for all aspects of a person’s life. It allows you the time and space to learn, practice, and integrate valuable skills necessary for day-to-day living and gain a sense of mastery over tasks that previously eluded you. But one of the most powerful pieces of the therapeutic community is the way it can nurture relationships.
“Clients come in without a lot of positive, healthy, successful relationships with other people. In fact, a lot of their social interactions have often been very negative,” Dr. Pleasants tells me. “Being able to come here and have interactions with peers that are very much about support and encouragement provides corrective experiences for people that goes a long way toward psychological healing.”
An extended duration of treatment means that many clients are able to develop close relationships with their peers. If you have often spent much of your time in isolation or without the opportunity to develop strong social support networks, this can be transformative. “One of our philosophies is that learning how to build a relationship and navigate the complexities of those relationships is invaluable, whether it’s resolving conflict, learning intimacy, or understanding social norms.” The length of time offered by Hanbleceya’s program allows you to gradually build up and nurture potentially life-long relationships with peers who can continue to be a part of your ongoing support network and personal growth.
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Part of the success of the therapeutic community model comes from the way it allows you to participate in a manner that is appropriate for your capabilities at each phase of recovery. “One of my favorite ways of thinking about the treatment we offer is as scaffolding,” Dr. Pleasants says.
Typically clients come in without a lot of skills. They don’t have a strong foundation, they don’t know how to hold themselves up on their own. So they need a ton of scaffolding; they’re very tightly held while pouring a foundation that has time to gel and set. Once that foundation is set we can start building in the form of skills and insight and opportunities and self-management. And as the person becomes increasingly sufficient in managing themselves, we can begin to take parts of the scaffolding off.
Over the course of treatment, the structures that have been holding you in place are slowly but progressively peeled back, giving you the opportunity to stand on your own two feet. This includes not only experiencing emotional stability, but taking over day-to-day responsibilities for medication management, appointments, transportation, time management and organization, and conflict resolution. By the time you are ready to enter the final stages of treatment, you have thus established the skills necessary for independent and successful adult living with the minimal amount of support needed for long-term success.
The Importance of the Family
At Hanbleceya, we recognize that the family is an indispensable part of each person’s life, and we seek to incorporate the family into the treatment approach whenever possible. Families attend weekly family therapy as well as biweekly family education groups and bimonthly family weekends, during which they participate in multi-family group therapy sessions and experiential activities designed in increase connection and insight into how to best support one’s self as well as the loved one with the mental illness. Families are also kept abreast of treatment progress via weekly telephone calls with your primary therapist.
This emphasis on family is one of the unique features that distinguishes Hanbleceya from other treatment facilities. “One of our beliefs about mental illness is that it’s a family affair,” says Dr. Pleasants.
It’s not something that exists in the individual alone. We see the family as the client versus the individual who is carrying the diagnosis. For change to really take place and last, change and adjustment has to happen across the entire family system. My experience over the past 20 years has been that families who are very involved, who attend their sessions and do the work, are the families who get better and whose change endures.
This level of family involvement allows for each member of the family to receive the help they need to move forward and have the opportunity to heal and learn. This can be particularly valuable for families who have had negative treatment experiences in the past or who are living in a state of trauma as they try to cope with their loved one’s illness.
Hanbleceya’s family programming also provides the time and space to explore any damaging family dynamics that may be hindering healing. “While a person’s symptoms may be largely a function of their illness, in some ways they may have been maintained by patterns and dynamics within the family,” Dr. Pleasant says. “That’s not to blame. People are typically doing their very best, but sometimes those patterns create an enabling or bullying environment.” By creating meaningful interventions for each family member, you can learn to disrupt those patterns and work together to establish healthier attitudes and behaviors that buoy you individually and collectively. “The person who carries the diagnosis is not going to get better on their own. They really need the support of their family or primary support system to help them develop and implement a different way of living their life.”
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Moving From “I Can’t” To “I Can”
The therapeutic community at Hanbleceya helps people make profound and fundamental transformations that open up paths to brighter, more joyful futures for themselves and their loved ones. While the development of independent living skills and self-management alone can be an extraordinary experience for many, for Dr. Pleasants the most exciting phenomenon is the way treatment changes her clients’ conceptualizations of themselves.
Folks come in with an identity as a mentally ill person. But through the process of being successful, encouraged, and supported and having those thoughts challenged here, they learn that they are not just an illness. They have a mental illness, but they are human, they’re adults, they’re capable, and they can go out and do what they need to do. That’s such a shift in identity.
By working with their loved one and the treatment team at Hanbleceya, families too can learn to see their loved one beyond mental illness, establishing a new vision of them as someone efficient, successful, and able to live a good life. “Families often come in with this idea that their kid is really sick and they’re not capable, but we show them that, yes, they are,” says Dr. Pleasants. “When everybody in the system starts experiencing the success and sees the person change, it also changes this idea of the person. I think that’s the most rewarding change of all.”
Hanbleceya offers comprehensive, multi-leveled residential treatment for people struggling with mental health disorders as well as co-occurring substance use disorders. Our innovative therapeutic community approach allows us to offer extraordinary treatment experiences for our clients that change the course of their lives and strengthen families. Contact us for more information about our renowned program and how we can help you or your loved one start the journey toward lasting wellness.