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Psychiatric Times. Vol. 20 No. 4
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Psychiatry's Hottest Niche Markets

Elizabeth Ellen
April 1, 2003

A private chef prepares all meals, and patients are encouraged to take advantage of the on-site nutritionist and exercise physiologist. The Lodge also employs a concierge, whose duties range from making restaurant reservations to arranging transportation for patients who may also happen to be executives required at a board meeting.

ŎCome into this warm and healing environment, and we'll take care of everything,Ŏ Powers explained. ŎWe'll prepare your meals. If you want to get to the hairdresser, you just mention it, and it's taken care of. It's really a very focused clinical program; you won't have to worry about anything.Ŏ

The emphasis on creature comforts greatly worries Atlanta psychiatrist Maass-Robinson. ŎMy concern is that we've made it too comfortable to get work done,Ŏ she said. ŎBy over-emphasizing the environment of comfort and luxury, I wonder if the reasons for going there in the first place--developing the ability to resolve psychiatric issues--is diminished by the environment itself. å Is it care or [are they] just customized spas with a different name?Ŏ

However, Duncan Lodge's Gordon is unequivocal about his conviction in the program's clinical integrity. ŎThis is not a spa or a place just to hang out,Ŏ he said. ŎIt's a place where a legitimate plan will be put in place, and you'll be expected to participate in that.Ŏ Individual therapy is offered nearly every day and patients are expected to attend community meetings daily. Patients can also participate in DBT and substance abuse treatment available at the main hospital.

Gordon said that a few patients have arrived unprepared for the clinical expectations of an inpatient stay. ŎWe have had the experience of patients coming in and, out of na‹vet‚, not knowing what treatment was about and thought their spa appointment was more important,Ŏ he said. ŎIt's crucial to the credibility and success of the program to face the fact that there will be times when you have to terminate the treatment because of a mismatch of expectations,Ŏ Gordon explained. ŎWe haven't lost an admission, but one admission probably left earlier than she would have if she hadn't become uncomfortable with the level of treatment that was expected of her.Ŏ In-depth intake interviews at all three programs are intended to eliminate such misunderstandings before they happen.

Harvard University's Miller believes there may be other potential challenges for the new high-end units. ŎSometimes you have to deliver bad news to people about themselves,Ŏ said Miller. ŎIf your need to promote your services and be a marketer makes it hard for you to do that, there may be some instances where marketing and clinical aims may clash and that may be one vulnerability for the private pay [units]. That's not a reason to not provide the service, but it's something people need to be alert to.Ŏ

Gordon agrees completely. ŎIf you allow something like that to color your vision, you're lost. Your authenticity would be in jeopardy very quickly.Ŏ

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