Visit Reports
Visit Reports

Jan 9, 2006, 11:50

Tucson, Arizona
Ryan Moore, Director of Marketing

Visit Report By: Larry Stednitz, October 27, 2005

Cottonwood de Tucson is located near Tucson, AZ, on an old dude ranch that encompasses 30-acres of beautiful grounds and southwest style buildings. Nestled amidst a peaceful setting of desert terrain and plants, the buildings are clean and orderly for the adults, young adults and teenage girls in residence at the facility. Cottonwood's model is described as experientially based programming with spirituality being the core. This visit report will focus on the two programs that are of interest to parents and consultants, the Young Adult Program and the 12-bed Adolescent Girl's Program.

The Young Adult Program, as defined by the American Psychiatric Association, enrolls men and women ages 18-23. The program was developed to meet the unique needs of this age group. Over 30 percent of all of the referrals coming into Cottonwood are of this age group. The program follows the developmental stages of young adults, established by Gail Sheehy, who wrote the book entitled "Passages." Cottonwood identifies the major issues of young adulthood as:

  • Establishing a peer group and a congruent role within that peer group.

  • Developing a sex role.

  • Anticipating an occupation or life-work.

  • Developing an ideology or worldview.

  • Finding a mentor.

  • Developing the capacity for romantic intimacy.

These stages also include young adults seeking personal independence, financial independence and learning what they want to do in life. The issues that brought them to Cottonwood are unearthed through focusing on these developmental stages of young adults. For example, when young adults explore how to achieve independence, they naturally bring to the forefront their particular problems in life and how those problems block their ultimate achievement of appropriate developmental attainment.

While Cottonwood is known for their substance abuse program, they work with all emotional and behavioral issues. A full 25 percent of their patients are dealing with trauma, depression and other disorders, with no substance abuse issues.

The program employs best current practices including cognitive behavioral therapies and stages of change with all counselors knowledgeable in Motivational Enhancement Interviewing approaches. The focus is often on helping patients to explore what the patient wants in his or her life, while looking at their strengths, needs, abilities and preferences. They believe that a program can not force feed patients, but they can help them see for example, how drugs are keeping them away from what they want to achieve in their life.

Group therapies using cognitive behavioral approaches take place two hours a day, five days a week. Lectures and small therapy groups are run throughout the week. These include trauma, nutrition, mood and food, sleep disorders, depression and co-dependency. Experiential work includes mind, body, meditation, psychodrama, mind/mood, kick boxing, challenge courses and equine therapy. The evenings include 12-Step groups in the community and additional lectures. The typical length of stay is five to six weeks.

The adolescent program, called Sweetwater, also works with a variety of problem areas, not only substance abuse. It was reported to me that the program's strengths are in the refinement of differential diagnoses, family focus and working with a "softer" girl. They screen out oppositional defiant and conduct disordered girls.

The adolescent girls program has many of the same approaches and shares some resources. For example, family groups include both the adults and adolescents with adolescent specific breakouts.

The adolescent program includes the treatment of substance abuse, mood disorders, sub-acute eating disorders, and includes those who are at risk of self-harm. The adolescent program also stresses cognitive behavioral therapies as well as extensive experiential therapies including rock climbing, art therapy, equine therapy, expressive arts and others. Cottonwood's adolescent patients also receive individual, group and family therapy and attention is also paid to full psychiatric and medical assessments. Their treatment model attempts to address the girls through a holistic approach, involving the mind, body and spirit.

During my two hour visit, all patients were in treatment groups and I was unable to speak with any of the girls. My general impression of the program was that for parents who want a thorough assessment of the various issues going on with their daughter and a short term intervention, Cottonwood is a good choice. Cottonwood has a comprehensive and clinically intensive program that heavily involves the family. Families who are looking for a best practices clinical program that includes other innovative approaches would be happy with Cottonwood.

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