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Exploring Mental Health 2025

Summer Solstice 2026

Residential Treatment vs Partial Hospitalization Programs: Which is Better for you?

By Nicole Holmes, LISW-S, Assistant Clinical Director, Clinician

When symptoms of a mental illness start to interfere with daily life, figuring out what level of care is needed can be challenging. Two common options for treatment include residential treatment and partial hospitalization programs (PHP). Both offer meaningful support, but they serve different purposes and knowing what is right can be confusing. For many individuals, especially those experiencing more complex or persistent symptoms, residential treatment can provide a stronger foundation for recovery. Understanding the difference between the two is the first step in being able to make an informed decision about what is right for you or your loved one.

What is Residential Treatment?

Residential treatment involves living full-time in a therapeutic setting with 24/7 support amongst others experiencing similar issues. This level of care is designed to provide structure, consistency, continual clinical oversight, and peer support. When someone is experiencing the symptoms of a major mental illness like schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, PTSD, or obsessive-compulsive disorder, all aspects of life can feel overwhelming and emotionally draining. Residential care offers a safe and accepting environment where routines can be established and therapeutic interventions can be delivered consistently throughout the day. This immersive setting reduces external stressors and allows individuals to fully focus on their recovery without the noise of outside life filtering in. Rather than trying to manage symptoms while navigating daily demands, clients can step into a space where healing is the primary focus.

What is a Partial Hospitalization Program?

 Partial hospitalization programs provide structured, intensive treatment during the day while allowing individuals to return home in the evenings. A PHP will often run for the majority of the day engaging individuals in group and individual therapy and can be a helpful option for those who are stable enough to function at home but still need significant support. A PHP offers the advantage of practicing skills in real-world environments. However, it also relies heavily on the individual to have insight into the need for treatment and to be able to maintain stability in their home life.

Why Residential Treatment Can Provide a Stronger Starting Point

 While both levels of care are important, residential treatment is often the more appropriate starting place when symptoms significantly impact functioning, insight is limited, or daily routines have broken down. Healing from serious mental health conditions often requires feeling support while engaging in daily activities in a structured manner over a long period of time. In a residential setting like Hopewell, therapeutic support is not limited to a few hours a day – it is woven into many aspects of daily living. Meals, activities, relationships, and routines all become part of the therapeutic community treatment process.

At Hopewell Therapeutic Community, we believe that healing happens through connection and meaningful work. Individuals are not isolated in their experience – they live alongside others who are also working toward recovery. Residential treatment, when done within a therapeutic community-based model, offers more than just stabilization. It provides opportunities to engage in purposeful activities, build relationships, create personal connections, and develop a sense of belonging within a supportive environment. This approach can be especially impactful for those struggling with how to cope with their mental illness, helping them rebuild confidence and a sense of identity beyond their diagnosis.

Both residential treatment and partial hospitalization play important roles in the continuum of care. But for many individuals, particularly those navigating complex conditions, residential treatment offers the depth, structure, and community needed to create meaningful and lasting change.

 

 

Founder’s Day, May 13, 2026

On May 13, 2026, we celebrate and honor the extraordinary life and enduring legacy of our founder, Clara T. Rankin, on her birthday. A native Clevelander, Clara was known for her leadership roles and lifelong philanthropic support of many organizations in Northeast Ohio. In her seventies, she saw the need for a therapeutic farm for adults with mental illness near Cleveland, and this became her passion.

For Clara, Hopewell was truly a labor of love. In 1993 she assembled a Board of Directors, secured initial funding, found a 325-acre working farm, hired an executive director, and together they went to work developing clinical programs and hiring staff. Under Clara’s dedicated leadership, her vision became reality.

Clara’s clear mission was to provide an opportunity for adults with serious mental illness to experience a self-reliant and satisfying life through participation in a vibrant residential therapeutic community. Her unwavering belief in the role that nature and meaningful work play in mental health recovery and her tireless efforts shaped this organization into what it is today.

Hopewell opened its doors to the first resident in 1996. Since then, we have welcomed adults with mental illness from across the United States and abroad. Clara remained actively engaged in fundraising, making connections, and spreading the word about Hopewell until age 107, her spirit of advocacy never waning.

On Founder’s Day, we remember Clara Rankin for her sharp mind, prodigious memory, profound empathy, her generosity, and leadership. She inspired so many to care about people suffering with mental illness, who are often stigmatized or invisible. She left a legacy that inspires our commitment to mental health recovery every single day.

In her legacy, on Founder’s Day, we will award an employee who exemplifies the characteristics that made Clara such an inspirational – and aspirational – role model with the Clara T. Rankin Award. The first winner of the Clara T. Rankin Award is Anne Skowronski. Ann has worked at Hopewell for almost 30 years and embodies the core values of our therapeutic farm and Clara’s spirit through her passionate commitment to our residents and our program.

Thank you, Anne, for your service to Hopewell. We are better because of you.

Spring 2026 Newsletter

Spring has arrived with outside activities, our visiting artist program, Hopewell’s newest board member, and a story about Hopewell’s outstanding OCD program.

More Than a Place to Stay: Understanding Therapeutic Communities and What They Mean for Your Loved One

Daniel B. Horne, LPCC-S, LSW, Clinical Director, Clinician

If someone you love has been referred to a therapeutic community, you may be feeling a mix of emotions — relief that help is finally within reach but uncertainty about what this kind of program really means. This guide is written for you.

At Hopewell, healing doesn’t happen in isolation. It happens in relationship with the land, with community, with meaningful work, and with compassionate support.

So, What Exactly Is a Therapeutic Community?

A therapeutic community (TC) is a type of residential treatment environment where the community itself — the people, the daily routines, the shared responsibilities — is the primary tool for healing and growth.

In a therapeutic community, treatment is something lived. Every meal shared, every chore completed, every honest conversation in a group session, all of it is part of the healing process. Rather than simply managing symptoms, a TC focuses on helping a person rebuild a whole life: their sense of identity, their relationships, their sense of purpose, and their ability to function in the world.

What Makes Hopewell Unique: Healing on the Farm

Hopewell is a therapeutic farming community. We believe what farmers have always known: working with the land is good for the human spirit. At Hopewell, residents participate in farm life and engage with nature as a core part of their treatment from tending to the vegetable garden, caring for animals, collecting maple sap, or hiking in the woods.

What Does a Typical Day Look Like?

Structure and routine are critical for people living with severe mental illness. Having a predictable, meaningful daily rhythm can help stabilize all of us.

A resident’s day might include:

  • Morning work crews such as farm, housekeeping, kitchen, or garden
  • Group therapy or community meetings
  • Individual therapy
  • Medication management with psychiatric and nursing support
  • Shared meals where residents and staff come together as a community
  • Social recreational time and creative activities

What Role Do Families Play?

Your role as a family member is significant, and Hopewell is committed to supporting you as much as your loved one.

At Hopewell, we encourage families to:

  • Stay in regular contact with your loved one’s treatment team to understand their progress and care plan.
  • Take care of yourself. Seek your own support through therapy, support groups like NAMI (National Alliance on Mental Illness), or trusted community resources.
  • Be patient with the process. Recovery from severe mental illness is not linear, and progress may be slow or even difficult to recognize in the immediate moment.

Common Questions Families Ask:

How long will my loved one be at Hopewell?

Therapeutic community treatment is intentionally longer term than hospitalization, months rather than days or weeks. Meaningful change can occur for some individuals over the course of 3-5 months, but more typical lengths of stay are 6-9 months. Some individuals benefit greatly from a stay of a year or more.

 Can I visit?

Family visits are an important part of the healing process and are encouraged at appropriate points in treatment. Your loved one’s care team will work with you to arrange visits in a way that supports their recovery.

 What if my loved one doesn’t want to be there?

Ambivalence is extremely common, especially at the beginning of treatment. Our staff are experienced in meeting people where they are with compassion and without judgment to build trust over time.

 Is this a locked facility?

Hopewell is a voluntary residential program, not a locked psychiatric facility. Residents choose to be here and participate in their own care.

What Recovery Can Look Like

Recovery from severe mental illness looks different for every person. For some, it means returning to work or school. For others, it means living more independently, or simply experiencing longer stretches of wellbeing between difficult periods.

We do not define recovery by the absence of symptoms alone, but by a person’s ability to live a life that feels worth living.

We’re Here to Talk

Hopewell’s team is always willing to answer your questions, explain our program, and help you understand whether a therapeutic farming community might be the right fit.

To learn more about Hopewell or to speak with a member of our team, please contact our Admissions Team at admissions@hopewell.cc or 440.426.2009. We welcome your

Should your therapy session be outdoors?

Article written by Maggie Penman, Washington Post.  Published by the Cleveland Plain Dealer on Sunday, April 12, 2026

Jennifer Udler has been a practicing therapist for 25 years. A little over a decade ago, she started training for a marathon, running with a group near her home in Montgomery County, Maryland.

“I noticed that people were more comfortable, less inhibited, opening up and talking during our group training runs,” Udler said. “And I started to wonder if there was a way to do a practice where people are moving.”

Udler sees children and adolescents as well as adults, and she suspected that her younger clients especially might feel more comfortable talking while walking on a nature trail rather than sitting in a therapist’s office. She decided to try it with one of her young clients with his mom’s permission.

“We met at a park, and we walked around, and he was a different kid,” Udler said. “He was running around, and he was showing me stuff in nature. And he talked.” She said they made more progress in one session outside than they had in two years meeting in her office.

“That was in the snow in February,” she added. “So I was like, it’s only going to get better.”

Udler started reading more about outdoor therapy, which is also known as walk-and-talk or nature-informed therapy. At that time she couldn’t find any formal training or certification programs, but she did learn that other therapists had tried it and found many of the same benefits she had.

“You’ve got the movement, you’ve got nature, which is extremely grounding and stabilizing for people, and you have the co-regulation, walking side-by-side,” Udler said. For her younger clients or anyone uncomfortable with therapy, it also helped to be walking while talking about difficult topics because they didn’t always have to make eye contact with her.

She wrote her own informed consent for her clients, establishing the additional risks of outdoor therapy and how confidentiality would work in a public park. She started a practice called Positive Strides, specializing in walk-and-talk therapy sessions outdoors in nature.

“As I did the work and saw different types of people with different kinds of mental health issues, I realized how amazing it is,” Udler said.

Trading the couch for the great outdoors

In March of 2020, when many therapists moved their practices online, a smaller number brought their practices outside. The benefits were not felt only by the clients. Nature acts as a sort of “buffer against burnout,” said Heidi Schreiber-Pan, the executive director and founder of the Center for Nature Informed Therapy, where she trains clinicians in how to bring their practices outdoors.

“What we’re hearing from people is that they can see more clients when they have outdoor sessions or nature-informed sessions,” Schreiber-Pan said.

The American Psychological Association put out new guidelines this past fall for how clinicians can implement walk-and-talk therapy into their practice.

The number of therapists working outside is still small. Shreiber-Pan believes that’s in part because therapists don’t realize that nature is all around us. One of the first questions she asks in her trainings is: When you think of nature, what comes to mind?

“They talk about, like, these beautiful national parks or the mountains or the ocean,” Shreiber-Pan said. “And where is your therapy office? Not there.” She said that part of the training is helping practitioners recognize that nature is all around us — even in a city park.

Miki Moskowitz is a clinical psychologist who practices in a primary care setting, which means she sometimes sees a patient only a couple of times.

“We’re trying to make a difference, even in one single session,” she said.

For Moskowitz, practicing outside has improved her own mental health and increased her capacity, but she also sees the immediate impact for her patients.

“What I’ve seen that’s so encouraging is that sometimes just that first session we go for the walk, and patients are, like: ‘Wow, I didn’t know this trail was here. This is so beautiful. This feels so great. This is totally something I can do on my own,’” Moskowitz said. “That is so much more powerful than if we’re sitting in my office, which has no windows, just talking about the idea of going outside.”

The brain benefits of getting outside — even when it’s freezing

When Marc Berman was doing research at the University of Michigan, he helped devise a study to look at the brain benefits of time in nature. Participants did a challenging task testing their memory and attention, and then they were sent on a walk either through downtown Ann Arbor or in the area arboretum.

Those who walked in nature showed a 20% improvement in their short-term memory, while those who walked in an urban environment did not.

Berman and his colleagues did this experiment in June and January. In the winter, the nature walk was less enjoyable – but just as beneficial.

“That was pretty cool because it suggested that you didn’t have to enjoy the nature walk to get these cognitive benefits. There was something deeper going on,” Berman said.

One explanation for why nature is so good for our brains is called the attention restoration theory. The idea is that our ability to pay attention is finite, and spending time in nature can replenish our capacity. Nature is also “softly fascinating.” It captures our attention without overwhelming our senses.

“I can kind of mind-wander and think about other things when I’m looking at a waterfall,” Berman said. “I can’t really mind-wander or think about other things when I’m in Times Square.”

Berman is now a psychology professor at the University of Chicago and author of the new book “Nature and the Mind: The Science of How Nature Improves Cognitive, Physical, and Social Well-Being.”

How to make the most of time outdoors

Whether or not you are in therapy, your brain can benefit from a dose of nature, especially during the colder months when many of us are inclined to stay indoors.

Here are some science-backed tips for how to get the benefits.

 Nature can be found anywhere: You just have to look for it. Research has shown that noticing nature and paying attention to it can have positive effects even in an urban environment. Psychologists recommend noting the bird song you hear on the walk to your car, looking at the leaves on the trees and the clouds in the sky, and just taking a moment to appreciate nature’s beauty — even if it’s just a small plant poking its way through the sidewalk.

 You don’t have to like it: Nature can be an acquired taste, especially when it’s cold. But you don’t have to be a backpacker or love camping to benefit from time outside. Berman and others have found in their research that we get the brain benefits whether or not we enjoy a walk in the woods.

 Try a mindfulness exercise: Many people struggle to sit still and meditate, despite its benefits — but Moskowitz said that mindfulness practices can come more easily outside. “Just look up at the treetops and notice what you see, notice what you hear,” Moskowitz said. “Look for something that’s moving, and watch the branches sway in the breeze. Look at something close up, or look at something far away. You’re doing a mindfulness practice, and you’re tuning into your senses, and you are focusing your attention, but it’s not hard work.”

 Bring nature inside: If you aren’t able to get outside as often as you would like, you can still get some of the benefits. Put a plant in your office — even a fake one — or look at pictures of beautiful landscapes. Listen to bird songs at your desk. “It’s not as strong as the real thing, but you can get benefits from the simulated nature,” Berman said.

 Embrace the winter: When it’s cold and snowy outside, our impulse is to stay inside. But less time outside can contribute to seasonal depression. Schreiber-Pan recommends following the Scandinavian practices of “friluftsliv” — or “openair living,” getting outside no matter the weather — and hygge, or embracing the cozy indoors when you come back in. “The happiest people on this planet are the Scandinavians,” Schreiber-Pan said. “They also have the longest winters.”

When Outpatient Therapy is not Enough: Signs Residential Care May Help

Nicole Holmes, LISW-S, Assistant Clinical Director, Clinician

 Outpatient therapy is often an essential first step in mental health treatment. Weekly sessions with a therapist, psychiatric medication management, and support from family and friends can be extremely impactful for a large population of individuals. However, there are times when outpatient care may no longer provide the level of support needed for someone struggling with mental illness.

How do you know when it may be time to consider residential treatment for yourself or a loved one? There are a few factors to consider:

Lack of progress: One of the most common signs is a lack of progress when someone is attending therapy regularly, following treatment recommendations, and still experiencing persistent or worsening symptoms. If things are not improving, it is likely time to consider residential care.

Difficulty with Activities of Daily Living: When mental health symptoms begin to interfere with basic tasks such as maintaining hygiene, preparing meals, keeping a job, or sustaining relationships it may signal that the structure of outpatient care is not enough. Residential treatment provides a supportive environment where individuals can focus fully on their recovery without the pressures of daily life.

Frequent Crises: One of the most concerning signs that outpatient care is not enough will be frequent crises that often lead to hospitalization. If someone is experiencing repeated mental health emergencies, suicidal thoughts, or episodes that require urgent intervention, a higher level of care is almost certainly needed. Residential care can offer safety, consistency, and continuous support towards stabilization.

Isolation: Often overlooked but a key indicator that residential care may be beneficial is isolation. People struggling with mental illness may withdraw from friends, family, and community. Over time, isolation can deepen symptoms, making recovery more challenging. Residential care introduces a built-in community, offering opportunities for connection through shared experiences that are difficult to find in outpatient treatment.

Additionally, challenges with maintaining treatment outside of sessions—such as difficulty following through on coping strategies or medication routines—can indicate a need for more immersive care. In a residential setting, individuals receive guidance and reinforcement throughout the day, helping them practice skills in real time.

Residential treatment is not just about increased supervision; it is about creating an environment where healing can take root with supportive trained staff available to help. At Hopewell, this philosophy is central to the care we provide. Hopewell offers a holistic, approach grounded in our therapeutic community, where the entire environment becomes part of the therapeutic process.

Residents at Hopewell engage in meaningful daily activities through our therapeutic work program and develop relationships within our community with others experiencing similar struggles. Whether tending to the land, caring for animals, or contributing to the community in other ways, this work fosters a sense of purpose, responsibility, and accomplishment—elements that are often diminished during periods of mental health struggle.

Choosing residential treatment can feel like a big step, but it is often the right one when outpatient care is no longer enough. If you or a loved one are feeling stuck, overwhelmed, or unsupported despite ongoing outpatient care, it may be worth exploring whether a residential setting could offer the next step in healing.

 

Hopewell Transition Program

Supporting the Move Toward Independent Living

Hopewell Transition Program (HTP) supports residents moving from Hopewell Farm to more independent living. Based in Cleveland’s walkable Larchmere neighborhood, the community-based program offers structured, individualized support with on-site staff and access to local resources. As clinical manager Carl Vondracek explains, “Think of it as a supportive bridge: structured enough to provide stability, but flexible enough to encourage growth, confidence, and realworld independence.”

Currently, entry into HTP is limited to individuals discharging from the farm program, though plans are underway to expand eligibility to direct community referrals or other providers. Participants join HTP once they’re ready to practice more independent living skills while continuing to receive guidance from a dedicated care team. Founded in 2020, the program has 17 alumni successfully managing housing, healthcare, and daily routines. Project director Candace Carlton notes, “One of the strengths of HTP is its dedicated, integrated care team,” which includes Carl, clinician Anne Boyle, and clinical services coordinator Sarah Turner. Together, they provide personalized support through counseling, case management, group sessions, and community activities tailored to each participant’s goals.

While independence is the goal, participants are never on their own. Staff assist with medications, healthcare connections, and everyday life skills. Many begin exploring work, school, or other meaningful activities within the first few months. Most participants remain in the same apartments after graduating. Some continue receiving long-term support from Hopewell, while others transition to community-based providers. Support levels remain flexible, adjusting as confidence and skills grow.

A standout success is the “Ladies of Larchmere,” a group of current and former participants who independently created a regular weekend social tradition. Their evenings often include dinner at a local restaurant followed by live piano music or karaoke. Through these shared experiences, the women have built genuine friendships and a natural support system while engaging with the community on their own terms.

Transitions can be both exciting and challenging. Hopewell Farm continues to offer additional support when needed, including respite stays if symptoms increase. With ongoing connection and individualized planning, HTP helps people move forward with confidence, knowing support is always close by.

EMDR Therapy at Hopewell

By Heidi Moser, MSEd, LPCC, Hopewell Clinician

In working with residents and their families, I have discovered that many people have heard of EMDR but tend not to know much about it unless they have engaged in EMDR therapy previously. EMDR stands for Eye Movement Desensitization and Reprocessing. The therapy was developed by Dr. Francine Shapiro in the late 1980s. EMDR therapy utilizes the technique of bilateral stimulation (BLS) of varying speeds to assist with the reprocessing of traumatic memories. While EMDR therapy does not erase painful memories, it can help clients become desensitized to them and adopt healthier beliefs about themselves and the world around them.

BLS can take the form of eye movements, tapping, vibration, or sounds that engage the right and left sides of the body and consequently, both hemispheres of the brain. It mimics the eye movements that occur during the REM cycle of sleep when the brain continues its activity during an altered state of consciousness, however clients engaging in EMDR therapy are fully awake and aware. Research has demonstrated the effectiveness of both EMDR therapy and BLS in the treatment of trauma.

EMDR therapy is based on the adaptive information processing (AIP) model, also developed by Dr. Shapiro, which posits that the brain has a natural capacity to adapt, similar to the body’s ability to heal. According to the AIP model, memory networks are created in the brain – memories that share certain characteristics. An EMDR therapist guides clients in targeting key memories in the “same network” and reprocessing those memories using BLS.  Through this process, clients can gain more adaptive responses to traumatic memories.

A client does not need to be diagnosed with post-traumatic stress disorder (PTSD) to benefit from EMDR therapy. EMDR therapy is appropriate for anyone grappling with issues that involve negative beliefs about themselves, others, or the world. Oftentimes, present issues are rooted in past experiences and the core beliefs that develop out of those experiences.

EMDR therapists assist clients in uncovering these negative beliefs, which are frequently unconscious and deeply held, and working to identify and take on healthier ways of thinking. While cognitive-based, “top-down” therapies, like CBT, also focus on changing negative thinking patterns, EMDR therapy is considered a “bottom-up” therapy, concerned with the somatic nature of trauma and how past experiences impact the nervous system.

Presently, Hopewell has three clinicians who are EMDR trained, which means they have completed the foundational training in EMDR therapy as designated by the EMDR International Association (EMDRIA). This training involves 20 hours of instruction, 20 hours of supervised practicum, and 10 hours of consultation. Residents at the farm who are interested in EMDR therapy are encouraged to speak to any one of Hopewell’s EMDR trained clinicians. EMDR therapy is an invaluable adjunct to Hopewell’s community-as-therapy program.

Winter 2026 Newsletter

Hopewell has exciting updates in this new year.  Learn more about Hopewell Transition Program, which supports residents moving from Hopewell Farm to more independent living, meet new board members, and buy your tickets for our Summer Solstice event.

Hopewell Taps Butternut Maple Farm for Sugaring Collaboration

A chance meeting at Leadership Geauga’s class of 2026 between Chief Executive Officer Colleen Welder and Renee Delafranconi, co-owner with her husband Pierre of Butternut Maple Farm in Burton, led to a sweet collaboration.

Renee and Pierre visited Hopewell to take a tour and learn about our sugaring operation.  “We were so impressed with Hopewell; we were talking about you for weeks!” Renee said. Pierre is now providing expertise to Hopewell staff in our sugaring “rebuilding year” that will improve processes and make them more efficient.

Hopewell runs a sugar house, built in 2016 with generous donor support, and harvests sap from our 750-maple tree sugarbush.  Each year staff and residents spend a day in the woods, tapping trees for sap and processing maple syrup the farm uses year-round. Residents love the opportunity to connect with nature and work hard. Maple syrup, maple candy, maple sugar, maple cream. . . what reward could be sweeter, especially since it is Hopewell-made!

 

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