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De l'international

Gregory Rizzolo, Charles Turk, Richard Hoffman Reinhardt

February 6, 2025

Lettre d'appui de la clinique Openings de Chicago

Dear Integrated Health and Social Services Center (C.l. U.S.S.S. de la Captiale Nationale)

We are writing as the clinicians responsible for Openings, a project dedicated to supporting those living with psychosis and who experience extreme states in Chicago, Illinois . Our project is an initiative of Depth Counseling, an Illinois-licensed Behavioral Health Clinic. We were distressed and concerned to hear the news that the 388 will close in March of this year due to budget cuts, and we are writing to request that you reverse this decision and recommit to supporting 388's irreplaccable work.

Openings begin its work because mental health clinicians at Depth Counseling were receiving requests for individual therapy from prospective patients who had been diagnosed with psychotic disorders and who were suffering. In considering how to respond to these requests, we extensively researched the methods that were the most effective at working with psychosis - not only in terms of managing some of the more difficult symptoms that psychosis entails, but also of creating change that individuals who suffer with psychosis consider to be meaningful themselves. Of those methods we have studied, 388 is the most impressive, effective, and well-documented, since it has led, in a significant number of cases­ not to the management of symptoms via lifelong compliance with medication regimens, as tends to be the oft-sought and seldom realized goal of some of the reigning psychiatrie approaches - but to a full and independent engagement in social life. (We know firsthand how difficult a result this is to achieve, since our patients often speak of the many mental health providers who have discouraged them from this, saying that it would be an impossible goal to pursue!) In many of the cases that have successfully be treated at the 388, the need for medication and hospitalizations were dramatically reduced or even completely eliminated. This is an exceptional accomplishment to such an extent that the closure of 388 could be said to effectively eliminate an entire tier of quality of care for people who are suffering in psychosis.

ln addition to 388's international reputation in the mental health community for the effective and exceptional quality of care it provides to a population generally considered to have a difficult prognosis and outlook, many aspects of 388's model and its underlying metapsychology are providing an invaluable blueprint that is presently being carefully studied and adapted for implementation in other contexts, such as is the case at Openings in Chicago. Willy Apollon, Danielle Bergeron, and Lucie Cantin's meticulous development and continuous honing of this model based on 40+ years of clinical experience simply makes the 388 irreplaceable, not only from the perspective of its importance as a clinical resource, but also from the perspective of the practical and theoretical resources it provides to professionals who are working on projects like ours. This is demonstrated in Apollon, Bergeron, and Cantin's many publications, as well as the conferences and congresses organized by Groupe interdisciplinaire freudien de recherche et d'intervention clinique et culturelle (Gifric), which several members of Openings' treatment team have attended. The closure of 388 would also stand to interrupt, are undermine, or to put an end to the valuable research that the clinicians of 388's treatment team have increasingly made available to international colleagues who are attempting to undertake comparable work at an historical venture in which mental health challenges, in general, and episodes of psychoric experience, in particular, are undergoing a staggering and unprecedented increase.

For all of these reasons, we ask you to reconsider your decision, which would stand to harm not only those currently receiving trearment at 388, but also deprive the world of a model that deserves to be promoted and upheld for its unique contribution. Instead, it would be better to give 388 and its aligned organizations increased support to effectively transmit the unique knowledge they have derived from their clinical experience to colleagues internationally and to work with them on how the model they have built and carefully honed might effectively and responsibly be expanded .

Sincerely,

Gregory Rizzolo, PhD LCPC
Editor-in-Chief, Journal of the American Psychoanalytic Association
Clinical Director, Depth Counseling
Faculty, Chicago Psychoanalytic Institute/Institute for Clinical Social Work

Charles Turk, MD
Openings Clinical Director, Depth Counseling
Analyst of the School, École freudienne du Québec (EfQ)
Responsible, Chicago Circle of the EfQ

Richard Hoffman Reinhardt, PhD
Openings Project Director and Analytic Clinician, Depth Counseling
Lecturer, MA Program in Art Therapy and Counseling, School of Art Institute Chicago
Candidate Analyst, Lacan School of Psychoanalysis