The Ridge: Care With More Than One Path

"A treatment mall is something that's done generally in mental health and substance use disorder services that brings choice into the hands of the client," Licensed Addiction Counselor Chuck Bergeson said. "They feel a little more power and autonomy in making decisions about what treatment planning they want, what groups they want, and what content they want."

The process is collaborative rather than entirely self-directed. A provider explains the available options and recommends services that may address concerns identified during an assessment. The client, however, is not treated as a passive recipient following the same preset program as everyone else.

Instead, the conversation can begin with a more personal question: What are you most concerned about right now?

If emotional regulation is creating the greatest difficulty, the next step may include coping skills, mindfulness, or principles drawn from cognitive behavioral therapy or dialectical behavior therapy. If financial stress is undermining stability, budgeting may be more immediately useful. Practical education can help turn a clinical recommendation into something sustainable.

The choices create room for clients to take ownership of their care while still benefiting from professional guidance.

"People who have mental health challenges, as we all do, can be empowered to make informed choices," Bergeson said. "That relational construct makes for healthy treatment, instead of being told, 'Do this, do that.'"

Expanding the Definition of Treatment

The Treatment Mall represents an expansion of what The Ridge has already been doing. Its outpatient group programming has historically centered largely on substance use disorders. The new model is intended to add more options for people whose primary needs involve mental health while also creating opportunities that can benefit clients across both areas.

A yoga session, for example, may be useful to people enrolled in different programs. So might a class on nutrition, stress management, medication, or healthy relationships. Rather than placing every service into a narrow clinical lane, the Treatment Mall creates a shared structure in which different kinds of support can work together.

The Ridge team organizes that whole-person approach around the eight dimensions of wellness: emotional, environmental, financial, intellectual, occupational, physical, social, and spiritual. The framework recognizes that health is influenced by far more than the symptoms that first bring a person through the door.

Physical wellness could include learning how nutrition affects symptoms and setting a realistic goal to improve eating habits. Emotional wellness could involve developing strategies for anxiety or making a plan to begin individual therapy for trauma. Occupational wellness may mean writing a resumé, connecting with Job Service North Dakota or vocational rehabilitation, or finding a more meaningful structure for the day. Financial wellness can begin with budgeting or learning to prioritize expenses. Daily living skills may include cooking, housekeeping, and other routines that some clients, particularly those who have experienced long periods of instability or justice-system involvement, may never have had the opportunity to develop.

The clinical and the practical are not competing forms of care. They reinforce one another.

A medication may be an important part of treatment, but a prescription alone does not answer every question surrounding it. A medication-management group can help clients understand what they are taking, organize prescriptions, and become more comfortable raising concerns with a provider. The Ridge's nurse practitioners and other specialists can share knowledge in a group setting while building familiarity and trust.

The same structure can incorporate psychoeducation about substance use disorders, mindfulness, goal setting, social connection, and other needs. Community organizations and outside speakers can also be invited to explain resources and help clients understand how to use them.

The result is not a requirement that every client complete every offering. In fact, the breadth of the model makes that neither practical nor desirable. The point is to identify what could make the greatest difference for a particular person at a particular time.

Treatment That Can Change With the Person

Recovery and mental health care rarely move in a perfectly straight line. A need that feels urgent during the first month of treatment may be less pressing later. Accomplishing one goal can reveal the next, while a change in housing, employment, relationships, or health can create an entirely new challenge.

The Treatment Mall is designed to move with that reality.

As clients meet objectives, they can establish new ones and select different services. The Ridge can also adjust its mix of groups in response to client and staff feedback. A session that is useful and well attended may continue or expand. Another may be revised or replaced as community needs change.

That flexibility also gives The Ridge a way to respond more quickly when a new behavioral health concern emerges locally. Instead of rebuilding an entire program, the team can bring in relevant expertise or add a group to the existing structure.

The commitment to choice does not mean individualized care is easy. Bergeson acknowledged that empowering clients is an ongoing practice and that providers will not always hit the mark immediately. What matters is creating a system willing to listen, learn and adjust rather than assuming a standardized plan will work for everyone.

The team has seen the limitations of "canned treatment," offering the same set of services to every person who arrives and expecting the same approach to meet dramatically different needs. By broadening the continuum of care, the Treatment Mall gives each client a better opportunity to find the combination of services that is relevant to their life.

Lived Experience at the Table

One of the most important pieces of that continuum is peer support.

The Ridge employs certified peer support specialists whose professional training is strengthened by lived experience with recovery or behavioral health challenges. That can create a different kind of connection, one grounded in the knowledge that the person offering support has faced some of the same barriers.

Peer specialists can help clients work toward goals outside a formal treatment group. They may connect someone with community resources, help them navigate an unfamiliar process, or simply walk beside them through a task that has felt overwhelming. Their role complements the work of counselors, nurse practitioners, and other clinical professionals.

"There's some synergy that gets going when the two work together," Bergeson said. "Peer supports typically have life experience and can speak to that directly, and then they're trained in how to help individuals reach a lot of their goals outside of the treatment group."

That collaboration matters because progress often has to survive beyond the therapy room. Understanding a coping strategy is one step; using it during a stressful afternoon is another. Hearing about a resource is valuable; making the call, completing the paperwork, or walking through the door may require a different kind of support.

By integrating peer specialists into the broader treatment team, The Ridge aims to connect those moments rather than leaving clients to bridge the gap alone.

The Eight Dimensions of Wellness

Emotional — Managing feelings, stress, anxiety, and other challenges

Environmental — Creating safe, supportive, and healthy surroundings

Financial — Budgeting, prioritizing expenses, and building stability

Intellectual — Learning, solving problems, and developing new skills

Occupational — Finding meaningful work, purpose or daily structure

Physical — Supporting health through nutrition, movement and medical care

Social — Building healthy relationships and a sense of connection

Spiritual — Exploring meaning, values, purpose and personal beliefs

More Choice, More Ownership

Ultimately, the Treatment Mall is not about offering more groups simply for the sake of having a longer schedule. It is about recognizing that effective care must make room for the person receiving it.

For one client, progress may begin with understanding a diagnosis. For another, it may begin with preparing a meal, creating a budget, or learning how to structure a day. Over time, those starting points can lead to new goals, new services, and a broader sense of what is possible.

The Ridge's role is to provide professional guidance, evidence-informed care, practical resources and human connection. The client's role is not merely to comply, but to participate, to identify concerns, make choices, offer feedback and help shape the next step.

That shared ownership is the promise at the center of the Treatment Mall. There may be many available paths, but the goal is deeply personal: helping each person build a healthier life that works beyond the walls of treatment.

Ridge Treatment & Reentry Center
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