A Family‐Oriented Psychiatric Inpatient Unit

Abstract

This article presents the structure and policies of a psychiatric inpatient unit that was developed with the goal of fully integrating family-oriented treatment approaches into its therapeutic program. There is an explanation of different methods to involve families in the hospital treatment process and delineation of a variety of treatment techniques specific for families of inpatients. The role of the nursing staff is described as well as some of the contradictions and paradoxes that are inherent in this type of inpatient unit.

Intensive family therapy: a way to change family functioning in multi‐problem families

“…The same theme may later be discussed between the mother and therapeutic team, together with the local network consisting of preschool teachers and other supportive resources. Although similar approaches are described from other parts of the world (Johnson and Savage, 1967;Nakhla et al, 1969;Lynch et al, 1975;Ney and Mills, 1976;Riddle, 1978;Goren, 1979;Harbin, 1979;Combrinck-Graham et al, 1982;Dydyk et al, 1982;Churven and Cinito, 1983;Cooklin et al, 1983) the special 'hothouse treatment' approach where the whole family is given the support of intensive family work seems to have been largely a Scandinavian approach (Ringstad and Spurkland, 1978;Larsen and Eldrup, 1989;Sundelin, 1995). Since this is an expensive treatment method it must be thoroughly evaluated.…”

The introduction of a full family orientation in a child psychiatric in-patient unit

“…We do not believe that such parents can learn how to regain control unless we firmly but temporarily assert our authority. We are becoming increasingly confident in imposing our authority in such cases feeling that it stems not from an authoritarian attitude but rather from expertise (Hildebrand, 1980). I t is interesting to compare our view with that of Bruggen andhis colleagues (1973, 1979).…”

“…Despite the vast amount of clinical data that supports the use of a family therapy approach for psychiatrically disturbed patients (Harbin, 1979) and the research data indicating its effectiveness (Gurman and Kniskern, 1979) most in-patient psychiatric units have not made full use of this modality. I n particular there is a paucity of literature referring to family-oriented children's in-patient units.…”

“…I n practice, however, we feel that we could be colluding with the family's resistances if we did not insist that children go home at weekends. Harbin (1979) has a similar practice to ours on his adult unit. He actively uses therapeutic leave of absence (a pre-arranged period of time when the identified patient is at home with his family).…”

“…T h e traditional approach to psychiatric in-patients has always been based on an individual perspective, and little attention has been paid in the literature to the family approach to the treatment of such patients (Harbin, 1979). Their families tend to be used as sources of information, and any therapeutic attention required is often allocated to a person other than the primary therapist.…”