The Status of Psychiatric Inpatient Group Therapy: Past, Present, and Future

Emond, Seija; Rasmussen, Brian

doi:10.1080/01609513.2011.553711

Cited by 15 publications

(12 citation statements)

References 54 publications

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“…Only 12.5% of groups were described as "closed," in which all group members start together, the group goes for a fixed number of weeks, and no new members are added. This is in stark contrast to the predominant closed group model employed in most research on inpatient therapy groups (Emond & Rasmussen, 2012). A small percentage (4.2%) of groups was described as having a single-session format.…”

Section: Perspective Of Group Therapistsmentioning

confidence: 98%

Provision and adaptation of group treatment in state psychiatric hospitals.

Snyder¹,

Clark²,

Jones³

2012

Professional Psychology: Research and Practice

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Over the past 2 decades, a growing emphasis on providing inpatients in state psychiatric hospitals with psychosocial treatment has been driven in part by several court decisions and federal investigations. Hospitals, chronically understaffed and underfunded, have tended to rely on the group treatment modality as their primary method for providing this treatment. Psychologists working in state psychiatric hospitals face the challenge of trying to implement evidence-based group treatments in an inpatient setting as part of rapid hospital efforts to increase hours of psychosocial treatments provided to each patient. However, there is limited information available to practitioners on whether and what kinds of group treatment are most effective for this population, as well as limited research on how to adapt the evidence-based treatment programs we know to be effective in outpatient populations for the inpatient setting. We surveyed psychology directors and psychologist group therapists in state psychiatric inpatient facilities to assess whether they endorsed using evidence-based group treatment practices; what modifications, if any, they needed to make for these practices to be relevant and useful to their population; and what factors supported or hindered the provision of evidence-based practices. Psychology directors considered the large majority of groups provided by their staff as based on evidence-based practices and identified methods to support and monitor the quality of group provision. Group therapists identified ways they needed to adapt group protocols to fit the needs of their clients and identified areas of support and challenges in providing group treatments.Keywords: severe mental illness, group treatment, state hospitals, evidence-based practice, inpatient treatment What do you do when your inpatient psychiatric hospital administration tries to rapidly implement 20 hrs of group treatment per week per patient, and you are called on to provide an array of offerings drawing on best practices and evidence-based treatments? This was the situation in the North Carolina state psychiatric hospitals in 2003. Those of us working in that system had to figure out how to apply and adapt evidence-based group therapy approaches developed in different settings and with different populations to the inpatient public mental health setting. An inevitable tension arises between treatment fidelity and adaptation to current needs and new populations, as well as between the need for rapid implementation of hospital-wide programming versus the desire for thoughtful development and therapist training. Curious about how others might have approached this dilemma, we surveyed psychology directors and psychology group therapists across state hospitals to identify common themes regarding provision and adaptations of group treatments based on evidence-based practices, what supports are available, and what challenges or obstacles are experienced in providing group therapy. It is our hope that this will lead to recommendations for hos...

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Section: Perspective Of Group Therapistsmentioning

confidence: 98%

Provision and adaptation of group treatment in state psychiatric hospitals.

Snyder¹,

Clark²,

Jones³

2012

Professional Psychology: Research and Practice

View full text Add to dashboard Cite

show abstract

“…Snyder, Clark, and Jones (2012) indicated that state psychiatric hospitals tend to utilize group therapy as the main therapeutic intervention, outside of medication, due to underfunding and understaffing. Emond and Rasmussen (2012) also indicated that the treatment of choice in such settings is group therapy. Psychologists, then, face the challenge of providing evidencebased group therapy to patients, while there is little evidence and research indicating the efficacy of such treatments in state psychiatric hospital settings.…”

Section: Psychologists 14mentioning

confidence: 99%

“…Two factors are involved in changes to the state psychiatric hospital treatment modalities in recent years: the progressive decline of inpatient treatment in favor of community interventions, and federal policies dictating the number of hours of treatment required for patients in inpatient settings (Snyder, Clark, & Jones, 2012). Group therapy often focuses on promoting ward stability, interpersonal skills, symptom reduction and preparation for discharge (Emond & Rasmussen, 2012). Early in the history of state hospitals, the purpose of group therapy was curative; therapists followed psychoanalytic principles and believed that mental illness was caused by faulty parenting or ego impairment, and participation in groups would "cure" mental illness.…”

Section: Psychologists 16mentioning

confidence: 99%

Psychologists working in state psychiatric hospitals: An exploration of factors related to work engagement

Игнатенко¹

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Psychologists working in state psychiatric hospitals: An exploration of factors related to work engagement Valerie Ignatenko The role of psychologists working in state psychiatric hospitals has been ambiguous throughout most of the last century. State psychiatric hospitals continue to provide care to patients with severe mental illness, and psychologists remain employed in such settings. Eight factors related to work engagement for psychologists in state psychiatric hospitals were explored, including geographic region, length of time in the field, length of time at the hospital, number of clients seen per week, number of supervision hours per month, job ambiguity, autonomy, and perceived social support. Results found that psychologists are engaged in their work in state hospitals, and three of the assessed factors, job ambiguity, autonomy, and perceived social support, were found to be significant predictors of work engagement. The identification of these three factors as predictors of work engagement in state hospitals highlights the need for hospital administrators to clearly define job roles, and for psychologists to ensure that they feel certain about their job role. Job ambiguity was found to offer the strongest negative prediction of work engagement. Further, the need for opportunity to socially interact with colleagues within the hospital is critical, and should be reinforced by hospital administration and encouraged by graduate training programs. A moderate level of autonomy was found to be the most predictive of work engagement, and offers new insights on how managers can approach the supervision of psychologists.

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“…These groups tend to be open-clients choose when to participate, come and go, and have reduced structure. Smaller therapeutic groups lend themselves to increased focus, intentionality and require higher functioning patients who may be expected to arrive on time and to minimize disruption to the group if they choose to leave (Emond & Rasmussen, 2012;Parkinson, 1999;Wyatt, Yalom & Yalom, 2006;Yalom, 1983 (Cowls & Hale, 2005;Khorasani & Campbell, 2013;Parkinson, 1999).…”

Section: Inpatient Group Settingmentioning

confidence: 99%

“…Emond and Rasmussen (2012) cite ward stability as a goal of psychiatric units. This refers to a multitude of research findings that has shown inpatient group therapy improves staff-patient relationships, decreases violent behavior, empowers patients, and creates a therapeutic ward milieu.…”

Section: Goals Of Inpatient Therapymentioning

confidence: 99%

Inpatient group facilitation guide: staff development and processing, connecting body and brain

Lee¹

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The purpose of this project is to provide resources for staff development and inpatient group facilitation. The project begins with a literature review on the history and evolution of inpatient group therapy, therapeutic goals and expectations. The effects of patient transference, facilitator countertransference, attachment theory, and social engagement is examined with a focus on the body and brain connection and what it means to be traumainformed. Evidence-based theoretical approaches that provide safety and stabilization are described and integrated for group members and practitioners alike. Included is a description of the format of the guide, target audience, goals, and resources. Lastly, the resource guide itself contains a list of specialized staff training, short staff development sessions, and safety and stabilization techniques for acute care group therapy.

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The Status of Psychiatric Inpatient Group Therapy: Past, Present, and Future

Cited by 15 publications

References 54 publications

Provision and adaptation of group treatment in state psychiatric hospitals.

Provision and adaptation of group treatment in state psychiatric hospitals.

Psychologists working in state psychiatric hospitals: An exploration of factors related to work engagement

Inpatient group facilitation guide: staff development and processing, connecting body and brain

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