Treatment of adolescents in a residential facility: a study of three approaches

This study examined the preferred professional treatment approach at a residential treatment center for socially and emotionally maladjusted girls. The dorm child-care workers and the clinical and educational staff responded to a questionnaire composed of statements reflective of three theoretical orientations: psychoanalytic, person-centered, and cognitive-behavioral therapy. No significant differences were found between the three departments (clinical, school, dorm) for each model of therapy. The results also indicated that the professional personnel employed at this treatment facility were all in agreement that the cognitive-behavioral model of therapeutic intervention is the one preferred. Implications of these findings are discussed.     

A comprehensive treatment program for inpatient adolescents

A unit-wide behavioral program for inpatient adolescents was developed and implemented on a coeducational residential unit for six months. Significant clinical reductions were achieved in broken windows, emergency restraint usage, PRNs, medication dosages and the percent of clients receiving psychotropic medications. These reductions continued during the program's maintenance phase. Factors are discussed that appeared to have contributed to the program's success. © 1998 John Wiley & Sons, Ltd.     

Hypersexuality in inpatient children and adolescents: recognition, differential diagnosis, and evaluation

We describe a 17-year-old girl with hypersexuality resulting from virilization, the latter a consequence of polycystic ovary syndrome, and we review the literature pertinent to hypersexuality in children and adults. Inappropriate sexual behavior (a common cause of disruption among children who are hospitalized for psychiatric disorders) may be caused either by hypersexuality or by simply ill-regulated behavior: a definition of hypersexuality is proposed that can be applied at the bedside (namely, sexual behaviors or fantasies that have abruptly increased in frequency by comparison with a previous baseline, are of sufficient excessiveness to disrupt expected or usual social, academic, or occupational functioning, or constitute a source of distress), so that this distinction can be made promptly, and we present a differential diagnosis for hypersexuality to direct its evaluation. Virilization does not seem to be a common cause of hypersexuality in children and adolescents, but it should not be overlooked when it does exist. The differential diagnosis of hypersexuality in adults, which we present for comparison, is much larger than it is in children.     

Social competence and family environment: 15-year follow-up of disturbed adolescents

Measures of familial emotional climate and communication deviance, obtained when subjects were adolescents, were used to predict social adjustment 15 years later. The results showed that disturbed family functioning predicted poor quality of later intimate relationships, but did not predict other dimensions of adult social functioning.     

Therapeutic factors in two forms of inpatient group psychotherapy: Music therapy and verbal therapy

Therapeutic processes in one type of creative arts group psychotherapy, music therapy, were compared with verbal group psychotherapy. Sixty-one short-term inpatients ranked group psychotherapy curative factors and completed satisfaction ratings. Therapists rated 201 group therapy sessions— 109 music therapy and 92 verbal therapy. Statistical analysis revealed that patients highly valued both group formats. The mean curative factor rankings for both groups included cohesiveness, instillation of hope, and altruism among the most helpful factors. Therapists' ratings indicated qualitative differences between the two groups. Music therapy involved more therapeutic interaction among patients and emotional expression, whereas verbal therapy emphasized concrete problem solving.Supported in part by Biomedical Research Support Grant Program grant #S07-RR05755 from the Division of Research Resources, National Institutes of Health.     

Treatment outcome of an inpatient group therapy for couples

In this article, we present the outcomes of an inpatient group treatment programme for couples with complicated problems that need intensive therapy. Each group includes five couples who are admitted for seven weeks. They receive a range of verbal and non‐verbal therapies in a fixed weekly protocol. Outcome was measured by means of two self‐report questionnaires (SCL‐90 and IPSI) completed before and after the treatment programme and at six and eighteen months of follow‐up. The results show that clinical group therapy for these couples is effective.     

A counselling group for adolescents

This paper outlines the aims and objectives of a group for young adolescents set up by two counsellors in an area youth counselling service. It examines the contract made between the counsellors and the group members, the methods used, and some current areas of conflict and potential growth.     

Symptom endorsement differences on the Children's Depression Inventory with children and adolescents on an inpatient unit

Responses to the Children's Depression Inventory (CDI; Kovacs, 1992), administered during intake, were collected from 521 children and adolescents (aged 7 to 17) at an inpatient crisis stabilization unit. Participants were grouped into 1 of 3 diagnostic groups: solely depressive, solely aggressive, or both depressive and aggressive. Self-report of symptoms for each diagnostic group, age and gender differences, and racial and ethnic differences in symptoms were examined in this study. There was a significant difference between the endorsement pattern of solely depressive and solely aggressive participants, whereas those categorized as both depressive and aggressive displayed an endorsement pattern similar to those who were solely aggressive. There was a significant gender difference in overall symptom report, with girls showing higher overall symptom levels than boys. This gender difference was significant for both the younger and the older age groups. These results held true even when gender was covaried out of the diagnostic group analyses and when diagnostic group was covaried out of the gender analyses. Symptom endorsement did not differ based on race and ethnicity. The primary contribution of this study centers around the findings from the item analyses of the CDI. These results are discussed in relation to the discriminant validity of the CDI and the need for additional research into comorbidity.     

Psychological and theological dynamics in an inpatient psychiatric chaplaincy group

This article describes the structure and goals of chaplaincy groups in an inpatient psychiatric setting. The article also explores their therapeutic benefits for patients and offers a theological framework for thinking about the conversations that unfolded in these groups. The article focuses in particular on the value of discussion and reflection in a group setting, the significance of receiving and answering questions, and the experience of participating in a simple ritual to name hopes.     

Alcoholics in inpatient,short-term interactional group psychotherapy: an outcome study

The differential outcome of 100 psychiatric inpatients distinguished by the presence/absence of secondary alcoholism was examined in shortterm closed group psychotherapy. Alcoholics did not differ from the general sample in outcome, but displayed distinct active/aggressive personality features. Group outcome was not affected by the presence/absence of alcoholic members.     

A systematic program to enhance clinician group skills in an inpatient psychiatric hospital

This article describes the collaborative effort of a team of discipline directors, administrators, and academicians to create a systematic program to enhance the group competencies of a large clinical staff working at a state hospital. The effects of the program were tested by a quasi-experimental field study. Quantitative measures of group process provided limited support for program effectiveness. Stronger support came from qualitative inquiry. The development and effectiveness of the program is examined within a larger context of group programs housed in large health care organizations.     

Food for thought: the use of food in group therapy with children and adolescents.

This article highlights the significance food may have in group therapy with children and adolescents and its meanings for particular group members. It focuses on the interactions between the group members and leaders in response to food. Along with providing actual nutrition, food represents emotional and symbolic nurturing, and may trigger salient conflicts and issues with which group members are struggling. An essential role of the group leader is to manage conflicts that may be evoked by the provision of food. Examples are provided to illustrate themes and meanings related to food in group therapy with children and adolescents.     

Therapeutic factors in group psychotherapy: A contemporary view

This paper reviews the two major approaches to the assessment of therapeutic factors in therapy groups: 1) questionnaires administered at termination, and 2) postsession Critical Incident reports. The major categories will be discussed, and a new study utilizing Critical Incident methodology reported which replicates previous results. Suitable studies will be reanalyzed from the standpoint of the change in therapeutic factors over time as a group develops. It is recommended that the Critical Incident methodology be further refined and used in preference to the questionnaire approach.