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.     

Therapeutic group approaches in an inpatient facility for children and adolescents: A 15-year perspective

Inner city, psychiatrically hospitalized adolescents are accessible to group therapy intervention. We developed a unique approach combining Slavson's theories with principles of family treatment and psychoanalytic theory. The group was conceptualized as a corrective family experience with the therapists functioning as model parents. Our model relies on a four-phase process, which is discussed.     

Multimodal therapy in an inpatient setting

Inpatient Multimodal Therapy (imt) is a residential treatment program, lasting a maximum of 36 weeks, for patients with severe neurotic symptoms. A group of 44 chronic obsessive-compulsive patients and a group of 40 chronic phobic patients were treated in order to assess the outcome and the process of treatment and to identify prognostic factors associated with the effect. At follow-up—on average, eight months after discharge—it was found that 60% had improved, 32% had remained the same, and 8% had deteriorated, indicating that, in general, the treatment was beneficial. That these effects were long-lasting is supported by the fact that, at follow-up, 78% of all patients were no longer receiving treatment, 18% were receiving outpatient or day treatment, and 4% were receiving inpatient treatment. Phobic patients appear to have gained more from the multimodal approach than did obsessive-compulsive patients, as indicated by the fact that the severity of symptoms decreased as they improved in rational thinking, assertiveness, and arousal. By contrast, obsessive-compulsive patients relapsed more than phobic patients did. This was attributed to the fact that the former gained less from the rational-emotive training, denied problems with assertiveness, and did not practice the acquired relaxation skills. It further appeared that a favorable outcome could be induced in patients who (1) expressed relatively mild symptoms in this otherwise severe group, (2) reported relatively few additional complaints, (3) could clearly indicate interpersonal problems, and (4) did not use psychotropic drugs. These prognostic factors are so widespread that not much weight can be ascribed to them. Yet they are useful for indication ofimt until better predictors are found.     

Hub Group: an innovative approach to group therapy in a short-term inpatient adolescent unit

Two and one-half years of Hub Group have shown that short-term, ward-based, heterogeneously mixed adolescent groups can work. Backed by a behaviorally based privilege system, Hub Group contracting methods facilitate rapid investment in group therapy, are flexible enough to accommodate change, and provide a meaningful ritual that involves all group members in promoting change for the individual. Hub Group's method of self-rating and rewards promotes objectivity in self-evaluation. The contracts' images are compact, but all encompassing, providing a continuum along which to move in developing greater responsibility and productive functioning for the adolescents. There are distinct advantages and disadvantages to mixed levels of functioning within the same group. The nurturance and tolerance for others fostered by Hub Group is a primary advantage. Despite the obvious disadvantages of rapid turnover, common issues such as acceptance, attachment, and separation are ever present to be addressed. Leadership must be either supportive or confrontive, but always active in these groups. Hub Groups have shown that with the support and supervision of IDTU's administrative staff, diversely trained staff can comfortably perform multiple roles within the unit and be effective as group leaders.     

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.     

Primitive group process and therapist technique: An approach to short-term inpatient group therapy

In this paper seven formations of primitive group life are portrayed: the cocoon group and two pathological subformations within it — the fusion phenomenon and the isolation phenomenon; the symbiotic group; the emerging identities group; the common griping group; and the give- and- take group. Three broad categories of technical intervention are outlined for treating primitive groups depending upon which formation is occurring: enhancement of group safety; advancement of identity formation; and encouragement of discussion. The thesis of this paper is that therapists can work more comfortably and successfully in primitive groups with an awareness of primitive group life and with the use of therapist responses that address themselves to primitive levels of experience.     

The evaluation of an equine-assisted therapy programme with a group of boys in a youth care facility

The goal of this study was to evaluate the efficacy of an equine-assisted therapy programme aimed at improving the psychological well-being of boys in a custodial school of industry. Participants were 39 boys who live in a youth care facility for boys who display problem behaviour. They were from different cultural groups (Black, Coloured, and White) and aged between 14 and 18 years. Horses were utilised in the structured sessions to help the boys learn different coping skills through experiential learning. Data were collected on the boys’ level of coping and subjective well-being in order to assess the efficacy of the programme. The data were analysed using independent groups t-test comparisons. The results showed that the programme significantly improved the boys’ subjective well-being, problem focused coping, and emotion focused coping. However, their levels of dysfunctional coping were unchanged following the intervention. An equine-assisted therapy programme appears to show modest evidence of enhancing psychological well-being of adolescent boys in custodial care.     

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.     

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.     

Adolescent depression and externalizing problems: testing two models of comorbidity in an inpatient sample

Differentiating between additive (quantitative) and interactive (qualitative) effects of comorbidity has important treatment implications. This study illustrates the heuristic superiority of a multifactorial approach over simple group comparisons in testing quantitative versus qualitative models of comorbidity. Analysis of variance was used to compare 266 adolescent inpatients identified as depressed, externalizing, both, or neither on self-report measures of personality, school problems, and substance abuse. The results support quantitative rather than qualitative models of comorbidity. Depressed status related most strongly to group differences in interpersonal and self-critical concerns. Externalizing status related most strongly to group differences in school problems and drug use. Main effects for the two statuses together explained especially elevated levels of reactance and alcohol abuse among the comorbid adolescents.     

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.     

Adolescent suicide attempters presenting to a pediatric facility

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem.