Psychological interventions on a specialist Early Intervention Inpatient Unit: An opportunity to engage?

Abstract

Psychological interventions are acceptable on a specialist early intervention psychosis inpatient ward and offer an opportunity to engage service users. Engagement was not predicted by demographic factors typically seen in community settings. Implications arising from these differences are discussed.

Mindfulness-based crisis interventions (MBCI) for psychosis within acute inpatient psychiatric settings; a feasibility randomised controlled trial

“…Offering these brief, targeted interventions at a time of mental health crisis may be particularly helpful, as difficult thoughts and emotions are more at the surface, and people may be more open to the offer of psychological CMHT Community mental health team; no. of contacts excluding therapy appointments therapy [27]. This therapeutic window of opportunity may be lost as the crisis resolves, particularly for people with a 'sealing over' style of recovery [28], who prefer not to think about their psychotic episode after discharge.…”

Clinical profiles of people with persecutory vs grandiose delusions who engage in psychological therapy during an acute inpatient admission

“…The primary treatment is anti-psychotic medication and although psychological therapy is not readily available, patients often report wanting greater access to this within inpatient settings (The Schizophrenia Commission 2012; Csipke et al 2014;Wood & Alsawy 2016). However, not all patients who are offered the opportunity to engage in a psychological therapy for psychosis during an acute admission will accept the offer (Mitchison et al 2015;Reynolds et al 2017). A better understanding of the profile of people who do agree to engage with a psychological therapy during an inpatient admission is therefore helpful to improve targeting of inpatient psychological therapies and adapting them appropriately to meet the needs of patients.…”

Interruptions to therapy sessions on acute psychiatric wards; how frequent are they, and who does the interrupting?

“…-p.481, (Yalom, 1967) Although recent studies conducted on acute inpatient wards indicate that it is feasible to deliver brief therapies successfully in these challenging clinical environments e.g. (Reynolds, Desai, Zhou, Fornells-Ambrojo, & Garden, 2017;Sheaves et al, 2018;Wood, Byrne, Therapy Interruptions 4 Enache, & Morrison, 2018), one of the on-going prejudices against the provision of inpatient therapies is that the chaotic and challenging environment may preclude the creation and maintenance of an appropriate therapy space (Kahn & White, 1989;Ng, Kumar, Ranclaud, & Robinson, 2001). However, empirical data on the frequency and nature of interruptions is lacking.…”