Quick question about inpatient

[ksuheather]

For those of you who work inpatient mental health, especially those with the child/adolescent population, how often do your patients receive individual therapy? Group therapy?

[Meriwhen, ASN, BSN, MSN, RN]

Group therapy: there's several groups throughout the day. Patient attendance is strongly encouraged but we can't force them to go if they don't want to.

Individual therapy: each patient gets a psychosocial assessment upon admission. After that, IT sessions are per MD orders and/or patient acuity, so the actual frequency can vary between patients.

[elkpark]

On all the units on which I've worked over the years, group psychotherapy (led by a qualified psychotherapist, as differentiated from the other groups that happen on the unit) was offered once a day Mon-Fri. Most of the units haven't offered individual therapy, other than the psychiatrist talking briefly with the clients on a daily basis. I worked in one program (as the child psych CNS), and I did some individual therapy with the kids on the acute inpatient unit and the kids in the residential treatment program on a limited basis as requested by the psychiatrists (in addition to being the group therapist).

[ksuheather]

Ok then where I'm working does the norm I guess. I was surprised to see how little actual therapy goes on in an inpatient setting. If it were my child, I would assume they were getting daily therapy.

[elkpark]

Ok then where I'm working does the norm I guess. I was surprised to see how little actual therapy goes on in an inpatient setting. If it were my child, I would assume they were getting daily therapy.

For many years now, the mental health community has operated under an ethical and legal mandate to treat people in the least restrictive setting possible (that will meet their needs). The focus of inpatient psychiatric hospitalization (whether adults or children), which is the most restrictive setting possible, has been to stabilize the immediate crisis and move the individual on to a less restrictive setting as quickly as safely possible, not to fully resolve all of someone's problems. Psychotherapy is a process that takes time and consistency, and is better suited to ongoing outpatient treatment after discharge from an inpatient setting. Even the "group therapy" that is offered on inpatient units is v. different from "real" group therapy out in the community.

[Safety Coach RN]

For those of you who work inpatient mental health, especially those with the child/adolescent population, how often do your patients receive individual therapy? Group therapy?

Group therapy pretty much all day. Individual varies dependent on need.

[elkpark]

Group therapy pretty much all day.

How are you defining "group therapy"? I'm sure you don't mean the clients sitting around in a circle with a qualified psychotherapist "pretty much all day." Yes, lots of group activities take place on inpatient psych units, and most of them are designed and intended to be therapeutic, but that's not the same as "group therapy."

[umbdude, MSN, APRN]

I work with adults. We have maybe a handful of psychotherapy groups a week (30 minutes each). They're run by social workers and mainly for informational purposes only and are not individualized. There are plenty of activity groups and those are mostly done by staff from the social work/therapy department or mental health workers (i.e. RNs basically don't run groups at my place). The reason we have virtually no psychotherapy group (or individualized ones) is exactly what elkpark explained. We do generally set up aftercare for patients that would include some form of psychotherapy and we strongly encourage that to happen, but ultimately it up to the patient to go.

[Safety Coach RN]

How are you defining "group therapy"? I'm sure you don't mean the clients sitting around in a circle with a qualified psychotherapist "pretty much all day." Yes, lots of group activities take place on inpatient psych units, and most of them are designed and intended to be therapeutic, but that's not the same as "group therapy."

Actually, licensed therapists run most of our scheduled groups throughout the day. We fill in on occasion when they're absent and a few groups we do, like crisis prevention planning for instance.

[hppygr8ful, ASN, RN, EMT-I]

For those of you who work inpatient mental health, especially those with the child/adolescent population, how often do your patients receive individual therapy? Group therapy?

Group therapy - 5 times a day

Individual - as often as the patient's insurance allow for it and if the Dr. Orders it.

Hppy