Abstract
ObjectiveTo measure the effectiveness of manualized cognitive-behavioural group therapy (CBGT) when it is integrated into the routine care on a general hospital psychiatric inpatient unit.MethodsA pre-post design is used to measure the "process", "results" and "outcome" indicators in the year before CBGT was introduced (2001) in contrast to the subsequent two years (2002, 2003). Readmission to hospital, compulsory admissions, ward atmosphere (i.e. the use of physical restraint, episodes of violent behaviour) and patients' satisfaction were assessed.Results90% of all inpatients in the years 2002–2003 attended the group therapy. In the years after CBGT was introduced the rate of readmission declined from 38% to 27% and 24% (p < .04), compulsory admissions were reduced from 17% to 4% (p < .03), the ward atmosphere and patients' satisfaction were both excellent (p < .01).ConclusionIt is probable that the improvements observed were attributable to the group therapy. These results and those observed in an earlier study are promising and further investigations of this approach are indicated.
Highlights
Cognitive-behavioural therapies have been applied successfully for schizophrenia in outpatient settings for many years
Despite a strong "socio-therapeutic" orientation no psychosocial approach to inpatient treatment has been developed in Italy [10]
Description of cognitive behavioural group therapy for inpatients The aims of Cognitive Behavioural Group Therapy, cognitive-behavioural group therapy (CBGT), for inpatients are: a) general: to improve the collaboration of patients with biopsychosocial treatment programs and to decrease the number of violent and aggressive behavioural acts; b) for services: 1) to motivate and to improve the professional skills of nurses and to minimize burn-out; 2) to improve collaboration between patients and among patients and professionals; 3) to assist patients and staff to cope with acute mental illness
Summary
Cognitive-behavioural therapies have been applied successfully for schizophrenia in outpatient settings for many years. And skills training strategies have shown benefits in reducing clinical and social morbidity [1,2], while recent research on individual cognitive-behavioural therapy has led to a classification of "probably effective" in reducing persisting psychotic symptoms [3,4,5,6]. Inpatient treatment tends to be crisisoriented, with the aim to control positive symptoms and to discharge the patients as soon as possible to community mental health centres. The approach followed in the ward (mainly pharmacological) is different from that of the community-based service (mainly psychosocial).
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