48.5 Evaluating the Impact of DBT Training on Inpatient Psychiatry Trainees’ Ability to Provide Therapeutic Care

The phenomenon of air guitar has become increasingly popular in mainstream society and recognised as a potential means of enhancing one’s sense of mental well-being. It allows for engagement with music that involves physical activation and can be conducted in groups allowing for non-verbal socialisation. To date, there has been limited examination of its potential usefulness in therapeutic settings, including in mental health services. We describe the development of an air guitar group in an inpatient psychiatry service including an iterative approach to the design of sessions and the impact in terms of patient engagement and feedback. The format of the group evolved over time according to feedback from participants and staff involved in patient care on the unit. We found that the group successfully engaged patients of varying age, gender and diagnostic profiles and was perceived as a valuable addition to the inpatient therapeutic programme. Based upon our observations during this pilot study, we outline a suggested format for air guitar sessions that includes our experiences around selection of music, duration of sessions, use of props, managing the physical demands of sessions and ensuring participant safety. Future work can investigate the impact of air-guitar as a therapeutic activity in other settings (including community-based) and exploring how it can be best applied in combination with other therapeutic modalities for use in patients with differing diagnostic and demographic profiles.

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Health Care Management Models for the Evolution of Hospitalization in Acute Inpatient Psychiatry Units: Comparative Quantitative Study (Preprint)

10.2196/preprints.15776 ◽

2019 ◽

Author(s):

Susel Góngora Alonso ◽

Beatriz Sainz-De-Abajo ◽

Isabel De la Torre-Díez ◽

Manuel Franco-Martin

Keyword(s):

Health Care ◽

Mental Disorders ◽

Hospital Admissions ◽

Hospital Costs ◽

Hospital Management ◽

Management Model ◽

Inpatient Psychiatry ◽

Mental Diseases ◽

Hospital Days ◽

The Impact

BACKGROUND Mental health disorders are a problem that affects patients, their families, and the professionals who treat them. Hospital admissions play an important role in caring for people with these diseases due to their effect on quality of life and the high associated costs. In Spain, at the Healthcare Complex of Zamora, a new disease management model is being implemented, consisting of not admitting patients with mental diseases to the hospital. Instead, they are supervised in sheltered apartments or centers for patients with these types of disorders. OBJECTIVE The main goal of this research is to evaluate the evolution of hospital days of stay of patients with mental disorders in different hospitals in a region of Spain, to analyze the impact of the new hospital management model. METHODS For the development of this study, a database of patients with mental disorders was used, taking into account the acute inpatient psychiatry unit of 11 hospitals in a region of Spain. SPSS Statistics for Windows, version 23.0 (IBM Corp), was used to calculate statistical values related to hospital days of stay of patients. The data included are from the periods of 2005-2011 and 2012-2015. RESULTS After analyzing the results, regarding the days of stay in the different health care complexes for the period between 2005 and 2015, we observed that since 2012 at the Healthcare Complex of Zamora, the total number of days of stay were reduced by 64.69%. This trend is due to the implementation of a new hospital management model in this health complex. CONCLUSIONS With the application of a new hospital management model at the Healthcare Complex of Zamora, the number of days of stay of patients with mental diseases as well as the associated hospital costs were considerably reduced.

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I don’t feel naked: The use of embodied supervision to examine the impact of patient clothing on clinical countertransference on an inpatient psychiatry unit

Drama Therapy Review ◽

10.1386/dtr.3.2.261_1 ◽

2017 ◽

Vol 3 (2) ◽

pp. 261-283 ◽

Cited By ~ 1

Author(s):

Dana George Trottier ◽

Lisa Hilt

Keyword(s):

Inpatient Psychiatry ◽

The Impact

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Commentary: Therapeutic Reparenting: What Does it Take?

Children Australia ◽

10.1375/jcas.36.3.109 ◽

2011 ◽

Vol 36 (3) ◽

pp. 109-112 ◽

Cited By ~ 1

Author(s):

Michelle Van Doorn ◽

Marilyn Connolly

Keyword(s):

Foster Care ◽

Human Services ◽

Significant Benefit ◽

Therapeutic Foster Care ◽

Therapeutic Environment ◽

Therapeutic Care ◽

Outcomes For Children ◽

The Impact ◽

Therapeutic Model ◽

Parenting Characteristics

The Circle Program is a therapeutic model of foster care in Victoria. Oz Child has delivered this model of foster care in partnership with The Australian Childhood Foundation and the Department of Human Services over the last four years. Therapeutic foster care is designed to assist children entering care to heal from the affects of trauma and abuse. A significant benefit of therapeutic care is the provision and emphasis on a supportive therapeutic environment for the child in everyday interactions with the carer. It is through the child's relationship with the carer that healing can begin. In order to provide such an environment carers are trained, assessed and accredited to have a working understanding of the impact of trauma and abuse, and are provided with tools and strategies to therapeutically re-parent these children. Carers are an integral part of the team and work alongside placement workers and clinicians to understand the impact of trauma and abuse. Together they develop strategies and interventions that are therapeutic and address the impact of trauma on all aspects of the child's development and wellbeing. While considering outcomes for children within a therapeutic model it is crucial to identify particular interpersonal and parenting characteristics held by carers. This commentary will consider the defining characteristics required to be a therapeutic foster carer.

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The impact of COVID-19 restrictions on the presentation of self-injury: experience at a tertiary centre

BJPsych Open ◽

10.1192/bjo.2021.614 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S230-S231

Author(s):

Tobias Adams ◽

A Arnaout ◽

S Bickerton ◽

L Li ◽

AWN Reid ◽

...

Keyword(s):

Mental Health ◽

Tendon Injuries ◽

Prior History ◽

Soft Tissue Reconstruction ◽

Inpatient Psychiatry ◽

Tertiary Referral Centre ◽

Self Injury ◽

Number Of Patients ◽

History Of ◽

The Impact

AimsThe national lockdowns due to the COVID-19 pandemic, have had a considerable effect on mental health, with reduced access to social interaction through work and leisure activities, and increased barriers to community mental health services.This study aims to evaluate how the presentation of patients with self-injury has changed during the first national U.K. lockdown, at a Plastic Surgery Tertiary Referral Centre in the East of England.MethodRetrospectively recorded data from 23 March 2020 to 31 December 2020, spanning the duration of the first two lockdowns in the UK, were compared to the same period in 2019. The demographics of patients, along with the nature, severity and outcomes of the self-injury were recorded and compared.ResultThe number of patients referred for self-injury reduced by 22.9% during lockdown (2020: N = 42/109, 2019: 67/109)The most common attendance route was via ambulance during lockdown (2020:40.5% 2019: 31.3%) whilst the most common attendance route being via the front door in 2019 (2019: 35.8%, 2020: 26.2%)The number of new presentations with no prior history of self-injury was higher in lockdown 38.1%) compared to 2019 26.9%.The lockdown cohort had a smaller proportion of patients presenting with complications (2020: 9.5% vs 2019: 17.9%), less readmitted (2020: 11.9% vs 2019: 23.9%). Similar re-attendance rate (2020: 40.3% vs 2019: 38.1%) and re-intervention (2020: 13.4% vs 2019: 14.3%).A greater proportion in 2020 met the threshold for inpatient psychiatry input (2020: 52.4% vs 2019: 41.8%).During the lockdown, a higher percentage of flexor tendon injuries involved multiple tendons (60.0% vs 52.2%). A higher percentage of extensor tendon injuries (14.3% vs 7.4%), and a greater proportion of these also involved multiple tendons (66.7% vs 40.0%). More self-injuries were complicated by fractures (7.1% vs 4.5%) and more required soft tissue reconstruction (11.9% vs 3.0%).ConclusionDespite fewer patients presenting with self-injury during the 2020 lockdown, the injuries were more severe. Many of which had multiple structural injuries, and some with life-changing injuries, this is in line with our clinical observations.During lockdown there was a higher proportion of first-time presentations without a history of self-injury and an increased need for inpatient psychiatry input. This may reflect the impact on mental health as a result of restricted social interactions.These findings demonstrate the impact of lockdown on mental-health and may help inform medical services of potential changes in the presentations in future national social restrictions.

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Health Care Management Models for the Evolution of Hospitalization in Acute Inpatient Psychiatry Units: Comparative Quantitative Study

JMIR Mental Health ◽

10.2196/15776 ◽

2020 ◽

Vol 7 (11) ◽

pp. e15776

Author(s):

Susel Góngora Alonso ◽

Beatriz Sainz-De-Abajo ◽

Isabel De la Torre-Díez ◽

Manuel Franco-Martin

Keyword(s):

Health Care ◽

Mental Disorders ◽

Hospital Admissions ◽

Hospital Costs ◽

Hospital Management ◽

Management Model ◽

Inpatient Psychiatry ◽

Mental Diseases ◽

Hospital Days ◽

The Impact

Background Mental health disorders are a problem that affects patients, their families, and the professionals who treat them. Hospital admissions play an important role in caring for people with these diseases due to their effect on quality of life and the high associated costs. In Spain, at the Healthcare Complex of Zamora, a new disease management model is being implemented, consisting of not admitting patients with mental diseases to the hospital. Instead, they are supervised in sheltered apartments or centers for patients with these types of disorders. Objective The main goal of this research is to evaluate the evolution of hospital days of stay of patients with mental disorders in different hospitals in a region of Spain, to analyze the impact of the new hospital management model. Methods For the development of this study, a database of patients with mental disorders was used, taking into account the acute inpatient psychiatry unit of 11 hospitals in a region of Spain. SPSS Statistics for Windows, version 23.0 (IBM Corp), was used to calculate statistical values related to hospital days of stay of patients. The data included are from the periods of 2005-2011 and 2012-2015. Results After analyzing the results, regarding the days of stay in the different health care complexes for the period between 2005 and 2015, we observed that since 2012 at the Healthcare Complex of Zamora, the total number of days of stay were reduced by 64.69%. This trend is due to the implementation of a new hospital management model in this health complex. Conclusions With the application of a new hospital management model at the Healthcare Complex of Zamora, the number of days of stay of patients with mental diseases as well as the associated hospital costs were considerably reduced.

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De-pathologizing love in therapeutic care: Attending to an unwitting hermeneutical violence

International Journal of Psychotherapy, Counselling and Psychiatry: Theory Research & Clinical Practice ◽

10.35996/1234/3/hermeneuticalviolence ◽

2018 ◽

Vol 3 ◽

Author(s):

Todd DuBose

Keyword(s):

Body Language ◽

Status Quo ◽

The Status ◽

Therapeutic Care ◽

Therapeutic Space ◽

The Impact

This paper addresses the nature of pathologization in general and the pathologization of love in therapeutic care in particular. “Pathologized or pathologization[u1] ,” means an event, person, action, thought, feeling, or circumstance that is de-valuated as “less than,” as compromised or broken, and unwittingly (ironically, in the name of love) demeaned, belittled, ignored, jettisoned or ostracized for its not-enough-ness, its incorrectness, or its inadequacy in light of rank-ordered scales of measured worth. The pathologist presumes an essentialist hegemony [ctsq2] should be healthy love, consequentiality, views any expression less than this prescription as a privation or pathologization of healthy love, and is thus immature, ill, or unethical. Common ways therapists pathologize love in therapeutic space include the use of a modified against nature argument; which today is reframed as an against the status quo argument. The use of inflection and body language that communicates disapproval are, enacting[u3] ideologies of deficit-correction that inherently stigmatize, interpreting expressions of love “as other than it is,” or, “as nothing but something else,” such as adoration interpreted as really dependency or teenaged pining as merely raging hormones. Essentialist rank-ordered scaling inherent in these forms of pathologization is deconstructed, then explored in terms of the impact of this deconstruction in therapeutic care. The essay is concluded[u4] with suggestions of how to care for expressions of love in non-pathologizing ways within therapeutic space.

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How High? Trends in Cannabis Use Prior to First Admission to Inpatient Psychiatry in Ontario, Canada, between 2007 and 2017: À quelle hauteur? Les tendances de l’usage du cannabis avant la première hospitalisation en psychiatrie en Ontario, Canada entre 2007 et 2017

The Canadian Journal of Psychiatry ◽

10.1177/0706743720984679 ◽

2020 ◽

pp. 070674372098467

Author(s):

Taylor McGuckin ◽

Mark A. Ferro ◽

David Hammond ◽

Shannon Stewart ◽

Bridget Maloney-Hall ◽

...

Keyword(s):

Psychotic Disorders ◽

Area Under The Curve ◽

Cannabis Use ◽

Medical Cannabis ◽

Inpatient Psychiatry ◽

Cross Sectional ◽

And Gender ◽

Using Data ◽

The Impact ◽

First Admission

Objectives: To examine the trends in cannabis use within 30 days of first admission to inpatient psychiatry in Ontario, Canada, between 2007 and 2017, and the characteristics of persons reporting cannabis use. Methods: A retrospective cross-sectional analysis was conducted for first-time admissions to nonforensic inpatient psychiatric beds in Ontario, Canada, between January 1, 2007, and December 31, 2017, using data from the Ontario Mental Health Reporting System ( N = 81,809). Results: Across all years, 20.1% of patients reported cannabis use within 30 days of first admission. Use increased from 16.7% in 2007 to 25.9% in 2017, and the proportion with cannabis use disorders increased from 3.8% to 6.0%. In 2017, 47.9% of patients aged 18 to 24 and 39.2% aged 25 to 34 used cannabis, representing absolute increases of 8.3% and 10.7%, respectively. Increases in cannabis use were found across almost all diagnostic groups, with the largest increases among patients with personality disorders (15% increase), schizophrenia or other psychotic disorders (14% increase), and substance use disorders (14% increase). A number of demographic and clinical factors were significantly associated with cannabis use, including interactions between schizophrenia and gender (area under the curve = 0.88). Conclusions: As medical cannabis policies in Canada have evolved, cannabis use reported prior to first admission to inpatient psychiatry has increased. The findings of this study establish a baseline for evaluating the impact of changes in cannabis-related policies in Ontario on cannabis use prior to admission to inpatient psychiatry.

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Formation of Lunar Craters and Bright Rays as a Result of Meteorite Impacts

Symposium - International Astronomical Union ◽

10.1017/s0074180900178404 ◽

1962 ◽

Vol 14 ◽

pp. 415-418

Author(s):

K. P. Stanyukovich ◽

V. A. Bronshten

Keyword(s):

Explosive Charge ◽

The Moon ◽

Meteorite Impacts ◽

The Earth ◽

Lunar Craters ◽

The Impact

The phenomena accompanying the impact of large meteorites on the surface of the Moon or of the Earth can be examined on the basis of the theory of explosive phenomena if we assume that, instead of an exploding meteorite moving inside the rock, we have an explosive charge (equivalent in energy), situated at a certain distance under the surface.

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