How Can a Music Therapy Student Facilitate Contributions by Adolescent Clients Who Have Psychiatric Disorders in Group Music Therapy?

<p>This study explored ways in which a music therapy student could modify and improve her own clinical practice in order to facilitate client contribution in group music therapy in an acute adolescent inpatient unit. Through cycles of observation, evaluation, planning, and action, the music therapy student was able to examine her facilitation techniques in detail and modified them accordingly. There were six fortnightly cycles and in each cycle, the research journal, research notes, and video-recording were systematically reviewed by the music therapy student herself, and themes were drawn out to contribute to the planning of the next cycle. The results suggested that while direct questions predominated at the start of study, the music therapy student was able to adopt a variety of other techniques by the end of the research period, including self-disclosure, appropriate eye contact, and the shifting of responsibility. The music therapy student also found that her own anxiety level, which was often caused by periods of silence in music groups, also had an important impact on her ability to facilitate. The discussion addressed other factors that are believed to have contributed to the student's ability to facilitate in group music therapy.</p>

How Can a Music Therapy Student Facilitate Contributions by Adolescent Clients Who Have Psychiatric Disorders in Group Music Therapy?

<p>This study explored ways in which a music therapy student could modify and improve her own clinical practice in order to facilitate client contribution in group music therapy in an acute adolescent inpatient unit. Through cycles of observation, evaluation, planning, and action, the music therapy student was able to examine her facilitation techniques in detail and modified them accordingly. There were six fortnightly cycles and in each cycle, the research journal, research notes, and video-recording were systematically reviewed by the music therapy student herself, and themes were drawn out to contribute to the planning of the next cycle. The results suggested that while direct questions predominated at the start of study, the music therapy student was able to adopt a variety of other techniques by the end of the research period, including self-disclosure, appropriate eye contact, and the shifting of responsibility. The music therapy student also found that her own anxiety level, which was often caused by periods of silence in music groups, also had an important impact on her ability to facilitate. The discussion addressed other factors that are believed to have contributed to the student's ability to facilitate in group music therapy.</p>

Adolescent inpatient mental health services in the UK

Inpatient mental health services are an indispensable part of the mental healthcare for adolescents. They provide comprehensive assessment and treatment for young people severely affected by mental health difficulties whose presentation is associated with high level of risk or where diagnostic clarity and effective intervention cannot be achieved with less intensive community input. In the UK, a range of different mental health units have been developed with the aim to meet the needs of young people requiring admission with the appropriate expertise and in the least restrictive way possible. Although an inpatient admission is necessary and helpful for a number of adolescents, it may also be linked to some adverse effects that need to be carefully assessed and managed when such an option is considered or pursued. Collaborative working between inpatient units, community teams and young people and their families is paramount in ensuring that inpatient interventions form part of a wider treatment plan, are as efficient and effective as possible and are used in a way that fosters engagement, independence and optimal outcomes.

Ethnic disparity in mental health legislation at the point of inpatient entry: pilot review in detained adolescents with developmental disorders

Purpose Ethical concerns about the use of the Mental Health Act (MHA) have led to calls for developmental disorders to be removed from the list of mental disorders for which individuals can be detained. In parallel, there are long-standing concerns of ethnic disparity in the application of the MHA. Nonetheless, the impact of the intersections of developmental disorder diagnosis, adolescence and ethnicity on the application of the MHA is unknown. This study aims to explore ethnic differences in MHA sections and the factors accounting for this, in an adolescent inpatient developmental disorder service. Design/methodology/approach File reviews were conducted to explore differences in MHA status, as well as demographic, clinical and risk factors that may account for this, between 39 white British and ethnic minority adolescents detained to a specialist inpatient developmental disorder service. Findings Consistent with adult literature, adolescents of an ethnic minority were overrepresented in the sample and were significantly more likely to be detained on Part III or “forensic” sections of the MHA than White British counterparts, with five times greater risk. Analyses revealed no significant differences between ethnic minority and white British participants on demographic variables, clinical needs, risk behaviours, risk measures nor application of restrictive practices and safeguarding procedures. Practical implications National audits exploring patterns of detention under the MHA across adolescent developmental disorder populations need to include analysis of intersections to ensure that the MHA is used as a means of last resort and in an equitable manner. Originality/value To the best of the authors’ knowledge, this paper is the first comprehensive exploration of the impact of ethnicity on detention patterns in ethnic minority and White British populations.

The impact of COVID-19 on adolescent psychiatric inpatient admissions

COVID-19 has disrupted the lives of individuals and families across the globe. For many, the impacts of this global pandemic have been insurmountable and have resulted in significant stressors. Although medical advances have allowed individuals to slowly begin to restore their sense of normalcy, COVID-19 has resulted in unprecedented mental health impacts for many, especially children and adolescents. The present study examines whether stressors related to COVID-19 and whether subsequent quarantine/isolation were possible contributors to psychiatric crises that led to adolescent psychiatric inpatient admissions. Electronic medical records of those admitted to Strong Memorial Hospital’s Child and Adolescent Inpatient Unit between March 13, 2020 and January 1, 2021 were reviewed. Admission and discharge notes were analyzed to determine the presence and context of keywords related to COVID-19. Approximately, 53% of all adolescent psychiatric crises that led to inpatient admission were related to COVID-19 stressors. Results of this study will be used to help understand the extraordinary mental health impacts of a global pandemic and will assist mental health service leaders to better plan for patient flow should there be another wave of quarantine/isolation. Additionally, these results can help inform and develop pandemic-related strategies and interventions that can reduce overall distress in children and adolescents.

A quality improvement project on timely completion of bloods and ECGs on a tier 4 child and adolescent inpatient unit

AimsPhysical health monitoring is paramount to optimal care for psychiatric patients. Blood tests and ECGs are invaluable tests throughout a patient's care. At baseline, they aid investigation of potential organic causes of psychiatric presentations and provide organ and electrolyte status before starting medication. Common psychotropic medications carry physical health risks: bloods and ECGs aid in monitoring potential side effects of prescribed medication.In this local Tier 4 inpatient unit, anecdotal observation revealed completion of these basic investigations was noted to be suboptimal.This project aimed to improve timely completion of baseline (within 72 hours of admission) and monitoring (within one week of due date) bloods and ECGS.MethodThis project was completed within a 12-bed child and adolescent inpatient unit. Using Plan Do Study Act (PDSA) methodology, the multidisciplinary team collated driver diagrams to identify potential areas for intervention. Following baseline analysis, colleague communication was considered key. Consequently, a chart for bloods and ECG completion was created.Each monthly PDSA cycle included the following consecutive interventions: PDSA cycle 1: chart implementationPDSA cycle 2: chart simplification and font size increasePDSA cycle 3: allocated change in team leader for this cyclePDSA cycle 4: Blood request pocket in officePDSA cycle 5: chart simplification through removal of datesPDSA cycle 6: ECG pocketPDSA cycle 7: box on handover listResultMonthly investigations and admission numbers are unpredictable and inconsistent in this cohort: relevant case numbers per PDSA ranged from zero to ten. The results were presented as percentages to allow for direct comparison between cycles.Baseline and results of each consecutive PDSA cycle described above were as follows (N/A represents a cycle where no investigations were required):Admission bloods were completed within 72 hours in 50%, 100%, 50%, 80%, N/A, 100%, 100%, 100%Admission ECG was completed within 72 hours in 30%, 66%, 50%, 70%, N/A, 100%, 100%, 100%Monitoring bloods were completed within one week of due date in 25%, 33%, 0%, 80%, 100%, 100%, 100%, 100%Monitoring ECG was completed within one week of due date in 0%, 0%, N/A, 66%, 100%, 66%, N/A 100%ConclusionThrough close multidisciplinary collaboration and chart implementation, completion of bloods and ECGs improved. Low patient numbers per PDSA cycle resulted in large changes in percentage results, limiting the significance of these findings. Wider implementation of the chart within local Trust inpatient wards is considered.