Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-18T20:51:58.943Z Has data issue: false hasContentIssue false
  • English
  • Français

A comparison of a milieu-based Behavioural Activation Communication with treatment as usual for acute psychiatric inpatients

Published online by Cambridge University Press:  27 November 2013

Jackie K. Gollan ,
Denada Hoxha ,
Bjorn Hanson ,
Evelyn Perkins ,
Maureen Slade  and
Patricia Roberts
Jackie K. Gollan*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Northwestern University's Feinberg School of Medicine, Chicago, Illinois, USA
Denada Hoxha
Affiliation:
Department of Psychiatry and Behavioral Sciences, Northwestern University's Feinberg School of Medicine, Chicago, Illinois, USA
Bjorn Hanson
Affiliation:
College of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
Evelyn Perkins
Affiliation:
Northwestern Memorial Hospital, Stone Institute of Psychiatry, Chicago Illinois, USA
Maureen Slade
Affiliation:
Northwestern Memorial Hospital, Stone Institute of Psychiatry, Chicago Illinois, USA
Patricia Roberts
Affiliation:
Northwestern Memorial Hospital, Stone Institute of Psychiatry, Chicago Illinois, USA
*
Correspondence to: Dr Jackie K. Gollan, Asher Center for Study and Treatment of Depressive Disorders, Department of Psychiatry and Behavioral Sciences, Northwestern University's Feinberg School of Medicine, 676 North St Clair Street, Suite 1000, Chicago, IL 60611, USA. E-mail: j-gollan@northwestern.edu
Get access

Abstract

Aim

Patient emotion, behaviour, and symptoms may explain avoidance of the daily programming on an acute psychiatric inpatient treatment milieu. We compared changes of emotion, behaviour, and symptoms among acutely ill psychiatric inpatients assigned to Behavioural Activation Communication (BAC), a newly designed milieu program, and those assigned to a unit representing treatment as usual (TAU).

Method

Participants included 144 adult inpatients treated between January 2011 and July 2011 at two similar psychiatric units at a medical centre. Psychiatric patients were assigned to either the BAC or the TAU unit based bed availability. At admission and discharge, patients completed the Brief Symptom Inventory, Positive Affect and Negative Affect Scale, and the Checklist of Unit Behaviors.

Results

A comparison of BAC and TAU patients showed greater relative change on positive affect and of behavioural activation with the daily programming.

Conclusion

The BAC program is associated with a significant increase of positive emotion and activation of inpatients.

Keywords

Behavioural Activation Communicationinpatient psychiatrytreatment engagement approachpositive affect
Type
Original Research Article
Information
Journal of Psychiatric Intensive Care , Volume 10 , Issue 2 , August 2014 , pp. 100 - 109
Copyright
Copyright © NAPICU 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blader, J.C. (2011) Acute inpatient care for psychiatric disorders in the United States, 1996 through 2007. Archives of General Psychiatry. 68(12): 1276–1283.CrossRefGoogle ScholarPubMed
Bruder-Mattson, S.F., Hovanitz, C.A. (1990) Coping and attributional styles as predictors of depression. Journal of Clinical Psychiatry. 46(5): 557–565.Google ScholarPubMed
Cuijpers, P., van Straten, A., Warmerdam, L. (2007) Behavioral activation treatments of depression: a meta-analysis. Clinical Psychology Review. 27(3): 318–326.CrossRefGoogle ScholarPubMed
Daughters, S.B., Braun, A.R., Sargeant, M.N., Reynolds, E.K., Hopko, D.R., Blanco, C., Lejuez, C.W. (2008) Effectiveness of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: the Life Enhancement Treatment for Substance Abuse (LETS Act!). Journal of Clinical Psychiatry. 69(1): 122–129.CrossRefGoogle ScholarPubMed
DeGenova, M.K., Patton, D.M., Jurich, J.A., MacDermid, S.M. (1994) Ways of coping among HIV-infected individuals. Journal of Social Psychiatry. 134(5): 655–663.Google ScholarPubMed
Derogatis, L.R. (1993) Brief Symptom Inventory (BSI): administration, scoring, and procedures manual. NCS Pearson, Inc., Bloomington.Google Scholar
Derogatis, L.R., Spencer, P.M. (1982) The Brief Symptom Inventory (BSI): administration, and procedures manual-I. Baltimore, MD: Clinical Psychometric Research.Google Scholar
Dimidjian, S., Marrera, M., Martell, C., Munoz, R.F., Lewinsohn, P.M. (2011) The origins and current status of Behavioral Activation treatments for depression. Annual Review of Clinical Psychology. 7: 1–38.CrossRefGoogle ScholarPubMed
Ekers, D., Richards, D., Gilbody, S. (2008) A meta-analysis of randomized trials of behavioural treatment of depression. Psychological Medicine. 38(5): 611–623.CrossRefGoogle ScholarPubMed
Ekers, D., Richards, D., McMillan, D., Bland, J.M., Gilbody, S. (2011) Behavioural activation delivered by the non-specialist: phase II randomised controlled trial. British Journal of Psychiatry. 98(1): 66–72.CrossRefGoogle Scholar
Hanson, B., Hoxha, D., Roberts, P., Gollan, J.K. (2013) The Checklist of Unit Behaviors (CUB): psychometric properties of a measure of patient milieu engagement on an acute inpatient psychiatric unit. Journal of Psychiatric Intensive Care. 9(2): 1–9.CrossRefGoogle Scholar
Hayes, S.C., Wilson, K.G., Gifford, E.V., Follette, V.M. (1996) Experiential avoidance and behavioral disorders: a functional dimension approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology. 64: 1152–1168.CrossRefGoogle ScholarPubMed
Hopko, D.R., Lejuez, C.W., LePage, J.P., Hopko, S.D., McNeil, D.W. (2003) A brief behavioral activation treatment for depression: a randomized pilot trial within an inpatient psychiatric hospital. Behavior Modification. 27(4): 458–469.CrossRefGoogle ScholarPubMed
Ireland, S., McMahon, R., Malow, R., Kouzekanani, K. (1993) Coping style as a predictor of relapse to cocaine abuse. In: Harris, L.-S. (ed.) Problems of drug dependence. Proceedings of the 55th annual scientific meeting, College on Problems of Drug Dependence. National Institute on Drug Abuse Research Monograph 141, p. 159.Google Scholar
Karekla, M., Panayiotou, G. (2011) Coping and experiential avoidance: unique or overlapping constructs? Journal of Behavior Therapy and Experimental Psychiatry. 42: 163–170.CrossRefGoogle ScholarPubMed
Kingston, J., Clarke, S., Remington, B. (2010) Experiential avoidance and problem behavior: a mediational analysis. Behavior Modification. 34: 145–163.CrossRefGoogle ScholarPubMed
Kortte, K.B., Veiel, L., Batten, S.V., Wegener, S.T. (2009) Measuring avoidance in medical rehabilitation. Rehabilitation Psychology. 54: 91–98.CrossRefGoogle ScholarPubMed
Martell, C.M., Addis, M.E., Jacobson, N.S. (2001) Depression in context: strategies for guided action. WW. Norton & Company, New York, 223 pp.Google Scholar
Murugesan, G., Amey, C.G., Deane, F.P., Jeffrey, R., Kelly, B., Stain, H. (2007) Inpatient psychosocial rehabilitation in rural NSW: assessment of clinically significant change for people with severe mental illness. Australian and New Zealand Journal of Psychiatry. 41: 343–350.CrossRefGoogle ScholarPubMed
National Association of Psychiatric Health Systems (2002) Trends in behavioral healthcare systems: a benchmarking report. NAPHS 2001 annual survey report. National Association of Psychiatric Health Systems, Washington.Google Scholar
National Institute for Health and Clinical Excellence (2009) Depression: the treatment and management of depression in adults, updated edition. National Clinical Practice Guideline 90. National Collaborating Centre for Mental Health. http://guidance.nice.org.uk/CG90 Google Scholar
Pereira, S., Woollaston, K. (2007) Therapeutic engagement in acute psychiatric inpatient services. Journal of Psychiatric Intensive Care. 3(1): 3–11.CrossRefGoogle Scholar
Snarski, M., Scogin, F., DiNapoli, E., Presnell, A., McAlpine, J., Marcinak, J. (2011) The effects of behavioral activation therapy with inpatient geriatric psychiatry patients. Behavior Therapy. 42(1): 100–108.CrossRefGoogle ScholarPubMed
Thibeault, C.A., Trudeau, K., d'Entremont, M., Brown, T. (2010) Understanding the milieu experiences of patients on an acute inpatient psychiatric unit. Archives of Psychiatric Nursing. 24: 216–226.CrossRefGoogle Scholar
Watson, D., Clark, L.A., Tellegen, A. (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology. 54: 1063–1070.CrossRefGoogle ScholarPubMed