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Multimodal Treatment of Acute Psychiatric Illness

Multimodal Treatment of Acute Psychiatric Illness: A Guide for Hospital Diversion

Justin M. Simpson
Glendon L. Moriarty
Copyright Date: 2014
Pages: 232
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  • Book Info
    Multimodal Treatment of Acute Psychiatric Illness
    Book Description:

    The multimodal treatment of acute psychiatric illness involves a set of integrated, systematic interventions that stabilize individuals with severe mental illness and help them avoid unnecessary psychiatric hospitalization. This volume focuses on those suffering from schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, severe anxiety, and substance dependence, and provides individual practitioners and professional teams with the tools for responding to crisis and delivering acute care. The authors bolster the text with real-world case examples, helpful diagrams, and printable worksheets.

    eISBN: 978-0-231-53609-7
    Subjects: Psychology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. I-VI)
  2. Table of Contents
    (pp. VII-VIII)
    (pp. IX-XVI)
  4. 1 Hospital Diversion Programs
    (pp. 1-12)

    The effort to bring mentally ill persons out of institutions and back into the community began a number of years ago. The Community Mental Health Centers Act of 1963 was created to provide for community-based care as an alternative to institutionalization, and the process of deinstitutionalization has continued at varying levels since then (Grob, 2008). The current trend has resulted in the development of several alternatives to inpatient treatment. The goal of these programs is to stabilize in the community, and preferably in their own home, individuals who are experiencing crisis.

    There is evidence to suggest hospital diversion programs will...

  5. 2 Integrative and Multimodal Treatment
    (pp. 13-21)

    When providing mental health treatment, it is typically important to have an underlying theoretical framework that will guide the various interventions in a purposeful manner. For instance, a cognitive therapist will set out to understand more clearly the underlying thoughts or assumptions that drive an individual’s behavior and eventually assist the person in challenging any assumptions that are faulty. The cognitive therapist will view most problems through this thought-behavior-consequence lens. Likewise, therapists who maintain other theoretical orientations have likely become comfortable with a particular perspective and approach clinical issues accordingly.

    There is nothing wrong with limiting oneself to one theoretical...

  6. 3 Severe Mental Illness Treatment Literature: AN OVERVIEW
    (pp. 22-46)

    Much effort has gone into developing an accurate and useful definition of severe mental illness. A National Institute of Mental Health working group used three criteria to define severe mental illness: a diagnosis of nonorganic psychosis or personality disorder; a long history of previous hospitalizations or outpatient treatment; and disability that includes dangerous or disturbing social behavior, moderate impairment in work and nonwork activities, and mild impairment in basic needs (NIMH, 1987). Some researchers (e.g., Parabiaghi et al., 2006; Ruggeri et al., 2000) have suggested a three-dimensional operational definition that includes psychiatric diagnosis, duration of service contact of two years...

  7. 4 Multimodal Acute Care
    (pp. 47-57)

    As hospital diversion programs serve greater numbers of severely mentally ill consumers, a practical framework is needed to help providers on all levels offer solid acute mental health care. Those who are entrusted to provide acute mental health care take on a tremendous responsibility, and their work can be very challenging. It is important that they act quickly and use effective strategies that can stabilize the person who is decompensating.

    In general, mental health professionals are primarily trained to help clients with the typical symptoms and impairments of their mental illness, and they receive less training in helping them during...

  8. 5 Fundamental Tools and Techniques
    (pp. 58-72)

    There are fundamental tools and techniques that can be used in the treatment of most conditions encountered by staff working in hospital diversion programs. These activities, which include various screenings, therapy techniques, and action plans, comprise the core intervention sequence for this text. Other, more diagnosis-specific, interventions will be discussed in the following chapters. The interventions are described below in the order they would typically be used during the course of treatment.

    As mentioned earlier, it is important to treat clients at a level that is appropriately aligned with one’s training and experience. Table 5.1 provides guidance on which interventions...

  9. 6 Schizophrenia and Schizoaffective Disorder
    (pp. 73-89)

    Schizophrenia is a potentially disabling condition characterized by delusions, hallucinations, negative affect, limited interest, and interpersonal difficulty. Individuals diagnosed with schizoaffective disorder may present with similar symptoms, but they have also experienced significant mood episodes (depression or mania). These clients are more likely to have impaired emotional functioning in addition to the psychotic symptoms, while clients diagnosed with schizophrenia often have impaired cognitive functioning. These are likely the clients that most mental health professionals and lay people think of when they hear the term “serious mental illness.”

    One of the best ways to understand the goal of treatment with psychotic...

  10. 7 Major Depression and Bipolar Disorder
    (pp. 90-105)

    Bipolar disorder typically involves a history of manic or hypomanic episodes (e.g., elevated, expansive, or irritable mood; inflated self-esteem; decreased need for sleep; pressured speech; excessive thrill seeking) and one or more major depressive episodes. Symptom presentations can vary, but the onset of mania is often marked by a mood that has either become exceedingly euphoric or extremely irritable. Medication is usually required to treat clients who experience a manic episode, while a combination of medication and psychosocial intervention is best for those experiencing a depressive episode.

    Major depressive disorder is one of the most commonly diagnosed psychiatric illnesses. The...

  11. 8 PTSD and Panic Disorder
    (pp. 106-128)

    Posttraumatic stress disorder and panic disorder are both anxiety disorders. This chapter focuses on both. Each section first highlights relevant information for PTSD and then shifts to panic disorder.

    PTSD can develop in response to several different kinds of trauma. For instance, being in a severe automobile accident, participating in military combat, witnessing a homicide or suicide, experiencing sexual or physical assault, and relentless societal oppression are included among the long list of precipitants. The traumatic event, or series of events, required the individual with PTSD to compensate for a lack of sufficient coping resources in ways that eventually altered...

  12. 9 Substance-Related Disorders
    (pp. 129-142)

    When assessing an individual with substance-related issues it is necessary to ask about mood, psychotic, anxiety, and other symptoms because substance abuse and other mental illnesses often occur together. When clients reports anxiety, it is important to ask about the concerns they have and whether their safety is in jeopardy. When a client is significantly depressed, the assessment should include a discussion about suicidal ideation and behavior. It can be difficult to determine if the client is actually experiencing two different conditions because cocaine and amphetamine use and the withdrawal from other substances can cause symptoms that might mimic anxiety,...

  13. 10 Important Treatment Considerations
    (pp. 143-160)

    Various issues that need to be considered when conducting acute psychiatric treatment are discussed in this final chapter. First, aspects of providing help to clients with a borderline personality disorder (BPD), or borderline traits, are reviewed. Next, some of the unique cultural perspectives regarding mental health treatment, as well as individual differences in treatment needs among varying ethnic groups, are described. Finally, the ways in which religion and spirituality can be important coping resources for some clients are presented.

    Many books and treatment manuals single out the borderline personality as a condition that is challenging for mental health service providers....

  14. APPENDIX A: Crisis Action Plan
    (pp. 161-165)
  15. APPENDIX B: Thought Change Worksheet
    (pp. 166-170)
  16. APPENDIX C: Stress-Vulnerability Model Diagrams
    (pp. 171-172)
    (pp. 173-206)
  18. INDEX
    (pp. 207-209)