Cognitive Therapy with Inpatients: Developing A Cognitive Milieu

Overview

Cognitive Therapy with Inpatients, the first volume to describe the development of a "cognitive milieu," is a practical manual that describes effective cognitive strategies and procedures for short-term psychiatric hospitalization.

The book begins with an overview of the basic concepts of cognitive therapy and hospital psychiatry. Detailed instructions are given for developing and maintaining different types of inpatient cognitive therapy units. Using a "step-by-step" approach, ...

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Overview

Cognitive Therapy with Inpatients, the first volume to describe the development of a "cognitive milieu," is a practical manual that describes effective cognitive strategies and procedures for short-term psychiatric hospitalization.

The book begins with an overview of the basic concepts of cognitive therapy and hospital psychiatry. Detailed instructions are given for developing and maintaining different types of inpatient cognitive therapy units. Using a "step-by-step" approach, the authors demonstrate how the cognitive milieu can be adapted to fit the needs of a wide variety of treatment settings. Extensive illustrations, including actual dialogue of treatment interactions, are used to describe interventions. Pragmatic advice is given for application in individual, group, and family formats.
The volume also offers indepth coverage of the theoretical and practical issues involved in combining cognitive therapy with pharmacotherapy. Asserting that the fusion of these models enhances both forms of treatment--and stressing the importance of interdisciplinary teamwork in effective hospital care--the book describes methods of building effective treatment teams and devotes particular attention to the functions of psychiatric nurses. Techniques are identified for maximizing the chances of good outcome while minimizing the risk of relapse. In addition, special applications for treatment of adolescent inpatients, alcohol and substance abuse, eating disorders, geropsychiatry, and chronic patients are discussed.

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Editorial Reviews

From the Publisher

"All of us who work in inpatient psychiatry have wondered how best to reorganize our units in response to ever-shortening lengths of stay and demands for increased efficiency and efficacy. This book provides an answer that I found complete and compelling. Cognitive theory and practice are the perfect complement to an inpatient medical model . The various chapters provide the rationale and nuts and bolts for creating a cognitively informed milieu and applying cognitive therapy to the special needs of different types of inpatients. My guess is that this book will become a powerful influence on inpatient psychiatry." --Allen Frances MD, Chair of Psychiatry, Duke University

"With the growing importance of short-term treatment, even for severely ill patients, this volume is an extremely rich, clinically valuable guide to the cognitive treatment of inpatients with diverse psychiatric conditions and to the development of a cognitive inpatient milieu. It draws on years of actual inpatient treatment experience and addresses such practical issues as how to conduct group or family cognitive therapy, cognitive treatment of general medical patients, elderly depressed alcoholic, eating disordered, and chronically ill patients. This book provides a guide for the roles of the therapist, physician, nurse, and occupational therapists. The case vignettes make it both extremely informative and easy to read. This volume provides a coherent, synthetic approach to inpatients using the cognitive model and techniques. It should be essential reading for all disciplines involved in inpatient care." --A. John Rush, MD, University of Texas Southwestern Medical Center at Dallas

"An excellent book which will be indispensable to anyone wishing to apply cognitive therapy in inpatient settings. The authors provide admirably clear accounts of how to create a cognitive milieu; train staff; identify suitable patients; monitor progress; and use the techniques of cognitive therapy with the wide range of populations and problems seen in inpatient psychiatry. Full of clinical illustrations and sound advice, this book offers a much needed and exciting new perspective for working with inpatients." --David M. Clark, D.Phil. Oxford University

"Cognitive therapy in inpatient psychiatry increasingly makes sense, given its demonstrated efficacy in outpatient clinical trials and beginning evidence of efficacy with inpatients, its comprehensibility to staff from a variety of disciplines, and its short-term, target-focused nature that fits well with the current movement toward decreased length of stay. This approach is likely to be increasingly used, and the present volume can serve as an extremely valuable handbook for the development of cognitive therapy inpatient programs. I now that I will rely on it heavily in training psychology interns and psychiatry residents." --Clive J. Robbins, Ph.D., Duke University Medical Center, in a review for Depression

"An excellent book which will be indispensable to anyone wishing to apply cognitive therapy in inpatient settings. The authors provide admirably clear accounts of how to create a cognitive milieu; train staff; identify suitable patients; monitor progress; and use the techniques of cognitive therapy with the wide range of populations and problems seen in inpatient psychiatry. Full of clinical illustrations and sound advice this book offers a much needed and exciting new perspective for working with inpatients." --David M. Clark, Oxford University
 

Psychotherapy and Psychosomatics

"Definitely an interesting book....Provides new clinical insights for those who work in hospital settings....Worthy of attention."--Psychotherapy and Psychosomatics
Innovations & Research

"Cognitive Therapy with Inpatients is a clearly written, comprehensive presentation of both the theoretical foundations and practical applications of this approach with more severely ill patients...Clinicians and family members alike will value the cogent presentations of theoretical issues along with clear examples of how CT can be applied within different modalities with a wide range of patient populations...In clear, practical terms the book then describes the use of CT with inpatients individual, group, and family modalities...The editors are not interested in merely putting forth a theoretical model. Rather, they've put together what is in effect a concise, highly accessible manual of cognitive therapy...The volume is, therefore, a valuable manual for clinicians interested in expanding their treatment strategies as well as family members who want to learn more about the development of hospital psychiatry and the efficacy of cognitive therapy....a valuable contribution to the treatment of severely ill people."--Innovations & Research
Hospital and Community Psychiatry

"Although cognitive therapy has been used extensively with outpatients, this book is the first programmatic description of its use in inpatient settings....The proliferation of inpatient cognitive therapy units speaks to the timeliness of this text. There is clearly a need to systematically develop and assess the psychotherapeutic interactions that form the basis of the inpatient milieu. These descriptions of inpatient cognitive therapy are a major advance toward this end."--Hospital and Community Psychiatry
Booknews
A series of papers discuss the increasing use of cognitive therapy (CT) in the hospital environment, and consider several treatment modalities, the biomedical interface, special applications, and guidelines for education and relapse prevention. With short-term stays and rising costs crowding treatment possibilities, cognitive therapy emerges as the Jiffy Lube of psychiatric care. Appends a listing of international inpatient CT programs. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

  • ISBN-13: 9780898628906
  • Publisher: Guilford Publications, Inc.
  • Publication date: 11/25/1992
  • Edition number: 1
  • Pages: 464
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.19 (d)

Meet the Author


Jesse H. Wright, Norton Psychiatric Clinic , Louisville Ky. 

Aaron T. Beck, MD, is University Professor Emeritus of Psychiatry, School of Medicine, University of Pennsylvania, and the founder of cognitive therapy. He has published more than 20 books and over 540 articles in professional and scientific journals. Dr. Beck is the recipient of numerous awards, including the Albert Lasker Clinical Medical Research Award, the American Psychological Association Lifetime Achievement Award, the American Psychiatric Association Distinguished Service Award, the Robert J. and Claire Pasarow Foundation Award for Research in Neuropsychiatry, and the Institute of Medicine's Sarnat International Prize in Mental Health and Gustav O. Lienhard Award. He is President of the Beck Institute for Cognitive Behavior Therapy and Honorary President of the Academy of Cognitive Therapy.

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Table of Contents

Pt. I General Principles of Inpatient Cognitive Therapy
Ch. 1 Overview of Cognitive Therapy 3
Ch. 2 Hospital Psychiatry in Transition 35
Ch. 3 The Cognitive Milieu: Structure and Process 61
Pt. II Treatment Modalities
Ch. 4 Individual Cognitive Therapy with Inpatients 91
Ch. 5 Group Cognitive Therapy with Inpatients 121
Ch. 6 Inpatient Family Therapy
Pt. A Inpatient Family Treatment: General Principles 154
Pt. B Family Cognitive Therapy with Inpatients 176
Pt. III The Biomedical Interface
Ch. 7 Cognitive and Biological Therapies: A Combined Approach 193
Ch. 8 Cognitive Therapy with Medical Patients 219
Ch. 9 The Role of the Nurse in the Cognitive Milieu 247
Pt. IV Special Applications
Ch. 10 Adolescent Inpatient Treatment 273
Ch. 11 Cognitive Therapy with Depressed Elderly Inpatients 295
Ch. 12 Cognitive Therapy of Alcoholism 315
Ch. 13 Cognitive Therapy for Eating Disorders 337
Ch. 14 The Chronic Patient 357
Pt. V Education and Relapse Prevention
Ch. 15 Staff and Patient Education 393
Ch. 16 Transition and Aftercare 414
Appendix. Inpatient Cognitive Therapy Programs 436
Index 439
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