Implementation of an ACT Curriculum on an Adolescent Inpatient Psychiatric Unit: A Quality Improvement Project
Pediatric psychiatric inpatient treatment serves an important function for youth in crisis or with serious emotional disorders. Fundamental to an inpatient unit’s program are the groups and activities scheduled throughout the day which help organize the patients’ time and also provide therapeutic socialization, creative and educational experiences. Evidence-based mental health interventions are available for child/adolescent treatment but there are few instances of their application in pediatric inpatient treatment. An interdisciplinary project team employed the quality improvement cycle to implement a series of Acceptance and Commitment Therapy (ACT) groups. To implement the largely staff-led groups the planning team developed group protocols and educational/development sessions with staff. The improvement was gauged by changes in parent/patient knowledge and satisfaction with group programming and changes on the Avoidance and Fusion Questionnaire for Youth (AFQ-Y); a measure which taps into psychological flexibility. Data collected over the course of a year indicated patient and parent knowledge of ACT principles increased as did their satisfaction with the group programming. Unit level data from three periods of collection indicate increases in adolescent’s time spent in groups, adoption of ACT language, improvement in AFQ-Y scores and increased parental knowledge of the unit’s treatment approach. The project demonstrates that it is possible to implement an evidence-based intervention and create a positive impact during brief inpatient treatment.
KeywordsInpatient psychiatric treatment Adolescents Acceptance and commitment therapy Quality improvement Inpatient groups
Author Kathleen Delaney has received research grants from the Patient Centered Outcomes Research Institute and HRSA. Health Resources and Services Administration (HRSA), 1D09HP02987-01–00. Advanced Education Nursing Grants. HRSA- D09HP09354. Advanced Education Nursing Grants. Patient Centered Outcomes Research Institute, Initial pilot grants in 2012- not numbered. None of the other authors have received grants.
M.M. collaborated with the design of study, implementation, data analysis and writing the final manuscript. D.T.B. assisted with the design of the study and data collection. J.F.H. collaborated in the design of the study, group implementation, data collection and editing of the final manuscript. S.M. collaborated with the design of the study, implementation and data collection. M.Mc.F. collaborated with the design, implementation, data collection, and analyses, K.R.D. collaborated with the design, data analysis and wrote the manuscript up to its final draft.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the parent institution and with the 1964 Helsinki declaration and its later amendments of comparable ethical standards. Institutional Review Board approval was obtained from Rush University Medical Center.
Since all data were de-identified the study was deemed minimal risk by the parent institution IRB and individual consents were not required.
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