We investigated the feasibility of implementing a recovery-oriented cognitive therapy (CT-R) milieu training program in an urban acute psychiatric inpatient unit. Over a 1-month period, 29 staff members learned short-term CT-R strategies and techniques in an 8-h workshop. Trainees’ perceptions of CT-R, beliefs about the therapeutic milieu, and attitudes about working with individuals with psychosis were evaluated both before the workshop and 6 months after the workshop had been completed. Incidents of seclusion and restraint on the unit were also tallied prior to and after the training. Results indicate that staff perceptions of CT-R and their beliefs about the therapeutic environment significantly improved, whereas staff attitudes towards individuals with psychosis remained the same. Incidents of seclusion and restraint also decreased after the training. These findings provide evidence that CT-R training is feasible and can improve the therapeutic milieu of an acute psychiatric inpatient unit.
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We would like to thank Kathryn Byars, Aaron Brinen, Ashley Chambers, Marion Conneen, Katie Daly, Sarah Farash, Jody Foster, Reed Goldstein, Samantha Goodin, Spencer Kostinsky, Kerry McCole, Dimitri Perivoliotis, Susan Rappaport, Zach Rosenberg, Eren Semen, and Tony Zapisek for their assistance with this project. Study results were presented at the 2012 annual meeting of the American Psychological Association, Orlando.
Conflict of interest
Drs. Grant and Beck have received royalties from Guilford Press. The remaining authors have no interests to disclose.
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Chang, N.A., Grant, P.M., Luther, L. et al. Effects of a Recovery-Oriented Cognitive Therapy Training Program on Inpatient Staff Attitudes and Incidents of Seclusion and Restraint. Community Ment Health J 50, 415–421 (2014). https://doi.org/10.1007/s10597-013-9675-6
- Milieu training
- Cognitive therapy