Anxiety Depression In-Patient
Understanding the hospital's Roll in Treatment:
1. Emphasize a "resident" rather than "patient" status
through informal dress of staff; open channels of communication
in all directions and broad (but clear)
authority structure.
2. Make clear through a set of rules and attitudes that
the residents are responsible human beings are expected
to follow certain minimal rules of group living
and are expected to do their share in participating in
self-care work recreational and social activities.
3. Utilize step systems which gradually increase the expectations placed
on the residents in terms of their degree
of independence and level of responsibility with community
return emphasized from the outset.
4. Encourage social interactions and skills and provide a
range of activities as well as regular large and small
group meetings.
5. Emphasize clarity of communication with concrete instruction
in appropriate behavior and focus on utilitarian
"action" rather than "explanation."
6. Provide opportunity to practice vocational and housekeeping
skills with feedback and specific training in
marketable skills when needed.
7. Reacquaint residents with the "outside world" by exposing
them to the community and bringing in community
volunteers for discussions.
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Treatments:
1- Electro-convulsive therapy (ECT).
These patients were
given ECT three times a week. The frequency was
decreased if the patient showed severe confusion or
memory loss. The average number of treatments'
was 19 for males and 25 for females.
2-Drug therapy
These patients were given antipsychotic
drugs (either trifluoperazine or chlorpromazine).
3- Individual psychotherapy
Patients in this group received
support therapy aimed at fostering a better
awareness of reality. This therapy' varied according
to the characteristics of the patient and the therapist.
Relatively little' emphasis -was placed on in-depth
interpretation; the primary focus was on working
through the patient's current problems. The number
of interview ranged from 12 to106.
4. Individual psychotherapy plus drug therapy.
Each patient in this group received both psychotherapy and
a drug. One measure of the success of a hospital program
is its discharge rate. In the Camarillo study, not all of
the subjects showed sufficient improvement to allow release.
Considering only those who were successfully released,
we find that the drug-alone, ECT, and psychotherapy-
plus-drug groups had mean hospital stays of
130, 135, and 138 days, respectively. The average stay
of the, psychotherapy-alone group was 185 days, while
the average for the milieu group was 163 days. Among
the unimproved patients, the psychotherapists persisted
much longer before giving up than clinicians using
other forms of treatment, both successfully and
unsuccessfully treated cases were combined, the drug alone
treatment was highly superior in shortening hospital
stay. Only two drug-alone patients were not improved
enough to be discharged.
In the Camarillo study, the drug-alone and psychotherapy-
plus-drug approaches provided the best
treatments for the average schizophrenic admitted to
that state hospital. There were no substantial differences
in effectiveness between these two groups. ECT was less
effective than either the drug alone or psychotherapy
plus drug treatments. Least effective of all were the psychotherapy
and milieu approaches. A follow-up carried
for several years after completion of the research suggested
that the same pattern of results had persisted
(May and others, 2011).
Even though the Camarillo project appears to argue
strongly for the use of antipsychotic drugs with
schizophrenics, not all of the results can be interpreted
so readily. Psychotherapy alone may indeed be ineffective
with hospitalized schizophrenics; however, its ineffectiveness
may have been due to the particular forms or
styles of psychotherapy used at Camarillo. Or perhaps'
the frequency of the psychotherapeutic sessions was too
low. One uncontrolled factor was the variability of the
approaches used by the psychotherapists. Perhaps, it is
significant that patients in the psychotherapy-alone condition
had fewer, but longer, contacts with their doctors
than patients in the other conditions. The apparent failure
of the psychotherapy and milieu conditions may
have been due to failures of the particular methods used
at Camarillo and not to inherent weaknesses in these
approaches.
A methodological weakness of the Camarillo study
is the fact that it could not use a blind or double-blind
technique. Thus, there is a limit to the extent to which
the results can be generalized for anxiety and depression.
Nevertheless, the results
provide a practical basis for using drugs to improve the
functioning of schizophrenics, together with a caution
against assuming that psychotherapeutic and milieu approaches
are always effective. Recent evidence suggests
although psychotherapy without drugs may not
yield favorable results within the hospital, the picture is
different after patients have been discharged. Psychotherapy
seems to play a positive role after discharge
(Davis, 2005). Perhaps the main effect of drugs is to.
alleviate symptoms and disordered thought while psychological
interventions improve the patients' interpersonal
functioning so that they are- more likely to stay out
of the hospital for anxiety and depression.
Looking for Anxiety or Depression treatment?
If you are ready to schedule a FREE Consultation...
I encourage you to access this website
for the Anxiety and Depression treatment I recommend here:
http://www.TheLiberatorMethod.com/
1. Emphasize a "resident" rather than "patient" status
through informal dress of staff; open channels of communication
in all directions and broad (but clear)
authority structure.
2. Make clear through a set of rules and attitudes that
the residents are responsible human beings are expected
to follow certain minimal rules of group living
and are expected to do their share in participating in
self-care work recreational and social activities.
3. Utilize step systems which gradually increase the expectations placed
on the residents in terms of their degree
of independence and level of responsibility with community
return emphasized from the outset.
4. Encourage social interactions and skills and provide a
range of activities as well as regular large and small
group meetings.
5. Emphasize clarity of communication with concrete instruction
in appropriate behavior and focus on utilitarian
"action" rather than "explanation."
6. Provide opportunity to practice vocational and housekeeping
skills with feedback and specific training in
marketable skills when needed.
7. Reacquaint residents with the "outside world" by exposing
them to the community and bringing in community
volunteers for discussions.
~~~~~~~~~~~~~~~~~~~~~~~~~~~
Treatments:
1- Electro-convulsive therapy (ECT).
These patients were
given ECT three times a week. The frequency was
decreased if the patient showed severe confusion or
memory loss. The average number of treatments'
was 19 for males and 25 for females.
2-Drug therapy
These patients were given antipsychotic
drugs (either trifluoperazine or chlorpromazine).
3- Individual psychotherapy
Patients in this group received
support therapy aimed at fostering a better
awareness of reality. This therapy' varied according
to the characteristics of the patient and the therapist.
Relatively little' emphasis -was placed on in-depth
interpretation; the primary focus was on working
through the patient's current problems. The number
of interview ranged from 12 to106.
4. Individual psychotherapy plus drug therapy.
Each patient in this group received both psychotherapy and
a drug. One measure of the success of a hospital program
is its discharge rate. In the Camarillo study, not all of
the subjects showed sufficient improvement to allow release.
Considering only those who were successfully released,
we find that the drug-alone, ECT, and psychotherapy-
plus-drug groups had mean hospital stays of
130, 135, and 138 days, respectively. The average stay
of the, psychotherapy-alone group was 185 days, while
the average for the milieu group was 163 days. Among
the unimproved patients, the psychotherapists persisted
much longer before giving up than clinicians using
other forms of treatment, both successfully and
unsuccessfully treated cases were combined, the drug alone
treatment was highly superior in shortening hospital
stay. Only two drug-alone patients were not improved
enough to be discharged.
In the Camarillo study, the drug-alone and psychotherapy-
plus-drug approaches provided the best
treatments for the average schizophrenic admitted to
that state hospital. There were no substantial differences
in effectiveness between these two groups. ECT was less
effective than either the drug alone or psychotherapy
plus drug treatments. Least effective of all were the psychotherapy
and milieu approaches. A follow-up carried
for several years after completion of the research suggested
that the same pattern of results had persisted
(May and others, 2011).
Even though the Camarillo project appears to argue
strongly for the use of antipsychotic drugs with
schizophrenics, not all of the results can be interpreted
so readily. Psychotherapy alone may indeed be ineffective
with hospitalized schizophrenics; however, its ineffectiveness
may have been due to the particular forms or
styles of psychotherapy used at Camarillo. Or perhaps'
the frequency of the psychotherapeutic sessions was too
low. One uncontrolled factor was the variability of the
approaches used by the psychotherapists. Perhaps, it is
significant that patients in the psychotherapy-alone condition
had fewer, but longer, contacts with their doctors
than patients in the other conditions. The apparent failure
of the psychotherapy and milieu conditions may
have been due to failures of the particular methods used
at Camarillo and not to inherent weaknesses in these
approaches.
A methodological weakness of the Camarillo study
is the fact that it could not use a blind or double-blind
technique. Thus, there is a limit to the extent to which
the results can be generalized for anxiety and depression.
Nevertheless, the results
provide a practical basis for using drugs to improve the
functioning of schizophrenics, together with a caution
against assuming that psychotherapeutic and milieu approaches
are always effective. Recent evidence suggests
although psychotherapy without drugs may not
yield favorable results within the hospital, the picture is
different after patients have been discharged. Psychotherapy
seems to play a positive role after discharge
(Davis, 2005). Perhaps the main effect of drugs is to.
alleviate symptoms and disordered thought while psychological
interventions improve the patients' interpersonal
functioning so that they are- more likely to stay out
of the hospital for anxiety and depression.
Looking for Anxiety or Depression treatment?
If you are ready to schedule a FREE Consultation...
I encourage you to access this website
for the Anxiety and Depression treatment I recommend here:
http://www.TheLiberatorMethod.com/