140 CHAPTER 4
Inpatient Treatment
Inpatient treatment is the term for treatment that occurs while a patient is in a
psychiatric hospital or in a psychiatric unit of a general hospital. This is the most
intensive level of treatment and is provided in two main circumstances: (1) when
individuals, because of a psychological disorder, are believed to be at risk of harming
themselves or another person (or have already done so); and (2) when individuals
do not appear able to take adequate care of themselves. The initial goals of hos-
pitalization are to ensure the patients’ safety, the safety of others, and reduce the
intensity or frequency of the patients’ symptoms.Partial Hospitalization
Partial hospitalizationconsists of treatment provided at a hospital or other facility,
but the patient does not sleep there; such treatment is more intensive than what is
available through once-a-week outpatient visits, but is less intensive than the treat-
ment received through hospitalization. Partial hospitalization is appropriate for
people who are not actively dangerous to themselves or others, and such programs
may last from 2 to 12 hours daily. Day treatment programs andevening programs
are examples of partial hospitalization. Such programs often provide many different
kinds of group therapy and teach skills for coping with symptoms such as delusions,
feelings of hopelessness, or continued bingeing and vomiting. These programs also
provide an opportunity for patients to discuss problems and concerns they have
with specifi c medications, such as how to minimize side effects.Residential Treatment
Residential treatment consists of staying in a staffed facility where patients sleep,
eat breakfast and dinner, and perhaps take part in evening groups. Typically
patients must go elsewhere during the day, such as to a partial hospitalization pro-
gram, school, or work. Residential treatment is for people who do not need the
intensity of inpatient care, but nonetheless need supervised care during the evening
and night.Self-Help
Some people choose to attend self-help groups, either as a supplement to their ther-
apy or instead of therapy. Like group therapy, self-help groups (sometimes referred
to as support groups) tend to focus on a particular problem or disorder. Self-help
groups generally do not have a leader who is clinically trained, although a mental
health professional may sometimes advise the group (Shepherd et al., 1999).
The fi rst popular self-help program was Alcoholics Anonymous (AA), which is
still widely used. AA is designed around a 12-step process of recovery from alcohol-
ism and a belief in a “higher power” (for most participants, God), which, according
to AA, is crucial to the recovery process. Most other 12-step programs, such as
Narcotics Anonymous, follow this model.
There are other self-help programs that use a different approach, however, such
as that of the Depression and Bipolar Support Alliance, which serves people suffer-
ing from depression or bipolar disorder and their friends and families. This program
provides education about the disorders and holds groups for patients where they
can learn from and support one another. Like the Depression and Bipolar Support
Alliance, self-help organizations may also offer information and support groups for
friends and family members (Citron, Solomon, & Draine, 1999). If a member wants
the services of a mental health clinician, a self-help organization often can provide
the names of therapists in the community who are experienced in treating people
with a given disorder.
Like group therapy, self-help groups can diminish feelings of shame and isola-
tion, as well as provide support and valuable information. However, sometimes the
lack of a trained leader may lead to negative group interactions that go unchecked.Inpatient treatment
Treatment that occurs while a patient is in a
psychiatric hospital or in a psychiatric unit of
a general hospital.
Partial hospitalization
Treatment is provided at a hospital or other
facility, but the patient does not sleep there.
Residential treatment
Treatment in which patients stay in a staffed
facility where they sleep, eat breakfast and
dinner, and perhaps take part in evening
groups.