International journal of partial hospitalization最新文献

A simple step-by-step plan for organizing and developing a computerized data base in a psychoeducational day-treatment program for children and adolescents is described. The plan is purposefully limited and simple in conception so that it can be replicated in freestanding and/or smaller programs, those who might not have the resources available when affiliated with a hospital or university. The article stresses the need for programs to make the commitment to begin a system of data collection. A table indicating measures and collection times is included.

Health-care professionals are currently operating in the context of a rapidly changing health-care delivery system, including the move away from inpatient services to outpatient services in order to control costs. Those who practice in partial-hospital settings are in a position to offer effective, cost-efficient services; however, there continue to be obstacles which hinder appropriate utilization of the modality. The development and use of a well-designed marketing plan is one strategy for removing these obstacles. This paper presents a brief overview of the marketing process, ideas for developing a marketing plan, and several examples of specific marketing strategies as well as ways to monitor their effectiveness. Partial-hospital providers must take an active role in answering the calls for alternative sources of psychiatric care. A comprehensive, education-oriented marketing approach will increase the public's awareness of such alternatives and enable programs to survive in a competitive environment.

We attempted to predict improvement during day psychiatric treatment by the use of content analysis of 5-min verbal samples obtained at the time of admission of 62 children. As predictors we used verbal sample scales of Hope, Human Relations, and Cognitive Impairment. As outcome measures we used changes on the Severity Level, Aggression, Inhibition, Neurotic, Rare Deviance, and Academic Scales of behavior checklists. We also divided the total group of children into groups classified as organically impaired and not organically impaired by use of neurobehavioral signs. We discovered that verbal sample analysis was only a modestly accurate predictor of improvement, that the Cognitive Impairment Scale was the best predictor, and that it predicted best with not organically impaired children.

This article reports on a study which reviewed the utilization of six adult psychiatric day hospitals in a Canadian urban region. The study looks at the utilization of services through the examination of clinical service staffing patterns, accessibility, and gaps in service. It is hoped that this comprehensive overview will promote the establishment of standards and guidelines for psychiatric day-hospital services and further enhance the overall planning for psychiatric services in the region.

An increasing number of short-term partial-hospital programs are being created as alternatives to standard inpatient care in the treatment of acutely ill patients. Despite this increase, both referring clinicians and partial-hospital staff are often unclear about the capabilities and limitations of such programs. The purpose of this study was to clarify the clinical functions of a short-term partial hospital within a comprehensive system of care. The findings include a description of the five functions identified for the program under study and a review of the process by which these clinical functions were accomplished over the partial-hospital stay. Implications of the findings for program planning, patient selection, and clinical training are discussed.

An innovative day-treatment program designed to reduce the likelihood that severely disturbed, older adolescents will become chronically ill young adults is described and clinical vignettes are presented which illustrate the program's effectiveness in facilitating educational achievement and enhanced social functioning among patients with significant histories of hospitalization and substance abuse.

AYC (Arizona Youth for Change) is the result of a joint venture between two of the leading adolescent service providers in inpatient and residential (long-term) care in the Southwest. Youth Health Resources, Inc., the corporate identity, focuses in the area of alternative treatment for adolescents. Components of the AYC programs are discussed, as well as some statistical data regarding the outcome of treatment. Also addressed are trends in the mental-health community, as well as the use of a "continuum-of-care" model.

The purpose of the current study was to examine patients' attitudes and their effects on treatment outcome in a partial-hospitalization program (PHP). Sixty-nine consenting PHP patients were administered the Symptom Checklist-90-R (SCL-90-R) and the Colorado Psychiatric Hospital Factor Attitude Scale (CPH) before and after treatment. Four groups were delineated: completed PHP, left against medical advice, did not show, and discharged to unit. Data were analyzed using a 2 x (2) ANOVA. The hypothesis that unfavorable attitudes would improve significantly by posttest was supported. However, there is no suggestion that attitude can predict treatment outcome. Implications for future research are discussed.

This paper explores the multiple uses of a psychiatrist-conducted educational group for patients on psychopharmacotherapy. The advantages of such an approach are considered from the viewpoint of the psychiatrist, the patients, and the nonmedical staff. Model answers to questions of particular concern to group members are examined.

This paper describes a complex treatment system which serves a large urban population with a very small number of inpatient beds. From its very outset, the South Beach Psychiatric Center, a state facility in New York City, was determined to treat its patients with minimal use of inpatient bed occupancy. As a result, it started with a large outpatient program, in which day hospitals played a critical role. The aim was to treat patients on their home turf and, thus, to limit inpatient bed use to the period when the patient was out of control and a danger to self or others. Partial-hospitalization (PH) literature is replete with articles about utilization and underutilization [see Kennedy, L. L., A Bibliography on Partial Hospitalization, American Association for Partial Hospitalization (AAPH), Washington, D.C., 1986, pp. 1-70; Proceedings of the Annual Conference on Partial Hospitalization, Washington, D.C., 1976-1986; Wilner, M. (ed.), AAPH Newsletter, AAPH, Washington, D.C.] There are many discussions about the appropriate use of the PH program, how to get the program reimbursed, and how to get referrals to the program. Often, a pragmatic, although inefficient and sometimes very wrong, decision is made that, in the absence of a proper choice of treatment modalities, one judges the best referral to be the one that is available. South Beach therefore presents a useful study because it has a very wide range of treatment modalities: inpatient acute, intermediate, and chronic beds, admitting services, clinics, day hospitals (adolescent, adult, geriatric, acute, chronic), varieties of residences including quarter-way housing and supervised and unsupervised apartments, etc.(ABSTRACT TRUNCATED AT 250 WORDS)