Cognitive Therapy with Inpatients: Developing a Cognitive Milieu

Over the past decade, cognitive therapy principles originally developed for outpatients have been successfully adapted for use with more severely ill, hospitalized patients. Noted for its cogent theoretical formulations, replicable procedures, and documentation of outcome--all features that are highly desirable on inpatient units--cognitive therapy also has the advantage of a short-term format, a critical factor in the face of escalating health care costs. COGNITIVE THERAPY WITH INPATIENTS, the first volume to describe the development of a "cognitive milieu," is a practical manual that describes effective cognitive strategies and procedures for short-term psychiatric hospitalization.

The book begins with an overview of the basic concepts of cognitive therapy and hospital psychiatry. Detailed instructions are given for developing and maintaining different types of inpatient cognitive therapy units. Using a "step-by-step" approach, the authors demonstrate how the cognitive milieu can be adapted to fit the needs of a wide variety of treatment settings. Extensive illustrations, including actual dialogued of treatment interactions, are used to describe interventions. Pragmatic advice is given for application in individual, group, and family formats.

The volume also offers indepth coverage of the theoretical and practical issues involved in combining cognitive therapy with pharmacotherapy. Asserting that the fusion of these models enhances both forms of treatment--and stressing the importance of interdisciplinary teamwork in effective hospital care--the book describes methods of building effective treatment teams and devotes particular attention to the functions of psychiatric nurses. Techniques are identified for maximizing the chances of good outcome while minimizing the risk of relapse. In addition, special applications for treatment of adolescent inpatients, alcohol and substance abuse, eating disorders, geropsychiatry, and chronic patients are discussed.

Designed as a treatment guide for all professionals who work in hospital settings, this unique volume is a valuable resource for psychiatrists, psychologists, social workers, occupational therapists, and nurses. It also serves as a text for graduate courses in cognitive therapy, psychiatry residency training programs, psychology doctoral programs, and graduate programs in psychiatric nursing.
 

Jesse H. Wright, Norton Psychiatric Clinic , Louisville Ky. 

Aaron T. Beck, MD, is the founder of cognitive therapy, University Professor Emeritus of Psychiatry at the University of Pennsylvania, and President Emeritus of the Beck Institute for Cognitive Behavior Therapy. Dr. Beck is the recipient of numerous awards, including the Albert Lasker Clinical Medical Research Award, the American Psychological Association (APA) Lifetime Achievement Award, the American Psychiatric Association Distinguished Service Award, the Robert J. and Claire Pasarow Foundation Award for Research in Neuropsychiatry, and the Institute of Medicine's Sarnat International Prize in Mental Health and Gustav O. Lienhard Award.