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Inpatient Treatment

An innovative inpatient program at Yale New Haven Psychiatric Hospital (YNHPH) makes weekday mornings a busy time. That’s when many of the adult patients in the hospital’s four different care units are allowed to choose which group-therapy session to attend that morning. They can opt for the one held just for patients in their unit or for one of two specialized “Treatment Mall” groups that include patients from all four units: general adult, dual diagnosis (psychiatric and substance abuse), adolescent and geriatric.

“We want to be able to provide specialized treatment to all patients, regardless of which unit they are in,” says Beth Klink, LCSW, the hospital’s Assistant Director of Clinical Affairs. “Through the Treatment Mall program, we offer two groups simultaneously so that the patients can select which group best meets their needs, as opposed to us prescribing which group they go to based on what we think they need.”

Launched in May 2011, the unique Treatment Mall initiative grew out of reacting to feedback elicited from routinely administered patient-satisfaction surveys. “They told us they wanted several things,” Klink reports, “such as more privacy in treatment groups, more time off the unit and access to more sophisticated groups.” Using that information, YNHPH developed two new treatment groups in addition to the existing groups within each unit. One provides specialized substance-abuse treatment; the other offers dialectical behavioral therapy, which emphasizes the value of a strong and equal relationship between patient and therapist.

“We start each day with a check-in, during which we ask patients how they’re doing and what they would like to focus on in group treatment that morning,” says Sandra Daignault, LCSW, the clinician who conducts the Treatment Mall’s substance-abuse group. “The patients decide on a daily basis whether they want to attend one of the two specialized groups.”

Based on those discussions, the clinicians put together discussion topics for each day’s groups. “We allow for a lot of autonomy,” Daignault explains, “because sometimes in those morning organizational meetings, we build a good sense of community. We don’t impose what we think would be a rigid structure to follow.”

The Treatment Mall brings together patients who might not otherwise interact. “We find that they’re people of similar motivational levels,” Daignault says. “This program allows for people with common goals to come together, and they enjoy that opportunity.”

The patients also appreciate the staff’s willingness to let them have an active voice in their own treatment. “In surveys, patients mention the level of respect they feel in being allowed to drive the treatment, and us responding, rather than the other way around,” Klink states.

The Treatment Mall is indicative of the patient-centered care that has become the treatment model philosophy at YNHPH. “We’re willing to think out of the box and deliver exactly what people need,” Daignault says. “We have a short-term care program, between seven and ten days, and we don’t want anyone to leave without having their needs met or having coping skills they can utilize afterward for their particular situation. That’s our job and obligation to people.”