This essay examines the role that milieu therapy plays with the acute inpatient environment. It’s purpose is to further examine my own practice and the frameworks in which milieu is used. Milieu therapy was chosen as practicing clinicians were observed to understand very little of what it is, myself included. The primary literature used is based on the work by Jones, Gunderson and Peplau. Current literature still relays very heavily on these works. This draws profoundly on the concept of the therapeutic community. The essay explores my own personal experiences in relation to the milieu and how I may use it to create a therapeutic environment. It then examines and discusses the history, theories, frameworks and interventions of milieu therapy. The milieu is all encompassing and a very powerful tool in acute inpatient settings. It is a framework from which other therapies can work within. The milieu is very broad and powerful yet poorly understood in the current social climate. The basic principles provided by the milieu are essential in the acute inpatient environment but poorly practiced. Further research need to be undertaken to understand the frameworks set out by Jones and Gunderson to align them with current social trends.
19
2008
The Critical Demand Index
The Critical Demand Index (CDI) is a tool designed to provide an
indicative measure of the varying acuity levels of the population
presenting to and using health services. The CDI establishes a
relationship between the number of people presenting and the degree of
acuity of their presenting condition. The relationship when represented
as a score provides an index reference point for acute patient demand
that permits relative comparisons to be made.
15
2008
Solution Focused Brief Therapy in acute in-patient units
Abstract: Solution Focused Brief Therapy (SFBT) aims to provide both the nurse/therapist and client with a short purposeful interaction designed to establish useful solutions and goals in the clients current situation. The purpose of this essay is to examine the efficacy of SFBT for use by nursing staff within the acute inpatient environment. The literature used in this essay ranges from the initial work conducted be De Shazer(1985,1988), through to current literature concerning examinations of SFBT in current inpatient settings. The premise for this investigation was to further research a relevant intervention which was highlighted in an earlier essay. Varying databases and literature have been searched using the search terms “Solution Focused Brief Therapy”, “SFBT”, “Solution Focused Brief Therapy acute inpatient” and “Solution Focused Brief Therapy nursing”. SFBT does offer the nurse and client a fast therapeutic intervention that can be completed in an environment that fosters a rapid turnover of clients. SFBT is an effective therapeutic intervention that is reported to have up to an 70-80% positive outcome in a minimum number of sessions. It requires minimal training and is a cost effective method of delivering quality care within a brief time frame.