THE NEW PSYCHIATRY BY MY GUEST BLOGGER

And, where clients are well enough to engage with “talking therapies”, the “going through” process can be facilitated with specialist support such as Life Skills Training, Group Therapy, Loss and Bereavement Counselling, Trauma Therapy, Schema Therapy, Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT), but I will say more about these methods below.

Therapeutic and Anti-Therapeutic Environments

An environment is therapeutic only if it is homely, only if it’s staffed by people who are thoroughly humanitarian and friendly, and only if client needs are met to the satisfaction of a sizeable majority of the clients for most of the time.

In a therapeutic environment, self-help should be facilitated as much as possible, but everyone’s frustrations should be managed well, and no one should be left “in limbo” for extended periods of time (not leaving someone “in limbo” meaning that when the client sees a need for a “way forward” with an important and/or urgent matter, he or she is not left getting more agitated for any significant period of time with no way forward).

Anti-therapeutic environments are environments that, apart from not meeting the above specifications, are staffed by people with agendas that serve some or many things other than client interests.  Such environments are damaging in that they can easily entrench existing “psycho-social health problems” and problems of “emotional disturbance”, and/or make matters a lot worse for clients with such problems.

Therapeutic and Anti-Therapeutic Staff Interventions

Excessive seclusion is “an abomination before the Lord”, doing much more harm than good.  Seclusion in isolation should definitely be used only until “unmanageable derangement” has subsided for around 5 to 10 minutes, and should be followed by “seclusionwith the company of a single member of the staff team who is up for the job of “talking the client down” into a place where the “seclusion” can be ended, with PRN “medication” being given “as part of the deal”, but only with the consent of the client.

Ideally, “restraint” (legalised assault{?}, especially if injury results) should only be used when a client is so clearly “unmanageable” that “restraint” is seen as necessary to get the client into seclusion.

 

 

 

 

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