Last month, the inpatient adolescent psychiatric unit at John T. Mather Memorial Hospital in Port Jefferson, N.Y., introduced a patient care model that incorporates the collaborative problem-solving approach by Ross Greene, PhD, and the Substance Abuse and Mental Health Services Administration recovery wheel.
With an average length of stay of seven to 10 days, the inpatient unit treats adolescents ages 12 through 17 who cannot function in the community and are in the acute stages of a disorder, such as bipolar affective disorder, major depression or behavioral dysfunction.
“We’re building on what we have developed over the past 19 years, and our goal is to improve the quality of care with an evidence-based focus,” said Linda Hill, RN, MS, CS, staff nurse, adolescent psychiatry. “After we identify our patients’ lagging skills, we work with them through collaborative problem-solving to help them develop healthier ways of coping.”
According to SAMHSA, there are 10 components to mental health recovery — self-direction, individualization, empowerment, holism, nonlinear, strengths-based, peer support, respect, responsibility and hope. Using SAMHSA’s recovery wheel and Greene’s approach, Mather staff created a workbook containing thought-provoking questions that focus on patients’ emotions, concerns and possible solutions.
“Along with the workbook, we involve our patients in activities, such as individual and group sessions, art and recreation therapies, games and movies, which support our model,” said Eugenia Ercole-Fricke, RN, MS, MPS, psychiatric nurse educator on the unit.From left, standing, are Karen Tuzzolo, RN, surgical director; Angela Shapiro, RN; Phillip Messina, RN, ED director; Jennifer Zeman, RN; Mary Lee Schroeter, RN, Magnet director; Andrea Wohlenberg, RN; Marie Mulligan, RN, CNO; AnnaMarie Braslow, RN, bariatric coordinator; Kathleen Jochen, RN; and Jean Arnold, RN, nursing recruitment director. From left, sitting, are Teresa Pickel, RN, interim ED nurse manager; Mary Ellen Glennon, RN; Julia Macauley, RN, critical care nurse manager; Maryanne Wisniewski, RN; Megan Hickey, RN; and Brandy Feliu, RN, clinical instructor.
After Paul Fritz, MD, medical director, investigated adolescent psych programs, and staff visited the adolescent psych program at the Sheppard Pratt Health System in Baltimore, the interdisciplinary team — RNs, a recreational therapist, adolescent psychiatrists and social workers — worked together to adapt and facilitate the new program. Staff attended a six-hour webinar training from Greene and participated in in-service programs on the model and its application to the unit. The unit received a grant from the Island Outreach Foundation and will be attending a conference conducted by Greene in July in Portland, Maine.
In the near future, Hill, who is leading the initiative, and Ercole-Fricke plan to present educational seminars for parents on collaborative problem-solving. “It’s all about helping our patients and their families understand that the children’s behaviors are not bad or wrong, but rather they are behaviors that have developed as a result of lagging skills,” Ercole-Fricke said. “We look at and work on the whys for the behaviors. For example, if they are not performing well in school, we help them get the support they need.”