Some characteristics of effective psychiatric treatment programs

• Published in: Journal of consulting and clinical psychology 1979-10, Vol.47 (5), p.799-817
• Main Author: Ellsworth, Robert B
• Format: Article
• Language: English
• Subjects: Adult; Health Facility Environment; Human; Humans; Male; Middle Aged; Milieu Therapy; Neurotic Disorders - therapy; Outcome and Process Assessment (Health Care); Psychiatric Department, Hospital; Psychiatric Hospital Programs; Psychiatric Hospitals; Psychotic Disorders - therapy; Social Environments; Substance-Related Disorders - therapy; Treatment Effectiveness Evaluation; United States
• ISSN: 0022-006X; 1939-2117
• DOI: 10.1037/0022-006X.47.5.799

Describes a VA cooperative study seeking to identify the ward milieu characteristics of effective psychiatric programs. It is the largest study undertaken so far in terms of number of programs (79), patients (21,667), characteristics examined (191), and adequacy of outcome measures used to estimate program effectiveness. It was performed as a multivariable, correlational natural history study. Differences in characteristics of patients treated in each program were controlled statistically, and a cross-validation design and multiple outcome measures were used to make spurious findings less likely. Program variables were divided into treatment and setting characteristics, or those characteristics that the staff did and did not have control over. Since the most promising treatment characteristics are to be used in a blind follow-up to this study, this article deals mainly with the setting variables. The major finding reported here is that patients admitted to and treated on wards in which a mixture of acute and chronic patients were being treated had better outcomes than patients treated on wards with a more narrowly defined patient population. (30 ref)