There is evidence that group cognitive behavioural therapy for psychosis (CBTp) is an effective treatment, but much of this research has been conducted with outpatient populations. The aim of this review was to determine the utility of group CBTp for inpatients. We systematically searched Scopus, Web of Science and EBSCO electronic databases to identify relevant research. We reviewed the resulting articles and included those which had been conducted with inpatients, with symptoms of psychosis, using cognitive behaviour therapy, delivered in a group format. Fourteen articles relating to ten studies were identified. Two were randomized controlled trials; two were cohort studies and the rest were pre-/post-intervention studies. There was considerable heterogeneity between the studies and all had methodological limitations. The findings suggest positive trends towards the reduction of distress associated with psychotic symptoms, increased knowledge of symptoms, decreased affective symptoms and reduced readmissions over several years. However, there is currently not enough evidence to draw any strong conclusions regarding the utility of group CBTp for inpatients due to the small number of studies and limitations in quality and generalizability. Therefore, this review indicates the need for further research, particularly large, methodologically rigorous, randomized controlled trials.

Background: There has been little evaluation or development of nurse observation charts on psychiatric in-patient units since they were first introduced. Aim: We aimed to develop a new nursing chart that adds a functional and contextual assessment of the observed behaviour. We describe its initial evaluation in an in-patient setting. Method: A member of the staff coded a participant's behaviour as either an instance of an individual's daily life problem; or an improvement; or a non-clinically relevant behaviour. We evaluated the charts in 14 in-patients and compared the coding of the behaviour against that of one of the investigators. Results: After brief training the inter-rater agreement resulted in Kappa = 0.496 with p < .001. Removal of a rating of neutral behaviours resulted in a higher Kappa = 0.546 with p < .001. Conclusions: The inter-rater reliability was only moderate for the Functional Analytical Nurse Observation Charts. Frequent training and support from management and therapy staff is required to maintain a psychologically informed environment and observation in an in-patient setting. An area for further research is to explore the impact that a FANOC has on staff satisfaction and an individual's experience of care, and whether it can assist in determining mediators of change before an improvement in symptoms.

The inpatient unit faces many challenges in the effort to deliver comprehensive psychiatric care to acutely ill patients with minimal lengths of stay. Cognitive behaviour therapy (CBT), a structured, problem-focused, time-limited form of treatment has been shown to be a promising intervention with the inpatient population. This paper describes a group-oriented inpatient CBT programme for women and reports pilot data on the experiences of 78 adult female patients. Repeated-measures ANOVAs revealed that participants exhibited improved psychosocial functioning from admission to discharge, with gains maintained at 1 month post-discharge. Partial correlations indicated that participation and engagement in CBT groups is related to improved functioning at discharge. Participants diagnosed with major depressive disorder, bipolar disorder, and psychotic disorders all evidenced similar positive treatment trajectories, suggesting that group-oriented CBT programming may be a useful addition to standard inpatient care.