Treating taboo thoughts on a psychiatric intensive care unit: a four-phase mixed methods single case experimental...

Area of Science:

• Psychiatry
• Clinical Psychology
• Mental Health Research

Background:

• Evaluations of psychological interventions in psychiatric intensive care units (PICUs) are infrequent.
• This study addresses the need for evidence-based psychological care within PICU settings.

Purpose of the Study:

• To assess the efficacy of cognitive behaviour therapy (CBT) for intrusive taboo thoughts in a bipolar disorder patient admitted to a PICU.
• To evaluate CBT's impact on self-harm risk and overall mental state.

Main Methods:

• A single-case experimental design with four phases (A, B, C, D) and mixed methods was employed.
• Idiographic and nomothetic measures were collected daily and at key time points, respectively.
• A follow-up community phase and interview were included to assess long-term outcomes.

Main Results:

• Behavioral and cognitive interventions improved calmness, optimism, and reduced rumination compared to baseline.
• Sociability showed limited improvement, and a relapse was observed during community follow-up.
• The participant reported 11 unexpected, personally significant changes related to therapy during the follow-up interview.

Conclusions:

• Single-case methods effectively track patient progress through different intervention modules and care pathways.
• There is a critical need for robust outcome methodologies on PICUs to evaluate psychological care.
• Findings underscore the potential of CBT in acute psychiatric settings while indicating the importance of sustained support.