Effects of a Collaborative Problem-Solving Approach on an Inpatient Adolescent Psychiatric Unit.

OBJECTIVE: Effects of collaborative problem-solving (CPS) approaches on an inpatient adolescent psychiatric unit were investigated during this study, modeling Dr. Ross Greene's CPS theory, which considers that cognitive deficits are associated with adolescent behavioral dysfunction; his research, treatment, and subsequent results on similar units were notably successful.

PROBLEM: The staff viewed prestudy, negative behavior modification and resultant punitive consequences as culturally acceptable. New York State's Office of Mental Health (OMH) disapproved these strategies, necessitating cultural transformation and alteration of routine responses to patients' maladaptive behaviors.

METHOD: The study incorporates quantitative, comparative, quasi-experimental design, utilizing retrospective staff surveys and hospital medical records to compare behavioral outcomes and staff perceptions during pre- and post-training phases of this 5-year study.

RESULTS: A significant decrease in punitive strategies and techniques (p = .001), reduction in behaviors related to the need for restraints, and significant decline in self-inflicted injury (p = .005), length of stay (p = .001), and need for security staff involvement (p = .001) were noted.