Mental Health Day Hospital
I was a nurse at an amazing Mental Health Day Hospital (DH) where patients were actively involved in planning a timetable of evidence-based therapeutic activities to support them in their recovery before being discharged as an in-patient.
It wasn’t a drop-in centre. Ward patients were referred by their Consultant and attended the DH normally for a period of 12 weeks. Part of the programme was that patients had to agree to attend their chosen groups. Once admitted, they would spend time with their named nurse (who oversaw their care at the DH) and together choose therapies and activities that would best suit their needs.
Their named nurse would attend their weekly multidisciplinary ward round to hand over documented patient progress. The multidisciplinary team (which includes the patient) would at some point decide the patient was well enough to be discharged from the ward as an in-patient. However, if that happened after only 6 weeks at the DH, the patient could stay with us to complete their programme.
Therapeutic groups and activities
We had many therapeutic groups and activities which were all run by our qualified and skilled nurses who demonstrated empathy, compassion and an abundance of energy. We created a safe, therapeutic space where patients could relax, learn new coping skills or hobbies and benefit from the evidence based therapies available.
There’s far too many groups and activities to mention here but when reading my friend Kacha’s (from Food for thought) recent post Mythical Monday on Visualisation — I was transported way back to the fun we all shared during this particular therapy. So I think I’ll start with that.
Visualisation was carried out in either small groups or for individuals twice a week. With individuals, we did what’s called virtual ‘in vitro‘ exposure to sources of threat for anxiety, phobias and panic disorders and later went on to ‘in vivo’ real-life practice. We were able to monitor their progress using the Beck Anxiety Inventory, which is a self-report measure of anxiety and more often than not, we saw a great reduction.
Virtual ‘in vitro‘ exposure is where you’ll support the patient in visualising their perceived threat, for example, let me tell you a shortened version of one young lady’s experience. Kerry was so anxious she found it difficult to go into shops on her own, particularly large stores like Tesco or Aldi. Once, while shopping with her two young children, she got distracted and knocked over a whole display of wines. She said she was absolutely mortified and is now terrified of shopping on her own.
In visualisation we took her back to the shop and she was actually panicking in the first session so we stopped. I engaged her in light conversation and, unbeknown to her, I started fishing. I asked about the last time she felt relaxed, which led to her telling me about a surprise birthday she’d been given a few years ago. I watched as she smiled at the memory then as she puffed wistfully ‘Ah, but that feels like so long ago,’ and the frown reappeared as she sagged into her chair.
I half whispered “Close your eyes Kerry…… that’s it, let your shoulders down from your ears, (and she giggled) stretch your jaw and let it fall, relaxed.” she did. “Now, let’s go back to that party — “Tell me, what did you see when you walked in?” She’s smiling now and telling me of all the family and friends greeting her, the decorated venue, the flowers and gifts……….
“Tell me what was it you heard?” She spoke of everyone cheering, singing happy birthday, all the greetings, the music…… her smile got wider.
“Were there any smells that you remember?” She babbled on about the overwhelming perfumes and aftershaves as everyone hugged her…….. When asked about any tastes, she raved on about the cake and laughed at how bad the ‘cheap’ champagne was.
“What were you feeling Kerry, can you remember?” She was grinning like the cat that got the cream, giggling, smiling and — totally relaxed. “Okay Kerry,” I’m smiling now, I asked her to open her eyes. She gasped, wide eyed, then huffed and puffed, “Oh, my word, that was amazing, I didn’t want it to stop,” she beamed, still totally relaxed.
The next sessions were never going to be as fulfilling but after the next virtual ‘in vitro’ exposure to her shopping anxiety, we ended with a happy ten-minute visualisation. We then went out together a few times for the ‘in vivo’ real-life shopping trips, which she eventually conquered, alone.
Throughout the 12 weeks Kerry had been given visualisation exercises she could carry out at home and she practised them religiously, using all the five senses as much as she could. She was discharged from the DH, not cured of her anxiety, but free from the panic of shopping and confident in her new coping techniques. She said she would continue to practice visualisation at home to help with other situations that made her anxious. She visited many months later to tell us of her new part-time job as a children’s dance teacher, something she’d done before becoming mentally unwell and never thought she’d achieve again.
All our patients, regardless of their diagnosis, were welcome to attend visualisation and while it wasn’t easy if someone was experiencing hallucinations or were in a manic phase, we found that all patients benefited in one way or another.
So, can visualisation help reduce anxiety, panic attacks and phobias? Can visualisation help improve your mood? Does visualisation work? There’s much research to prove it does and yes, I certainly think so.
Now some might disagree. If it hasn’t worked or benefitted you in some way, I could suggest that perhaps the therapist wasn’t as qualified or skilled as is necessary to carry out effective visualisation techniques. I would also say that it’s really not an easy activity to carry out alone, without any therapeutic input. But, okay. I agree it’s not for everyone.
What do you think? Have you tried it? With or without a therapist’s support?
Disclaimer. Whilst I am a qualified practitioner, I do not suggest you try this at home. If you think this therapy might benefit you, speak to your GP.