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
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.
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What a story! I smiled with Kerry when she was at her birthday party, seems so fun!
Thank you for linking back to my post. As you see, your use of visualization is embedded in something more meaningful and is guided by someone. Which is very much needed. It isn’t that simple as some pop-psychologist would like to make it seem.
I very much enjoyed your post, it is so well written, I was doing the shoulders and the relaxing cheeks! I think you’re really good in guiding people, and not only through visualization. x
Aaaww, thank you Kacha. I’m so glad you like this post and you found it ‘could’ work with guidance 🙂 You’re right about some people making it sound easy — obviously it’s better if you’re actually taught the techniques. Next time at your laptop, drop your shoulders down from your ears,, stretch your jaw (I know your a tooth grinder) and just breathe for a few seconds. It always makes me smile – cos I’ve been trained lol! Believe it or not, I also trained as a Hyonotherapist and while I didn’t actually practice it within the hospital, it was easy to get patients into a ‘trance like’ state (like in visualisation) so that they could relax before any talking therapies.
Hypnotherapy that is one controversial subject, I would love to read about that.
It’s all about how the memory works, I love it!
I am not against all the therapies or suggestion, I’m just against people who are ‘selling’ a half truth or a ‘quick’ fix for a cash grab.
I’m typing now with shoulders relaxed and jaw stretched, makes me yawn!
Lol 🙂 I’ve just yawned! The word just makes me do it lol. Yep, I get it. Charlatans making money but not even providing a proper service.
I just loved all the training I did and I was constantly at it for 15 years, always wanting to know more. I eventually had a great toolbox of therapeutic interventions that I could use interchangeably with patients.
I guess they miss you all, your spirit, knowledge and dedication.
Especially the lady who threw her undies away! 😀
Hahahaha. You are so sweet. x
Wow, great job with Kerry! What a happy story!! That’s good karma you have!!
I love the concept of having visualization at a mental hospital. The last time I was in one, in 2006, I was bored out of my mind. Visualization would’ve helped, and it would’ve been stimulating too, in a good way. This is my fantasy mental hospital: visualization, friends, libraries filled with books, great cafeteria food, helping each other, etc. And that wasn’t far from my experience with them, aside from the lack of books. 🙂
Thank you Meg, really appreciate your thoughtful comments. We had so many activities at the day hospital and I’m looking forward to writing about it all. It was a terrific place which benefited lots of patients during the years it was open — and was the absolute most cost effective service in the whole of East London.
Nice! I’m so glad you were a part of that!!
You’re page is so interesting, as a current nurse in training its so interesting hearing about mental health from this perspective, thank you!
Your
Thank you, that’s so lovely to hear. The name of your blog suggests that you experience mental illness too? I’m sad if that’s true, but do you know what — I believe that’s going to make you a better nurse, more empathic and compassionate 🙂 I hope I haven’t put you off. But hopefully you’ll read things that make you want to be a better nurse?
Hasn’t put me off at all, I experience it myself and it can be painful but you’re right it makes you much more understanding of other people’s issues . Mental health is so important and I’ll always be an advocate for those people through my training and my future career. Thank you !
I’m sure you will. I’m here for you if you need anything at all 🙂
Visualization has really helped me personally with my anxiety. I tried it out a few years ago with my therapist at the time and it really helped me.
I’m really glad to hear it helped you too Pooja. I really found it beneficial for both myself and our patients.
That’s wonderful that you had your patients engage all the senses in their visualization! A lot of times I think visualization and guided meditation focus only on the sense of sight, but adding those little details makes it much more powerful. I used to do a sort of self-guided meditation to music before going to sleep at night. I included sensations and sounds as well as sight, though I often forgot about smells. Odd, considering I’m a bit sensitive that way in real life. 😉 But it still helped with getting good sleep!
That’s so good to hear. I still try to do it when I get restless legs 🙂
Reblogged this on "An Extraordinary Life": The Young Kiwi Nurse (M: A New Book) and commented:
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Thanks for the like and all the best with your blog
C
Be Happy
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Oh my word, Craig. More tears — You don’t know how much this means to me right now 🙂 Thank you 🙂
You’re a Sweetheart Craig 🙂
thanks for the kind words
“hope not too syrupy sweet non-macho man” c
lol not at all 🙂