Now that we've discussed the ways in which therapy actually works, this lesson will discuss some of the settings in which therapy takes place.
The particular areas of focus include:
Private therapy settings are where you can facilitate more of an away-from-the-public therapy session, either by yourself or with a small group.
These generally occur in private practice offices, in which one or more psychologists or psychiatrists come together and create an office where people can get away from other settings, such as home or work, in order to specifically deal with their mental health issues.
Private settings are one of the most common treatment settings; however, a lot of mental health professionals are also looking towards a home setting, in which the professional comes to the client's home.
This would allow the client to feel a bit more open and comfortable, thus helping to establish the therapeutic alliance that is essential to the effectiveness of the treatment.
Institutional settings are one of the most controversial of the different treatment settings. These are specific settings or organizations that are established to help people with mental health issues.
One instance of this is an existing hospital or clinic which might have a wing or a section that's devoted specifically to mental health care. The benefit of this setting, as opposed to a more private practice, is that there is access to all sorts of medical tools which might be helpful, particularly in cases where there are more severe issues occurring. These are tools such as brain scanners, surgery, pharmaceuticals, or biological therapies that aid in psychotherapy.
In addition to hospitals, institutional settings can be private homes and centers where people that have behavioral or mental health needs can live in order to receive more assistance on a daily or regular basis.
There is a nonprofit organization called Devereux that has many locations across the country. The organization aims to help people with severe behavioral problems or mental retardation by enabling them to live in a setting with others in similar situations, as well as with experienced staff that can aid them on a daily basis.
Mental hospitals are another very controversial treatment setting. These are private or state-run institutions that specifically house people dealing with psychiatric issues.
People inside of them are generally hospitalized, meaning that they're placed in a protected, therapeutic environment staffed by mental health professionals. Stays in a mental hospital can be either short -- in fact, most of them are 20 days or less -- or they can be more long-term.
They can also be voluntary or involuntary, meaning that a stay can be mandated by a court. However, a person who's in a mental hospital can ask to leave. If there's no other reason for a person to stay, state laws in most states require that the person be allowed to leave within two to seven days.
The circumstance that requires someone to stay in a hospital if he or she is mandated to stay there, or to stay for a longer period of time, is that the person is either a danger to him or herself or to other people.
That's the key phrase to remember when talking about mental hospitals. If a person is a danger to him or herself or to others, that person is required to stay in the hospital.
However, whether a stay is voluntary or not, people always have a right to be informed about why they're there and what kind of treatments they're receiving. They also have a right to refuse if they think that a certain type of treatment is either experimental or unnecessary for them.
Since around the 1980s, there has been an ongoing trend called deinstitutionalization, meaning the reduction in the use of full-time commitment to mental hospitals and mental institutions for patients with serious mental problems.
Historically, there have been some issues that go along with the use of mental hospitals. Some of the hospitals are viewed as more of a prison-like setting, providing very poor treatment.
People have been treated inhumanely while in mental hospitals, and a lot of times, the setting can exacerbate the problems that people originally had because patients are only exposed to other patients with mental problems.
However, this deinstitutionalization trend and the closure of a lot of mental hospitals has also led to a series of other problems. Many of these patients that are dangerous or self-destructive are now being released without adequate care. They don't have the support that they otherwise would get inside of a mental hospital.
Thus a lot of these patients are also ending up in prisons, where the focus is not on their mental health and rehabilitation, but rather on the crimes that may have committed.
In order to help people make transitions from mental hospitals and other institutions like prisons, there are settings called halfway houses.
A halfway house is community-based institution that helps people to make the transition from an institution into the community and independent living, which ties into the final category of treatment settings.
Community mental health centers are able to provide mental health care to specific areas and populations within cities and towns.
They can also provide preventative measures to a lot of these areas— resources like consultations, education about issues within mental health care, and crisis intervention.
Community mental health centers can also deal with wider issues that are troubling the community, such as unemployment, drug abuse, gang activity, or anything else that might be specifically influencing the mental health of the community's residents.
Thus in a lot of ways, community mental health centers can be very effective as therapeutic settings because they consider the wider context of what's occurring. They can consider the culture and the backgrounds of the people living within the community, making mental health care a bit more accessible to people because it's happening at a community level.
These centers can also make their treatment more personalized to the particular community. A lot of people who work in a community mental health center come from similar situations to the ones that they're dealing with.
They understand the people and the situations, and they can relate. In the community setting, a lot of religious organizations provide mental health care assistance as well.
In this lesson, you learned about four different settings in which therapeutic treatment can occur. Private settings, such as homes or private practices, are the most well-known of the types of treatment settings. Institutional settings and mental hospitals are the most controversial, as they have historically been known for mistreating patients.
However, the trend of deinstitutionalization poses its own problems, namely that these patients don't have access to the treatment they need. This is why halfway houses have become a setting that serves as a type of bridge between institution and community life. In that same vein, community mental health centers can be a very helpful and effective setting, as they provide care at the community level based on the specific needs of the community's members.
Source: This work is adapted from Sophia author Erick Taggart.
State or privately run institutions that remove people with more severe mental disorders from the general public and place them in a secure therapeutic setting.
Attempt to improve conditions for persons in long-term mental health facilities. Resulted in reduced use of full-time facilities, staff. Intended to foster independent living.
Facility that often houses more than one type of assistance for people with mental illnesses - employment, day treatment, recreation, addictions programs, education, crisis intervention, therapy.
Transitional housing between institution and community living. Work (or looking for work) is often a required to be able to stay there.