Effectiveness and Efficiency of Cognitive-Behavioral Group Therapy for Inpatients: 4-Year Follow-up Study

OBJECTIVES: The goals of this study were to evaluate the effectiveness of manualized cognitive-behavioral group therapy (CBGT) integrated into routine care on a psychiatric inpatient unit and to compare the impact of the intervention on patients with the following diagnoses: schizophrenia, major depression, bipolar disorder, or personality disorders. The results presented here expand on those presented in a previous publication by including 2 more years of data and additional analyses concerning diagnosis and economic outcomes. METHOD: A pre-post design was used to measure voluntary and compulsory readmissions, ward atmosphere, patient satisfaction, mean length of stay, and cost-income in the year before CBGT was introduced (2001) compared with the next 4 years. RESULTS: In the years 2001-2005, percentage of total readmissions declined from 38% to 24% (p < 0.02); of those readmissions, 17% were compulsory in 2001 compared with 0 in 2005 (p < 0.02). A progressive improvement in ward atmosphere was observed from baseline to the following 4 years (p < 0.001). There was also statistically significant improvement in patient satisfaction compared with baseline, mainly observed during the first 2 years of the intervention (p < 0.001). The reduction in readmissions was statistically significant only for patients with schizophrenia (p < 0.001) and bipolar disorder (p < 0.04). CONCLUSIONS: These results are promising and indicate that CBGT may contribute added benefit to treatment on an inpatient psychiatric ward.