Mind-Body Medicine in Inpatient Psychiatry. David Låg Tomasi
that every other parameter, including group attendance, patient satisfaction, and therapeutic outcomes directly influence, and in turn are influenced by, the complexity of the work therapist perform on the unit.
Among the most interesting results in this study, we have found a strong correlation between therapeutic outcomes and patient-provider therapeutic alliance. Furthermore, very specific data provided insight on the particular causes for increase and maintenance of patient attendance in therapy groups. Finally, a much more precise analysis of group type and provider’s role has allowed for further differentiation of correlation vs. causation in the context of clinical outcomes. The latter is a truly important cornerstone of our research, although the ultimate evaluation of our study was filtered by an appropriate philosophical evaluation of other aspects of the healing path. More in detail, we have referred to the philosophical mind-body problem in defining a more therapeutically effective way to provide evidence for the clinical strategies thereby utilized, and support the patients in their views on life’s meaning and purpose, thus promoting full recovery.
1 As we will briefly mention in the following chapters, it remains to be seen whether these improvements will be allowed to continue in the future, given the expected changes—including detrimental cuts to funding, personnel, and therapeutic offerings and quality—to the hospital in question, UVMMC, and more specifically the Inpatient Psychiatry unit, which started right at the end of this research.
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Acknowledgments
This research discusses Mind-Body Medicine strategies to improve clinical outcomes in inpatient psychiatry settings. This work is the result of the support and contributions of many people in my life, without whom not only the study hereby presented would not have been possible, especially given that investigating concepts such as the ones discussed in this research presented multiple challenges, form a theoretical as well as from a purely statistical point of view. In this context, I would like to thank Jessica Haunschild, Christian Schön, Valerie Lange, and Malisa Mahler at ibidem Verlag for their continuous support and inspiration, as well as the whole team at Columbia University Press.
Furthermore, I would like to acknowledge all the professors and academic staff at Azteca University, Sofia University, Central University of Nicaragua, University of Vermont Medical Center, University of Vermont College of Education and Social Services, Department of Leadership and Developmental Sciences, Human Development and Family Studies, UVM Larner College of Medicine, UVM College of Nursing and Health Sciences, and UVM Integrative Health, in particular Jeremy Sibold, Karen Westervelt, Patricia Prelock, Susan Kasser, Theodore Angelopoulos, Cara Feldman-Hunt, as well as Nonna Aydinyan-Allaire, Sheri Gates, and Emily Reyns.
A very special thanks goes to Mariangela, Gilberto, and Consuelo Trapin, Andrea Rivelli, Bianka and Efe Çimrin, and the students and researchers Emily Stockwell of the University of Vermont Department of Leadership & Developmental Sciences, Alex Krupp and Culli Pringle of the University of Vermont Department of Rehabilitation and Movement Science and Michael Bancroft, William Donaway, Nicholas Freiberger, Takara Lyons of the University of Vermont Business School for their incredible dedication and hard work leading to the specific areas of research presented for inpatient psychiatry exercise strategies and scheduling changes, respectively.
Last but absolutely not least I would like to acknowledge the understanding, the support and the encouragement of my family both in Europe and the USA, especially my parents Lino and Rosa, my wife Livija and my sons Lucas and Adrian.
This study is dedicated to you.
David Låg Tomasi
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Foreword by Nonna Aydinyan-Allaire
A guide for professionals to learn effective treatment and management strategies in inpatient psychiatry
In this dense but well-reasoned and open-minded study, Scientist, College Professor and Psychotherapist at the University of Vermont Medical Center (UVMMC), Dr. David Tomasi digs deep into previously unpublished data collected over a period of 5 years at UVMMC in inpatient psychiatry unit to conduct a meta-analysis research study of Mind-Body Medicine in Psychotherapy, in order to utilize better support in the healing process and treatment plans for patients with multiple mental health diagnoses.
A thorough display of a vast knowledge in philosophy, clinical psychology, psychiatry and psychotherapy is found in this research study applying quantitative and qualitative analysis through surveys, questionnaires, as well as referencing his previously published research “Medical Philosophy. A Philosophical Analysis of Patient Self-Perception in Diagnostics and Therapy” (Tomasi, 2016) and “Wishful thinking, hope, and placebo. Exploring the connections between religion and medicine beyond illusion, delusion, and ideation” (Tomasi, 2015). Tomasi breaks down his data collection and research findings into three main areas: Individual and Group Therapy Sessions, Exercise Groups and Group Attendance and Session Standardization. He then further analyzes the therapeutic relationship and alliance and how to apply Mind-Body medicine to psychotherapy. Tomasi finds a strong correlation between therapeutic outcomes and patient-provider therapeutic alliance. The author wonderfully highlights in his research how strategies from positive psychology, spirituality or religion, gentle exercise and physical activation, play key stones in developing coping skills; identifying grief/loss, feelings, and stressors/problems; increasing activity level, increasing affective range; etc.
Through this research work and ongoing study, Tomasi hopes for future investigations on on the benefits of constant, gentle and monitored physical exercise on psycho-physical health of the patients in the inpatient psychiatry Unit at UVMMC. He concludes his research by addressing the connections between religion and medicine in discussing wishful thinking, hope and placebo. Tomasi encourages readers to ask themselves how come the placebo effect seems to be more manifested in some cases and less or almost non-manifested in others? Tomasi draws attention to how our physical health depends on our sense of connectedness with others including health providers.
Well worth reading for the general public, but especially healthcare professionals in different fields.
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Introduction
“Patient-centered medicine means mind-centered and body-centered therapy”
This analysis focuses on a multidisciplinary approach for the therapeutic interventions in an inpatient psychiatry setting. More specifically, we were interested in combining statistical analyses of therapeutic offerings, patient attendance and participation over time, and specific theoretical paradigms with direct observations, to create a very accurate picture of the efficacy, effectiveness, and efficiency of the current standardized treatment for patients and strategies for the amelioration of scheduling aspects on one side, and therapeutic changes on the other. In the hope of offering positive suggestions and advice to other medical institutions—also as a way to improve awareness of possible mistakes, obstacles and setbacks vs. optimized clinical and organizational strategies—our analysis is based on the clinical work and data collected via multiple research studies at the University of Vermont Medical Center Inpatient Psychiatry Unit. Furthermore, we also wanted to elucidate the distinctions, special features and similarities in often overlapping fields such as psychotherapy, psychology, and psychiatry from such perspectives. Given the very complex issues at hand, and the very nature of mental health and human nature, empirical data have also been re-interpreted via meta-analyses as well as through philosophical investigations, which we deem fundamental for any work conducted in the fields above. Thus, some of the theoretical elements hereby presented have been discussed, albeit more generally and without a focus on specific therapeutic strategies and standardization processes, in other works, especially “Medical Philosophy”