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” and “Critical Neuroscience” as well as specific peer-review articles as reported in the bibliographical references at the end of this volume. For the direct clinical observations instead, we have worked with multiple teams in the Inpatient Psychiatry Unit at the University of Vermont Medical Center, also in collaboration with other departments, in particular the University of Vermont Department of Rehabilitation and Movement Science, the University of Vermont College of Nursing and Health Sciences, the University of Vermont Larner College of Medicine, and the University of Vermont Integrative Health. We are also very thankful to the precious work of the University of Vermont Medical Center Volunteer Department and the University of Vermont Medical Center Department of Clinical Ethics for their continuous support. Furthermore, this work also attempts to investigate the conceptual issues at the center of epistemological and methodological frameworks aimed at understanding the placebo/nocebo effects in psychiatry, with a special focus on medical perspectives on mind-body connection and an emphasis on mental health. Implementing cutting-edge scientific discoveries with a solid philosophical investigation is fundamental in order to avoid possible therapeutic and epidemiological errors and provide a solid theoretical background to those areas of scientific investigation still open to clinical trials, diagnosis and statistical analysis. In particular, the focus on the connections, as well as the differences, between terms such as perception and consciousness fosters the combination of data collected through neurobiological experimentation, especially in neuroimaging, and the philosophical debate on the applicability of such terms in the context of the human healing process. Thus, new perspectives on the reality and reason, in causal terms, of certain healing mechanisms are discussed beyond the current bio-psycho-social standpoint. Thus, the research study at the center of this proposal focuses on Mind-Body Medicine strategies (psychotherapy-based interventions, body activation vs. relaxation techniques, and other integrative approaches) to improve clinical outcomes in inpatient psychiatry settings. More specifically, multidisciplinary approaches in the areas of clinical psychology and behavioral medicine have been utilized to better support the healing process and treatment plans for patients with multiple mental health diagnosis.
Methods:
The research consists of a meta-analysis of previously unpublished data collected over a period of 5 years at the University of Vermont Medical Center—Inpatient Psychiatry Units Shepardson 3 South (from now on simply referred to as “Shepardson 3” or “Shep 3”in the text) and Shepardson 6 divided into three main areas:
1 Individual and Group Therapy Sessions,
2 Exercise Groups, and
3 Group Attendance and Session Standardization.
Moreover, the research study is further subdivided into the following categories:
Individual and Group Psychotherapy Sessions, including but not limited to Cognitive-Behavioral Therapy, Dialectic-Behavioral Therapy, Compassion-Focused Therapy, and Rational Emotive Behavior Therapy (see complete list below)
Multidisciplinary approaches in Integrative vs. Complementary and Alternative Medicine, including but not limited to Meditation, Mindfulness, Relaxation, Art Therapy, Music Therapy, and Dance-Movement Therapy
Exercise groups focused on gentle movement techniques, T’ai Chi Chuan, and Yoga
Improvement of therapeutic attendance via standardization and optimization of session offerings and weekly schedules
Statistical analysis of patients’ feedback via survey and questionnaires addressing the multidisciplinary treatment team (Psychiatrists, Psychotherapists, Registered Nurses, and Social Workers) and staff members (Mental Health Technicians, Licensed Practical Nurses, and Licensed Nurse Assistants)
Intradepartmental strategies for therapeutic improvement, including Productivity and Cost-benefit analysis, Healthcare Policies Development and Translational Medicine frameworks.
Volunteer Programs Offerings, including Recovery Groups/AA, Pet Therapy Groups, and Gardening Groups
The statistical analysis of the data has been conducted via the Electronic Health Record Software Epic/Prism, and conducted via the Statistical Software Stata13. No personal, clinical and medical information regarding the single patient has been collected and presented as part of this research. All the information for each of the research studies, meta-analyses, and theoretical reviews presented herein has been collected without any identifiers and used only for statistical purposes, and it will not be connected or linkable to clinical/medical records of single patients and/or categories/diagnosis as part of this research and publication. We also want to stress that the data collection and following statistical analysis part of research study has been conducted in a very specific healthcare setting, namely the UVM Medical center, and in a particular clinical environment, the Inpatient Psychiatry Unit. Thus, any generalization and universal validity of the results hereby presented will need to be further examined in the light of multiple variables and differences in different clinical inpatient vs. outpatient settings. In our case, the conduction and administration of therapies and following questionnaires and surveys has been directed/operated by the Clinical Research Teams:
Head of Research—Principal Investigator:
David Låg Tomasi, PhD, EdD-PhD, MA, MCS, AAT
Clinical Direction, Administration, and Research Support (2010–2017):
Isabelle Desjardin, MD, Chief Medical Officer (2017);
William Tobey Horn, MD, Inpatient Psychiatry Medical Director (2017);
Allison M. Kaigle Holm, PhD—Senior Research Specialist, Jeffords Institute for Quality;
Stacey Ward, RN, Inpatient Psychiatry Nurse Manager;
Katharine Monje, RN, BSN, Inpatient Psychiatry Nurse Manager (2014–2015);
Elaine A. Koenig, RN, BSN, Inpatient Psychiatry Nurse Educator;
Kevin A. Huckshorn, PhD, MSN, RN, CADC, ICRC—Six Core Strategies;
Allison Kaigle Holm, PhD, Director of Research, Jeffords Institute Research, the University of Vermont Medical Center
Team 1—Psychotherapists/Group Therapists/Activity Therapists1 (2012–2017):
Carol
