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Neuiopsychiatiic Institute
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Salt Lake City, 0tah, 841u8
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The 0niveisity Neuiopsychiatiic Institute (0NI) is a 1Su beu full-seivice psychiatiic
hospital pioviuing inpatient, paitial hospitalization, intensive outpatient, anu outpatient
seivices foi chiluien, auolescents anu auults.



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The 0niveisity Neuiopsychiatiic Institute is committeu to pioviue excellence in mental
health caie to the Inteimountain West Community.



$45467
To pioviue leaueiship in patient caie, built on a founuation of
knowleuge, innovation, anu human values.



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Continuous Impiovement
Innovation
Respect
Integiity
Auministiatois
Caiing
Auvocacy
Communication
Collaboiation






http:healthcaie.utah.euuuni



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Nap of Facility 4
Kiustai 6
Teenscope 11
Chilu Inpatient 17
2South 2S
2East 28
2Noith SS
SSouth Auolescent Inpatient S8
SNoith Auolescent Inpatient 49
4South 6u
4Noith 64
SWest 67
Ciisis Seivices 68
Wellness Recoveiy Centei 7u
Receiving Centei 71
Recoveiy Woiks 72
ECT 7S
CAT 76




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6
Kidstar UNI
General
Child Day Treatment program Monday thru Friday. The program provides a structured and nurturing
milieu to help address the emotional, behavioral and educational needs of children and clarify the
diagnosis.
The program includes an accredited school program within the facility, University Academy, to help
patients with academic and school related problems.


7
Cri t eri a f or Admi ssi on
The patient must have the ability to function in a school setting. Most patients are from the inpatient
units at UNI or come by recommendation from other therapists. Some need additional support to make
the transition back to school.
The patient poses as a safety threat towards self or others

Age Range
5-12 years old (Can be over the age of 12 due to impaired cognitive and social ability or on the Autism
Spectrum)
Elementary school or early Jr. High

Di agnosi s/ Sympt oms and Behavi ors
Mood disorder, Anxiety disorder, Attention Deficit Disorder with Hyperactivity, Behavioral Disorders,
Oppositional Defiant Disorder, Autism Spectrum Disorder, Generalized Anxiety Disorder, Major
Depressive Disorder, Separation Anxiety Disorder
Explosive and physical behaviors, mentions of psychotic behavior, aggression towards family, not doing
well in school or school poses as a trigger for other negative behaviors such as refusal and failing or
aggression toward peers and/or staff

Cogni t i ve Abi l i t y
The patient needs to have the ability to function in a school setting
Patients cognitive abilities differ, but the patient needs to have the cognitive capacity to make the
program effective

Heal t h Consi derat i ons
The patient doesnt need in-depth medical treatment or medical team
Staff needs to be aware of abuse history and be cautious of sexual acting out

Ri sk Fact ors/Cont raband l i st
No: cell phone, electronics, pagers, drugs, alcohol, tobacco, weapons, or other hazardous materials.
Medications must be turned in and distributed by staff
Allowed: shoes, jackets with strings

Expect ed Out comes
The length of stay is highly dependent on insurance benefits; self pay is an option
The emotional, environmental and biological factors that impact the childs ability to be successful are
addressed

8
The patient is no longer a threat to harm self or others and can demonstrates the ability to use coping
skills rather than destructive behaviors such as aggression or any other unsafe behavior. This is
expected to happen in school, social situations and home environments
Other expected outcomes are to increase in positivity and the ability to function with weekly outpatient
therapy if needed. With reasonable level of support and encouragement, the patient will be able to self
regulate mood and behavior
The patient is prepared for transfer to a Residential Treatment Center or back to school/home life
The patient will have met individual treatment goals
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation

Level Syst em/ Pri vi l eges


9
Gr oup Ti ps
Special Considerations for the Unit:
o Consider the range of ages and developmental stages when planning interventions
o Check with staff for current problems, considerations, or individual behavior plans before starting
group
o An outline of the group plan, and clear instructions and expectations help decrease anxiety and
increase cooperation
o A review of rules can decrease acting out and have a basis for prompting the patients

Engage in Processing
o Motivation to engage in discussion:
! Consider the effects of the variety of developmental levels and ability to be accountable
and honest
! Feeling safe and respected goes a long way in helping a child disclose and engage in
discussions
! Utilize patients who are willing and able to disclose and process as a model for the rest of
the group. This can frequently give other children the courage to engage.
! Most children are motivated to earn points and pluses to maintain or increase their level
and privileges. Handing tokens, even one Skittle to reinforce desired behavior, can
dramatically increase involvement and compliance

o Ability to make analogies/ metaphors:
! Children can work with metaphors as a way to express their emotions, but may struggle
with literally understanding what the metaphor means in their world

o Reality orientation:
! Deficits in reality orientation are more related to a child's ability to be accountable and
honest and their natural egocentric level of development

o Level of intellectual capacity or capability:
! Children range from low average to high intellectual capabilities.

Effective Interventions:
o This is highly dependent on the current group of children. It is best to start with high structure
and gradually work to less structure wherein the children have to implement self regulation and
cooperation

Effective Intervention Approaches:
o Games and crafts

1u
o Tactile: Most of the children love to explore with materials, building, creating, and learning to
master the mediums.
o Handouts: Not highly effective
o Visual: Helpful with less concrete concepts. Drawing a map of gym initiatives can help a child have
a frame of reference before the actual initiative starts.
o Interactive: Most of the children have been admitted due to their low level of capacity to have safe
and respectful interactions. They struggle with reciprocal interactions, but these experiences give
them a chance to practice what they are learning.
o Teamwork: Working together can be very challenging for these children, especially if they are on
the Autism Spectrum. Frontloading with rules, what to expect, and how to problem solve during
difficult portions, is necessary until the group is more cohesive and skilled.
o Verbal encouragement: Focus on and reinforce the positive. Undue attention to negative
behaviors creates a higher probability that the behavior will be repeated.
o Motivations: Treats, extra privileges and verbal acknowledgement of effort

Group Tips Information provided by: Mauria Tanner, MTRS, CTRS
Teenscope UNI
General
Adolescent Day Treatment: program during the week for up to 24 youths, designed to meet mental
needs of teens, helps to clarifying diagnosis, strategize to resolve family issues, and address chemical
dependency and eating disorder issues
Has an accredited school program within the facility, University Academy, to help patients with
academic and school related problems


12
Cri t eri a f or Admi ssi on
Patient must have the ability to function in a school setting
Most patients are from the inpatient units at UNI or come by recommendation from other therapists
Some patients need additional support to make the transition back to school or to a Residential
Treatment Center (RTC)
Most patients have posed as a safety threat towards self or others

Age Range
13-18 years old
Junior High or High School
Autism Spectrum Disorder patients; depending on their cognitive and social ability

Di agnosi s/ Sympt oms and Behavi ors
Major Depressive Disorder, Anxiety Disorder, Depression, Hyperactivity, PTSD, Autism Spectrum
Disorder, Generalized Anxiety Disorder, Mentions of Psychotic Behavior, Attention Deficit Disorder,
Mood Disorder, Mathematics Disorder, Disorder of Written Expression, Social Phobia, Eating Disorder
Less acute than inpatient units, suicide attempt, harm toward self or others, drug usage, addiction,
lacks accountability, problems remaining safe, withdrawn, refusal to attend school, addiction

Cogni t i ve Abi l i t y
Patients have the ability to function in a school setting
Patients cognitive abilities range; need to be higher functioning cognitively to make program effective

Heal t h Consi derat i ons
Don't need in-depth medical treatment or medical team
Some might experience seizures or have diabetes, but to the extent that they could be managed
personally at school

Ri sk Fact ors/Cont raband l i st
No: backpacks, purses, cell phone, electronics, pagers, drugs, alcohol, tobacco, weapons, or other
hazardous materials. Medications must be turned in and distributed by staff while in day treatment
Allowed: shoes, jackets with strings

Expect ed Out comes
Length of stay is highly dependent on insurance benefits
Patients increase accepting responsibility for their actions and learn to value trusting themselves and
others. Patients learn life skills to help reintegration into their home life and community/school setting
Expected that patient is no longer a threat of harming self or others, demonstrates the ability to use
coping skills and not use destructive behavior

1S
Other outcomes are to decrease aggression and self-harm and increase positivity. Need to
demonstrate and maintain the ability to be safe in school and home environment and feel comfortable
with once a week outpatient therapy. Not be in need of constant support
Met individual treatment goals
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation

Level Syst em/ Pri vi l eges
Level 0 (79-0pts):
o Has to eat lunch downstairs
o No free time
o Not able to participate in any of the fun activities
Level 1 (89-80pts):
o Able to eat lunch upstairs in cafeteria
o No dessert
Level 2(100-90pts):
o Highest level with the most freedom
o Given 10 extra minutes of free time
o Able to pick food station for lunch and gets dessert

14

Group Ti ps
Special Considerations for the Unit:
o They can go outside
o They are allowed to have shoes
o They get to go home at the end of the day
o They could possibly have sharps
o They are in the program for 6 weeks or more
o There is a large age range/functional range

Engaging in Processing:
o Motivation to engage in discussion:
! Depends on length of stay. Sometimes they are motivated, while other times they
defer to their more outspoken peers. Learning disabilities are common, and
occasionally prohibitive to engaging meaningfully in discussions.
o Ability to make analogies/ metaphors:
! They are usually fun and easy to joke around with. You can make jokes with them
frequently, and they get it. When asked to sum up the group in their own words, the
teens generally will use a metaphor.

1S
o Reality orientation:
! Most often grounded into reality. They seem the most oriented of all the units. If a
person is actively psychotic or manic, they arent in the program.
o Level of intellectual capacity or capability:
! Many of the teens have learning disabilities that are either not diagnosed or recently
diagnosed. Most of the teens are doing recovery credits in school, and have special
accommodations made for them.
o Deficits:
! They seem to generally struggle to interpret social cues; most often they are taught
how to interpret facial responses or non-verbal responses. Some general lethargy
among the teens.

Effective Interventions:
o Physical activity works well.
o Activities where they can interact with each other
o Teaching general social skills
o Teaching coping skills and how to apply these skills to life in general

Effective Intervention approaches:
o Tactile:
! The teens enjoy using clay in Art Therapy
o Handouts:
! The teens usually throw these away, or lose them with their schoolwork that they
take home
o Interactive:
! Most everything is interactive and teaches social skills
o Teamwork:
! Large focus on learning teamwork and how to effectively apply skills learned in
groups to everyday life, especially working with family at home at the end of the day
o Verbal encouragement:
! The teens do well with praise, as this is often the most supportive environment they
have
o Motivations:
! Point system and appropriate behavior so they arent on refocus/insight

Specific interventions/initiatives:
o Purpose/Goals:
! Often social skills and learning how to effectively communicate.
! Coping skills and how to apply these skills to life outside of treatment.

16
o Possible discussion questions:
! Depends on the group, but usually direct questions to how the group applies to
other things they are learning in treatment or how they can apply the group theme to
themselves.

Group Tips Information provided by: Seth Wright, TRS, CTRS
Child Inpatient UNI
General
Child Inpatient Treatment: 12 bed unit for youth in immediate crisis with complex mental health issues
Treatment address patient's medical, psychological, and social needs in a safe, protected, secure, and
consistent environment


18

Cri t eri a f or Admi ssi on
Harm to self or harm to others. Need to be on close observation. This is an "acute care" unit where
children need help to feel safe and stable

Age Range
4-12 years old


19
Di agnosi s/ Sympt oms and Behavi ors
Mood NOS, Depression, Autism Spectrum Disorder, Pervasive Developmental Disorder, Tourette's
disorder, Bipolar Affective, Anxiety disorder, Attention Deficit Disorder, Hyperactivity, Oppositional
Defiant Disorder, Psychosis, Attachment Disorder, Severe Behavior Disorders
Extreme aggressiveness, withdrawal, short attention spans, soiling clothes, defiance of authority, mood
swings, learning disabilities, problematic family and peer relationships and poor reality testing may be
symptoms of a child's inability to cope, abuse victim, might need to be in a locked seclusion to remain
safe.

Cogni t i ve Abi l i t y
High to Low functioning depending on diagnosis

Heal t h Consi derat i ons
Diabetes, enuresis, asthma, continuous positive airway pressure (CPAP), cuts and bruises, burns,
broken bones

Ri sk Fact ors/Cont raband l i st



2u

Expect ed Out comes
Help the child develop adaptive coping skills, stronger interpersonal/social relationships, increase self-
esteem, develop greater autonomy, and help with educational growth
Ensure safety, develop a better behavior plan, educate parents on effective ways to praise and disciple
their child to prevent harm to self or others
Have a stronger understanding of medications that are helpful and effective
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation

Level Syst em/ Pri vi l eges


21


22

Star Program:
o Every 15 minutes patients can earn a star that can be used towards getting a reward
o Child focuses on 3 goals through out the day



2S
Themes f or t he day
Monday- Dealing with Anger
Tuesday- Friends and Family
Wednesday- Self Control
Thursday- Boundaries
Friday- Choices
Saturday- Feelings
Sunday- Self-Esteem.

Group Ti ps
Special Considerations for the Unit:
o The range of ages and developmental stages of patients can vary, so make sure that
interventions are age appropriate for all
o Staff does an excellent job with behavioral management, but it's helpful to speak with the tech
that will be in-group to communicate what you, as the group leader, needs from them
o Limited attention span, labile behavior, strict about goals/rules, not much processing

Engage in Processing
o Motivation to engage in discussion:
! The variety of developmental levels effect this
o Ability to make analogies/ metaphors:
! Children can work with metaphors as a way to express their emotions, but may
struggle with literally understanding what the metaphor means in their world. An
example might be that a child is able to explain how a dragon behaves when it
is angry (which gives us clues to how the child reacts), but doesn't necessarily relate
that directly back to self.
o Reality orientation:
! On occasion there are disorganized children, who presents challenges, but if the
therapist is thinking about both individual and group needs, this can be addressed
o Level of intellectual capacity or capability:
! Children can be non-verbal to highly verbal on the unit and again, the therapist
should think about the individual needs

Effective Interventions:
o Finding ways to express feeling appropriately and learn how to recognize when feelings are
getting stronger so that coping skills can be used in a practical way
o Dealing with anger, communication with family/friends, boundaries, self control,
identifying/expressing feelings in a positive way


24
Effective Intervention Approaches:
o Games and crafts
o Tactile: Goes along with interactive, especially for kids with Autism, this works really well
o Handouts: Not highly effective
o Visual: If doing an art project or explaining a difficult concept
o Interactive: this work really well because it holds their attention, anything they have to make
or actively do works really well
o Teamwork: Yes, Pair them up (dont let them pick teams so there are no hurt feelings and
they have to work through things together. Try to make rules that each person has to
participate so one person isnt dominating the team and bossing everyone around)
o Verbal encouragement: Focus and reinforce the positive; limit attention given to negative
behaviors
o Motivations: treats and extra privileges

Group Tips information provided by Alexandrea Clark-Ditolla, ATR and Kathryn Storrs, TRS, CTRS
2S UNI
General
Medical and Geriatrics Unit

Cri t eri a f or Admi ssi on
Patient has high medical needs and need more assistant with activities of daily living
Might have a handicap/disability/impairment, be a high fall risk or going through detoxification, need a
handicap room or to be on a medical bed
Patient is at risk for harm to self or others

Age Range
18" (typically geriatric patients)

Di agnosi s/ Sympt oms and Behavi ors
Depression, Anxiety disorder, Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder,
Psychosis NOS, Bipolar, Schizophrenia, Schizoaffective Disorder, Bipolar Disorder, Manic
Getting Electroconvulsive Therapy (ECT) treatment, impaired mobility, have difficulty with performing
activities of daily living, delusional, have an alcohol dependence, suicidal ideation, dementia, oxygen
dependent, sleep apnea

Cogni t i ve Abi l i t y
Might have dementia or memory loss, confusion, psychosis
Patients have a harder time processing and relating metaphors to their life situation

Heal t h Consi derat i ons
In need of a wheelchair, IV or Oxygen/Concentrator
May be diabetic

Ri sk Fact ors/Cont raband Li st

No: shoes with laces, strings or drawstrings, belts

26
Expect ed out comes
Medical stabilization, disposition for transfer to another facility, meet the requirements to transfer to a
nursing home
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation

Level Syst em/ Pri vi l eges
Close observation first 24 hours wears scrubs, on unit only
Most are on level 1 with own clothes, caf privileges, smoke breaks
To increase privileges, patient must attend groups, interact with milieu, have good behavior, and
participate

Themes f or t he day
Monday- Manage Emotions
Tuesday- Safety Planning
Wednesday- People Skills
Thursday- Coping Strategies
Friday- Enhancing Self-worth
Saturday- Leisure
Sunday- Mindfulness

Group Ti ps
Special Considerations for the Unit:
o Limited attention span, trouble hearing, medical problems on top of psychiatric problems

Engage in Processing:
o Difficulty in finding a motivational factor to get patients to engage in discussion, struggle to
make analogies and metaphors, lack of reality orientation, varied levels of intellectual capacity
or capability

Effective Interventions:
o Education about DBT skills, safety plans, coping skills, leisure time, life choices/goals

Effective Intervention Approaches:
o Interventions that affect the senses
o Tactile: simple games and crafts, clay, flowers

27
o Handouts: In the form of worksheets
o Visual: helpful if doing an art project or explaining a difficult concept
o Interactive: effective because it holds their attention. Anything they have to make or actively
do works really well as long as they are physically able
o Teamwork: try to make rules that each person has to participate so one person isnt
dominating the team and bossing everyone around
o Verbal encouragement: focus on and reinforce positive.
o Motivations: treats

Specific Interventions/Initiatives
o Focus on mindfulness and interpersonal skills
o Create an activity where the patients dont have to be skilled but can gain insight about
themselves through the initiative. Focus on the process more than the outcome

Group Tips information provided by: Kathryn Storrs, TRS, CTRS and Nataunya Kay, ATR

2E UNI
General
Intensive Treatment Unit for acutely suicidal, homicidal and psychotic patients, detox patients, patients
with co-morbid medical disorders and patients experiencing cognitive and/or neurological deficits.

Cri t eri a f or Admi ssi on
Individual must be medically clear
Most patients have experienced a psychotic break and have had a serious suicide attempt
Most are involuntary admitted
Planned, or attempted to act on a plan to harm self or others

Age Range
18 "

Di agnosi s/ Sympt oms and Behavi ors
Borderline Personality, Suicidal Ideation, Schizophrenia, Bipolar Affective Disorder, Manic, Psychotic
Behavior, Schizoaffective Disorder, Psychosis, Obsessive Compulsive Disorder, Mood Problems,
Depression

Cogni t i ve Abi l i t y
Depends on the amount of drug usage
Varies on the severity of diagnosis and mania
Their illness often makes their IQ decrease low enough that many can't hold jobs

Heal t h Consi derat i ons
Many patients have decreased their activities of daily living, many are homeless, have history with drug
usage, often patients have stopped taking their medication and become manic and/or psychotic


29
Ri sk Fact ors/Cont raband l i st

Expect ed Out comes
Help patients stabilize their illness
Help patients increase their ability to care for self, take care for self by increasing daily ADLs, taking
medication, and being safe to self and others
Not be a risk for suicide
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills

Su
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation

Level Syst em/ Pri vi l eges
Close observation first 24 hours wears scrubs
Most are on level 1 with own clothes, caf privileges, Fresh Air Breaks (FAB)/Smoke breaks
! Need to follow the rules: no harm to self, no harm to others, not a risk of eloping, be
compliant
Level 2 allows for 30 min breaks off unit or 1 hour off unit with family

Themes f or t he day
Monday- Manage Emotions
Tuesday- Safety Planning
Wednesday- People Skills
Thursday- Coping Strategies
Friday- Enhancing Self-worth
Saturday- Leisure
Sunday- Mindfulness

Group Ti ps
Special Considerations for the Unit:
o Limited attention span, severe psychiatric D/Os (you never know what to expect), Doctors
pull patients from group
o Acute psychiatric, locked unit, maximum capacity 20, voluntary/ involuntary mix of people, 15
min safety checks, actively suicidal & self harming, acute psychosis, substance detoxification,
contraband (glass, metal, sharps, no plastic bags, anything of value, pens/pencils in room,
string/ laces longer than 12", etc.) For the most part, what you bring on the unit must come
back out

Engage in Processing:
o Average attention span 10 min. Guardedness, defensiveness, opposition to treatment of any
kind (Suggesting fault or weakness). Tendency to isolation, trying to figure out any reason to
use the phone / computer or any other reason not to be in the moment or in the group and
newness to the program.
o Motivation to engage in discussion:
! Most are avoidant of social interaction unless they have (hypo)/mania and then they
are overly social sometimes intrusive. Those that have been in the hospital for one

S1
week also attend more. Front-load the group with a discussion in the first part of the
group planning for the first 10 minutes, and then do the activity after that.
o Ability to make analogies/ metaphors:
! Most have some intellectual impairment and don't do well with metaphoric language
(with the exception very short bibliotherapy readings) People with psychosis are
either very concrete in thinking or excessively abstract and loose. Even so, start the
discussions as if they would fully understand and if they are unable to, simplify the
concepts at that moment.
o Reality orientation:
! Comes by milieu feedback: the activity, the rules, schedule, communication, social
interaction, orientation to the group, discussion on the requirements needed to get
them out of the hospital.
o Level of intellectual capacity or capability:
! Psychosis doesn't always impair intellect however most have an inverted attention
and lack of awareness of the seriousness of their condition. This mixed with impulsive
behavior make for poor tolerance and cooperation.
o Deficits:
! Insight into ones own condition, fixations of blame for their hospitalization (Doctors,
fault, society's fault, family, ect.), opposition to treatment including taking medication
attending groups, difficulty with memory, processing new concepts, jumping to wrong
explanations, tolerance for distress, interpersonal conflicts, NO STRESS REDUCTION
or COPING SKILLS equivalent to depth of their illness.

Effective Interventions:
o Education about DBT skills, safety plans, coping skills, leisure time, life choices/goals
o Discussions on "who is on their treatment team and what they do"
o Ice breakers, talking about themselves their favorite topic, busy work, music, craft projects,
group games (Competitive & Noncompetitive)
o Famous people with mental illness
o How cognitive therapy works, recreation education, DBT education, self esteem, writing a
safety plan, leisure education resources, how medications help, the negative impact of stress
in their life, social skills, ethic questions, genetics, pet therapy,
o Identifying issues or what they want out of treatment

Effective Intervention Approaches:
o Interventions that affect the senses
o Tactile: simple games and crafts, clay, flowers, scratch art and crafts
o Handouts: in the form of worksheets; it gives them an outline to follow, information and helps
late comers

S2
o Visual: helpful if doing an art project or explaining a difficult concept, music videos
o Interactive: work really well because it holds their attention. Anything they have to make or
actively do works really well as long as they are physically able, group games, introductions,
auto-biographies
o Teamwork: Try to make rules that each person has to participate so one person isnt
dominating the team and bossing everyone around), anything that requires them to take
turns or contribute to a objective like game
o Verbal encouragement: focus on and reinforce the positive, asking a patient who has been
here a while to orient other to the group and the objectives of the group, self-esteem journals
o Motivations: Candy and tokens go a long way. Also, recognition, praise, looking good for their
doctor, social support and making the best of the situation by being active and involved

Specific Interventions/Initiatives
o Focus on mindfulness and interpersonal skills
o Create an activity where the patients dont have to be skilled but can gain insight about
themselves through the initiative. Focus on the process more than the outcome.
o Purpose/Goals: Often writing on the board OBJECTIVE or GOALDiscussions on depression,
anxiety, pro social behavior from social media and self-esteem.
o Possible discussion questions: Besides going home. What do you want to get out of
this hospitalization or learn from this experience?

Group Tips information provided by: Kathryn Storrs, TRS, CTRS, and Greg Smith, TRS, CTRS

2N UNI
General
Intensive Treatment Unit: for acutely suicidal, homicidal and psychotic patients, detox patients, patients
with co-morbid medical disorders and patients experiencing cognitive and/or neurological deficits

Cri t eri a f or Admi ssi on
Individual must be medically clear
Most patients have experienced a psychotic break and have had a serious suicide attempt
Most are involuntary admitted
Planned, or attempted to act on a plan to harm self or others

Age Range
18 "

Di agnosi s/ Sympt oms and Behavi ors
Mood disorder, Anxiety disorder, Bipolar Affective Disorder, Manic, Psychotic Behavior, Post-Traumatic
Stress Disorder (PTSD), Attention Deficit Hyperactivity Disorder (ADHD), Borderline Personality
Disorder, Depression with suicidal ideation, Psychosis, Schizoaffective, Schizophrenia

Cogni t i ve abi l i t y
Depends on the amount of drug usage
Varies on the severity of diagnosis and mania
Illness often makes the IQ decrease low enough that many can't hold jobs

Heal t h Consi derat i ons
Asthma, seizures, sleep apnea, diabetes
Can not require: cane, walker, wheelchair, cPap, O2, or feeding tube


S4
Ri sk Fact ors/Cont raband l i st


Expect ed Out comes
Be able to care for self, take care of daily ADLs, take medication, be safe to self and others
Not be a risk for suicide
Be able to develop and follow through with plans, be at baseline personality, ready to transition home
or to a residential treatment home
Help patients stabilize their illness. Patients normally have serious behavior issues that are affecting
their living situation
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills

SS
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation

Level Syst em/ Pri vi l eges
Close observation: first 24 hours wears scrubs, on unit only
Most are on level 1 with own clothes, caf privileges, and Fresh Air Breaks (FAB)/Smoke breaks
! To increase privileges must attend groups, interact with milieu, have good behavior,
and participate
! Need to follow the rules: no harm to self, no harm to others, not a risk of eloping, be
compliant
Level 2 : Can earn the privilege of 30 minutes off unit to walk around hospital grounds or 1 hour off
unit with family

Themes f or t he day
Monday- Manage Emotions
Tuesday- Safety Planning
Wednesday- People Skills
Thursday- Coping Strategies
Friday- Enhancing Self-worth
Saturday- Leisure
Sunday- Mindfulness

Group Ti ps
Special Considerations for the Unit:
o Acute psychiatric, locked unit, maximum capacity 20, voluntary/ involuntary mix of people, 15
min safety checks, actively suicidal & self harming, acute psychosis, substance detoxification,
contraband (glass, metal, sharps, no plastic bags, anything of value, pens/pencils in room,
string/ laces longer than 12".... etc) For the most part, what you bring on the unit must come
back out

Engage in Processing:
o Average attention span 10 min. Guardedness, defensiveness, opposition to treatment of any
kind (Suggesting fault or weakness). Tendency to isolation, trying to figure out any reason to
use the phone / computer or any other reason not to be in the moment or in the group and
newness to the program.
o Motivation to engage in discussion:
! Most are avoidant of social interaction unless they have (hypo)/mania and then they
are overly social sometimes intrusive. Those that have been in the hospital for one

S6
week also attend more. Front-load the group with a discussion in the first part of the
group planning for the first 10 minutes, and then do the activity after that.
o Ability to make analogies/ metaphors:
! Most have some intellectual impairment and don't do well with metaphoric language
(with the exception very short bibliotherapy readings) People with psychosis are
either very concrete in thinking or excessively abstract and loose. Even so, start the
discussions as if they would fully understand and if they are unable to, simplify the
concepts at that moment.
o Reality orientation:
! Comes by milieu feedback: the activity, the rules, schedule, communication, social
interaction, orientation to the group, discussion on the requirements needed to get
them out of the hospital.
o Level of intellectual capacity or capability:
! Psychosis doesn't always impair intellect however most have an inverted attention
and lack of awareness of the seriousness of their condition. This mixed with impulsive
behavior make for poor tolerance and cooperation.
o Deficits:
! Insight into ones own condition, fixations of blame for their hospitalization (Doctors,
fault, society's fault, family), opposition to treatment including taking medication
attending groups, difficulty with memory, processing new concepts, jumping to wrong
explanations, tolerance for distress, interpersonal conflicts, NO STRESS REDUCTION
or COPING SKILLS equivalent to depth of their illness.

Effective Interventions:
o Discussions on "who is on their treatment team and what they do"
o Ice breakers, talking about themselves their favorite topic, busy work, music, craft projects,
group games (Competitive & Noncompetitive)
o Famous people with mental illness
o How cognitive therapy works, recreation education, DBT education, self esteem, writing a
safety plan, leisure education resources, how medications help, the negative impact of stress
in their life, social skills, ethic questions, genetics, pet therapy,
o Identifying issues or what they want out of treatment

Effective Intervention Approaches:
o Tactile: scratch art and crafts
o Handouts: gives them an outline to follow, information and helps late comers
o Visual: music videos once a week
o Interactive: group games, introductions, auto-biographies
o Teamwork: anything that requires them to take turns or contribute to a objective like a game

S7
o Verbal encouragement: asking a patient who has been here a while to orient others to the
group and the objectives of the group or self esteem journals
o Motivations: candy and tokens go a long way. Also, recognition, praise, looking good for their
doctor, social support and making the best of the situation by being active and involved

Specific Interventions/Initiatives
o Purpose/Goals: Often writing on the board OBJECTIVE or GOAL... Discussions on depression,
anxiety, pro social behavior from social media and self-esteem.
o Possible discussion questions: Besides going home.... What do you want to get out of
this hospitalization or learn from this experience?

Group Tips information provided by: Greg Smith, TRS, CTRS



S8
3S AIP UNI
General
Adolescent Inpatient Treatment Unit for youth in immediate crisis and those who have complex mental
health issues. This unit addresses the patients medical, psychological and social needs in a safe,
protected environment to help the individual develop a treatment plan focused on stabilization, finding
a solution, and transferring to a less restrictive level of care.



S9

Cri t eri a f or Admi ssi on
Admission to this unit includes that the patient is a danger to himself or herself or someone else.
"Danger" includes thoughts, actions or plans to harm self or others, running away, drug use, and not
being able to function in daily responsibilities
This is an "acute care" unit
Problems at school lead to many admissions


4u
Age Range
15-18 years old
In high school

Di agnosi s/ Sympt oms and Behavi ors
Depression, Psychotic Behavior, Eating Disorder, Mood Disorder NOS, Psychosis, Bipolar Disorder,
Attention Deficit Hyperactivity Disorder (ADHD), Anxiety Disorder, Asperger's Syndrome, Behavioral
Misconduct
Many patients form cliques, problems with patients sharing personal information, issues around deep
connections with peers due to similar situations or sexual connections, abuse victims, as well as
externalizing behavior disorders

Cogni t i ve abi l i t y
Most have a mild-high cognitive level, but have problems interacting socially
Able to process groups at a higher level

Heal t h Consi derat i ons
Substance abuse, scoliosis, bullying, being teased, social anxiety, seizures, eating disorder, syncope,
diabetics, cutting, restricting food





















41
Ri sk Fact ors/Cont raband l i st

Expect ed out comes
Stabilization after 7-10 days
If the incident is isolated:
o Help overcome the situation, plan for the future and develop better coping skills to prevent
another incident
Patient might have a history of illness and needs help preparing for RTC/ long-term care/Teenscope
Comprehensive Assessment Testing (CAT) for diagnosis clarification
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation


42
Level Syst em/ Pri vi l eges


4S


44


4S


46


47

Star program
o Rewards and tokens every 15 minutes
o Patient works towards 3 goals throughout the day

Themes f or t he day
Monday- Self-esteem and self-worth
Tuesday- Distress tolerance (DBT skill)
Wednesday- Communication
Thursday- Emotional Regulation (DBT skill)
Friday- Life Goals/Life Choices
Saturday- Social/Peer Relationships/ Interpersonal Effectiveness
Sunday- Mindfulness (DBT skill)

48
Group Ti ps
Special Considerations for the Unit:
o AIPS is much more mature than AIPN
o Power struggle, pushing limits, side talking (DO NOT LET THEM DO IT), disrespect/non-
compliance, lack of self-esteem, lack of positive coping skills, cliques (they do form),
inappropriate conversation (DO NOT LET THEM DO IT), sometimes guarded and resistive to
processing, always make sure you have a psych tech in your group
o This population really benefit from Expressive Therapy groups because they spend most of
their day sitting around with little structured interactions. Initiatives that challenge them and
require them to interact and process through their situation are beneficial

Engage in Processing:
o They usually have moderate to high motivation. They respond better when they are informed
that this is the feedback part of group in terms of points for the level system.
o Struggle to make analogies and metaphors, and get burnt out from the overuse of analogies
that most group leaders use to process
o Lack of reality orientation and varied levels of intellectual capacity or capability; most can think
abstractly

Effective Interventions:
o Developing positive coping skills, mindfulness, developing self-esteem, interpersonal
effectiveness, distress tolerance, emotional regulation, communication, life choices, life goals,
stress reduction skills, etc.

Effective Intervention Approaches:
o Tactile: crafts
o Handouts: Yes, in the form of worksheets they fill out and discuss
o Visual: art project or games
o Interactive: works really well because it holds their attention and keeps them engaged.
Anything they have to make or actively do works really well as well as problem solving
initiatives
o Teamwork: Pair them up (dont let them pick teams so there are no hurt feelings and they
have to work through things together. Try to make rules that each person has to participate
so one person isnt dominating the team and bossing everyone around)
o Verbal encouragement: focus on and reinforce the positive
o Motivations: treats/awards, extra privileges

Group Tips information provided by: Kathryn Storrs, TRS, CTRS and Joe Walker, TRS, CTRS

49
3N AIP UNI
General
Adolescent Inpatient Treatment Unit for youth in immediate crisis and those who have complex mental
health issues. This unit addresses the patients medical, psychological and social needs in a safe,
protected environment to help the individual develop a treatment plan focused on stabilization, finding
a solution, and transferring to a less restrictive level of care.


Su

Cri t eri a f or Admi ssi on
Admission to this unit include that the patient is a danger to himself or herself or someone else.
"Danger" includes thoughts, actions or plans to harm self, running away, drug use, and not being able
to function in daily responsibilities.
This is an "acute care" unit. Patient admitted are in crisis and need immediate help. Those on the
Autism Spectrum Disorder (ASD) are also admitted to this unit.


S1
Age Range
12-15 years old
8
th
grade and younger

Di agnosi s/ Sympt oms and Behavi ors
Suicidal ideation, Depression, Autism Spectrum Disorder (ASD), Mood disorder, Attention deficit
hyperactivity disorder (ADHD), Psychosis NOS, Schizophrenia, Anxiety disorder, Post-Traumatic Stress
Disorder (PTSD), Bipolar Disorder, Social Anxiety, Intellectual Disabilities, Eating Disorders
Clique behaviors around milieu, disrespectful towards staff, passive aggressive, verbal threats, cutting,
restricting food

Cogni t i ve abi l i t y
Varies, lots of lower functioning due to many patients being on the Autism Spectrum Disorder
Harder to keep all engaged during group processing

Heal t h Consi derat i ons
Drug usage, eating disorders, chronic headaches, selective mutism, scoliosis, constipation, back pain,
diabetes






















S2
Ri sk Fact ors/Cont raband l i st

Expect ed out comes
Be able to remain safe towards self and others. Make medication adjustments and clarify diagnosis,
make progress towards goals
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation


SS
Level Syst em/ Pri vi l eges


S4


SS


S6


S7


S8

Star program
o Rewards and tokens every 15 minutes
o Patient works towards 3 goals throughout the day

Themes f or t he day
Monday- Self-esteem and self-worth
Tuesday- Distress tolerance (DBT skill)
Wednesday- Communication
Thursday- Emotional Regulation (DBT skill)
Friday- Life Goals/Life Choices
Saturday- Social/Peer Relationships/ Interpersonal Effectiveness
Sunday- Mindfulness (DBT skill)


S9
Group Ti ps
Special Considerations for the Unit:
o You can often re-create CIP groups for AIPN because they are less mature.
o Power struggle, pushing limits, side talking (DO NOT LET THEM DO IT), disrespect/non-
compliance, lack of self-esteem, lack of positive coping skills, cliques (they do form),
inappropriate conversation (DO NOT LET THEM DO IT), sometimes guarded and resistive to
processing, always make sure you have a psych tech in your group
o Be careful with things you bring into group (pencils, pens, scissors, etc.)

Engage in Processing:
o Lack of motivation; they seem to respond well to positive reinforcement, bring candy in to help
motivate the teens to engage and open up
o Struggle to make analogies and metaphors, lack of reality orientation, varied levels of
intellectual capacity or capability

Effective Interventions:
o Developing positive coping skills, mindfulness, developing self-esteem, interpersonal
effectiveness, distress tolerance, emotional regulation, communication, life choices, life goals,
problem solving, stress reduction, ect.

Effective Intervention Approaches:
o Interactive games/interventions, problem solving, teamwork, crafts
o Tactile: crafts
o Handouts: yes, in the form of worksheets they fill out and discuss
o Visual: art project or games
o Interactive: works really well because it holds their attention and keeps them engaged.
Anything they have to make or actively do works really well
o Teamwork: Yes. Pair them up (dont let them pick teams so there are no hurt feelings and
they have to work through things together. Try to make rules that each person has to
participate so one person isnt dominating the team and bossing everyone around)
o Verbal encouragement: Focus on and reinforce the positive rather than giving lots of attention
to negative behaviors
o Motivations: treats/awards, extra privileges

Group Tips information provided by: Kathryn Storrs, TRS, CTRS, Sarah Lovato, TRS, CTRS

4S Detoxification UNI
General
Safe withdrawal off drugs and alcohol to help initiate the recovery cycle

Cri t eri a f or Admi ssi on
Individual who has a chemical dependency and is in need of detoxification
Patients are voluntarily admitted

Age Range
18 "

Di agnosi s/ Sympt oms and Behavi ors
Major Depressive Disorder, Anxiety Disorder, Mood Disorder, Bipolar Affective Disorder

Cogni t i ve abi l i t y
Patients might have cognitive impairments due to the effects of substance abuse, dependent on the
years of abuse. Thymine levels might be affected.
During detox and ECT treatments, memories and other issues might be impaired.

Heal t h Consi derat i ons
Patients might be dealing with detoxification side affects. There is less staff on this unit so patient
needs to be able to care for own ADLs. Might need IV or others medical equipment to help during
detox.
Side affects of detox include sweats, tremors, body aches, vomiting, nausea and disorientation
Asthma, hypertension, alcohol and drug dependence, diarrhea, Obesity, sleep apnea, symptoms of
withdrawal.

Ri sk Fact ors/Cont raband l i st
o No: internet or camera on phones, drugs or alcohol
o Allow: can have shoes and belts, appropriate clothes, money and cards, lighters and
cigarettes

Expect ed Out comes
Be physically comfortable and off detox medications
Be able to go to inpatient recovery or intensive outpatient recovery
Have a plan to help support continues sobriety
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills

61
o Build Resources for Distress Tolerance
o Support Emotional Regulation

Level Syst em/ Pri vi l eges
Voluntary and open unit, 1 hour checks


62






6S
Group Ti ps
Special Considerations for the Unit:
o Low self esteem/depression, lack of interest/motivation, manipulative
o Make sure you still set limits with the patients and dont let them push you around
o Detoxification side affects, such as being shaky, or needing help to do intricate things

Engage in Processing:
o Difficulty in finding a motivational factor to get patients to engage in discussion, varied levels
of intellectual capacity or capability and deficits
o Patients are normally very willing to engage in processing at a superficial level

Effective Interventions:
o DBT skills, safety plans, coping skills, leisure time, life choices/goals, self-esteem, stress
management
o Focus on mindfulness and explain the purpose and positive effects. Work with the patients to
identify positive moments from the past and expand on the positive choices in their past to
help them move forward.

Effective Intervention Approaches:
o Tactile: games, problem solving interventions, crafts
o Handouts: yes, in the form of worksheets
o Visual: If we are doing an art project or explaining a difficult concept
o Interactive: anything they have to make or actively do works really well because it holds their
attention
o Teamwork: try to make rules that each person has to participate so one person isnt
dominating the team and bossing everyone around
o Verbal encouragement: focus on and reinforce the positive
o Motivations: treats

Group Tips information provided by: Kathryn Storrs, TRS, CTRS and Nataunya Kay, ATR



4N Mood Disorders UNI
General
Mood Disorders

Cri t eri a f or Admi ssi on
Individuals who has suicidal ideation, a plan or attempted suicide
Patients can be admitted voluntary or involuntary and are struggling with controlling their mood

Age Range
18 "

Di agnosi s/ Sympt oms and Behavi ors
Bipolar Disorder, Major Depressive, Alcohol Dependence, Mood Disorder, Anxiety Disorder, Psychosis,
Postpartum Depression
Patients might be receiving ECT therapy

Cogni t i ve abi l i t y
Higher functioning; able to attend groups and do well during processing
Groups seem to be a place where they can learn and gain skills

Heal t h Consi derat i ons
Patients might be dealing with detoxification side affects or ECT symptoms such as being confused or
psychotic
Patient might be causing self-harm by scratching and/or cutting
















6S
Risk Factors/Contraband list

Expect ed out comes
Be able to attend groups and be social, no isolating self, able to transition home or to a treatment
program, have a safety plan
Have zero self-harm
The patient will learn and practice the DBT skill set:
o Build Mindfulness Skills
o Promote Interpersonal Effectiveness Skills
o Build Resources for Distress Tolerance
o Support Emotional Regulation


66
Level Syst em/ Pri vi l eges
Close observation first 24 hours wears scrubs, on unit only
Most are on level 1 with own clothes and caf privileges
Level 2 allows for 30 min breaks off unit
Adult level 2 is similar to 4S with more breaks when groups are going on

Group Ti ps
Special Considerations for the Unit:
o Low self esteem/depression, lack of interest/motivation, excessive sleeping
o Patients might be so depressed that they seem catatonic

Engage in Processing:
o Limited by their motivation to engage in discussions, levels of intellectual capacity or capability
and deficits

Effective Interventions:
o DBT skills, safety plans, coping skills, leisure time, life choices/goals, self-esteem

Effective Intervention Approaches:
o Tactile: games, problem solving interventions, crafts, clay
o Handouts: yes, in the form of worksheets
o Visual: when doing an art project or explaining a difficult concept
o Interactive: anything they have to make or actively do works really well because it holds their
attention. Allowing patients to choose their favorite song to listen to so they can create a
comfortable environment and open up
o Teamwork: try to make rules that each person has to participate so one person isnt
dominating the team and bossing everyone around
o Verbal encouragement: focus on and reinforce the positive. Assist the patients to work on
small steps of interaction. Have low expectations and meet each patient where they are.
o Motivations: treats

Group Tips information provided by: Kathryn Storrs, TRS, CTRS and Nataunya Kay, ATR

5W UofU Hospital
General
Located in the general University of Utah hospital with separate psychiatric unit
Inpatient acute care

Cri t eri a f or Admi ssi on
Patients who are chronically mentally ill, and often have medical complications
Persons with Mental Health and Substance Abuse Disorder
Persons with Post-Traumatic Stress Disorder (PTSD)

Age Range
18 "

Di agnosi s/ sympt oms and behavi ors
Anxiety, Eating Disorders, Process Addictions, Substance Abuse, Dissociative Disorders
Acute Stress, Alcohol, Anxiety, Depression, Personality Disorders, Substance Abuse

ht t p: //ment al -heal t h-f aci l i t i es. f i ndt hebest . com/l /608/Uni versi t y-of -Ut ah-Hospi t al -and-Cl i ni cs

ht t p: //heal t hcare. ut ah. edu/careers/nursi ng_resources/hospi t al _uni t s/behavi oral _medi ci ne/ad
ul t _i npat i ent . ht ml




Crisis Services UNI

UNI, in partnership with Salt Lake County and OptumHealth SLCo, is now providing comprehensive crisis response to
Salt Lake County residents. This 24 hour, 7 days a week crisis service is staffed by an interdisciplinary team of
mental health professionals.

Services provided include:
Cri si sLi ne - 801-587-3000, TTY: 801-587-8511
o The UNI CrisisLine provides 24 hour, 7 days-a-week phone crisis service and is staffed by
mental health professionals providing emotional support, assistance, crisis intervention, and
suicide prevention to individuals experiencing emotional distress or psychiatric crisis.
! The goal is to provide prompt, compassionate and effective help during personal,
family or community emergency.
! The crisis services include:
# Crisis intervention
# Emotional support
# Problem solving
# Referral to available resources
# Risk Assessment

The UNI CrisisLine provides crisis services locally for residents of Salt Lake County and state-wide as the Utah
affiliate for the National Suicide Prevention Network Lifeline at 1-800-273-TALK (8255).

Mobi l e Cri si s Out reach Team
o The University Neuropsychiatric Institute Mobile Crisis Outreach Team (UNI MCOT) is a
partnership with Salt Lake County and OptumHealth SLCo providing crisis services to county
residents. UNI MCOT is an interdisciplinary team of licensed professionals and certified peer
specialists available 24 hours a day, 7 days a week.
o Services include:
! Crisis resolution services for anyone experiencing, or at risk of, a mental health crisis,
and who requires mental health intervention
! Rapid response - face to face assessment and crisis intervention anywhere in Salt
Lake County
! Consultation and support to individuals of any age, families and treatment providers

Follow-up services including information and referrals, linkage with appropriate community based mental health
services for ongoing treatment



69

The Warm Li ne
o A recovery support line available daily from 3 p.m.11 p.m. Certified peer specialists provide
callers within Salt Lake County with support, engagement and encouragement. They promote
wellness in a nonjudgmental and respectful manner by listening, empowering a person to
resolve his or her own problem, and fostering a sense of hope, dignity and self-respect.
o 801-587-1055

http://healthcare.utah.edu/uni/crisis/

WRC UNI
Wel l ness Recovery Cent er
The Wellness Recovery Center (WRC) is a short-term residential program for Salt Lake County residents
experiencing an acute mental health crisis.
The Center follows a recovery/resiliency model.
Staffed by a team of nurses, social workers, psychiatric technicians, consulting psychiatrists and
certified peer specialists, the WRC provides crisis triage and intervention, assessment services,
medication intervention, safety, security and assistance in alleviating the crisis.

Peer Bri dger Program
The Peer Bridger Program provides a unique and personal level of support and service to effectively
deliver consistent, uninterrupted quality care to individuals transitioning into the community from
hospital or WRC stays.

What
The Peer Bridger program provides WRC consumers with continued follow-up and support for up to 30
days after leaving the WRC.
Peer Bridger assists clients in making appointments with treatment providers, organizing
transportation to appointments, obtaining documents and negotiating systems of care. All of which are
crucial elements for successful transition back into the community.

http://healthcare.utah.edu/uni/crisis/wellness_recovery.html

RC UNI
Recei vi ng Cent er
The UNI Receiving Center (RC) is an innovative program providing a short-term, secure crisis center for
up to 23 hours.
The RC is designed to offer a safe, supportive and welcoming environment to both voluntary and
involuntary individuals. It recognizes each person as a guest and provides the critical time needed to
work through his or her crisis.

What
The center features the Living Room model including peer support and clinical staff.
Treatments include therapeutic crisis management, strength based assessment utilizing peer
specialists, health screenings to determine health-care needs, assessment by a licensed mental health
professional, medication intervention, safety, security and assistance in discharge planning.
The RC acts as the primary receiving facility for law enforcement officers and EMS personnel in Salt
Lake County.

UNI CrisisLine - 801-587-3000

ht t p: //heal t hcare. ut ah. edu/uni /cri si s/recei vi ng_cent er. ht ml




RW UNI
Recovery Works Out pat i ent Program
An intensive outpatient program for adults struggling with drug and alcohol problems
Patients work in a group therapy setting four nights a week for eight weeks, to ensure success after
completion of treatment. Continued weekly aftercare support is available for participants.
The multidisciplinary treatment team includes a board certified psychiatrist, social workers, licensed
substance abuse counselors, a nurse, and expressive therapists.
What
The program incorporates the philosophy of Alcoholics Anonymous with participants expected to attend
12 Step meetings. Essential to the program is the families participation in a family group held once a
week. Equine therapy is also integrated into the program.

Qual i f i cat i ons
To be included in Recovery Works, individuals must be medically clear and detoxified from alcohol and
drugs. Regular attendance is required.
A Young Adult Recovery Works specialist is available and addresses the unique aspects of chemical
dependency in patients 1826 years of age.

ht t p: //heal t hcare. ut ah. edu/uni /chemi cal dependency/recovery_works. ht ml


ECT UNI
General
Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain,
intentionally triggering a brief seizure.
ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental
illnesses. It often works when other treatments are unsuccessful.
Much of the stigma attached to ECT is based on early treatments in which high doses of electricity were
administered without anesthesia, leading to memory loss, fractured bones and other serious side
effects.
ECT is much safer today and is given to people while they're under general anesthesia. Although ECT
still causes some side effects, it now uses electrical currents given in a controlled setting to achieve the
most benefit with the fewest possible risks.

Why
Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe symptoms of a
number of mental health conditions. It may be an effective treatment in someone who is suicidal, for
instance, or end an episode of severe mania. ECT is used to treat:
o Severe depressi on, particularly when accompanied by detachment from reality (psychosis), a
desire to commit suicide or refusal to eat.
o Treat ment -resi st ant depressi on, a severe depression that doesn't improve with
medications or other treatments.
o Severe mani a, a state of intense euphoria, agitation or hyperactivity that occurs as part of
bipolar disorder. Other signs of mania include impaired decision making, impulsive or risky
behavior, substance abuse, and psychosis.
o Cat at oni a, characterized by lack of movement, fast or strange movements, lack of speech, and
other symptoms. It's associated with schizophrenia and some other psychiatric disorders. In some
cases, catatonia is caused by a medical illness.
o Agi t at i on and aggressi on i n peopl e wi t h dement i a, which can be difficult to treat and
negatively affect quality of life.
ECT may be a good treatment option when medications aren't tolerated or other forms of therapy
haven't worked. In some cases ECT is used:
o During pregnancy, when medications can't be taken because they might harm the developing fetus
o In older adults who can't tolerate drug side effects
o In people who prefer ECT treatments over taking medications
o When ECT has been successful in the past

74
Ri sks
Although ECT is generally safe, risks and side effects may include:
o Conf usi on. Immediately after an ECT treatment, patient may experience a period of confusion
that can last from a few minutes to several hours, may not know where they are or why you're
there, may be able to return to normal activities right away, or may need to rest for several hours
after treatment. Rarely, confusion may last several days or longer. Confusion is generally more
noticeable in older adults.
o Memory l oss. ECT can affect memory in several ways. Patient may have trouble remembering
events that occurred before treatment began, a condition known as retrograde amnesia. It may be
hard to remember things in the weeks or months leading up to treatment, although some people
do have problems with memories from previous years, as well. Patient may also have trouble
recalling events that occurred during the weeks of your treatment. And some people have trouble
with memory of events that occur even after ECT has stopped. These memory problems usually
improve within a couple of months.
o Physi cal si de ef f ect s. On the days you have an ECT treatment, patient may experience
nausea, vomiting, headache, jaw pain, muscle ache or muscle spasms. These generally can be
treated with medications.
o Medi cal compl i cat i ons. As with any type of medical procedure, especially one that involves
anesthesia, there are risks of medical complications. During ECT, heart rate and blood pressure
increase, and in rare cases, that can lead to serious heart problems.
What you can expect
The ECT procedure takes about five to 10 minutes, with added time for preparation and recovery. ECT can be done
while patients is hospitalized or as an outpatient procedure.
I nduci ng a sei zure
When asleep from the anesthetic and muscles are relaxed, the doctor presses a button on the ECT machine. This
causes a small amount of electrical current to pass through the electrodes to the brain, producing a seizure that
usually lasts less than 60 seconds.
Because of the anesthetic and muscle relaxant, patient remains relaxed and unaware of the seizure. The only
outward indication that they are having a seizure may be a rhythmic movement of their foot if there's a blood
pressure cuff around your ankle. But internally, activity in the brain increases dramatically. A test called an
electroencephalogram (EEG) records the electrical activity in your brain. Sudden, increased activity on the EEG
signals the beginning of a seizure, followed by a leveling off that shows the seizure is over.

7S
A few minutes later, the effects of the short-acting anesthetic and muscle relaxant begin to wear off. Patient is taken
to a recovery area, where they are monitored for problems. When they wake up, they may experience a period of
confusion lasting from a few minutes to a few hours or more.
Seri es of t reat ment s
In the United States, ECT treatments are generally given two to three times weekly for three to four weeks for a
total of six to 12 treatments. The number of treatments needed depends on the severity of their symptoms and how
rapidly they improve.
Some people may be advised not to return to work until one to two weeks after the last ECT in a series or for at least
24 hours after the last treatment.
Resul t s
Many people begin to notice an improvement in their symptoms after two or three treatments with electroconvulsive
therapy. Full improvement may take longer. Response to antidepressant medications, in comparison, can take
several weeks or more.
No one knows for certain how ECT helps treat severe depression and other mental illnesses. What is known, though,
is that many chemical aspects of brain function are changed during and after seizure activity. These chemical
changes may build upon one another, somehow reducing symptoms of severe depression or other mental illnesses.
That's why ECT is most effective in people who receive a full course of multiple treatments.
Even after symptoms improve, patient still needs ongoing treatment to prevent a recurrence. Known as maintenance
therapy, that ongoing treatment doesn't have to be ECT, but it can be. More often, it includes antidepressants or
other medications, or psychological counseling (psychotherapy).

ht t p: //www. mayocl i ni c. org/t est s-procedures/el ect roconvul si ve-t herapy/basi cs/ri sks/prc-
20014161






Electroconvulsive therapy (ECT). (n.d.). Risks. Retrieved July 10, 2014, from
http://www.mayoclinic.org/tests-procedures/electroconvulsive-
therapy/basics/risks/prc-20014161
CAT UNI

Comprehensi ve Assessment and Treat ment f or Chi l dren and Adol escent s
CAT program

What
4 - 6 week, comprehensive clinical evaluation for ages 5-17 in a safe and secure environment. The
multi-disciplinary treatment team will assess psychiatric and medical conditions, provide behavioral &
educational assessments, psychological testing, therapy, and when necessary, address chemical
dependency issues.
The program includes:
o Psychiatric evaluation provided by board certified Child and Adolescent Psychiatrists with
diagnostic expertise in Major Depression, Bipolar, Schizophrenia, ADHD, Reactive Attachment,
Autistic Spectrum Disorders and Substance Abuse
o Psychological & Neuropsychological testing and therapy provided by PhD psychologists
o Medical evaluation provided by board certified pediatricians
o A collaborative approach constructed by complete multi-disciplinary team consisting of child
psychiatrists, pediatricians, psychologists, nurses, licensed clinical social workers, recreational
therapists, art therapists, music therapists and education specialists
o Active family involvement throughout the assessment period
o Inpatient care in a beautiful, state-of-the-art facility, which includes secure outdoor play areas
and a ROPES challenge course
o Appropriate and evidenced based treatments throughout the program with daily contact with
the psychiatrist

Often, children and adolescents enter treatment programs without an accurate diagnosis or a clear-cut
understanding of what is to be gained by the treatment. The CAT program will help provide an understanding of the
child/adolescent and create a dynamic, individualized treatment plan that will facilitate the most appropriate match
of community resources with the child/adolescents specific needs.

ht t p: //heal t hcare. ut ah. edu/uni /servi ces/assessment _t reat ment . ht










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Kat heri ne Kopl ow
Recreat i onal Therapy I nt ern
Uni versi t y Neuropsychi at ri c I nst i t ut e
Summer 2014
Uni versi t y of Ut ah