South Eastern
Private Hospital
Program Outline
Mental Health
Services
PROGRAM DESCRIPTION
The Mental Health Program is an open group program
providing evidenced based therapy for patients of
South Eastern Private Hospital.
The program aims to equip patients with knowledge
and skills to cope better with the emotional and
psychological difficulties that have led to their
admissions.
PHILOSOPHY
•• Mood disorders are understandable within a
bio-psycho-social framework.
•• Mood disorders, including severe and chronic
forms, are treatable within an integrated model
that addresses the biological, behavioural, cognitive
and interpersonal vulnerabilities and deficits.
•• Patients with mood disorders will benefit from a
warm, supportive group environment
in which they are:
a. Encouraged to experience and express their
feelings
b. Given the opportunity to learn that their
experiences are shared by others with mood
disorders
c. Encouraged to interact in constructive ways.
GOALS
•• To foster a positive and constructive group.
•• To improve emotion management and regulation.
and anxiety and learn skills to manage these
conditions.
•• To change or better cope with unhelpful thinking
patterns.
•• To improve interpersonal skills, particularly
communication and assertiveness.
•• To build self-esteem.
•• To reduce the risk of relapse.
•• To provide knowledge, encourage awareness
and teach skills that enable individuals to take
responsibility and control to enable them to enjoy
an improved quality of life.
•• To develop skills to decrease areas of vulnerability
and prevent relapse.
TARGET POPULATION
Inclusion:
•• Patients with a DSM-V Axis I mood disorder
including: Major Depression, Bipolar Disorder,
Most Recent Episode Depressed, Dysthymic
Disorder, and Schizoaffective Disorder and aged
psychiatry.
•• Patients who are willing to comply with the
treatment Program.
•• Patients who are under the care of a psychiatrist
and agree to see that person regularly during their
time in the Program.
•• Patients who are willing to be a part of a group
and commit to the group rules.
•• To learn skills to manage stress.
•• To increase understanding of depression
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Exclusion:
•• Current alcohol / substance abuse, high suicide
risk, severe self-harm not being effectively treated,
active psychosis or history of aggression.
•• Child Psychiatry – under 18 years of age.
GROUP SIZE
Minimum- 4
Maximum-12
Staffing
•• Primary diagnosis of an Eating Disorder.
Nursing Staff
Psychologist
Physiotherapist
Occupational Therapists
Exercise Physiologists
Social Worker
Dietitian
•• Intoxicated patients or patients under the
influence of alcohol or illicit substances.
ASSESSMENT PROTOCOL
•• Patients who are currently being assessed or
treated under provisions of the Victorian Mental
Health Act 2014.
•• Primary diagnosis of Alcohol and/or drug
dependency.
•• Patients with a history of violence, assaults and
disruptive behaviour.
•• Patients who have an extensive forensic history.
•• Patients with an acute presentation that cannot
be safely managed with the resources available at
the Hospital at that point in time.
•• Patients that are deemed unsuitable by the
Director of Clinical Services and/or Mental Health
Program Manager.
Patients are assessed for inclusion in the program by
the multi disciplinary team. A group folder is provided
that contains a description of the groups that occur
in the program, educational information and handouts
related to the group sessions. One of the team also
gives patients a brief orientation to the nature and
content of the program.
PATIENT REVIEW PROCESS
Patients are reviewed at least twice weekly by the
treating consulting psychiatrist and also through the
daily nursing handovers. The multi disciplinary team
also provide and receive feedback regarding patient
progress.
Patients are also reviewed individually, as the need
arises. The following indicators automatically lead to
a review:
•• Evidence of self-harm risk
•• Regularly failing to abide by group rules
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•• Difficulty engaging with the group, including low
disclosure or contribution to the group.
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LENGTH OF STAY
OUTCOME MEASURES
Length of stay is determined individually for each
patient.
Patients are given the following measures upon
admission and discharge to the unit: Health of the
Nation Outcome Scales (HoNOS), the Mental Health
Questionnaire (MHQ-14) and Patient Experience
Questionnaires.
OUTCOME GOALS
Throughout their stay patients will have had the
opportunity to:
•• Increase their understanding of the nature
of anxiety and depression (causes, symptoms,
moderators and treatment).
•• Learn to identify, express and communicate
emotions more effectively.
De-identified HoNOS and MHQ-14 Questionnaires
results are analysed on a quarterly basis and are
benchmarked with other Healthecare psychiatric
facilities as well as other hospital groups.
Patients are surveyed for their feedback about the
Group Therapy Program three times a year (every 4
months).
•• Learn strategies to reduce sensations of anxiety.
•• Learn more adaptive coping skills to manage
distress.
•• Learn better ways to cope with unhelpful thinking
patterns that are responsible for distressing
emotional states.
•• Learn approaches to encourage re-engagement
with avoided activities.
•• Learn to manage stress and emotional states more
effectively.
•• Develop and practice acceptance based strategies
to cope with distressing thoughts and emotions.
PROGRAM CONTENTS
The program is based on evidence based therapies
that have been proven to be effective in treating
depression and anxiety disorders: Cognitive Behaviour
Therapy (CBT), Interpersonal Psychotherapy (IPT)
and Acceptance and Commitment Therapy (ACT).
The program also includes elements from Dialectical
Behavioural Therapy (such as self soothing strategies
and distress tolerance and coping plans) to assist with
the more rigid personality structures that frequently
present co-morbid to depression and anxiety disorders.
•• Develop ways to behave towards themselves that
are consistent with healthy self-esteem.
•• Learn to communicate more assertively and
openly with those at work and home.
•• Learn to identify early warning signs of their
respective conditions & maintain newly learnt skills
in order to prevent relapse and deal with setbacks.
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Cognitive Behaviour Therapy (CBT)
CBT is based on the principle that identifying and
challenging maladaptive, distorted thinking, leads
to changes in affect and behaviour. It focuses on the
negative feedback cycles that occur in depression and
anxiety disorders between unhelpful thinking, affect
and behaviours, and then setting positive exercises in
order to have a corrective experience. The process of
CBT involves:
•• Identifying errors in thinking such as the
classic thought distortions of overgeneralising,
magnifying negatives and minimalising positives,
and catastrophising
•• Highlighting the core beliefs potentially underlying
the distorted thoughts
•• Gaining cognitive distance from distorted
thoughts, and exploring alternatives that are
realistic, helpful and positive
•• Implementing action strategies to overcome
the low motivation and inactivity that forms an
inherent part of depression and challenge the
negative fearful assumptions that are present with
anxiety disorders.
•• Overall improving self esteem and increasing sense
of control and purpose through the corrective
experience of achievement and having had
unhelpful assumptions disconfirmed.
Interpersonal Psychotherapy (IPT)
IPT is aimed at determining and addressing the
interpersonal context (the relationship factors) in
which the patient’s distress came about, is reinforced,
and continues.
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IPT is concerned with four main problem areas:
Grief, Interpersonal Disputes, Role Transitions and
Interpersonal Sensitivity. The focus of IPT is helping
patients to:
•• Express feelings about problems, the painful
feelings as well as the pleasant;
•• Accept painful feelings;
•• Assess communication patterns to identify
communication failures and to express feelings and
wishes more directly;
•• Resolve conflicts by first identifying the conflicts
and then assisting the patient in making choices
about a plan of action.
Acceptance and Commitment Therapy (ACT)
ACT (pronounced act) has the overriding goal of
increasing psychological flexibility, which includes the
ability to be psychologically present, to be able to
control behaviour, to be present with what life brings
us and to move toward “Valued” behaviour.
ACT has six main components:
•• Contact with the present moment (mindfulness),
which is consciously bringing awareness to the
here and now experience, without defence or
judgement, which enables full engagement with
what is happening, and facilitates a conscious
choice of behaviour.
•• Acceptance: The capacity to be actively in contact
with private experiences (especially unpleasant
/ uncomfortable feelings) and allowing them
to come and go without struggling with them,
running from them or giving them undue
attention.
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•• Diffusion: Being able to observe thoughts rather
than being consumed by them or struggling to
avoid them, allowing for more flexible responses.
•• Self as context: Awareness of being able to observe
experiences rather than being defined by them or by
the labels commonly applied to the self.
•• Values: Connecting with freely chosen, desired
qualities of ongoing action, which provide
guidance and motivation for positive, life affirming
action (as opposed to the inherent difficulties
in being motivated by avoiding unwanted
experiences).
•• Committed Action: Setting goals, guided by your
values and taking effective action to achieve them.
The groups typically involve a presentation and
discussion of the relevant topic. While active
participation is voluntary, patients are encouraged to
give feedback and be involved in the group process.
The topics covered in the group program include:
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Overcoming Anxiety Module
•• The “Understating Anxiety” group defines anxiety
from a CBT perspective and provides a rationale
for strategies that will help overcome this
problem.
•• The “Slow Breathing and Panic Surfing” group
provides strategies to manage the effects of
anxiety.
•• The “Challenging Anxious Thoughts” group
provides individuals with cognitive strategies to
help them deal with anxious thoughts that trigger
and maintain anxiety.
•• The “Overcoming Avoidance” group helps
individuals confront their fears through graded
exposure.
Managing Depression Module
•• The “Understanding Depression” group defines
depression from a CBT perspective and discusses
strategies that will help overcome this problem.
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•• The “Goal Setting and Motivation” group
provides strategies to increase level of motivation
and activity.
•• The “Problem Solving” group provides patients
with a five step practical approach to solving
problems.
•• The “Challenging Unhelpful Thoughts” group
provides patients with strategies to deal with the
unhelpful thoughts that maintain depression.
Acceptance and Commitment Therapy
•• The “Changing Unhelpful Coping” group
encourages patients to explore the effects
that struggling against and controlling painful
emotional and cognitive states have on
their functioning. Strategies that encourage
experiencing and acknowledging these states are
discussed and explored as an alternative.
practiced in group.
Assertiveness
•• This group defines different communication styles
and their consequences. It also provides strategies
for altering communication styles and applying
assertive communication techniques.
Coping with Distressing Emotional States Groups
•• The “Identifying and Expressing Feelings” group
provides strategies to identify and manage the
effects of feelings/emotions, allowing them to be
utilised in a constructive manner.
•• The “Anger Management” group aims to help
patients develop more helpful strategies to
cope with anger. Discussion includes ways to
appropriately express anger, and ways to manage
problematic anger and the types of thinking
patterns that maintain anger.
•• The “Acceptance and Mindful Awareness”
group further explores these issues and presents
mindfulness as an alternative approach towards
managing distressing private experiences.
•• The “Dealing with Guilt” group provides patients
with a greater understanding of guilt and explores
strategies that might help resolve problematic or
persistent guilt.
•• The “Core Values” group explores the core
values patients may have and encourages them to
commit to incorporate these values into their lives,
despite distressing emotional states that might act
as barriers to this.
•• The “Managing Stress” group aims to teach
individuals effective stress management
techniques, such as the importance of balance and
perspective, time management skills, and setting
limits.
Improving Communication Skills
•• This group focuses on the importance of
communication skills in managing the way
individuals interact with others. Methods of
communicating effectively are discussed and
•• The “Managing Worry” group discusses strategies
for managing worry, in particular mindfulness and
problem solving. The unhelpful nature of worry
and the way it is maintained are also discussed.
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•• The “Dealing with Grief and Loss” group
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discusses the nature of the grief process, factors
that can interfere with appropriate reactions
to grief and loss, and ways to help facilitate
appropriate grieving.
Dealing with Stigma
•• This group focuses on the impact of having a
mental illness and challenges concepts related to
mental illness and psychological difficulties. The
importance of utilizing different ways of dealing
with stigma and accepting mental illness are
discussed.
Improving Sleep
•• This group aims to help individuals get a better
nights sleep. The concepts of “sleep hygiene” are
discussed in order to improve the amount and
quality of sleep individuals are getting.
apply the techniques. A variety of different types
of mindfulness meditation styles are used including
mindful breathing, mindful bodyscans and mindful
distancing from distressing thoughts and feelings.
Open discussion
•• This is a group in which patients are given an
opportunity to discuss issues that are relevant
to them in a less structured format. Patients are
encouraged to discuss and practice techniques
reviewed in other groups.
Overcoming Perfectionism
•• This group focuses on how unrealistically high
expectations of the self and others can negatively
impact on self-esteem and rob the individual of a
sense of achievement. Ways of managing this are
discussed in the group.
Improving Social Networks and Support
•• This group focuses on the variety of needs that can
be met by our social network and the importance
of working on, improving and accessing this
support. The importance of our social network for
support, helping us manage stress and staying well
are discussed.
Managing Social Anxiety
•• This group discusses the factors that can create
anxiety in social situations and the beliefs that
help maintain social anxiety. Ways to manage
the situations individuals typically find difficult are
discussed in this group.
Mindfulness Practice
•• These groups involve active practice of mindfulness
meditation in order to help patients to learn and
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Preparation for discharge (including Relapse
Prevention) Improving Social Networks and
Support
•• This group aims to help patients prepare for
discharge from hospital by discussing the
difficulties they may face. It further involves
the development of strategies to assist with
management of the identified issues.
Weekend Planning
•• Prior to the weekend patients discuss their
plans for the weekend. Individual goals for
the weekend are established and strategies
to assist with potential problems that may be
encountered are discussed.
Weekend review
•• This group occurs following the weekend.
Problems faced over the weekend and how
patients coped with these difficulties are
discussed. Goals achieved over the weekend are
discussed and also goals for the upcoming week
are established.
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