Implementation of an ACT Curriculum on an Adolescent Inpatient Psychiatric Unit: A Quality Improvement Project

Pediatric psychiatric inpatient treatment serves an important function for youth in crisis or with serious emotional disorders. Fundamental to an inpatient unit's program are the groups and activities scheduled throughout the day which help organize the patients' time and also provide therapeutic socialization, creative and educational experiences. Evidence-based mental health interventions are available for child/adolescent treatment but there are few instances of their application in pediatric inpatient treatment. An interdisciplinary project team employed the quality improvement cycle to implement a series of Acceptance and Commitment Therapy (ACT) groups. To implement the largely staff-led groups the planning team developed group protocols and educational/development sessions with staff. The improvement was gauged by changes in parent/patient knowledge and satisfaction with group programming and changes on the Avoidance and Fusion Questionnaire for Youth (AFQ-Y); a measure which taps into psychological flexibility. Data collected over the course of a year indicated patient and parent knowledge of ACT principles increased as did their satisfaction with the group programming. Unit level data from three periods of collection indicate increases in adolescent's time spent in groups, adoption of ACT language, improvement in AFQ-Y scores and increased parental knowledge of the unit's treatment approach. The project demonstrates that it is possible to implement an evidence-based intervention and create a positive impact during brief inpatient treatment.