title: [Cognitive milieu therapy and restraint within dual diagnosis populations].
abstract: BACKGROUND
  The use of restraint is common practice within psychiatry and is most frequently used with patients with a co-occurring serious mental illness and substance abuse or dual diagnosis. Furthermore restraint has being shown to have a negative impact on treatment outcomes and on the psychological wellbeing of patients. Cognitive behavioural therapy has been shown to contribute to positive treatment outcomes for a range of mental health problems, including schizophrenia and substance abuse.
  
  
  METHODS
  The following study examined the incidence of restraint within a dual diagnosis inpatient ward before and after the implementation of cognitive milieu therapy.
  
  
  RESULTS
  Data collected over a four-year period showed that the incidence of physical restraint was significantly reduced after the introduction of cognitive milieu therapy, and that this reduction was not offset by increases in other forms of restraint.
  
  
  CONCLUSIONS
  The implications of these results are discussed regarding the use of restraint on dual diagnosis populations within psychiatric settings.
authors.affiliation: Sct. Hans Hospital, Center for Kognitiv Terapi, Afdeling M, Roskilde. joern.lykke@shh.regionh.dk
authors.forename: Jørn
authors.initials: J
authors.lastname: Lykke
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Austin
authors.forename: Mille Metz
authors.initials: MM
authors.lastname: Mørch
mesh_terms: D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D003068:Coercion; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy; D011619:Psychotropic Drugs / Q000008:administration & dosage; D012149:Restraint, Physical / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D011619:Psychotropic Drugs