Structure
When planning the seminar, which we chose to refer to as an introduction seminar, we wished to use the waiting time in a way that was beneficial to the patients. We were not familiar with any similar models, and were therefore unable to draw on experience from elsewhere. Finally it was decided to arrange the introduction seminar over three days, from 12 noon to 3 p.m. over a period of two weeks. When we started in 2003, two seminars were arranged per year, but in 2009 the frequency was increased to four seminars annually.
The content of the seminar has three main components. First, the psycho-educative part, which consists of popularised lectures on general aspects of mental health. In recent years we have concentrated on three topics that recur in each seminar: the conditions and challenges of human life, the basis for a positive self-image, and group therapy – can it be done?
The second main element comprises a presentation of the various forms of treatment that our outpatient clinic offers (Box 1). The presentations emphasise group-based therapies, since these tend to be least well known to the audience and because we wish to encourage more people to make use of such services. Several studies indicate that group-based treatment is more resource-efficient, and that the effect of such treatment is equal to that of individual treatment. This applies to most of the disorders for which patients are referred to psychiatric outpatient clinics (1).
Box 1
Overview of treatment programmes in the psychiatric outpatient clinic, Jæren DCP
Coping with anxiety, 8 sessions
Coping with depression, 10 sessions
Self-confidence training group, 10 sessions
Active everyday life, cooperation with NLWA
Group-based outpatient clinic, 3 days per week over 4 months
Coping with pain, 8 sessions
Individual therapy
The third component is a practical exercise, for which the patients are assigned to groups during the last half hour of every seminar day. The groups are led by nurses who have experience of group work. The participants can ask questions or talk about their expectations, and thereby gain some experience in group participation.
The staff of the clinic is responsible for all professional and practical aspects of the introduction seminars. On the first seminar day, each participant receives a folder with written material describing relevant treatment alternatives and other practical information. Each seminar day is registered and billed as an outpatient consultation. After each seminar, the participants fill in an anonymous evaluation form.
All the seminars have followed the structure described above, but some minor adjustments have been made. One key change was to leave the provision of information on one of the group-based treatment programmes to a former patient who has completed the programme.
Immediately after the introduction seminars, all participants have an exploratory conversation with a doctor or a psychologist at the clinic. The conversations are recorded in the patient’s journal, further treatment plans are discussed with the patient and a preliminary conclusion regarding diagnosis and choice of therapy is made.