Patterns of Staff Perception of Difficult Patients in a Long-Term Psychiatric Hospital
Donald B. Colson Ph.D.1,
Jon G. Allen Ph.D.2,
Lolafaye Coyne Ph.D.2,
David Deering R.N.,M.Ed.3,
Nancy Jehl M.S.W.4,
William Kearns M.D.2, and
Herbert Spohn Ph.D.2
1 The Menninger Foundation in Topeka, Kansas, The Menninger Foundation, Box 829, Topeka, Kansas 66601
2 The Menninger Foundation in Topeka, Kansas
3 The Menninger Foundation in Topeka, Kansas the C. F. Menninger Memorial Hospital
4 The Menninger Foundation in Topeka, Kansas the Outpatient Psychotherapy Service and Diagnostic Service
The Menninger Foundation, Box 829, Topeka, Kansas 66601.
In a study to determine which psychiatric patients are perceived by staff as most difficult to treat, clinical staff from several disciplines rated problem behaviors of 127 long-term inpatients in a private psychiatric hospital; staff also rated overall treatment difficulty, progress, and prognosis. No single patient characteristic determined staff's perception of patients as difficult to treat. Instead, four clusters of patient characteristics contributed to this perception; in decreasing order of influence, they are withdrawn psychoticism, severe character pathology, suicidal-depressed behavior, and violence-agitation. The study also showed that the patients who are considered particularly difficult are perceived as improving less and as having a poor prognosis.
