Psychiatric Disorders

The psychiatric team works on an interdisciplinary basis with clients whose primary difficulty is socioemotional in nature. Although mood and anxiety disorders are the most prevalent diagnoses amongst the clientele, a variety of psychological, physical and social difficulties often co-occur for each individual. Suitability for rehabilitation is determined based on information from the referral source, including age, previous treatment outcomes and participation in vocational and/or social activities.

The duration of the rehabilitation program is generally 4-6 weeks. Most clients living in the Reykjavík metropolitan area participate in the program on an outpatient basis but inpatient status is offered for various reasons, including rural residence and nursing needs. An assessment interview typically occurs prior to admission, whereby the client's motivation, current physical and psychiatric status and general rehabilitation needs are determined. Clients with a history of substance abuse need to have ceased the abuse at least 6 months prior to admission.

The Rehabilitation Program

Once admitted, an interdisciplinary team works with each client towards reaching rehabilitation goals, which are set in conjunction with the client. As each client‘s rehabilitation program is individually tailored, it differs somewhat from one client to the next. However, all clients are seen by a psychiatrist and receive some form of individual counselling or psychotherapy delivered by a psychologist and/or a psychiatric nurse.

Treatment approaches used within the program include but are not limited to: Cognitive-behavioral therapy (including imagery rescripting), mindfulness, EMDR, hypnosis and compassion-focused therapy. In addition, most clients participate in some group activities, such as self-esteem enchancement, social skills training, cognitive-behavioral treatment, mindfulness and various psychoeducational seminars.

Each client is also assigned to a physical therapist and an occupational therapist. Physical therapists set up an individualized exercise program in conjuction with sports therapists. Clients with musculoskeletal problems, e.g., chronic pain, fibromyalgia or arthritis, also receive physical therapy. Occupational therapists work with clients to identify important and valued activities that each client finds difficult. The activities may be related to self-care, work or leisure. Emphasis is placed on using the client‘s strengths and resources to lead meaningful, satisfying and productive lives. Individual goal setting, weekly planning, home- and community-based intervention is also offered. When needed, a social worker works with those who require financial and/or social services. Finally, neuropsychological assessment and rehabilitation, as well as consultations with a nutritionist, are provided on an as-needed basis.

Upon discharge, follow-up is generally provided by the referring physician. Clients are, however, typically offered a follow-up interview by their rehabilitation team a few weeks post-treatment, aimed at reinforcing and maintaining skills developed during the rehabilitation program. Clients are also offered participation in an 8-week mindfulness-based cognitive therapy group as a means to reduce risk of relapse.