Friends Hospital has been home to many “firsts” in our 200-year history. Another milestone occurred in 2011 when the hospital implemented “FIRST at Friends” – a comprehensive multidisciplinary approach to treatment. Using evidenced–based best practices, this approach centers psychiatric care and treatment around the concepts of FIRST – (F) family, (I) individual, (R) recovery, (S) strengths and (T) trauma-informed care. The patient, his/her loved ones and the treatment team work together to develop an individualized plan to assist the patient on the path to recovery.
The FIRST at Friends Model
At Friends Hospital, we understand the importance of a person and family-centered approach to a successful outcome. This includes family (both immediate and extended), the community and others identified by the patient as being invested in his/her recovery. Couples and family therapists offer family psycho-education and supportive services as part of family-focused treatment intervention. We work with community and advocacy groups to identify and utilize external resources to support the individual and the family on the pathway to recovery. We incorporate the family at all stages of treatment and care, ranging from the initial assessment to aftercare planning.
Friends Hospital is also home to the Family Resource Center (FRC). Founded by a local mental health advocate, the center is staffed by trained individuals who share the experience of having a loved one with mental illness. The FRC provides literature, support and contact information for additional community resources.
The concept of “individual” is an important part of Friends Hospital’s treatment philosophy. Friends Hospital recognizes that every patient is unique and that in order for treatment to be effective, the care provided must be tailored to the individual. Each patient is at the center of a multidisciplinary treatment team that develops a plan for both the hospital stay and aftercare.
This culturally competent, person-centered approach creates collaborative, strengths-based treatment guided by the voice of the patient. All patients are assigned a therapist to provide individual counseling. Every therapist is trained in components of evidence-based practice, including Acceptance & Commitment Therapy (ACT), which considers the power of language, acceptance and personal empowerment during trauma-informed group therapy and substance abuse assessment and treatment. A social services therapist is also assigned to assist with family sessions, define and update specific treatment goals, develop a wellness plan and assist with accessing post-discharge resources.
Friends Hospital’s Department of Psychology is accredited by the American Psychological Association and uses specific assessment tools to assess for harm to self or others, substance abuse and trauma. All of these individual components are incorporated into the treatment planning process, ensuring a comprehensive and holistic approach to treatment.
Consistent with the philosophy of our Quaker founders, Friends Hospital opened Philadelphia’s first recovery-oriented inpatient psychiatric unit in 2010. Integrating key recovery principles that create a collaborative environment between the patient, the staff and the community, personal goals are identified that include continued therapy, recognition of personal strengths and the development of support systems that will aid in recovery.
In 2012, Friends Hospital integrated and expanded these recovery principles to all units within the hospital. Promoting choice, wellness, empowerment and strengths, we created an environment that supports the individual’s personal journey to wellness. This includes offering a variety of therapeutic groups from which a patient can choose based on his/her individual needs, the development of a personal empowerment plan that guides discharge planning and the use of certified peer specialists who, having gone on their own personal journey to wellness, can provide support to others.
At all stages of treatment, the patient shares his/her voice with the team, creating a collaborative, interactive and empowering treatment experience. Patients are provided with information and access to community support and are active participants in their discharge planning process.
A primary principle of personal recovery is the encouragement and promotion of an individual’s strengths and resiliencies – both within oneself and throughout the community. Friends Hospital’s specialized treatment plan specifically emphasizes developing strengths and successful coping strategies that can be applied to current and future stressors. Every individual, family and community has assets and support that, with hope and encouragement, can be nurtured to promote wellness and recovery.
In keeping with the recovery principles, certified peer specialists provide group sessions that help patients identify their strengths and develop methods to use them to tackle challenges. The patient is viewed as the source of control, understanding that with choice and recognition of strengths and self-empowerment, acceptance and change can occur.
Many patients who present for treatment may also have a history of a trauma. It is not uncommon for a patient to identify episodes or periods of abuse, neglect and crises, either in the past or present. Friends Hospital has incorporated a trauma-informed perspective approach to patients and families. We create a secure environment that enables patients to safely address their issues by educating and supporting staff to be sensitive to a patient’s history and to provide support using non-invasive measures when assisting patients and de-escalating situations.
Friends Hospital utilizes this approach throughout all of our programs and services, including our Admissions Department, and has incorporated an initial trauma screening into all assessments. If trauma is indicated, additional evaluations are conducted. The results of these assessments are shared with the patient and treatment team so that specific goals to address these issues can be developed in both the treatment plan and the patient’s personal empowerment plan.