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This study employs a quasi-experimental design to evaluate the effectiveness of a 6-month multidisciplinary rehabilitation program integrating psychodynamic group therapy, art therapy, music therapy, and cognitive stimulation compared to standard rehabilitation (physiotherapy and occupational therapy). It will be done between a group of a total of 20 patients are divided into an intervention group and a control group from the forensic psychiatric department in Al Masarra Hospital.
Forensic psychiatric patients with treatment-resistant psychotic symptoms often experience persistent cognitive, functional, and social deficits, posing significant challenges to rehabilitation. Traditional approaches may not adequately address these complex needs, highlighting the importance of innovative, multidisciplinary interventions. This study employs a quasi-experimental design to evaluate the effectiveness of a 6-month multidisciplinary rehabilitation program integrating psychodynamic group therapy, art therapy, music therapy, and cognitive stimulation compared to standard rehabilitation (physiotherapy and occupational therapy). A total of 20 patients are divided into an intervention group (n=10) and a control group (n=10) using convenience sampling from the forensic psychiatric department in Al Masarra Hospital. Data is collected using the Positive and Negative Syndrome Scale (PANSS) to assess psychotic symptoms and the Montreal Cognitive Assessment (MoCA) to evaluate cognitive function, administered at baseline and post-intervention. Data is analyzed using descriptive statistics (median, interquartile range) and non-parametric tests, including the Wilcoxon Signed-Rank Test for within-group comparisons and the Mann-Whitney U Test for between-group comparisons. Effect sizes are calculated using Cliff's Delta to assess the practical significance of the findings. The null hypothesis states that there will be no significant difference in PANSS and MoCA scores between the intervention and control groups post-intervention. If the null hypothesis is rejected, the findings will provide evidence for integrating creative and psychotherapeutic interventions into forensic psychiatric rehabilitation, offering a scalable model for similar settings.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention Group: Multidisciplinary Rehabilitation Arm | Experimental | 10 forensic psychiatric patients selected via convenience sampling from the forensic department of Al Masarra Hospital. All participants are diagnosed with treatment-resistant psychotic disorders and exhibit persistent cognitive, social, and functional deficits despite receiving pharmacological treatment. The patients included in this group match the inclusion criteria. This group is enrolled in a 6-month structured multidisciplinary rehabilitation program that integrates four distinct therapeutic modalities, each targeting a different domain of recovery: psychodynamic group therapy, art therapy, music therapy, and cognitive stimulation beside the tradition rehabilitation done (physiotherapy and occupational therapy. The integration of these therapies is designed to address the residual psychotic symptoms, cognitive, functional, emotional and relational impairments of the patients with resistant psychotic symptoms, which are often neglected in standard rehabilitation approaches. |
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| Control Group: Standard Rehabilitation Arm | Experimental | The control group consists of another 10 forensic psychiatric patients selected from the same department using the same inclusion criteria and sampling method. These patients are also diagnosed with treatment-resistant psychotic disorders and have longstanding impairments in cognition, functioning, and social interaction. However, instead of receiving the enhanced multidisciplinary program, they participate in the existing standard rehabilitation services provided at Al Masarra Hospital. This group serves as the comparison arm (control group) in this comparative experimental study. The standard rehabilitation program primarily includes physiotherapy and occupational therapy, both of which are routinely available within the hospital's forensic unit. These therapies aim to maintain physical health and promote basic functional independence in hospitalized patients with severe mental illness. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MoCA: Montreal Cognitive Assessment (MoCA) and Positive and Negative Syndrome Scale (PANSS) | Diagnostic Test | MoCA: A 30-point screening tool assessing attention, memory, language, visuospatial and executive functions; quick and sensitive to mild cognitive deficits. PANSS: A 30-item scale rating positive, negative, and general psychopathology symptoms in psychotic disorders; widely used to track severity and change. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Psychotic Symptoms Measured by the Positive and Negative Syndrome Scale (PANSS) | Psychotic symptom severity will be assessed using the Positive and Negative Syndrome Scale (PANSS). Scores range from 30 to 210, with higher scores indicating greater severity. The unit of measure is score change from baseline to post-intervention. | Baseline (pre-intervention) and 6 months (post-intervention). |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Cognitive Function Measured by the Montreal Cognitive Assessment (MoCA) scale | Cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA) scale. Scores range from 0 to 30, with higher scores indicating better cognitive performance. The unit of measure is score change from baseline to post-intervention. | Baseline (pre-intervention) and 6 months (post intervention). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sara A. Habib, Specialist | Al Massara Hospital,MOH Oman | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Al Massara Hospital | Muscat | Muḩāfaz̧at Masqaţ | Oman |
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This quasi-experimental, non-randomized parallel-group study evaluates a 6-month multidisciplinary rehabilitation program for forensic psychiatric inpatients with treatment-resistant psychotic symptoms at Al Masarra Hospital. Twenty patients will be allocated by convenience sampling to an intervention group (n=10) or control group (n=10). The intervention integrates psychodynamic group therapy, art therapy, music therapy, and cognitive stimulation (4-5 hrs/week), while controls receive standard physiotherapy and occupational therapy (3-4 hrs/week). PANSS and MoCA will be administered at baseline and post-intervention by blinded assessors. Data will be analyzed using Wilcoxon Signed-Rank and Mann-Whitney U tests, with effect sizes reported via Cliff's Delta. The null hypothesis is that there will be no significant differences in psychotic symptoms or cognition between groups post-intervention. outcomes may support rehabilitation importance in forensic settings.
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| Rehabilitation program in the form of : psychodynamic group therapy, music and art therapy , cognitive stimulation techniques | Behavioral | Participants received a structured 6-month program designed to address persistent psychotic symptoms and associated deficits. The intervention included: Art Therapy: Weekly sessions promoting self-expression, emotional regulation, and enhancement of social interaction. Cognitive Stimulation: Structured group exercises aimed at improving attention, memory, executive functions, and problem-solving. The program was delivered by a multidisciplinary team in a group of 10 patients, ensuring active participation, individualized support, and integration of therapeutic modalities. |
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| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| D001155 | Art Therapy |
| ID | Term |
|---|---|
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
| D026421 | Sensory Art Therapies |
| D000529 | Complementary Therapies |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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