Since it emerged in 2006, recovery-oriented cognitive therapy has expanded to use in residential facilities and hospitals as a way to reduce patient outbursts and hospitalizations for complex behavioral patients.
Recovery-oriented cognitive therapy, or CTR, is designed to give healthcare providers the tools to determine what matters to patients and help them take steps toward their goals. Created by Aaron Beck, MD, it has been used in state hospitals among some of the most complex psychiatric patients who often experience aggression or are prone to commit self-harm and experience intense emotional states.
“While it has ‘therapy’ in the name, one of CTR’s greatest strengths is that it works across multidisciplinary teams,” Paul Grant, PhD, director of Beck Institute’s Center for Recovery-Oriented Cognitive Therapy, a nonprofit research center in Philadelphia, told Becker’s. “It offers a framework to understand unpredictable behaviors, promotes empathy, and provides actionable steps for support. It’s about helping both patients and staff feel safe and connected.”
Hospitals that have implemented the approach found staff reported feeling more empowered and effective and experiencing less burnout. And some of the best results came from staff members who do not traditionally provide therapy.
“Hospital culture can often lean toward control, which leads to bad outcomes. Giving people even small choices — “Would you like to do this now or later?” “This group or that group?” — can cool the fire that drives reactive behaviors,” Lindsey Pinto, a clinical consultant for Beck Institute, told Becker’s. “It creates a sense of autonomy and helps staff recognize unmet needs.”
For patients, CTR improves resiliency and family relationships while reducing physical aggression and behavioral challenges, self-injurious behaviors and incidents of elopement.
Langhorne, Pa.-based Woods System of Care, an organization that offers outpatient health and behavioral care for children and adults, first implemented CTR in 2022. The system piloted the program in two of its residential facilities that primarily help children with intellectual disabilities, those on the autism spectrum, and those with serious and persistent behavioral health needs.
Not only did patients and families see a reduction in behavioral issues, but the therapy model was linked to reduced emergency department visits, lowered behavioral incidents toward others and themselves and decreased hospitalizations.
“These outcomes offer tangible cost savings, not just for healthcare organizations, but for society,” Tine Hansen-Turton, president and CEO of Woods System of Care, told Becker’s. “While exact financial figures are still being gathered, the preventive nature of this therapy clearly leads to more stable, sustainable care, and reduces systemic burdens funded by public dollars.”