Acute psychiatric care has historically had limited involvement from psychological practitioners and there is limited published assessment of the efficacy of psychological treatments in this context. Recently a number of authors have argued strongly that Cognitive Behaviour Therapy (CBT) should be more available to psychiatric inpatients. Hoewever, the evidence for the efficacy of psychological therapies in this setting is estremely limited. Furthermore the acute environment provides a number of challenges in gathering evidence for psychological approaches. In particular, the complexity of this setting often does not lend it self to single model approaches and many psychological interventions may be preparatory. It may often be difficult to define good outcomes and psychological interventions frequently occur in conjunction with other treatments.

Several attempts to measure outcomes and studies based on user experiences are reviewed. It is argured that these actually provide very little in the way of evidence for psychological therapies. Particular attention is paid to difficulties in translating existing research into an acute psychiatric setting and measuring outcomes. A number of suggestions are made for developing research in this area including consideration of a range of outcome indicies and the ways in which psychological ideas may be employed in care planning.