In brief
A cross-sectional descriptive survey of an Indonesian nurse-led psychiatric counseling clinic found mostly women aged 20 to 40 with schizophrenia and low self-esteem, widespread ineffective family coping, medication discontinuation as a key trigger, and Cognitive Therapy and Family Psychoeducation as the most-used...
What this article is about
Quick Answer
A cross-sectional descriptive survey of an Indonesian nurse-led psychiatric counseling clinic found mostly women aged 20 to 40 with schizophrenia and low self-esteem, widespread ineffective family coping, medication discontinuation as a key trigger, and Cognitive Therapy and Family Psychoeducation as the most-used therapies.
Student takeaways
Key Takeaways
- This descriptive, cross-sectional survey examined clients and families using a nurse-led psychiatric counseling clinic (Grha Atma, West Java Province Mental Hospital, opened July 2013), the therapies most used, and therapy completion.
- Most clients and families attended directly through referral from psychiatric medical specialists as outpatients, and the largest client group were women aged 20 to 40, mostly high-school educated.
- Schizophrenia was the most common diagnosis; many clients experienced low self-esteem, and ineffective family coping was reported among all accompanying families.
- Predisposing factors were mostly hereditary, failure, and economic factors, while the leading precipitating factor was stopping antipsychotic medication, along with failure and economic factors.
- Cognitive Therapy was the most commonly used individual specialist therapy and Family Psychoeducation the most commonly used family therapy, while roughly equal numbers of clients completed and did not complete therapy.
Student summary
Why This Research Matters
This paper reports a descriptive study from Indonesia that looked at psychiatric nursing specialist therapy offered to clients and their families. In July 2013, the West Java Province Mental Hospital opened a psychiatric counseling clinic (the Poli Konseling) at a site called Grha Atma, staffed with specialist psychiatric nurses. The researchers wanted to describe who used this counseling service, which specialist therapies were used most often, and how often therapy was completed successfully. To do this, they used a survey with a quantitative, cross-sectional design, meaning they gathered information at a single point in time rather than following people over months or years.
The study reports several descriptive patterns. Most clients and families came to the clinic directly, referred by psychiatric medical specialists who were caring for them as outpatients. Among the clients, the largest group were women aged 20 to 40, most had a high school (SMU) education, and roughly equal numbers were employed and unemployed. The most common diagnosis was schizophrenia. Many clients were described as experiencing low self-esteem, and ineffective family coping was reported among all of the families who accompanied clients to counseling.
The study also grouped the causes behind clients' difficulties into predisposing factors (longer-standing background influences) and precipitating factors (more immediate triggers). The predisposing factors were mostly hereditary factors, a history of failure, and economic factors. The precipitating factors were most often stopping antipsychotic medication (medication discontinuation), failure, and economic factors. This link between stopping antipsychotic medication and a return of difficulties is a well-recognized concern in mental-health care and is a useful point for nursing students to notice.
When it came to the therapies themselves, the most commonly used individual specialist therapy was Cognitive Therapy, while the most commonly used family therapy was Family Psychoeducation. Cognitive Therapy helps people examine and adjust unhelpful thought patterns, and Family Psychoeducation helps families understand a condition and learn practical ways to support their relative. The study reports that the number of clients who completed their course of therapy was roughly similar to the number who did not complete it, which points to real-world challenges in keeping people engaged in mental-health care.
For nursing students, this study is a helpful illustration of the specialist role that psychiatric nurses can play, not only in caring for individual clients but also in working with whole families. It shows how a nurse-led counseling clinic can serve outpatients referred by psychiatrists, and it highlights common themes in community psychiatric care: schizophrenia as a frequent diagnosis, low self-esteem among clients, family coping difficulties, and the important risk that comes with stopping antipsychotic medication. It also underlines the value of family-centered approaches, since the whole family in this sample struggled to cope.
A few cautions are important. Because this is a cross-sectional, descriptive study from a single clinic, its numbers describe that particular group of clients and families and cannot be treated as proof that these therapies caused specific outcomes or that the same pattern would appear elsewhere. The abstract does not give a precise sample size or detailed statistics, so the descriptions of 'most' or 'largest group' should be read as general summaries rather than exact figures. The finding that many clients did not complete therapy should prompt thinking about barriers to care, such as cost, stigma, distance, and access, rather than any judgment about the clients themselves. On safety: the observation that stopping antipsychotic medication was a common trigger is a reminder that changes to psychiatric medication should always be made with a prescriber's guidance, never abruptly on one's own, and that supporting medication adherence and family understanding is a key nursing responsibility. Read carefully, this study offers a grounded picture of how specialist psychiatric nurses and family-focused therapies fit into community mental-health care.
Source abstract
Study Overview
Sejak Juli 2013, Rumah Sakit Provinsi Jawa Barat membuka Poli Konseling Psikiatri di Grha Atma yang melibatkan perawat spesialis keperawatan jiwa. Penelitian yang dilakukan adalah dengan menggunakan penelitian survei dengan metode kuantitatif dan menggunakan rancangan cross sectional. Tujuan dari penelitian ini adalah untuk mengidentifikasi karakteristik klien dan keluarga yang berkonsultasi di Poli Konseling, terapi spesialis keperawatan jiwa yang banyak digunakan dan keberhasilan terapi spesialis keperawatan jiwa terhadap klien dan keluarga. Sebagian besar klien dan keluarga yang melakukan konseling dengan datang langsung berdasarkan rujukan dari dokter spesialis kesehatan jiwa kepada klien rawat jalan di Grha Atma. Pada penelitian ini didapatkan bahwa kelompok terbesar adalah kelompok jenis kelamin perempuan usia 20-40 tahun, berpendidikan SMU, jumlah yang bekerja hampir sama dengan yang tidak bekerja, didiagnosis skizofrenia, sebagian besar klien mengalami harga diri rendah, sedangkan koping keluarga inefektif dialami oleh seluruh keluarga yang mendampingi klien saat konseling. Faktor predisposisi sebagian besar faktor herediter, kegagalan, dan faktor ekonomi, sedangkan faktor presipitasi sebagian besar diakibatkan oleh putus obat antipsikotik, kegagalan, dan faktor ekonomi. Terapi spesialis keperawatan jiwa individu yang paling banyak dilakukan adalah Cognitive Therapy, sedangkan terapi spesialis keperawatan jiwa yang paling banyak dilakukan adalah terapi Family Psycho Education. Jumlah klien yang tuntas melakukan terapi hampir sama dengan yang tidak tuntas melakukan terapi. Penelitian ini diharapkan dapat memberikan gambaran karakteristik klien dan terapi spesialis yang dilakukan serta untuk membuat suatu bentuk pemberian terapi spesialis keperawatan jiwa yang optimal terhadap kendala-kendala yang ada.
Abstract
Therapy Specialist Nursing Psychiatric Specialist Therapy. Mental Hospital of West Java province since July 2013 opening poly psychiatric counseling at Grha Atma involving nurse specialist psychiatric nursing. Research conducted using survey research with a quantitative method using cross sectional. The purpose of this study was to identify the characteristics of the client and family are consulted in poly counseling, psychiatric nursing specialist therapy that is widely used and successful psychiatric nursing specialist therapy to clients and families. Most of the client and family counseling based on those referrals come from mental health specialists in outpatient clients at Grha Atma. In this study it was found that the largest group is the age group 20—40 years, female gender, the majority of high school educated, almost the same amount of work with that are not work, the majority of diagnosed schizophrenia, most clients experience low self-esteem while ineffective family coping experienced by the whole family who accompany clients when counseling. Predisposing factors largely hereditary factors, failure and economic factors, while most of the precipitation factor due to antipsychotic drug withdrawal, failures and economic factors. Therapeutic nursing specialist individual soul is the most widely performed while therapy Cognitive Therapy specialist psychiatric nursing is the most widely performed therapy Family Psycho Education. Number of clients who completed therapy similar to incomplete therapy. This study is expected to provide an overview of client characteristics and treatment specialists who performed as well as the constraints that exist to make a form of therapy specialist psychiatric nursing optimal.
Keywords: polyclinic counseling, client and family characteristic, psychiatric nursing specialist ther
Evidence appraisal
Main Findings
- This descriptive, cross-sectional survey examined clients and families using a nurse-led psychiatric counseling clinic (Grha Atma, West Java Province Mental Hospital, opened July 2013), the therapies most used, and therapy completion.
- Most clients and families attended directly through referral from psychiatric medical specialists as outpatients, and the largest client group were women aged 20 to 40, mostly high-school educated.
- Schizophrenia was the most common diagnosis; many clients experienced low self-esteem, and ineffective family coping was reported among all accompanying families.
- Predisposing factors were mostly hereditary, failure, and economic factors, while the leading precipitating factor was stopping antipsychotic medication, along with failure and economic factors.
- Cognitive Therapy was the most commonly used individual specialist therapy and Family Psychoeducation the most commonly used family therapy, while roughly equal numbers of clients completed and did not complete therapy.
Practice transfer
Clinical Relevance
- Specialist psychiatric nurses can lead counseling services that support both individual clients and their families, extending care beyond medication management.
- Because stopping antipsychotic medication was a common trigger for difficulty, supporting medication adherence and educating clients and families about safe, prescriber-guided changes is a key nursing role.
- Family Psychoeducation and family-focused care are valuable when family coping is strained, which was true for all families in this sample.
- High non-completion of therapy signals a need to identify and reduce barriers such as cost, stigma, distance, and access, rather than attributing dropout to the client.
- As this is single-site descriptive data, nurses should treat the patterns as context for planning services, not as proof that any therapy caused specific outcomes.
Faculty notes
Educational Relevance
This descriptive, cross-sectional survey from an Indonesian nurse-led psychiatric counseling clinic is a useful teaching case for the specialist psychiatric nursing role and for family-centered care. It describes the clients and families using the Grha Atma Poli Konseling (opened July 2013, West Java Province Mental Hospital), the therapies most used, and completion rates. Students can practice reading descriptive statistics reported as proportions rather than tests of causation: the largest client group was women aged 20 to 40, mostly high-school educated, with roughly equal employment status; schizophrenia was the most common diagnosis; low self-esteem was common; and ineffective family coping was reported across all accompanying families. The study distinguishes predisposing factors (hereditary, failure, economic) from precipitating factors (notably antipsychotic medication discontinuation, failure, economic), a strong prompt for discussing relapse and adherence. Cognitive Therapy was the most-used individual therapy and Family Psychoeducation the most-used family therapy. Notably, roughly equal numbers completed and did not complete therapy, opening discussion of engagement barriers (cost, stigma, access). Emphasize that single-site, cross-sectional data describe associations, not causes, and that medication changes must be prescriber-guided. It is a good anchor for teaching cultural safety and the value of family involvement in psychiatric care.
Critical appraisal
Limitations
- The study is cross-sectional and descriptive, so it captures a single point in time and cannot establish that therapies caused particular outcomes.
- It reflects one nurse-led clinic in one region of Indonesia, limiting how far its patterns transfer to other settings.
- The available abstract does not report a precise sample size or detailed statistics, so terms like 'most' and 'largest group' are general summaries rather than exact figures.
Classroom use
Discussion Questions
- What does a cross-sectional, descriptive design tell us, and what can it not tell us about cause and effect?
- Why might a nurse-led psychiatric counseling clinic be valuable within a mental-health service?
- The study distinguishes predisposing from precipitating factors. How would you explain the difference to a patient or family?
- Why is stopping antipsychotic medication a serious concern, and what nursing actions can support adherence safely?
- All families in the sample showed ineffective coping. How might Family Psychoeducation help, and what would you include in it?
- Roughly half of clients did not complete therapy. What barriers might explain this, and how could a clinic address them?
- How does Cognitive Therapy work, and why might it be a common choice for individual specialist therapy?
- How should culture and context shape the way we interpret and apply findings from a study in West Java, Indonesia?
- Why is low self-esteem an important focus in care for people living with schizophrenia?
- How can nurses involve families respectfully while still protecting the client's autonomy and confidentiality?
Knowledge check
Quiz
1. What research design did this study use?
- A cross-sectional, descriptive survey
- A randomized controlled trial
- A longitudinal cohort study
- A laboratory experiment
Rationale: The abstract states the study used survey research with a quantitative, cross-sectional design.
2. Who staffed the counseling clinic (Poli Konseling) at Grha Atma?
- Specialist psychiatric nurses
- Only physicians
- Volunteers
- Physical therapists
Rationale: The clinic, opened in July 2013, involved specialist psychiatric nurses providing therapy to clients and families.
3. What was the most common diagnosis among clients?
- Schizophrenia
- Diabetes
- Asthma
- Broken bones
Rationale: The abstract reports that the majority of clients were diagnosed with schizophrenia.
4. Which was reported as the leading precipitating factor?
- Stopping antipsychotic medication
- Regular exercise
- A new job
- A balanced diet
Rationale: The abstract identifies antipsychotic drug withdrawal (medication discontinuation) as the main precipitating factor, along with failure and economic factors.
5. What was the most commonly used individual specialist therapy?
- Cognitive Therapy
- Electroconvulsive therapy
- Hydrotherapy
- Art therapy
Rationale: The abstract states Cognitive Therapy was the most widely used individual specialist therapy.
6. What was the most commonly used family therapy?
- Family Psychoeducation
- Group art class
- Couples dance therapy
- None was used
Rationale: The abstract reports Family Psychoeducation as the most widely used family therapy.
7. What did the study find about therapy completion?
- Roughly equal numbers completed and did not complete therapy
- Everyone completed therapy
- No one completed therapy
- Completion was not examined
Rationale: The abstract notes the number who completed therapy was similar to the number who did not.
8. What was reported about the families who accompanied clients?
- Ineffective family coping was found across all of them
- All coped very well
- None attended counseling
- They were all healthcare workers
Rationale: The abstract states ineffective family coping was experienced by all the families accompanying clients.
9. Why should this study's numbers be interpreted cautiously?
- It is single-site, cross-sectional, and descriptive, so it cannot prove causation
- It was a large global trial
- It followed patients for ten years
- It used a placebo control
Rationale: Descriptive, single-time-point data from one clinic describe patterns, not cause-and-effect relationships.
10. What is a safe nursing message about antipsychotic medication?
- Changes should be prescriber-guided, never stopped abruptly alone
- Patients should stop whenever they feel better
- Doubling the dose is always safe
- Medication does not matter in schizophrenia
Rationale: Because medication discontinuation was a common trigger, supporting adherence and prescriber-guided changes is essential for safety.
Study cards
Flashcards
What type of study is this?
A quantitative, cross-sectional descriptive survey.
Where and when did the clinic open?
At Grha Atma, West Java Province Mental Hospital, Indonesia, in July 2013.
Who provided the therapy?
Specialist psychiatric nurses.
What were the study's aims?
To describe the clients and families, the specialist therapies most used, and how often therapy was completed.
How did most clients reach the clinic?
By direct attendance following referral from psychiatric medical specialists, as outpatients.
What was the largest client group by sex and age?
Women aged 20 to 40.
What education level was most common?
High school (SMU).
What was the most common diagnosis?
Schizophrenia.
What emotional issue was common among clients?
Low self-esteem.
What was found about family coping?
Ineffective family coping among all families who accompanied clients.
What were the main predisposing factors?
Hereditary factors, failure, and economic factors.
What were the main precipitating factors?
Stopping antipsychotic medication, failure, and economic factors.
What is a precipitating factor?
A more immediate trigger that brings on or worsens difficulty.
What is a predisposing factor?
A longer-standing background influence that increases vulnerability.
Most-used individual therapy?
Cognitive Therapy.
Most-used family therapy?
Family Psychoeducation.
What is Family Psychoeducation?
An approach that helps families understand a condition and learn practical ways to support their relative.
What did the study find about therapy completion?
Roughly equal numbers completed and did not complete therapy.
What safety point relates to medication?
Antipsychotic changes must be prescriber-guided; abrupt discontinuation is a known relapse trigger.
Why interpret findings cautiously?
It is single-site, cross-sectional, and descriptive, so it shows patterns, not causes, and may not transfer elsewhere.
Search-ready answers
Frequently asked questions
What was this study about?
It described who used a nurse-led psychiatric counseling clinic in West Java, Indonesia, which specialist therapies were used most, and how often therapy was completed.
What kind of study is it?
A quantitative, cross-sectional descriptive survey, gathering information at one point in time.
Who were the typical clients?
The largest group were women aged 20 to 40, mostly high-school educated, and most were diagnosed with schizophrenia.
Why does stopping antipsychotic medication matter?
It was the leading precipitating factor for difficulty, underlining why medication changes should be prescriber-guided and adherence supported.
What therapies were used most?
Cognitive Therapy for individuals and Family Psychoeducation for families.
What does the completion finding tell us?
Roughly half did not complete therapy, suggesting real barriers to staying engaged, such as cost, stigma, or access.
What is Family Psychoeducation?
Teaching and support that helps families understand the condition and respond in helpful, coping-strengthening ways.
Can these results apply everywhere?
Not directly. As single-site descriptive data, they describe this clinic's clients and should be interpreted with cultural and local context.
What is the specialist psychiatric nurse's role here?
To deliver individual and family therapies and support outpatients referred by psychiatrists, complementing medical care.
What is the key safety takeaway?
Support medication adherence, involve families respectfully, and ensure any medication change is guided by a prescriber, never done abruptly alone.