Adapting evidence-based psychological treatments for inpatient care: Commentary on Rudd (2025)

Rudd (2025) submitted a comment on our recent editorial, which highlights the widespread lack of access to evidence-based psychological treatment (EBT) in psychiatric inpatient care and encourages increased efforts to study adaptations of existing EBTs for this setting (Hawes, Marcello, & Kleiman, 2025). In our editorial, we specifically call for investment in inpatient group therapy, as this is the dominant mode of psychological treatment in psychiatric hospitals due to limited staff availability coupled with a lack of reimbursement incentives for individual therapy. Rudd offers a compelling case for the consideration of problem-specific and strategic treatment add-ons adapted from existing EBTs for inpatient care, such as his adaptation of brief cognitive behavioral therapy (CBT) for suicide prevention for inpatient care (BCBT-I). BCBT-I is an abbreviated version of a one-on-one outpatient EBT that produced comparable reductions in posttreatment suicide risk to the full protocol (Diefenbach et al., 2024). We agree that existing EBTs that can serve as efficient add-ons to traditional care, such as BCBT-I, can offer a compelling avenue for improving inpatient care. We view adaptations of EBTs for group therapy and strategic add-on formats as complementary and overlapping strategies that together address the ongoing crisis in inpatient care. In this article, we elaborate on the challenges in adapting EBTs for acute settings and how nontraditional treatment models, like strategic treatment add-ons and open, stand-alone single-session groups, can address these challenges.