Pub Date : 2022-04-01DOI: 10.1080/17522439.2022.2057578
A. Friedlander, D. Tzur Bitan, P. Lichtenberg
ABSTRACT Background Since 2016, Soteria homes have been operating in Israel. In this report we describe the implementation of the model. Methods Data for 486 residents staying in one of three Soteria homes from 2016 through 2020 are presented. The model, and necessary modifications, are discussed. Results The majority of the residents in the Soteria homes suffered from psychotic (41.3%) or bipolar disorder (20.9%) and were of a mean age of 34.5 (SD = 12.83). While operating according to the principles of Soteria, adaptations had to be made. The homes used professional staff as well as companions. Accepting a wide range of residents exposed the home to situations of violent behaviour which required adjustment in admission policy. Work with insurers limited the possible length of stay. Financial constraints expanded the home capacity to 10 residents, while limiting work shifts to 12 hours. Cultural considerations led to the establishment of single-gender homes. Discussion Soteria homes can be a viable component of publicly-funded mental health care systems. The implementation of the Soteria model can provide important lessons for the future development of a professional and humane mental health care service – not as an alternative, but as an integral part of the system.
{"title":"The Soteria model: implementing an alternative to acute psychiatric hospitalization in Israel","authors":"A. Friedlander, D. Tzur Bitan, P. Lichtenberg","doi":"10.1080/17522439.2022.2057578","DOIUrl":"https://doi.org/10.1080/17522439.2022.2057578","url":null,"abstract":"ABSTRACT Background Since 2016, Soteria homes have been operating in Israel. In this report we describe the implementation of the model. Methods Data for 486 residents staying in one of three Soteria homes from 2016 through 2020 are presented. The model, and necessary modifications, are discussed. Results The majority of the residents in the Soteria homes suffered from psychotic (41.3%) or bipolar disorder (20.9%) and were of a mean age of 34.5 (SD = 12.83). While operating according to the principles of Soteria, adaptations had to be made. The homes used professional staff as well as companions. Accepting a wide range of residents exposed the home to situations of violent behaviour which required adjustment in admission policy. Work with insurers limited the possible length of stay. Financial constraints expanded the home capacity to 10 residents, while limiting work shifts to 12 hours. Cultural considerations led to the establishment of single-gender homes. Discussion Soteria homes can be a viable component of publicly-funded mental health care systems. The implementation of the Soteria model can provide important lessons for the future development of a professional and humane mental health care service – not as an alternative, but as an integral part of the system.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44429729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-25DOI: 10.1080/17522439.2022.2044895
S. Bryce, A. de Winter, Lisa Phillips, Nicholas Cheng, M. Alvarez-Jimenez, K. Allott
ABSTRACT Background Identifying cognitive strengths may be one avenue for enhancing functional recovery in people with first-episode psychosis (FEP). This study explored the perspectives of young people with FEP on the conceptualisation of cognitive strengths and the perceived risks and benefits, and pragmatic considerations, of a cognitive strengths-based approach to assessment and treatment. Methods Ten participants, aged 18 to 26 (M age = 21.44 years, SD = 2.70), were recruited from an early psychosis assessment and treatment service. Data were collected using a semi-structured interview and analyzed using thematic analysis. Results Four overarching themes emerged, related to: 1) Understanding cognitive strengths in FEP; 2) Potential benefits; 3) Barriers and risks; and 4) Considerations for development and implementation. Young people held positive views toward assessment and treatment methods focused on cognitive strengths, suggesting that identifying strengths and building confidence beliefs may promote greater functioning. Potential barriers, including harms related to being unable to identify cognitive strengths or neglecting deficits, were areas requiring further consideration. Discussion A cognitive strengths-based approach to assessment and treatment in FEP is a promising area of investigation, according to young people with FEP. The results provide insight regarding a cognitive strengths definition and the ways that these could be measured in future.
{"title":"Cognitive strengths in first-episode psychosis: perspectives from young people with lived experience","authors":"S. Bryce, A. de Winter, Lisa Phillips, Nicholas Cheng, M. Alvarez-Jimenez, K. Allott","doi":"10.1080/17522439.2022.2044895","DOIUrl":"https://doi.org/10.1080/17522439.2022.2044895","url":null,"abstract":"ABSTRACT Background Identifying cognitive strengths may be one avenue for enhancing functional recovery in people with first-episode psychosis (FEP). This study explored the perspectives of young people with FEP on the conceptualisation of cognitive strengths and the perceived risks and benefits, and pragmatic considerations, of a cognitive strengths-based approach to assessment and treatment. Methods Ten participants, aged 18 to 26 (M age = 21.44 years, SD = 2.70), were recruited from an early psychosis assessment and treatment service. Data were collected using a semi-structured interview and analyzed using thematic analysis. Results Four overarching themes emerged, related to: 1) Understanding cognitive strengths in FEP; 2) Potential benefits; 3) Barriers and risks; and 4) Considerations for development and implementation. Young people held positive views toward assessment and treatment methods focused on cognitive strengths, suggesting that identifying strengths and building confidence beliefs may promote greater functioning. Potential barriers, including harms related to being unable to identify cognitive strengths or neglecting deficits, were areas requiring further consideration. Discussion A cognitive strengths-based approach to assessment and treatment in FEP is a promising area of investigation, according to young people with FEP. The results provide insight regarding a cognitive strengths definition and the ways that these could be measured in future.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46305864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-23DOI: 10.1080/17522439.2022.2056629
S. Lewis
{"title":"Antidepressed: a breakthrough examination of epidemic antidepressant harm and dependence","authors":"S. Lewis","doi":"10.1080/17522439.2022.2056629","DOIUrl":"https://doi.org/10.1080/17522439.2022.2056629","url":null,"abstract":"","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49446457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.1080/17522439.2022.2037693
I. García del Castillo, S. López García, A. Pérez-Balaguer, D. Varillas Delgado, Claudio Fuenzalida Muñoz, Javier Sempere Pérez
ABSTRACT Background Multifamily groups (MFG) have shown to reduce the risk of relapse of psychotic symptoms in first episodes of psychosis (FEPs) but are not frequently implemented in treatment programs. This paper describes the implementation of the interfamily therapy-model in a FEP early intervention program within a Mental Health Centre in Spain . The aims were to examine (a) relapses (measured as re-hospitalization), (b) duration of re-hospitalizations and (c) voluntary versus involuntary re-hospitalizations during participation in MFG compared with the previous year. Methods Twenty-one subjects participated in a MFG over 12 months, 11 participants with a diagnosis of psychosis and 10 family members. Results Patients and their relatives participated in around 50% of treatment sessions and manifested satisfactory experience during treatment. Among the patients who participated in MFG, a lower relapse rate was observed: a lower number of psychiatric admissions (7 versus 3) and of shorter duration [23.57 (SD 18.5) days pretreatment versus 19.33 (SD 10.2) days during treatment] although it was not statistically significant (p > 0.05), probably due to small sample size. Discussion Multifamily therapy has been well accepted by both patients and their families, with a high degree of participation. Our impression is that the simultaneous participation in different therapeutic activities (individual, group and multifamily) improves the experience of the therapeutic process.
{"title":"Multifamily therapy in first psychotic episodes: a pilot study","authors":"I. García del Castillo, S. López García, A. Pérez-Balaguer, D. Varillas Delgado, Claudio Fuenzalida Muñoz, Javier Sempere Pérez","doi":"10.1080/17522439.2022.2037693","DOIUrl":"https://doi.org/10.1080/17522439.2022.2037693","url":null,"abstract":"ABSTRACT Background Multifamily groups (MFG) have shown to reduce the risk of relapse of psychotic symptoms in first episodes of psychosis (FEPs) but are not frequently implemented in treatment programs. This paper describes the implementation of the interfamily therapy-model in a FEP early intervention program within a Mental Health Centre in Spain . The aims were to examine (a) relapses (measured as re-hospitalization), (b) duration of re-hospitalizations and (c) voluntary versus involuntary re-hospitalizations during participation in MFG compared with the previous year. Methods Twenty-one subjects participated in a MFG over 12 months, 11 participants with a diagnosis of psychosis and 10 family members. Results Patients and their relatives participated in around 50% of treatment sessions and manifested satisfactory experience during treatment. Among the patients who participated in MFG, a lower relapse rate was observed: a lower number of psychiatric admissions (7 versus 3) and of shorter duration [23.57 (SD 18.5) days pretreatment versus 19.33 (SD 10.2) days during treatment] although it was not statistically significant (p > 0.05), probably due to small sample size. Discussion Multifamily therapy has been well accepted by both patients and their families, with a high degree of participation. Our impression is that the simultaneous participation in different therapeutic activities (individual, group and multifamily) improves the experience of the therapeutic process.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60194917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.1080/17522439.2022.2044896
Bradley Hall, M. Hayward, Rachel Terry
ABSTRACT Background Cognitive Behavioural Therapy for voice hearing (CBTv) has been shown to be effective at reducing distress. However, it is unclear why voice hearers might deteriorate or continue to benefit post-intervention. This study aimed to explore therapeutic change processes following CBTv. Methods A critical realist, grounded theory methodology was utilised. Individual interviews were conducted with 12 participants who had experienced distressing voice hearing and had completed a CBTv intervention in the last 3–12 months. Participants were recruited from a specialist hearing voices service. Results Three categories were found to be facilitative of positive change within CBTv: “New Ways of Managing”, “Overcoming Challenges” and “Gaining New Perspectives”. Five categories denoted the maintenance or furthering of positive change following intervention: “Having a Sense of Control”, “Standing on My Own Two Feet”, “Voices Are Just Part of My Life”, “Investing in Sustaining Relationships”, and “Rediscovering and Developing Identity”. Challenging circumstances faced by participants are also incorporated into a model for maintaining change following CBTv. Discussion The model adds to current literature on change processes occurring within and after CBTv. The results support the need for those working with voice hearers post-therapy to focus on rebuilding social relationships, meaning making and identity.
{"title":"A grounded theory study exploring change processes following cognitive behavioural therapy for distressing voices","authors":"Bradley Hall, M. Hayward, Rachel Terry","doi":"10.1080/17522439.2022.2044896","DOIUrl":"https://doi.org/10.1080/17522439.2022.2044896","url":null,"abstract":"ABSTRACT Background Cognitive Behavioural Therapy for voice hearing (CBTv) has been shown to be effective at reducing distress. However, it is unclear why voice hearers might deteriorate or continue to benefit post-intervention. This study aimed to explore therapeutic change processes following CBTv. Methods A critical realist, grounded theory methodology was utilised. Individual interviews were conducted with 12 participants who had experienced distressing voice hearing and had completed a CBTv intervention in the last 3–12 months. Participants were recruited from a specialist hearing voices service. Results Three categories were found to be facilitative of positive change within CBTv: “New Ways of Managing”, “Overcoming Challenges” and “Gaining New Perspectives”. Five categories denoted the maintenance or furthering of positive change following intervention: “Having a Sense of Control”, “Standing on My Own Two Feet”, “Voices Are Just Part of My Life”, “Investing in Sustaining Relationships”, and “Rediscovering and Developing Identity”. Challenging circumstances faced by participants are also incorporated into a model for maintaining change following CBTv. Discussion The model adds to current literature on change processes occurring within and after CBTv. The results support the need for those working with voice hearers post-therapy to focus on rebuilding social relationships, meaning making and identity.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48393584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-23DOI: 10.1080/17522439.2021.1985161
F. Davoine
{"title":"Approche Psychotherapeutique des Psychosis (A psychotherapeutic approach to psychosis)","authors":"F. Davoine","doi":"10.1080/17522439.2021.1985161","DOIUrl":"https://doi.org/10.1080/17522439.2021.1985161","url":null,"abstract":"","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45121043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-21DOI: 10.1080/17522439.2022.2038254
Emma Izon, Karmen Au-Yeung, K. Berry, P. French
ABSTRACT Background The outcomes for a wide range of physical and mental health conditions can be influenced by the level of criticism and warmth in the family environment known in the literature as Expressed Emotion (EE). This finding is also true for individuals with an At-Risk Mental State (ARMS) for psychosis with individual’s perceptions of EE predicting transition to psychosis. While the original concept of EE incorporates both positive and negative aspects of relationships, most measures of EE and research focus on the negative aspects of relationships. Positive factors are also important and associated with improvements in functioning and reduced symptoms. However, the absence of a comprehensive, self-report measure of positive aspects of EE has hindered research in this area. Methods This study aimed to investigate the reliability and validity of a new 10-item Service User Perceived Criticism and Warmth Questionnaire (SU-PCaW) based on the 2-item Perceived Criticism and 2-item Perceived Warmth questionnaires. Results The measure was quick and easy to administer and had high internal consistency and reliability. Conclusion This measure would aid services in screening families for therapy, be helpful in evaluating family intervention in groups such as the ARMS population and a useful measure for future research developments.
{"title":"Service User Perceived Criticism and Warmth (SU-PCaW) Questionnaire","authors":"Emma Izon, Karmen Au-Yeung, K. Berry, P. French","doi":"10.1080/17522439.2022.2038254","DOIUrl":"https://doi.org/10.1080/17522439.2022.2038254","url":null,"abstract":"ABSTRACT Background The outcomes for a wide range of physical and mental health conditions can be influenced by the level of criticism and warmth in the family environment known in the literature as Expressed Emotion (EE). This finding is also true for individuals with an At-Risk Mental State (ARMS) for psychosis with individual’s perceptions of EE predicting transition to psychosis. While the original concept of EE incorporates both positive and negative aspects of relationships, most measures of EE and research focus on the negative aspects of relationships. Positive factors are also important and associated with improvements in functioning and reduced symptoms. However, the absence of a comprehensive, self-report measure of positive aspects of EE has hindered research in this area. Methods This study aimed to investigate the reliability and validity of a new 10-item Service User Perceived Criticism and Warmth Questionnaire (SU-PCaW) based on the 2-item Perceived Criticism and 2-item Perceived Warmth questionnaires. Results The measure was quick and easy to administer and had high internal consistency and reliability. Conclusion This measure would aid services in screening families for therapy, be helpful in evaluating family intervention in groups such as the ARMS population and a useful measure for future research developments.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41893413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-14DOI: 10.1080/17522439.2022.2039273
Nicholas C. Borgogna, S. Aita, C. Trask, G. Moncrief
ABSTRACT Background We examined differences in demographics, access to mental healthcare, and perceived treatment barriers in college students with a history of receiving a psychotic disorder diagnosis compared to non-clinical (no history of diagnosis) and clinical (history of non-comorbid depression) control students. Methods Data came from the 2018–2019 Healthy Minds Study (HMS), n=159 students reported having been diagnosed with a psychotic disorder (0.27% prevalence). Comparison groups included 159 randomly drawn non-clinical and 159 clinical control participants. Results Students with a history of psychotic disorder diagnosis were more likely to identify as non-heterosexual (53.5%) and gender non-conforming (17%), were more likely to have a medication prescribed in the past 12 months (84.7%), have a history of participating in counseling (95.5%), received significantly more prescriptions from different medication classes, reported higher perceived need for treatment, and reported experiencing significantly more barriers to treatment compared to control groups. No differences were evident across groups regarding knowledge of campus treatment resources, sex assigned at birth, and race. Discussion College students with a history of psychotic disorder diagnosis face multiple barriers to receiving adequate treatment. University healthcare systems should consider adjusting treatment needs to this population.
{"title":"Psychotic disorders in college students: demographic and care considerations","authors":"Nicholas C. Borgogna, S. Aita, C. Trask, G. Moncrief","doi":"10.1080/17522439.2022.2039273","DOIUrl":"https://doi.org/10.1080/17522439.2022.2039273","url":null,"abstract":"ABSTRACT Background We examined differences in demographics, access to mental healthcare, and perceived treatment barriers in college students with a history of receiving a psychotic disorder diagnosis compared to non-clinical (no history of diagnosis) and clinical (history of non-comorbid depression) control students. Methods Data came from the 2018–2019 Healthy Minds Study (HMS), n=159 students reported having been diagnosed with a psychotic disorder (0.27% prevalence). Comparison groups included 159 randomly drawn non-clinical and 159 clinical control participants. Results Students with a history of psychotic disorder diagnosis were more likely to identify as non-heterosexual (53.5%) and gender non-conforming (17%), were more likely to have a medication prescribed in the past 12 months (84.7%), have a history of participating in counseling (95.5%), received significantly more prescriptions from different medication classes, reported higher perceived need for treatment, and reported experiencing significantly more barriers to treatment compared to control groups. No differences were evident across groups regarding knowledge of campus treatment resources, sex assigned at birth, and race. Discussion College students with a history of psychotic disorder diagnosis face multiple barriers to receiving adequate treatment. University healthcare systems should consider adjusting treatment needs to this population.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48040606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-09DOI: 10.1080/17522439.2022.2038255
Robert Reiser, D. Turkington, M. Garrett
ABSTRACT Background When clinicians adopt the standard 16–26 session maximum suggested by CBTp efficacy research, clients with long-term medication resistant psychosis may receive an inadequate dose of therapy. Building engagement and trust can take significantly longer for clients who have been given a stigmatizing medical explanation for their difficulties. Methods We present a case study of successful long-term CBTp consisting of 200 sessions over a 6-year period. Supervision aided the recovery process over the last 2 years of therapy. Results A client with a 30-year history of medication resistant persecutory delusions, voices, stigma and prominent negative symptoms gradually formed a working alliance with the therapist. A CBT formulation emphasizing activating the adaptive mode led to later targeted work to reduce distress and social avoidance and address underlying trauma. Social recovery was achieved with increased independence and enhanced creativity. A commentary is provided by a senior clinician from a psychodynamic perspective. Discussion Clients with long-term medication resistant psychosis often need an increased number of CBT sessions but can still recover. Ongoing supportive supervision prevents early discharge and a failure to achieve a recovery trajectory. We should not accept that medication resistant clients are CBT resistant following a brief course of therapy.
{"title":"Medication resistant psychosis: how many CBT sessions might be needed for recovery? A case report with psychodynamic commentary","authors":"Robert Reiser, D. Turkington, M. Garrett","doi":"10.1080/17522439.2022.2038255","DOIUrl":"https://doi.org/10.1080/17522439.2022.2038255","url":null,"abstract":"ABSTRACT Background When clinicians adopt the standard 16–26 session maximum suggested by CBTp efficacy research, clients with long-term medication resistant psychosis may receive an inadequate dose of therapy. Building engagement and trust can take significantly longer for clients who have been given a stigmatizing medical explanation for their difficulties. Methods We present a case study of successful long-term CBTp consisting of 200 sessions over a 6-year period. Supervision aided the recovery process over the last 2 years of therapy. Results A client with a 30-year history of medication resistant persecutory delusions, voices, stigma and prominent negative symptoms gradually formed a working alliance with the therapist. A CBT formulation emphasizing activating the adaptive mode led to later targeted work to reduce distress and social avoidance and address underlying trauma. Social recovery was achieved with increased independence and enhanced creativity. A commentary is provided by a senior clinician from a psychodynamic perspective. Discussion Clients with long-term medication resistant psychosis often need an increased number of CBT sessions but can still recover. Ongoing supportive supervision prevents early discharge and a failure to achieve a recovery trajectory. We should not accept that medication resistant clients are CBT resistant following a brief course of therapy.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41912944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-04DOI: 10.1080/17522439.2021.2023615
E. Fossey, C. Harvey, P. Ennals, A. Wiggins, J. Farhall
ABSTRACT Background This study explored care co-ordinator reports about provision of six evidence-based psychosocial interventions (PSIs) for people living with psychosis, to better understand decision-making about provision. Methods Conducted as an adjunct to the Second Australian National Survey of Psychosis in one catchment area, care co-ordinators completed a structured interview about evidence-based PSIs provided to 33 consumers as part of their community mental health care. Descriptive analyses were conducted. Results Care co-ordinators reported most consumers were provided at least one of the PSIs during the previous year; all were provided at least one non-evidence-based, typically briefer or simpler, alternative. Relapse Prevention Planning using early warning signs was reported as most provided; Family Psychoeducation was the least provided but rated as most helpful. The primary reason for non-provision of PSIs was that they had not been offered, with lack of relevance the most cited explanation. Conclusions PSIs may be more commonly provided than previously reported, if non-evidence-based alternatives are also considered: reasons for not offering evidence-based PSIs require further study. Meaningful guidelines are needed about when and how to offer PSIs in collaborative practice, including briefer or simpler interventions when preferred over more complex interventions.
{"title":"From evidence to realities: psychosocial intervention provision in Australian routine community mental health practice","authors":"E. Fossey, C. Harvey, P. Ennals, A. Wiggins, J. Farhall","doi":"10.1080/17522439.2021.2023615","DOIUrl":"https://doi.org/10.1080/17522439.2021.2023615","url":null,"abstract":"ABSTRACT Background This study explored care co-ordinator reports about provision of six evidence-based psychosocial interventions (PSIs) for people living with psychosis, to better understand decision-making about provision. Methods Conducted as an adjunct to the Second Australian National Survey of Psychosis in one catchment area, care co-ordinators completed a structured interview about evidence-based PSIs provided to 33 consumers as part of their community mental health care. Descriptive analyses were conducted. Results Care co-ordinators reported most consumers were provided at least one of the PSIs during the previous year; all were provided at least one non-evidence-based, typically briefer or simpler, alternative. Relapse Prevention Planning using early warning signs was reported as most provided; Family Psychoeducation was the least provided but rated as most helpful. The primary reason for non-provision of PSIs was that they had not been offered, with lack of relevance the most cited explanation. Conclusions PSIs may be more commonly provided than previously reported, if non-evidence-based alternatives are also considered: reasons for not offering evidence-based PSIs require further study. Meaningful guidelines are needed about when and how to offer PSIs in collaborative practice, including briefer or simpler interventions when preferred over more complex interventions.","PeriodicalId":46344,"journal":{"name":"Psychosis-Psychological Social and Integrative Approaches","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44176427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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