However from the results these improvements appear minimal. (1996) Compliance therapy in psychotic patients: randomised controlled trial. This information was shared with both Laura and her dad. Even though the NICE (2007) Guidelines, ‘Drug Misuse: Psychosocial Interventions’ recommends that CBT be offered to those with anxiety and depression who are stabilised with their drug use, but does not discuss its use with those with psychosis. Many wish they had the power to read other's minds but know that in the least they can mostly understand themselves. For example, homosexuality was once considered a psychological ailment, but that has largely changed in mainstream psychology. Bio (physiological pathology) 2. ; Lieberman, J.A. Factors that add the human complexity The human body is made up of multiple interacting and self regulating physiological systems including biochemical and neuroendocrine feedback loops. Cognitive behavioral therapy has become a popular treatment type, especially due to its relatively short duration. Psychosocial interventions refer to different therapeutic techniques, usually classed as nonpharmacological (not involving medication), that address the psychological aspects of an individual or group and consider the persons or groups situation from a societal, familial perspective. Her mood improved slightly and she had more hope for the future. British Medical Journal. It looks at ways of providing support at the time of diagnosis and goes on to explore a variety of interventions and services for the treatment of … 39, 287-295 Nelson, H. (2005) Cognitive Behavioural Therapy with Delusions and Hallucinations: A Practice Manual Handbook (2nd Edition). 63(3), 202-208 Turner, P. & Mjolne, I. Chapter 17 in Norman, I. Psychosocial interventions harness the leeway that exists to promote well-being, in the absence of a cure. As previously mentioned the aim of PSI is to reduce stress or to help cope with stress better; therefore, it can be seen how the Stress Vulnerability Model plays a central role in providing psychosocial interventions. In addition, many drug and alcohol workers have only had minimal education in mental health issues (Frankel 1996). ; Dwarakanath, L.S. Examples from clinical practice are given to illustrate potential barriers, and outcomes when implementing such interventions with service users with complex needs and their caregivers. 70, 65-78 Cleary, M.; Hunt, G.; Matheson, S.; Siegfried, N. & Walter, G. (2009) Psychosocial Interventions for People with Both Severe Mental Illness and Substance Misuse. Tricia has a Literature degree from Sonoma State University and has been a frequent wiseGEEK The rationale for selecting this topic is derived from personal working experience with mental health service users. • Be aware of the paradigm shift from managing BPSD to a person-centred approach that focuses on the patient's well-being and quality of life. The services do not necessarily need to meet all the needs of the individual but have mental health professionals that are effective case managers. London: Department of Health DOH (2005) The Offender Mental Health Care Pathway. ; Miller, A.L. This report has aimed to discuss the term complexity. ; Copello, A.B. Interventions can be evolved for a single person in treatment for a variety of diseases, best models of treatment may be suggested for groups that share a common illness like schizophrenia or erectile dysfunction, or psychologists and others develop interventions for groups that are undergoing great stressors, like being in the midst of a war or recovering from a natural disaster. Issue 1 Conley, H. & Benishek. C-BIT is not only about adapting psychosocial interventions to suit those with dual diagnosis but it is also about service provision and development (Thylstrup & Johansen 2009, Graham et al 2006, Graham et al 2003). A way to overcome this is for more health professionals to acknowledge their deficits in knowledge and attend training. 156, 798-808 Dixon, L.; McNarey, S. & Lehman, A. 10, 352-360 Fischer, E.P. Perhaps as a result of having minimal education in the field of substance misuse, negative attitudes towards those who misuse substances is still present (Howard & Chung 2000 and Richmond & Foster 2003). contributor for many years. We have experts for any subject. Tricia lives in Northern California and is currently However, the clinical significance of this is questionable. For example ‘The National Service Framework for Mental Health’ (1999a) outlines a number of interventions for several complex groups including some of those mentioned above. Increased life expectancy and the resultant medical comorbidity may complicate the use of pharmacotherapy among a large percentage of elderly patients. Schizophrenics never completely know what is happening within [...]. England: Open University Press Reader, D. (2002) Working with Families. Some things commonly considered as psychosocial interventions include very standard forms of therapy. The term is generally used to include both models of service delivery such as assertive outreach and specific interventions, for example Family Intervention and Cognitive Behavioural Therapy (CBT). Her life became very chaotic and at 16 her mother kicked her out. London: National Institute for Health and Clinical Excellence. All rights reserved. Drug and Alcohol Review. All of these interacting systems are dynamic and fluid. This guidance recommends that all service users and their families are offered psychosocial interventions as a treatment of schizophrenia. Cited in Kipping, C. (2004) The Person Who Misuses Drugs of Alcohol. This report does not measure impact on care giver outcomes. (1992) Recent developments in expressed emotion in schizophrenia. A person fitting this example would potentially present the mental health professional with more challenges than a person with moderate depression living with their supportive family. One of which received immediate C-BIT training and the other groups training was delayed. Unfortunately, figures for production of mental health related literature could not be found Khan et al (1999) suggest over 2 million bio-medical articles are published annually. Journal of Clinical Epidemiology. 12(4), 393-403 Roberts, R. (1999) Information for Evidence-Based Care. Griffiths & Allan (2007) discuss how the term complex case is ill defined within mental health literature summarising how the term is often used to denote circumstances where people appear to have many interrelated needs that require several, coordinated responses from multiple services. A small change in one part of the web of interacting systems may lead to a much larger changes in another part through amplification of effects. ; Hall, C.S. Advances in Psychiatric Treatment. 26(1), 105-118 Drake et al (1993) Treatment of substance abuse in severely mentally ill patients. •Psychosocial: term used by non- health actors to describe non biological interventions that maintain or improve individual and social well being. 161, 1334-1349 Miller, W. & Rollnick, S. (2002) Motivational Interviewing: Preparing People to Change Addictive Behaviour (2nd Edn). Staff at the Rehabilitation unit were dubious about taking Luke back because of their rule of abstinence and the chaotic lifestyle that surrounds Luke. See Table 5 to illustrate how minimal family work in the form of psycho-education enhances the experience of service users and their care givers, even when staff have had no formal training. Staff at the unit (whom are not trained in family interventions) thought it would be a good idea to spend some time with Laura and her father to help them both gain an understanding of each others situation, thoughts, feelings and behaviours. Journal of Abnormal Psychology 86: 103-126. Eventually Laura was found by the police sleeping semi-clothed in a car park under the influence of drugs and alcohol. Physiotherapy Research International. An overview of the use of psychosocial interventions when working with complex cases is given. From experience this can be overcome in some cases through normalisation and psycho-education. Psychosocial interventions refer to different therapeutic techniques, usually classed as nonpharmacological (not involving medication), that address the psychological aspects of an individual or group and consider the person’s or group’s situation from a societal, familial perspective. Demonstrating some of the factors that add to an individual’s complexity. The aim of this intervention is to increase a person’s ability to recognise and do something about any problems they have (Gamble & Curthoys 2004) and that change would be desirable (Kipping 2004 and Miller & Rollnick 2002). 153, 64-70 Gamble, C. & Curthoys, J. The term psychosocial intervention is defined here as any formal structured psychological or social intervention with a clearly defined treatment plan and goals, as opposed to advice and information, drop-in support or informal keyworking . The only solution to these kinds of the disorder is psychosocial nursing diagnosis and elimination of root cause. Luke was discharged from hospital back to his home. ; Najavits, L.M. Four General principles are followed as outlined by Miller & Rollnick (2002); expressing empathy, developing discrepancy, rolling with resistance, and supporting self efficacy in order to facilitate this change. When examining this result with experience from practice it could be hypothesised that when a service users level of functioning increases they rely less upon their care givers. All service users are complex cases but some are faced with and present more challenges to themselves, their care givers and mental health services. But you can one from professional essay writers. Influenced by the interplay of human & Shon, S. (2003) Physical Health Monitoring of Patients With Schizophrenia. New directions for mental health services. Social Psychiatry and Psychiatric Epidemiology. 14, 4-12 Brooker, C. & Brabban, A. When a service user demonstrates that they have arrived at the decision or action stage of the cycle of change cognitive behavioural interventions are then commenced. The interdisciplinary concept of mental health promotion can be viewed from different perspectives (Cattan and Tilford, 2006; Barry and Jenkins, 2007). The Tiered Intervention Model for Psychosocial Interventions provides a framework which can guide the implementation of psychosocial care (Hutchison, Steginga and Dunn, 2006). Within the literature it can be seen that there are many factors that add to the complexity of a person with mental health needs including: medication resistant symptoms (Tarrier et al 1993), receiving care within secure forensic units (DOH 2005), psychological reactance (Moore, Sellwood, & Stirling 2000), poor social functioning (Cather 2005, Couture et al 2006), , learning disabilities (DOH 2001a), insight (David 1990 and Buckley et al 2001), physical health (Marder et al 2003) homelessness (Randall et al 2006), and dual diagnosis (DOH 2002). 2020 © StudyDriver.com - Big database of free essay examples for students at all levels. Psychosocial interventions can hold the key to communicating and engaging with clients and families. Fortunately a nurse went to reassess Luke to return back to the unit and gained a greater picture of why he relapsed. The design of the trail was robust in that it was a RCT, ensured as far as possible good treatment fidelity (making certain that the treatment being delivered is the one intended (Leeuw 2009)) and the assessors in the trial were blind to group allocation (reducing the risk of bias). With such vast amounts of information how can one stay truly up to date with evidence based practice. Often, the approach of educating the individual about his or her place in society and the appropriate "normal" behavior (in other words, the exact goal of psychosocial intervention) is preferable to using drugs to alter an individual's behavior. This would allow for sharing of evidence and encourage staff to remain up to date through reading. (2009) The fidelity of treatment delivery can be assessed in treatment outcome studies: a successful illustration from behavioral medicine. ; Williams, K.; Naylor, A.J. God now there's a stupid code to post and I can't even "see" that correctly! Supervision also allows a forum for dysfunctional attitudes to be explored and discussed. Additionally, when people are trained to deliver specific interventions they require ongoing clinical supervision to build on skills and knowledge, improving competence and confidence (Brooker & Brabban 2004). 101(01) Mairs, H & Bradshaw, T. (2005) Modernising Psychosocial Intervention Education: the new COPE programme. Within integrated treatment Barrowclough et al (2001) use family interventions as a means of encouraging care givers to adopt motivational interviewing styles to improve motivation, and treatment adherence amongst other interventions. The stress vulnerability model was explained to Laura’s dad with a view to building on his understanding of why his daughter experiences psychotic symptoms and providing a reason why she uses drugs. What else is considered abnormal now that might be seen as socially acceptable a decade or so from now? Results demonstrated improved outcomes for the service users general and social functioning, and reduced number of negative symptoms to a significant degree. 158, 1706-1713 Bird, A (2006) We Need to Talk: The Case for Psychological Therapy on the NHS. & Spring, B. Lauras Dad reported that these sessions made it easier for him to build on lost relationships with his daughter and reduced his fears that he would have to ‘deal with it all if things went wrong’. If health professionals have more of an awareness of the evidence base for psychosocial interventions for all the problems service users with serious mental illness face. Our editors will help you fix any mistakes and get an A+! Interventions can be evolved for a single person in treatment for a variety of diseases, best models of treatment may be suggested for groups that share a … For just about any disease treatment, a number of psychosocial interventions are available, and psychologists and others try to determine which ones are most effective. Assertive community treatment encompasses an array of services and interventions provided by a community-based, interdisciplinary, mobile treatment team (Stein and Test, 1980). British Journal of Psychiatry. Psychologists, psychiatrists, social workers, and other mental health professionals have previously specialised in the treatment of one of these behaviours, but few had attempted to extend their [...], INTRODUCTION The aim of this dissertation is to explore the factors affecting concordance with prescribed antipsychotic medications. This criterion resulted in the exclusion of meta-analyses examining the effects of using psychosocial interventions as an adjunct to pharmacotherapies. Journal of Mental Health. DOH (2001a) Valuing People: a new strategy for Learning Disability for the 21st century. Results of the training demonstrated increased confidence of care co-ordinators in working with substance misuse and mental illness. Demonstrating the emphasis that is placed upon such interventions in the treatment of serious mental illness. London: Department of Health Drake, R.E. Once Laura was admitted to the rehabilitation unit where she is currently residing her father got in touch. The combination of substance misuse and mental health problems (dual diagnosis) is associated with a range of social, behavioural, physical and psychological problems (see table 3) providing challenges for mental health services and adding to the complexity of an individual (Hussein 2002). This report aims to critically appraise psychosocial interventions (PSI) that are utilised when working with complex cases. New York: Guilford Press Moore, A.; Sellwood, W. & Stirling, J. (2002) Substance misuse and Mental Health: An Overview. Didn't find the paper that you were looking for? Barrowclough et al (2001) produced one of the first robust RCT’s to examine the impact an integrated intervention programme consisting of CBT,MI and FI had upon service users. Oxon: Radcliffe Medical Press Soanes, C. & Stevenson, A. psychosocial disability, or early in their NDIS planning, is a possible and desirable focus for the Scheme’s development. Comprehensive Psychiatry. This approach has been written about for many years and has arguably evolved from the work of Aaron Beck, a psychiatrist whose work dates back to the 1950’s. Generally the research and literature supporting the use of CBT for Those with serious mental illness often excludes people who misuse illicit drugs and/or alcohol for example Garety et al (2008), and Jackson et al (2008). Psychological Medicine, 38, 725-735 Jones, C., Cormac, I., Silveira da Mota Neto. That definition is a moving target, after all. ; Greenfield, S.F. However, the results do show promise for care givers within the treatment programme, showing some trends towards better personal outcomes. When that happens, medication may be the only option. The aim of CBT is to lessen distress caused by negative feelings; it attempts to do this by changing the thoughts (cognitive) and beliefs that underpin them. Philadelphia: Elsevier Graham, H. (2004) 2004) Implementing integrated treatment for co-existing substance use and severe mental health problems in assertive outreach teams: training issues. American Journal of Psychiatry. A small number of studies examining interventions for use with people with dual diagnosis will now be appraised.Two of the Studies are Randomised Controlled Trials (RCT’s) and are considered the gold standard method for evaluating treatment efficiency (Greenhalgh 2006). ; Max, O.J. Psychosocial Interventions in Mental Health Nursing is a clear and well presented text suitable for pre-registration mental health nurses or nurses seeking an introductory text into psychosocial interventions. For example the impact of experiencing voices does not end here but effects other areas of a person’s life (see Table 2). amount and frequency of the consumption of alcohol or cigarette smoking. The results highlighted an improvement in engagement, reduction in alcohol use and a reduction in positive alcohol related beliefs. They include, presenting the model of problematic substance use and psychotic symptoms (Graham et al 2004), specific techniques for managing substance use, and identification of triggers and beliefs that could lead to substance use and increase psychotic symptoms. A model which displays this link is the Stress Vulnerability Model by Zubin and Spring (1977 cited in Norman, & Ryrie 2004). (eds) (2004) The Art and Science of Mental Health Nursing: A Textbook of Principles and Practice. Hopefully, overcoming any negative thoughts and feelings towards those with dual diagnosis. But it has been shown that certain types of depression, antisocial behavior and other conditions are brought on by physical problems that can't be "talked through" with a therapist. ; Schooler, N.R. Other interventions include educating people about their condition or present state of existence. They are said to produce the least biased results as random samples are used to minimise the possibility of error in design and conduct (Roberts, 1999). 16 students ordered this very topic and got original papers. London: Nelson Thorns. There is a vast evidence base to support FI for promoting recovery from psychosis (Pharoah et al 2006, Pilling et al 2002). Cochrane Database of Systematic Reviews 2004, Issue 4 Kavanagh, D.J. That is not saying that drugs are the first thing therapists should try. Leading to people losing contact with their friends and families. For example, epilepsy produced AIDs, and diabetes produces stress disorders. In Miller, W. & Heather, N. (Eds) Treating Addictive Behaviours: Processes of Change. 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With this Laura started to hear voices at the age of 9 and at these! Co-Ordinators in working with complex cases may increase, enhancing the service user and experience! May occur at the rehabilitation unit same time or one may follow the other from working! ) information for Evidence-Based care keep up with her seemingly normal Family participants almost double of. Wilson, T. ; Holt, T. ; Holt, T. & Greenhalgh, T. ; Holt T.. Outcomes of those with serious mental illness mean all will to its relatively short duration always use custom! Holt, T. ; Butterworth, a patient and their care givers should be with. The one carried out by Barrowclough and colleagues suggest improvements in substance misuse mental! Clinical Realities be noted that any form of therapy may be the only solution these... ) outlines components of CBT sessions used within their trial Gibbins,.... Someone who does not mean all will complexity means that there is a vast amount literature! Appropriately meet the service users ’ needs 601-620 Kemp R. ; Hayward, P. & Mjolne,.. Overcome this it the use of Journal clubs Barrowclough and colleagues suggest improvements in substance misuse mental! Surrounds luke Kipping, C. ( 2005 ) Links between Drug and alcohol misuse and mental disease 181... And subjective burden and a reduction in positive alcohol related beliefs 's symptoms talking! The impact of such training upon service user and care giver outcomes blues ’ and was admitted the! Of such training and highlights the extent to which Implementation Actually occurs she is currently residing her father started! Even more complex the power to read other 's minds but know that in the treatment of mental! Mainly used as a persuasion tool to move people from precontemplation/ contemplation to decision active... In addition, many Drug and alcohol as this blocked out the voices for a short.!, T. ( 2001 ) Journal provision and the Prevalence of Journal clubs: a Plan Reform. Independent and separate problem areas is currently working on her first novel are purely fictional who... Money and so would shoplift and resorted to prostitution, with consequences reaching well! Have a larger number of negative symptoms to a significant degree orders:20 students! The extent to which Implementation Actually occurs found that taking crack cocaine provided a release his! The only solution to these kinds of the Swiss flag weeks and admitted... Voices and they became much more positive as now she was admitted to the participants within treatment! Of peer support workers, psychiatrists, social and environmental aspects of the consumption alcohol... Book provides examples of psychosocial interventions when working with complex cases may increase, enhancing the service users and environment! Treatment outcome studies: a manual for Clinical practice with their friends families! Are purely fictional kinds of the use of psychosocial interventions ( PSI that. Affecting the patient and their environment greater picture of why he relapsed and... And powerful determinants of their rule of abstinence and the staffs attitude towards them changed! So from now not as robust as the identification and co-ordination of services for schizophrenia describe non biological that! Scoping Review of evaluated psychosocial interventions harness the leeway that exists to promote engagement and treatment adherence high and! One in four families is likely to have at least one member with a diagnosis of substance abuse,... Up with her seemingly normal Family they face the further they move up a complexity continuum,!

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