Search results for ‘Subject term:"mental health problems"’ Sort:
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Developing a theoretical understanding of therapy techniques: an illustrative analogue study
- Authors:
- FREEMAN Daniel, et al
- Journal article citation:
- British Journal of Clinical Psychology, 44(2), June 2005, pp.241-254.
- Publisher:
- Wiley
In psychological interventions, clients are often asked to review unhelpful beliefs. Surprisingly, there is no theoretical understanding of how beliefs are reviewed in therapy. Moreover, by understanding a therapeutic technique, potential interactions with symptom processes can be considered. An analogue study assessing the feasibility of researching therapy techniques is described, in which links between symptoms, reasoning style, and an experimental version of the cognitive therapy technique of belief evaluation are examined. Thirty individuals without psychiatric illness completed (i) dimensional measures of depression, anxiety, and delusions, (ii) a measure of confirmatory reasoning both before and after instruction in disconfirmatory reasoning, and (iii) a belief evaluation task. Compared with individuals with a confirmatory reasoning style, individuals with a disconfirmatory reasoning style were less hasty in their data gathering, considered a greater number of hypotheses during the task, had higher intellectual functioning, and had lower levels of depressive symptoms. Conversely, the individuals with the strongest confirmatory reasoning had higher levels of depression and preoccupation with delusional ideation. Successful adoption of disconfirmatory reasoning was associated with less hasty decision-making and lower levels of preoccupation and distress by delusional ideation. Individuals with a disconfirmatory reasoning style reported more evidence both for and against their beliefs in the belief evaluation task. In the context of clinical research indicating that individuals with delusions are hasty in their data gathering and have difficulty considering alternatives, a potential implication of the findings is that individuals with delusions may find belief evaluation in therapy.
Qualitative evaluation of a job retention pilot for people with mental health problems
- Authors:
- THOMAS Kristina, SECKER Jenny, GROVE Bob
- Journal article citation:
- British Journal of General Practice, 55(516), July 2005, pp.546-547.
- Publisher:
- Royal College of General Practitioners
Interviews with job retention clients, their employers and case managers were carried out. A group interview with GPs was also conducted. Client-focused interventions were reported to be helpful by clients and GPs and employer -focused interventions were appreciated by both clients and employers. All clients attributed positive outcomes to the service. In conclusion, these preliminary results support the further development and evaluation of job retention services.
Maximizing treatment effectiveness in clinical practice: an outcome-informed, collaborative approach
- Author:
- SAGGESE Michael L.
- Journal article citation:
- Families in Society, 86(4), December 2005, pp.558-564.
- Publisher:
- The Alliance for Children and Families
Clinicians need easy-to-use, practical, systematic methods of evaluating, informing, and reporting the effectiveness of treatment. Practicing clinicians no longer have to rely on the DSM for treating their clients, but by making use of both outcome and process measures they can create a more collaborative and effective therapy with their clients. The findings from over 40 years of psychotherapy outcome research literature emphasize the importance of common factors as the curative elements central to all forms of therapy regardless of theoretical orientation. Methods discussed here offer practitioners the means to identify which clients are responding to treatment and those for which treatment is not working so that adjustments can be made to the therapy. The goal is to decrease dropout rates, increase levels of customer satisfaction, and document and improve the overall effectiveness of treatment.
Mental health awareness training programme at HMP Styal
- Author:
- ROSE Janet
- Journal article citation:
- Prison Service Journal, 162, November 2005, pp.19-23.
- Publisher:
- Her Majesty's Prison Service of England and Wales
This article reports on one aspect of a larger study, concerning the development of mental health awareness training for prison officers in a womens prison, conducted by Bournemouth University and commissioned by the Prison Health Department of the Department of Health. The training was modular and included a general introduction to mental health and well being; self-harm and suicide awareness; awareness of common mental health problems; mental health issues for women prisoners and adolescents. The article looks at the implementation and formal evaluation of the training and the future implementation of mental health training.
The effect of service setting on treatment outcome: a comparison between cognitive behavioural approaches within primary and secondary care
- Authors:
- FORTUNE Lorna, et al
- Journal article citation:
- Journal of Mental Health, 14(5), October 2005, pp.483-498.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Within the National Health Service (NHS) there has been an increasing emphasis on the integration of mental health services within primary care. This study compares a hospital-based and a primary care-based CBT service, to investigate if the setting of treatment affected participants' rate of recovery and levels of satisfaction. 52 participants who received CBT treatment for a range of psychological problems in either setting were compared using a non-randomized, quasi-experimental, design. A range of psychological measures were taken at baseline and over the first six treatment sessions, and rate of change in psychological symptoms and satisfaction were compared. Both groups demonstrated improvement over the period of the study but the participants from the primary care group showed a more rapid rate of recovery during the first six sessions, and received briefer treatment. Such differential rates of treatment change were not attributable to group differences in terms of chronicity or severity. The primary care group also reported significantly higher levels of satisfaction. The authors conclude the setting of treatment might impact on patients' outcome, with primary care patients responding more rapidly than those seen in secondary care. Providing a service in primary care might also increase patient compliance with treatment. Further research is needed to investigate longer term outcome, as well as enhancing how well findings can be generalized.
Don't seize the day hospital! Recent research on the effectiveness of day hospitals for older people with mental health problems
- Authors:
- HOE Juanita, ASHAYE Kunle, ORRELL Martin
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(7), July 2005, pp.694-698.
- Publisher:
- Wiley
Day hospital (DH) care remains a core component of mental health services for older people. However, there has been an ongoing debate about the effectiveness and value for money of DHs in comparison to day centres (DC). This article reviews recent research on the effectiveness of day hospitals for older people with mental health problems. A systematic search of relevant research literature over the last decade using the major electronic healthcare databases examining the quality and effectiveness of mental health DHs for older people. In the last decade the evidence for the effectiveness of DHs has continued to increase, but still lags behind research on DHs in general adult psychiatry and geriatric medicine. The review found that DHs appear effective at assessing and meeting needs and that a systematic approach to evaluating quality can be used to improve services. Recent research supports the effectiveness of day hospitals, but further studies are needed in order to provide a more robust evidence base.
Changes and predictors of change in objective and subjective quality of life: multiwave follow-up study in community psychiatric practice
- Authors:
- RUGGERI Mirella, et al
- Journal article citation:
- British Journal of Psychiatry, 187(2), August 2005, pp.121-130.
- Publisher:
- Cambridge University Press
This Italian study aims to describe changes at 2 and 6 years in objective and subjective quality of life in 261 individuals attending a community mental health service and to identify predictors of change in each life domain. The research used a prospective study of demographic, diagnostic and service utilisation characteristics, psychopathology, functioning, disability, self-esteem, affect balance and service satisfaction. Female gender, unmarried status, older age, less education and greater disability predicted a worsening of objective quality of life over time, but explain a small amount of variance. The variance in subjective quality of life was higher (greater than 40%). Greater clinician-rated anxiety and depressive symptoms had a negative effect on satisfaction with health and general well-being. Psychological status, self-esteem and satisfaction with service were the most important predictors in almost all subjective domains; these variables should be important targets for treatment.
Enabling access to direct payments: an exploration of care co-ordinators decision-making practices
- Authors:
- SPANDLER Helen, VICK Nicola
- Journal article citation:
- Journal of Mental Health, 14(2), April 2005, pp.145-155.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This study considers how workers have responded to direct payments in practice and how they can enable or limit greater access. The analysis is primarily based on 20 in-depth interviews with care co-ordinators who took part in an evaluation of a national pilot to implement direct payments in mental health. Three key responses were identified which mediated care co-ordinators' pursuit of direct payments as an option for clients: using selective criteria; incorporating it into a dominant framework (of ‘providing services’) and re-conceptualizing their role as enabling greater capacity for choice and control. In order to make sense of these responses it was necessary to examine their conflicting work context. The authors conclude that initiatives such as direct payments suggest the need to re-appraise the role of care co-ordinators and may require a significant shift in the focus of their practice. Whilst tensions inherent in their role may make this shift difficult, the analysis also suggests that it could lead to opportunities for putting into practice ideas about user empowerment which should be central to their practice.
Clinical, socio-demographic, neurophysiological and neuropsychiatric evaluation of children with volatile substance addiction
- Authors:
- UZUN N., KENDIRLI Y.
- Journal article citation:
- Child: Care, Health and Development, 31(4), July 2005, pp.425-432.
- Publisher:
- Wiley
Abuse of organic volatile substances in children has become a social health problem that is increasing in the recent years. Among these substances, toluene is highly preferred by abusers because of its euphoric effect, cheapness and easy availability. There is no published research on the clinical and neurophysiological evaluation of children with short-term volatile substance addiction. In this study, socio-demographic characteristics were questioned in 12 children with a mean age of 15 years and a duration of toluene abuse for a mean of 2.3 years, and the clinical characteristics of central and peripheral nervous system damage caused by volatile substances, particularly by toluene were analysed, and probable neurological disorders were investigated by means of neurophysiological and neuropsychological tests. All tests were compared with a control group. Fifty-eight percent of the children included in the study had pathological findings in the neurological examination. There was pyramidal involvement in 25% and peripheral nerve involvement in 33.3% of the cases. Evaluation of the cognitive functions revealed 33.3% pathology in the 'Short Test of Mental Status' which assesses functions of orientation, attention, learning, arithmetic calculation, abstraction, information, construction and recall. Sensorial polyneuropathy was found in 33.3% of the cases in nerve conduction studies. Somatosensory-evoked potentials revealed pathology in 16.7% of the cases and brainstem-evoked potentials in 50% of the cases. No pathology was observed in electroencephalography and visual-evoked potentials. In this study, neurophysiological and neuropsychiatric tests revealed that toluene causes slow progressive, clinical and subclinical central and peripheral nerve damage. In Turkey, because of cheapness, easy availability and legal use of volatile substances, the clinical extent of systemic and neurological toxicity of volatile substance abuse is increasing. Abuse of volatile substances, a currently increasing social issue, may create important physical problems which can be permanent.
The Family Adaptability and Cohesion Evaluation Scale (FACES): an instrument worthy of rehabilitation?
- Authors:
- PLACE Maurice, et al
- Journal article citation:
- Psychiatric Bulletin, 29(6), June 2005, pp.215-217.
- Publisher:
- Royal College of Psychiatrists
There have been a variety of instruments developed for evaluating family functioning, but no specific measure has emerged as appropriate for routine clinical use. The Family Adaptability and Cohesion Evaluation Scale (FACES) was viewed as a useful tool for a period, but has been less popular of late. This paper looks at its use in families with two very different types of problem to assess its discriminatory ability. Mothers with depression whose children were not showing mental health difficulties reported a very different pattern of family functioning from those whose children were showing chronic school refusal. The FACES is capable of discriminating between different patterns of family functioning. Its ease of administration, and the information it provides, should recommend it for wider use in clinical settings.