Search results for ‘Subject term:"mental health problems"’ Sort:
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Toward the integration of neuroscience and clinical social work
- Author:
- MONTGOMERY Arlene
- Journal article citation:
- Journal of Social Work Practice, 27(3), 2013, pp.333-339.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reviews recent findings in neuroscience in light of the history of social work, the scientific support for clinical social work interventions, and the challenges of integrating neuroscience into academic and practice settings. Illustrations of several critical neurophysiological underpinnings of important clinical phenomena are described, including disorders of personality, defence mechanisms, attachment styles, and the close relationship between ego functions and right hemisphere functions. (Edited publisher abstract)
DSM-5 and the general definition of personality disorder
- Author:
- WAKEFIELD Jerome C.
- Journal article citation:
- Clinical Social Work Journal, 41(2), 2013, pp.168-183.
- Publisher:
- Springer
- Place of publication:
- New York
There is a fundamental change proposed for DSM-5 in the general definition of personality disorder, representing a new conceptualisation that shapes how the DSM distinguishes personality pathology from other undesirable or negative personality features. The change is needed due to serious deficiencies in the current DSM-IV approach. Specifically, personality disorder is to be conceptualised as impairment in both self organisation and interpersonal relating, caused by pathological (extreme) personality traits. This represents progress in that marked impairment in self organisation and interpersonal relating are plausibly characteristic of personality disorder. However, the required level of impairment remains too low, and the kinds of impairment are not restricted to those which indicate disorder versus culturally undesirable features. Moreover, extreme traits are neither necessary nor sufficient for personality disorder because personality represents not the sum of traits but the holistic organisation of traits and other meanings. The DSM-5’s diagnostic focus on traits thus potentially opens the way to massive false positive diagnoses. An earlier proposal to reframe personality disorders using global similarity matching of the patient’s condition to prototypical descriptions of specific personality disorders is argued to also lead toward less valid diagnoses. (Publisher abstract)
“It’s us that have to deal with it seven days a week”: carers and borderline personality disorder
- Authors:
- DUNNE Emma, ROGERS Bertha
- Journal article citation:
- Community Mental Health Journal, 49(6), 2013, pp.643-648.
- Publisher:
- Springer
Carers provide unpaid support to family or friends with physical or mental health problems. This support may be within the domain of activities of daily living, such as personal care, or providing additional emotional support. While research has explored the carer experience within the National Health Service in the United Kingdom, it has not focused specifically on carers of individuals with a diagnosis of borderline personality disorder (BPD). Eight carers for those with a diagnosis of BPD were invited to take part in two focus groups. The first carers’ focus group, entitled ‘The role of Mental Health services,’ produced four super-ordinate themes. The second carers’ focus, entitled ‘Experiences in the Community,’ produced six super-ordinate themes. It seems carers of those with a diagnosis of BPD are continuing to be overlooked by mental health services, and subsequently require more support to ensure their own well-being. (Publisher abstract)
Advances in the conceptualization of personality disorders: issues affecting social work practice and research
- Authors:
- LANIER Paul, BOLLINGER Sarah, KRUEGER Robert F.
- Journal article citation:
- Clinical Social Work Journal, 41(2), 2013, pp.155-162.
- Publisher:
- Springer
- Place of publication:
- New York
This article provides a review of the research that has informed the proposed changes to the DSM-5 conceptualisation of personality psychopathology with a focus on implications for social work practice and research. A paradigm shift to a dimensional model is likely to replace the current categorical model of personality disorders and will have profound implications for the profession. While establishing a diagnostic system that is grounded in empirical knowledge is the primary benefit, this tool will also be more consistent with social work’s orienting theories and values. Social workers should gain knowledge about the proposed changes and actively participate in the review process. (Publisher abstract)
Social inclusion and personality disorder
- Author:
- CASTILLO Heather
- Journal article citation:
- Mental Health and Social Inclusion, 17(3), 2013, pp.147-155.
- Publisher:
- Emerald
Purpose – This study aims to investigate the process of recovery for people diagnosed with personality disorder. This is related to the application of the new meaning of recovery from mental illness as explored by members of The Haven which, as the service setting for the study, addresses the problems of a client group that suffers significant social exclusion and aims to examine efforts which attempt to reverse this social exclusion. Design/methodology/approach – A participatory action research approach was chosen for this study and The Haven Research Group, comprised of the author and Haven clients, formulated proposed research questions and conducted focus groups and individual client interviews with 66 participants, over a period of three years. The group has been concerned with the effectiveness of The Haven as a recovery tool from the perspective of service users and carers. Findings – An examination of emerging themes, and the interplay between themes, gives insight into what participants considered to be the key steps to recovery for someone with a personality disorder diagnosis. From this thematic analysis, a map is proposed of the journey of recovery for people with the diagnosis. Practical implications – As an alternative to the historically sequential path of rehabilitation and proposed recovery, this study offers a new, socially inclusive way of working with people who have a personality disorder diagnosis where they may choose to retain a haven while continuing to develop and progress on their chosen path in the wider world. Social implications – The Haven has emerged as a unique model where therapeutic community principles have been combined with a crisis unit which shows that it is possible to work effectively with a relatively large number of people with personality disorder, well in excess of 100 at one time, many of whom had not made progress in other service settings, resulting in significant financial savings to the health, social care and criminal justice system. Originality/value – This study offers contributions to knowledge in terms of the service design and proposes a new model of recovery in personality disorder. This is defined as a journey of small steps highlighting recovery as a process rather than a goal, leading to the emergence of the new concept of transitional recovery. (Publisher abstract)
Research watch: art therapy: a dose of treatment, an aid to social inclusion or an unnecessary indulgence?
- Author:
- HOLTTUM Sue
- Journal article citation:
- Mental Health and Social Inclusion, 17(2), 2013, pp.64-69.
- Publisher:
- Emerald
Purpose – This Research Watch aims to summarise two recent and very different research publications on art therapy and comments on their ability to shed light on the usefulness of art therapy to address mental distress and enhance social inclusion. Design/methodology/approach – The author discusses a recent edition of a UK art therapy journal in which research papers focus on art therapy with people who have been given a diagnosis of personality disorder. The main methodologies are qualitative describing participants’ and/or therapists’ experiences and the role of art therapy in addressing serious mental distress. The second publication is a recent report of a large randomised controlled trial of art therapy for people given a diagnosis of schizophrenia. The author assesses the value of both publications in informing us about the usefulness of art therapy in addressing mental distress and enhancing social inclusion. Findings – In the author's view, neither publication establishes definitively how or whether art therapy might address serious mental distress, whether labelled personality disorder or schizophrenia. However, the qualitative articles provide insight into possible helpful (and less helpful) aspects of therapy. The randomised trial should have been able to establish general principles about the effectiveness of art therapy for a specific group of people in specified contexts, but instead exemplifies many problems inherent in the pervasive research culture of putting numbers onto complex human interactions and calculating their value for money, sometimes at the expense of really understanding what is going on. Originality/value – The author draws upon these two very different examples of research to reflect a current dilemma in UK art therapy research, and tentatively looks at possible ways forward. (Publisher abstract)
Do “complex needs” need “complex needs services”? – part one
- Author:
- JOHNSON Robin
- Journal article citation:
- Mental Health and Social Inclusion, 17(3), 2013, pp.127-134.
- Publisher:
- Emerald
Purpose – This paper – the first of two – aims to trace the origins of, and suggest the underlying intentions behind, the recent appearance of the new term “complex needs”, amongst commissioners, service providers and some service user groups. Design/methodology/approach – The paper takes a narrative approach, describing the early appearance of the term “complex needs” in services for those excluded from and/or stigmatised in mental health services. This is then contextualised with UK Government policy papers. Findings – Contemporary usage of the term “complex needs” may at times be inconsistent and confusing; but it reflects government concerns that service provision has become too narrow in focus, and less needs-led. The concept embodies an implicit critique of overly narrow practice, and holds the prospect of more systemic change. Originality/value – “Complex needs” is relatively new, as a quasi-technical term; as is any analysis locating its usage in the context of current overly narrow service definitions. (Publisher abstract)
Supporting staff working with people who challenge services: guidance for employers
- Authors:
- SKILLS FOR CARE, NATIONAL DEVELOPMENT FORUM FOR INCLUSION
- Publisher:
- Skills for Care
- Publication year:
- 2013
- Pagination:
- 52
- Place of publication:
- Leeds
This strategic guidance which has been developed in partnership with people, families, employers and commissioners to help with decision making around workforce development in the context of people who may challenge; is aimed at adult social care employers and commissioners working specifically with adults with a range of support and care needs such as older people with conditions across the dementia spectrum, people with mental health and personality conditions, and those with learning disabilities who have particularly complex needs and/or are labelled as challenging services. The guide will help employers with developing competency and expertise in providing support to people who challenge, across different groups. Following an Introduction outlining its purpose, the guide is arranged as follows: organisational actions; building workforce skills and knowledge; using learning tools and resources and identifying the best training solutions; specialist approaches: additional considerations for working with different people (learning disability, autism, mental health, older people, and multiple conditions); and useful contacts. (Edited publisher abstract)