There is a developing, though limited, evidence base for their effectiveness from clinical trials and routine services. It can also alter actions (behavioural) and circumstances that are affecting these thoughts and feelings (Nelson 2005). Strategies to overcome such barriers are generated and recommendations are made. Psychosocial interventions have a greater or more direct focus on a person's social environment in interaction with their psychological functioning.. ; Greenfield, S.F. For example the interventions explored in this report (CBT, MI and FI) display potential for improving service users and care givers outcomes and optimising service delivery. Therefore, leading to a different delivery of services compared to someone who uses substances to self medicate. & Vlaeyen, J.W.S. Elyn starts with describing her childhood growing up with her seemingly normal family. (2008) Doceo;Learning as Loss 1 [On-line] UK: Available: Accessed: 16 May 2009 Baker, A.; Bucci, S.; Lewin, T.J.; Kay-Lambkin, F.; Constable, P.M. & Carr, V.J. Supervision also allows a forum for dysfunctional attitudes to be explored and discussed. & Mairs, H. (2007) Does structured clinical supervision during psychosocial intervention education enhance outcome for mental health nurses and the service users they work with? Nursing Times Clinical. Psychiatrists commonly prescribe drugs to manage symptoms of mental disorders. London: National Institute for Health and Clinical Excellence. There is a vast amount of literature examining the use of CBT with psychosis (Jones et al 2004). 50, 258-263 Clark, R.E. Journal of Obstetrics and Gynaecology. 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). The use of PSI is based on a diagnostic assessment of the patient’s psychopathology. (1996) Family Support for People with Dual Disorders. While there are many different therapies with different focuses, educating the person suffering and their family or support system about the condition and treatment approach is key to the success of any psychosocial intervention. For example, someone experiencing psychosis and living with their family may be offered cognitive behavioural family interventions work (CBFI), while someone living with emotionally unstable personality disorder may be offered DBT; both may be offered vocational or educational support and possibly peer support with a view to reducing isolation. Demonstrating some of the factors that add to an individual’s complexity. Laura first started to hear voices at the age of 9 and at first these did not bother her. London: IPPR/Turning Point Randall, G., Britton, J., Brown, S. & Craig, T. (2006) Getting through – access to mental health services for people who are homeless or living in temporary or insecure accommodation: a good practice guide. (2000) Compliance and psychological reactance in schizophrenia. That is the use of non-medicinal means to alter a person's behaviors and relationships with society in order to reduce the impact of the person's disorder or condition. Thereupon improved functioning has a positive indirect effect upon carers. (2004) Measured success: A scoping review of evaluated psychosocial interventions training for work with people with serious mental health problems. Potential barriers may occur when implementing these newly acquired skills and knowledge due to feelings of diminished confidence as part of the learning process (Atherton 2008). ; Casey, D.E. Such interventions are used as part of an individualised treatment plan that incorporates the key principles of working with dual diagnosis (see table4). psychosocial support in crisis response and development work has become increasingly clear, particularly as we have watched major operations such as the 2003 Bam earthquake, the 2004 Indian Ocean tsunami and subsequent emergency responses. Nursing Times Clinical. Another negative to this study as with that of Barrowclough et al(2001) was that the interventions were carried out by highly trained psychologists; Echoing the argument of generalisability. Complications posed by dual diagnosis (Cleary 2009, Drake & Mueser 2000, Clark 1996, Dixon, McNarey & Lehman 1995, Griffiths & Allen 2007 and Gibbins & Kipping 2006) Increased risk of – Suicide, Self Neglect, Violence, Poor compliance with treatment, More inpatient stays – worsening psychiatric symptoms Relapse, Homelessness, HIV and Hepatitis, Contact with criminal justice system Prejudice and Stigma. 28(1), 5-10 Thylstrup, B. ‘Made of many different things or parts that are connected; difficult to understand’ (Soanes & Stevenson 2005) Interpreting the above definition of complex within the Oxford Dictionary of English one could describe a complex case as a service user with more than one problem or need that are connected making the case more difficult to work with. ;Blow, F.C. This can lead to people slipping through the net or being passed from service to service with no one willing to take responsibility for a person’s care (see table 6: The case of Luke). Family Studies and Intervention Strategies Ph.D. The psychosocial impacts of emergencies are like ripples in a pond, with consequences reaching out well beyond the main location of the event. Talk therapies are most common for this form of intervention. Many wish they had the power to read other's minds but know that in the least they can mostly understand themselves. 99(20) Couture, S.M. Psychosocial Interventions for Schizophrenia. Visit the Psychotherapy Approaches: Help & Review page to learn more. Journal of Clinical Epidemiology. 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). However, these results were not statistically clinically significant. The family dynamics of a person with a dual diagnosis is often impacted greatly due to the complexities discussed earlier and there is growing evidence to suggest how family involvement can have positive impacts on outcomes for both the service user and their families (Fischer et al 2008; Dixon, McNarey and Lehman 1995). Issues in Mental Health Nursing. 27, 183-186 Graham, H.; Copello, A.; Birchwood, M. J.; Mueser, K.; Orford, J.; McGovern, D.; Atkinson, E.; Maslin, J.; Preece, M.; Tobin, D. & Georgiou, G. (2004) Cognitive-Behavioural Integrated Treatment (C-BIT): A treatment manual for substance misuse in people with severe mental health problems. 164, 100-107 Wilson, T.; Holt, T. & Greenhalgh, T. (2001) Complexity Science: Complexity in Clinical care. Once Laura was admitted to the rehabilitation unit where she is currently residing her father got in touch. 's' : ''}}. & Lewis, S. (2003) Cognitive Behavioural Therapy and Motivational Intervention For Schizophrenia and Substance Misuse: 18 Month Outcomes of a Randomised Controlled Trial. The review was conducted to explore psychosocial interventions for adults with substance-use disorders. ; Griffin, M.L. This causes barriers on numerous levels such as cost implications of all staff receiving training, back fill of their hours, cost of trainer and venue etc.. ; Hall, C.S. ; Essock, S.M. Psychosocial interventions are used 152, 456-458 DOH (1999a) The National Service Framework For Mental Health: Modern Standards and Service Models. British Journal of Psychiatry. Learn more. The therapist may not want to know why a person wants a cigarette, only how they are going to stop the person from taking the cigarette. Aliases are used within the scenarios of this report in order to maintain anonymity of the service users and carers described to illustrate points and examples. Luke managed to do this for a few weeks and was admitted to the rehabilitation unit. psychosocial disability, or early in their NDIS planning, is a possible and desirable focus for the Scheme’s development. With such vast amounts of information how can one stay truly up to date with evidence based practice. PSI’s aim is to reduce stress experienced by an individual with psychosis or help him or her to cope with stress more effectively.” As a result of adopting a PSI approach an individualised service is offered to the service user to help meet their needs utilising a variety of interventions and services with great emphasis being placed upon collaboration. All of the above recommendations would enhance service user and care giver experience through staff being more knowledgeable about working with dual diagnosis and providing evidence based psychosocial interventions. Principles of treatment of substance misuse in people with severe mental illness Assertive outreach to facilitate engagement • Close monitoring to provide structure and social reinforcement • Integrated concurrent service • Comprehensive, wide range of interventions • Stable living situation • Flexibility and specialisation (modified approaches) • Stages of treatment: engagement, persuasion, active treatment and relapse prevention • Longitudinal perspective for relapsing and chronic disorder • Optimism – instilling hope in patients and carers. A way to overcome this is for more health professionals to acknowledge their deficits in knowledge and attend training. A model which displays this link is the Stress Vulnerability Model by Zubin and Spring (1977 cited in Norman, & Ryrie 2004). Create your account. - Definition & Techniques, Biological and Biomedical In addition to this mental health services need to be clear on their admissions criteria, accepting that substance misuse and psychosis are co-morbid and not two separate entities where one must be eradicated before a person can access services. This important report provides a synthesis of evidence on the application of specific supports as early intervention for people experiencing psychosocial disability. Again, adding to the complexity of individuals that because one individual responds one way to an event does not mean all will. Psychosocial Assessment: Impacting Care Planning & Intervention Presented by: Paige Hector, LMSW Debbie Lane, MSW Objectives Identify crucial components of psychosocial assessment Demonstrate how psychosocial assessments should impact the care plan Biopsychosocial-spiritual Perspective Physical or medical aspects of ourselves (bio) A method to help tackle this is the formation of journal clubs within mental health services. 35(3), 347-365 Hussein, R.G. Over 50% of people with a severe mental illness also use illicit drugs and/or alcohol at hazardous levels (Cleary et al 2009) and even low levels of substance misuse can have detrimental effects and cause serious complications (Barrowclough et al 2001). Luke started to hear voices at the age of 18 and was soon admitted to an acute unit where he commenced anti-psychotic medication. The robustness of the study was discussed above. This could result in mental health professionals and substance misuse workers feeling unequipped in working with people with a dual diagnosis; resulting in them receiving inadequate care. ; McSweeny, J.C.; Pyne, J.M. The Haddock et al (2003) study is a follow on from the Barrowclough et al (2001) study reporting further service user outcomes, cost effectiveness and carer outcomes over an 18month period. 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. Wilson, Holt and Greenhalgh (2001) discuss the term complexity in relation to human health and illness. (eds) (2004) The Art and Science of Mental Health Nursing: A Textbook of Principles and Practice. Using the Stress Vulnerability Model (Bucket Analogy) she helped Luke to see how his behaviour impacts negatively upon him and that crack cocaine only provides a short term fix. 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