Patients? understanding and participation in a trial designed to improve the management of anti-psychotic medication

Rogers, Anne; Day, Jenny; Randall, Fiona; Bentall, Richard P.

doi:10.1007/s00127-003-0693-5

Cited by 34 publications

(20 citation statements)

References 17 publications

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“…This highlights the need for qualitative research and multi-sector collaboration when designing a complex intervention (Byng & Jones, 2004) and suggests that the need to standardize the intervention should pay less attention to individual components of the intervention and be more concerned with its actual process and function (Hawe, Shiell & Riley, 2004). Equally, it has been shown how combining a RCT with a qualitative study of service user perspectives can enrich the theoretical understanding of benefits of the intervention (Rogers et al, 2003). In this paper I propose to further develop this line of inquiry by pointing out that while valuable in their own right, RCT studies are blind to the ''on the ground'' interpersonal dynamics of service delivery.…”

Section: Introductionmentioning

confidence: 99%

Understanding a complex intervention: Person-centred ethnography in early psychosis

Larsen

2007

Journal of Mental Health

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Background: Mental health interventions are increasingly ''complex'' as it is recognized that a holistic, integrated or ''biopsychosocial'' approach is required to provide adequate treatment and support. While randomized controlled trial (RCT) studies are applied to assess clinical outcome, the actual workings and experiential effectiveness of this type of intervention are poorly understood and documented. Aims: To discuss the value of a social science perspective of interpretive understanding (verstehen) and existential phenomenology to study sociocultural processes in a complex intervention, in particular when taking an ethnographic approach. Methods: A person-centred ethnographic study of a Danish early intervention in psychosis service involved two years participant observation and repeated interviews with 15 clients. Results: The study detailed therapeutic encounters in the intervention, supplemented by clients' reflections and insights generated through dialogue. Following first episode psychosis clients experienced an existential crisis, and the intervention offered therapeutic engagement, support and systems of explanation that provided meaning and life direction through the recovery models of ''episodic psychosis'' and ''chronic schizophrenia''. Conclusions: The person-centred ethnographic approach provides rich insights into the sociocultural and personally experienced workings of a complex mental health intervention, which allow a critical understanding of therapeutic processes and how they may be improved.

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Section: Introductionmentioning

confidence: 99%

Understanding a complex intervention: Person-centred ethnography in early psychosis

Larsen

2007

Journal of Mental Health

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“…This is especially true for health behaviors (Bandura, 1991(Bandura, , 1986O'Leary, 1985;Strecher, De Vellis, Cevoy, Becker, & Rosenstock, 1986;Yallow & Collins, 1987). Perceived efficacy has been positively associated with antipsychotic medication adherence (Rogers, Day, Randall, & Bentall, 2003) and has been identified as a cornerstone of medication adherence (McCann, Clark, & Lu, 2008). Therefore, we predicted the following:…”

Section: Treatment-seeking Intentionsmentioning

confidence: 99%

Treatment via Television: The Relation Between WatchingDr. Philand Viewers’ Intentions to Seek Mental Health Treatment

Rasmussen

Ewoldsen

2016

Journal of Health Communication

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Many people with a mental disorder fail to obtain professional treatment for a diagnosable mental disorder, and some turn to media outlets for diagnosis and treatment recommendations; however, little is known about outcomes associated with exposure to media mental health professionals. We reasoned that exposure to Dr. Phil would be associated with greater intentions to seek mental health treatment for oneself and for one's child and that this relationship would be serially mediated by higher levels of parasocial relationship with Dr. Phil and greater efficacy beliefs in treating the mental illness of oneself and one's child. As predicted, frequent viewing of Dr. Phil was associated with higher levels of parasocial relationship with Dr. Phil, which in turn was itself associated with greater efficacy beliefs in treating a mental illness of oneself and of one's child, which was ultimately related to greater intentions to seek treatment for oneself or for one's child. The findings suggest that the relationship that develops between media mental health professionals and their audience can encourage intentions to seek mental health treatment.

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“…In other studies, Kemp's compliance therapy has been found to be associated with greater improvements in psychiatric symptoms, compared with treatment as usual. 69,70 Moreover, in a qualitative study, Rogers et al 71 interviewed patients with schizophrenia or schizoaffective disorder who participated in a medication management trial comparing treatment as usual, psychoeducation, and an MIbased intervention. Qualitative analyses revealed accounts of improved therapeutic alliance, increased sense of agency and self-efficacy, as well as more positive attitudes toward antipsychotics in the narratives of patients who received either the MI-based or psychoeducational interventions, while such accounts were absent among those who received routine care only.…”

Section: For Dual Diagnosismentioning

confidence: 99%

Extending Motivational Interviewing to the Treatment of Major Mental Health Problems: Current Directions and Evidence

2011

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Motivational interviewing (MI) was originally developed for the treatment of substance abuse but is rapidly expanding to other major mental health populations beyond addictions. This brief review considers the use of MI and related motivational enhancement therapies (METs) in the treatment of anxiety, depression, and eating disorders, and concurrent psychosis and substance use disorders. MI-MET has been added and (or) integrated into treatment for these problems in a wide variety of ways, most commonly as a pretreatment to other therapies (psychosocial treatments and pharmacotherapy) or integrated into standard assessment procedures. In each problem domain, the bulk of the current evidence supports the value of adding MI to existing therapies in increasing engagement with treatment and in improving clinical outcomes. This is particularly encouraging in that many of the populations included in these investigations represent severe and treatment-recalcitrant populations. However, research on the application of MI to other major mental health problems beyond addictions is in the early stages, with existing studies having numerous limitations (for example, small uncontrolled studies or lack of adequate control groups, and failure to establish both MI treatment integrity and the unique contribution of MI in integrated treatments). In short, the substantial body of promising preliminary findings strongly support the continued investigation of MI and related methods for these populations in well-designed clinical trials that examine not only the additive value of MI but also mechanisms underlying these effects and individual differences (moderators) indicating the need for MI.

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Patients? understanding and participation in a trial designed to improve the management of anti-psychotic medication

Abstract: Qualitative research accompanying trials illuminates and adds to the quantitative outcomes. The key to interpreting participants' accounts of the process and outcomes of this trial suggests the need to give greater emphasis to participants' past and current experience of service contact.

Cited by 34 publications

References 17 publications

Understanding a complex intervention: Person-centred ethnography in early psychosis

Understanding a complex intervention: Person-centred ethnography in early psychosis

Treatment via Television: The Relation Between WatchingDr. Philand Viewers’ Intentions to Seek Mental Health Treatment

Extending Motivational Interviewing to the Treatment of Major Mental Health Problems: Current Directions and Evidence

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