The Outcome of Training Community Psychiatric Nurses to Deliver Psychosocial Intervention

Brooker, Charlie; Falloon, Ian R. H.; Butterworth, A.; Goldberg, David; Graham-Hole, Victor; Hillier, V.

doi:10.1192/bjp.165.2.222

Cited by 140 publications

(103 citation statements)

References 19 publications

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“…If training and supervision are inadequate, such therapies are less likely to be effective (Fadden, 1998). Thorn training courses, run at centres in London, Manchester and Nottingham, have been shown to improve nurses' effectiveness in delivering researchbased interventions in schizophrenia (Brooker et al, 1994). Joint case discussions and team-based journal clubs on evidence-based practice can enable interprofessional sharing of complementary perspectives and promote continuing professional development.…”

Section: Developing and Maintaining Core Skillsmentioning

confidence: 99%

Running an effective community mental health team

Singh¹

2000

Adv. psychiatr. treat

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Community psychiatric teams are an integral part of modern mental health services. The development of such teams has allowed the care of patients to be transferred from institutions to the community. A Cochrane review of community-based programmes showed that community team-based psychiatric services led to a reduction in suicide rates, improved patient engagement and were more acceptable to patients (Tyrer et al, 1999). Community care also reduces the number of days patients stay in hospital, but not the number of admissions (Marshall et al, 1995). However, community mental health teams (CMHTs) have been criticised for their ambiguous and overambitious aims, and their tendency to neglect people with the most challenging health- and social-care needs (Patmore & Weaver, 1991; Sayce et al, 1991). All mental health workers are not necessarily eager, or skilled, to work effectively in teams. Building and maintaining an effective team requires commitment, clarity of purpose, a shared vision and frequent review of team operations. In a previous issue of APT, Burns & Guest (1999) described the adaptation and running of an assertive community treatment team in an inner-city area. Here I examine the attributes of effective CMHTs (Box 1), enumerate barriers and challenges to team-working (Box 2) and suggest strategies for improving team effectiveness (Box 3).

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Section: Developing and Maintaining Core Skillsmentioning

confidence: 99%

Running an effective community mental health team

Singh¹

2000

Adv. psychiatr. treat

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“…These studies have reported positive effects of family intervention, including reduced relapse or rehospitalization, along with improved occupational functioning, social functioning, and family burden. In addition, Brooker et al (1994) conducted a quasi-experimental study to evaluate the effects of training community nurses in behavioral family therapy (based on Falloon et al's, 1984, model). In a within-subjects design, families were placed on a waiting list for 6 months, followed by 12 months of family intervention, or assigned to a delayed treatment group for whom family treatment was initiated 1 year later.…”

Section: Effectivenessmentioning

confidence: 99%

Empirically supported couple and family interventions for marital distress and adult mental health problems.

Baucom¹,

Shoham²,

Mueser³

et al. 1998

Journal of Consulting and Clinical Psychology

497

411

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This article evaluates the efficacy, effectiveness, and clinical significance of empirically supported couple and family interventions for treating marital distress and individual adult disorders, including anxiety disorders, depression, sexual dysfunctions, alcoholism and problem drinking, and schizophrenia. In addition to consideration of different theoretical approaches to treating these disorders, different ways of including a partner or family in treatment are highlighted: (a) partner-family-assisted interventions, (b) disorder-specific partner-family interventions, and (c)more general couple-family therapy. Findings across diagnostic groups and issues involved in applying efficacy criteria to these populations are discussed.Since the 1970s, there has been a major shift in knowledge regarding the effectiveness of couple-based and family-based interventions for treating adult mental health problems. During this period, various theoretical perspectives have been articulated, specific manual-based intervention strategies have been developed, and controlled treatment outcome investigations have explored a number of specific issues of importance. The current article examines the empirical status of these couple-and family-based interventions for treating (a) marital distress and (b) adult individual diagnosable disorders. More explicitly, the primary goal of this article is to use the criteria put forth by Chambless and Hollon (1998) to evaluate the efficacy, clinical significance, and effectiveness of various interventions that involve a couple or family format.The criteria provide a unifying framework for evaluating the wide variety of psychological interventions. As we reviewed the literature on couple-and family-based interventions, we became aware that there were a number of decisions that had to be made with regard to the application of these criteria. Given that other reviewers may have interpreted and applied the Chambless and Hollon (1998) guidelines in a different manner, we begin this We thank Emily Sartor for her assistance in the preparation of this article.Correspondence concerning this article should be addressed to Donald H. Baucom, Davie Hall CB 3270, Psychology Department, University of North Carolina, Chapel Hill, North Carolina 27599-3270. Electronic mail may be sent via Internet to don_baucom@unc.edu.review by articulating how we have applied them so that the reader can better understand the bases of our conclusions.One of the major decisions that affects the empirical status of an intervention involves what investigations to include in reviewing the literature. In determining the efficacy status of a treatment, we restricted our consideration to published investigations. Attempts to obtain a comprehensive set of findings from conference presentations, unpublished dissertations, and so forth necessarily result in an incomplete and potentially skewed set of data. At times, unpublished findings are cited if mey help to make a certain point or clarify issues, but they are not considered in dete...

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“…In una revisione relativamente recente, Lehman et al (1995) riportavano lo scarso aggiornamento degli operatori dei servizi psichiatrici nell'applicazione persino delle strategic farmacologiche piii elementari e la totale mancanza di applicazione delle strategie psicosociali. Lo studio di Brooker et al (1994) ha mostrato che il tempo che ogni infermiere psichiatrico territoriale dedicava agli utenti afferenti al servizio era di 33 minuti settimanali per la conduzione di approcci non-specifici e che invece erano necessari 47 minuti per condurre un intervento psicosociale integrato con gli utenti ed i loro familiari. Questi ultimi interventi producevano, ad un anno, un netto miglioramento della sintomatologia e del funzionamento sociale della persona, con una netta riduzione delle giornate di ricovero, mostrando una riduzione statisticamente significativa del disagio dei familiari, una loro maggior conoscenza dei farmaci antipsicotici ed una loro maggior soddisfazione nei confronti del servizio (Brooker et al, 1994).…”

Section: La Diffusione Dei Trattamenti Psicoeducativi Familiariunclassified

“…Lo studio di Brooker et al (1994) ha mostrato che il tempo che ogni infermiere psichiatrico territoriale dedicava agli utenti afferenti al servizio era di 33 minuti settimanali per la conduzione di approcci non-specifici e che invece erano necessari 47 minuti per condurre un intervento psicosociale integrato con gli utenti ed i loro familiari. Questi ultimi interventi producevano, ad un anno, un netto miglioramento della sintomatologia e del funzionamento sociale della persona, con una netta riduzione delle giornate di ricovero, mostrando una riduzione statisticamente significativa del disagio dei familiari, una loro maggior conoscenza dei farmaci antipsicotici ed una loro maggior soddisfazione nei confronti del servizio (Brooker et al, 1994). Tali risultati dovrebbero ulteriormente incoraggiare gli investimenti interni di formazione sugli interventi psicosociali efficaci: Putilizzazione di pacchetti specifici di insegnamento e di materiali strutturati nella conduzione degli interventi facilitano una buona riproducibilita e la verifica di processo, oltre che di esito, dei trattamenti.…”

Section: La Diffusione Dei Trattamenti Psicoeducativi Familiariunclassified

Psychoeducational treatments in schizophrenia: love for foreigners or application of evidence-based interventions?

Casacchia¹,

Roncone²

1999

Epidemiol Psichiatr Soc

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MASSIMO CASACCHIA e RITA RONCONE Quando Brown ed i suoi collaborator! dell'Istituto di Psichiatria di Londra pubblicarono nel 1962 il loro articolo sull'impatto del clima familiare nel decorso della schizofrenia (Brown et al., 1962) non immaginavano che il loro studio avrebbe generato un filone di ricerca e di applicazioni cliniche cosi ricco e fertile, le cui implicazioni potevano condurre ad una nuova formulazione dei modelli assistenziali in psichiatria. Nel contempo gli stessi autori non potevano pensare che sarebbero stati necessari piii di trent'anni per inserire nella pratica dei servizi di salute mentale modalita operative che riconoscessero l'importanza della famiglia nella gestione di una malattia mentale grave, come la schizofrenia, di uno dei suoi membri. E che, a distanza di trent'anni, molti operatori, almeno in Italia, avrebbero continuato a guardare con sospetto gli interventi psicosociali successivamente sviluppati da questo studio pionieristico.L'autentica rivoluzione che lo studio ha innescato riguarda, in primo luogo, l'attenzione, del tutto innovativa per quei tempi, per la famiglia, abitualmente esclusa dal trattamento incentrato sulla relazione medico-paziente. In secondo luogo, gli autori proposero lo studio, con modalita scientifiche, del clima emotivo familiare, da sempre oggetto di speculazioni piuttosto fantasiose dei clinici e degli psicoanalisti, elaborando una specifica misura riproducibile, quale Expressed Emotion (Emozione Espressa, EE) (Kavanagh, 1992), rilevabile attraverso una intervista semi-strutturata. Tale misura era in grado di vaIndirizzo per la corrispondenza: Professor M.

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The Outcome of Training Community Psychiatric Nurses to Deliver Psychosocial Intervention

Abstract: The study offers some evidence that CPNs can be taught to improve the outcome for families who care for a relative with schizophrenia.

Cited by 140 publications

References 19 publications

Running an effective community mental health team

Running an effective community mental health team

Empirically supported couple and family interventions for marital distress and adult mental health problems.

Psychoeducational treatments in schizophrenia: love for foreigners or application of evidence-based interventions?

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