Care for the Person with Schizophrenia - Effective Health Care. August 2000. Volume 6. Number 3. ISSN: 0965-0288
Supportive Educational Interventions (Individual Psycho educational Programme)
Family - Social - Biological - Pharmacological: Support, Information, Management. Pekkala, E., Merinder, L. (2000) Psycho educational intervention for schizophrenia and other severe mental illness. The Cochrane Review. Issue 3. Oxford. Update Software.
(Family Work) Provision of support - Education - Interaction - Lower burden of care. Decrease stress within the family. Education about schizophrenia. Training in problem solving. Collaboration with relatives who care for the person with schizophrenia. Reduce emotional stress. Reduce burden on relatives. Enhance family ability to anticipate problems. Reduce feelings of anger. Reduce experience of guilt. Goal setting for person suffering with schizophrenia. Agreement on limit setting. Agreement on appropriate solitude balanced within family interaction. Opportunity for adaptation in family interaction. Exploration of family expectations for care and support. Forum for healing hostility. Sharing disagreeable ideas. Department of Health (1999) The National Service Framework for Mental Health. - Modern standards and service models. :London. DoH.
Skills Training
(Life Skills) Promote independent daily living. Money management. Home management. Domestic skills. Personal care. Nicol, M., Robertson, I., Connaughton, J. (2000) Life skills for chronic mental illness Cochrane Review. Issue 3. Oxford. Update Software.
(Social Skills) Enhance social performance. Reduce distress. Assessment of interpersonal skills. Communication. Perception. Social cue processing. Give and receive social reinforcement. Build and develop individual elements of social skill into competent social performance. Pilling, S., Orbach, G., Connaughton, J. (2000) Social skills programmes for schizophrenia. The Cochrane Review. Issue 3. Oxford. Update Software.
(Vocational Skills) Pre vocational training. Sheltered work. Supported employment. Crowther, R., Bond, G., Huxley, P., Marshall, M. (2000) Vocational rehabilitation for people with severe mental disorders. (Protocol) The Cochrane Review. Issue 3. Oxford. Update Software.
Symptom focused interventions.
(Cognitive behavioural therapy) Distress reduction. Examination of distressing belief. Challenge thinking patterns that cause distress. Promotion of reasoning. Look for alternative choices. Improve mental state. Spend time with patient. Jones, C., Cormac, I., Mota. J., Campbell, C. (2000) Cognitive behaviour therapy for schizophrenia. The Cochrane Review. Issue 3. Oxford. Update Software.
(Cognitive rehabilitation) Retraining - memory, attention, speed of mental processing and mental abstraction, to improve overall mental functioning Spring, B., Ravdin, I., (1992) Cognitive remediation in schizophrenia: Should we attempt it? Schizophrenia Bulletin. 18: 15 - 20. Hayes, R., McGrath, J. (2000) Cognitive Rehabilitation for people with schizophrenia and related conditions. The Cochrane Review Oxford. Update Software.
(Token economy) Improvement in negative symptoms of schizophrenia. McMonagle, T., Sultana, A. (2000) Token economy for schizophrenia. The Cochrane Review. Issue 3. Oxford. Update Software.
Service Provision
(Assertive community treatment) Community based multidisciplinary team. - psychiatrist - sister/charge nurse - staff nurse - social worker - occupational therapist - nursing assistant - community psychiatric nurse - senior house officer - senior registrar - liaison psychiatric nurse - specialist nurse practitioner - general medical practitioner - research nurse - administrator - administrative assistant - transport officer.
Small case load. 24 hour cover. Frequent home contact. Multidisciplinary team-work in the community. Low client:staff ratio. Assertive outreach. Medication adherence. Emergency cover. Intensive case management. Bouras, N., Turnell, G., Brough, D., Watson, J. (1986) Model for integration of community psychiatric and primary care. Journal of the Royal College of General Practitioners 36: 62-6. McGraw, J., Bond, G. (1995) Critical ingredients of Assertive Community Treatment: judgements of the experts. Journal of Mental Health Administration 22: 113-25. Marshall, M. Lockwood, A. (2000) Assertive community treatment for people with severe mental disorders. The Cochrane Review. Issue 3. Oxford. Update Software.
(Community mental health teams) Nurse - Occupational Therapist - Psychiatrist - Psychologist Bennett, D., Freeman, H. (1991) Principles and Prospects. Pages 1-39. in Community Psychiatry Edinburgh: Churchill Livingstone. Merson, S. Tyrer, P. Onyett, S. (1992) Early intervention in psychiatric emergencies: a controlled clinical trial. The Lancet 339: 1311-4. Tyrer, P., Coid, J. Simmons, S. (2000) Community mental health teams for people with severe mental illness and disordered personality. The Cochrane Review Issue 3. Oxford. Update Software.
(Home based care & Initial crisis intervention) 24 hour Mental Health 1st Aid. Querido, A., (1968) The shaping of community mental health care. British Journal of Psychiatry 114: 293-302. Weisman, G. (1989) Crisis Intervention. in Bellack, A, (ed). A clinical guide for the treatment of schizophrenia. New York. Plenum Press.
(Acute Day Hospital) Creed, F., Black, D., Anthony, P. (1990) Randomised controlled trial of day patient versus inpatient psychiatric treatment. British Medical Journal 300: 1033-1037. Sledge, W., Tebes, J., Rakfeldt, J. (1996) Day Hospital crisis respite care versus inpatient care. part 1. clinical outcomes. American Journal of Psychiatry 153: 1065-1073. Creed, F., Mbaya, P. Lancashire, S, (1997) Cost effectiveness of day and inpatient psychiatric treatment: results of a randomised controlled trial. British Medical Journal 314: 1381-1385. Almaraz-Serrano, A., Marshall, M. Creed, F. (2000) Day hospitals for people with psychiatric disorders (protocol) The Cochrane Review Issue 3. Oxford. Update Software.
(Day Care) Crisis House. Catty, J., Burns, T., Comas, A. (2000) Day centres for severe mental illness. (protocol) The Cochrane Review Issue 3. Oxford. Update Software.
(Case Management) Co-ordinating services. Case Manager. Assess needs. Develop care plan. Provide care. Audit quality. Maintain contact. Improve social functioning. Improve quality of life. Holloway, F. (1991) Case management for the mentally ill: looking at the evidence. International Journal of Social Psychiatry 37: 2-13. Thornicroft, G. (1991) The concept of case management for long term mental illness. International Review of Psychiatry 3: 125-32. Rossler, W., Loffler, B. Fatkenheuer, A., Riecher-Rossler, A. (2000) Case management for schizophrenic patients at risk of rehospitalisation - a case control study. European Archives of Psychiatry & Clinical Neuroscience Kanter, J. (1991) Integrating case management and psychiatric hospitalisation. Health & Social Work 16: 34-42. Rossler, W., Loffler, W. Fatkenheuer, B. Reicher-Rossler, A. (1992) Does case management reduce the rehospitalisation rate? Acta Psychiatricia Scandinavia. 86:445-9. Marshall, M. Grey, A., Lockwood, A., Green, R., (2000) Case management for people with severe mental disorders. The Cochrane Review Issue 3. Oxford. Update Software.
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