There is growing literature examining the use of CBT for those with a dual diagnosis (Cleary et al 2009, Barrowclough et al 2001, Baker et al 2006, Weiss et al 2007 and Haddock et al 2003) although, as mentioned earlier the amount of literature in this area is limited. (1995) Substance Abuse and Family Relationships of Persons with Severe Mental Illness. The topics covered within CBT sessions for those with dual diagnosis differs from that of someone who does not use substances. Nonetheless, they do provide a good grounding for recommending that such interventions show promise for enhancing service user and carer experience. Therefore, the use of clinical supervision may also provide a method of reducing the number of negative attitudes towards those who misuse substances, ultimately reducing another barrier that those with dual diagnosis may face when receiving effective psychosocial interventions. 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. & Ryrie, I. Her mood improved slightly and she had more hope for the future. In Miller, W. & Heather, N. (Eds) Treating Addictive Behaviours: Processes of Change. They suggest their findings add evidence to the recommendations made for implementation of interventions for this client group presented in Mental Health Implementation Guide: Dual Diagnosis Good Practice (DOH 2002). The services do not necessarily need to meet all the needs of the individual but have mental health professionals that are effective case managers. However, the clinical significance of this is questionable. Alternately, standard psychotherapy or other schools of therapy may be part of psychosocial interventions. contributor for many years. ; Schooler, N.R. Issue 1 Conley, H. & Benishek. There is a vast evidence base to support FI for promoting recovery from psychosis (Pharoah et al 2006, Pilling et al 2002). & Campbell, C. (2004) Cognitive Behaviour Therapy for Schizophrenia. This example has been uploaded by a student. Cited in Kipping, C. (2004) The Person Who Misuses Drugs of Alcohol. England: Open University Press. @Logicfest -- I'm not sure how much I like the term "societal norms." Luke’s Mother had now had enough and didn’t want Luke back home. This will allow professionals to build on skills, knowledge and competence when working with complex cases. ; Williams, K.; Naylor, A.J. Psychosocial support must be the concern of all providers, locally, regionally and nationally. Journal of Obstetrics and Gynaecology. In terms of a complex case it could be proposed that an individual’s complexities cause stress in themselves and/or increase a person’s vulnerability to stress. working on her first novel. An example of how ‘The Stress Vulnerability Model’ can be illustrated to enable it to be shared with a service user with complex needs, using an easy to understand analogy can be seen in Appendix 1. This book provides examples of psychosocial interventions: taking into consideration the individual, social and environmental aspects of the person's life. Luke’s motivation was draining and he was experiencing little enjoyment in life. Her life became very chaotic and at 16 her mother kicked her out. Strategies to overcome such barriers are generated and recommendations are made. ; Davis, J.M. & Mueser, K.T. Chapter 17 in Norman, I. Psychosocial interventions refer to different therapeutic techniques, usually classed as nonpharmacological (not involving medication), that address the psychological aspects of an individual or group and consider the person’s or group’s situation from a societal, familial perspective. Individuals and their immediate social relationships are embedded within wider social political and cultural systems which can influence outcomes in entirely novel and unpredictable ways. But you can one from professional essay writers. & Shon, S. (2003) Physical Health Monitoring of Patients With Schizophrenia. • Be aware of the paradigm shift from managing BPSD to a person-centred approach that focuses on the patient's well-being and quality of life. What are the Different Types of Group Therapy Interventions? This integrated treatment, namely C-BIT (Cognitive-Behavioural Integrated Treatment), has a number of components; Cognitive Behavioural Therapy, Motivational Interviewing and Family Interventions. The stress vulnerability model was explained to Laura’s dad with a view to building on his understanding of why his daughter experiences psychotic symptoms and providing a reason why she uses drugs. & DiClemente, C. (1986) Towards a Comprehensive Model of Change. Wilson, Holt and Greenhalgh (2001) discuss the term complexity in relation to human health and illness. One in four families is likely to have at least one member with a behavioral or mental disorder. One way of attempting to overcome this it the use of journal clubs. This report does not measure impact on care giver outcomes. medicine, art, film, history, politics, ethics, and religion. For example Baker et al (2006) outlines components of CBT sessions used within their trial. Humanitarian groups must determine how best to address the psychological and social needs of these societies. He was only there a few days when he relapsed and used excessive amounts of alcohol and crack cocaine and his mental health deteriorated dramatically. Barrowclough et al (2001) and Haddock et al (2003), Alcoholism, Dual Diagnosis, Mental Disorder, Mental Health, Psychotherapy, Schizophrenia, Substance Abuse, Health Care, Medication, Mental Disorder, Obesity, Schizophrenia, Substance Abuse, Caregiver, Major Depressive Disorder, Mental Disorder, Mental Health, Research, Schizophrenia, Stress, Alcoholism, Cognitive Behavioral Therapy, Disability, Dual Diagnosis, Major Depressive Disorder, Mental Disorder, Substance Abuse, Cognitive Behavioral Therapy, Dissociative Identity Disorder, Mental Disorder, Nervous System, Positive Psychology, Schizophrenia, Social Constructionism, Clinical Psychology, Mental Disorder, Mental Health, Prison, Psychopathology, Schizophrenia, Substance Abuse, Co-morbidity in Substance Use and Psychosis, An Autobiographical Review of Schizophrenia. Clinical supervision it thought to reduce burnout, increase job satisfaction and alter dysfunctional attitudes (Bradshaw, Butterworth & Mairs 2007 and Hykras 2005). Get your own essay from professional writers. Comprehensive Psychiatry. Bio (physiological pathology) 2. 28(1), 5-10 Thylstrup, B. This suggestion itself produces barriers though; for all health professionals to provide evidence based care they must stay abreast of new knowledge, research, and guidelines in order to practice competently (Turner & Mjolne 2001). They are said to produce the least biased results as random samples are used to minimise the possibility of error in design and conduct (Roberts, 1999). (1977) Vulnerability – A New View Of Schizophrenia. 156, 798-808 Dixon, L.; McNarey, S. & Lehman, A. Also, documents such as ‘From values to action: The chief nursing officers review of mental health nursing’ (DOH 2006) recommends the use of psychological therapies to improve outcomes for service users and ‘The mental health policy implementation guide’ (DOH 2001b) advocates the use of psychosocial interventions through a variety of service delivery modes. Baker et al (2006) also report that there was no significant difference in improvement of functioning or positive symptoms; providing opposite and contrast results of the Barrowclough et al (2001) study. Elyn started displaying symptoms of her schizophrenia while she was an adolescent, shortly after she graduated high school and started college. C-BIT is not only about adapting psychosocial interventions to suit those with dual diagnosis but it is also about service provision and development (Thylstrup & Johansen 2009, Graham et al 2006, Graham et al 2003). 16 students ordered this very topic and got original papers. 1. & Vlaeyen, J.W.S. A model which displays this link is the Stress Vulnerability Model by Zubin and Spring (1977 cited in Norman, & Ryrie 2004). Such type of various other complications and chaos exist that needs to be coped effectively. Results of the training demonstrated increased confidence of care co-ordinators in working with substance misuse and mental illness. British Journal of Psychiatry. He describes a part of case management as the identification and co-ordination of services that can appropriately meet the service users’ needs. This study was not as robust as the Barrowclough et al (2001) study in relation to randomisation and assessor blindness. Adopting an approach that incorporates psychosocial interventions could help to achieve a personalised response and provide individualised, tailored care for the service user and their care givers. An example of a related PPI is ‘prosocial spending’. Luke was brought up in a deprived area of a large city and often experimented with illicit substances with his friends. ; Pakkal, M.; Brace, V. & Awonuga, A. Unfortunately, figures for production of mental health related literature could not be found Khan et al (1999) suggest over 2 million bio-medical articles are published annually. Such interventions are used as part of an individualised treatment plan that incorporates the key principles of working with dual diagnosis (see table4). Luke self referred to a local drug scheme (under the pressure of his mother and the threat of becoming homeless) but they were reluctant to take him on because he was self medicating. Cochrane Database of Systematic Reviews 2004, Issue 4 Kavanagh, D.J. 16 students ordered this very topic and got original papers. Psychiatrists commonly prescribe drugs to manage symptoms of mental disorders. ; Greenfield, S.F. All of the reports mentioned here suggest further research is needed to establish a firm evidence base for integrated treatment programmes that use interventions such as CBT, MI and FI. 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). An overview of the use of psychosocial interventions when working with complex cases is given. She is especially passionate about reading and writing, although her other interests include British Journal of Psychiatry. This is a luxury most of the general population experiences, but not all of it. Arguably the benefits Laura experienced may have inevitably occurred without staff intervention. Luke managed to do this for a few weeks and was admitted to the rehabilitation unit. With a view to provide evidence based interventions for dual diagnosis to those even when not in a specialised team. Journal of Mental Health. They continue recommending that nurses working within the substance misuse field should be trained in picking up such information. Then maybe confidence to work with complex cases may increase, enhancing the service users experience of mental health services and improving individualised outcomes. Laura was keen to build on the relationship between her and her father and started to visit him once a week. A place was found for Luke at a rehabilitation unit but he must first give up the use of any illicit substances or he would not be admitted. Table 1 (Wilson, Holt, Greenhalgh 2001 p685), Mairs and Bradshaw (2005 page 28) suggest PSI is –, Table 4 (Drake et al 1993 cited in Abou-Saleh 2004). Graham et al (2006) suggest these findings illustrate the effectiveness of such training and highlights the extent to which implementation actually occurs. To treat mental disorders psychological interventions can be coupled with psychoactive medication. Examples of Psychosocial Interventions. Often, the approach of educating the individual about his or her place in society and the appropriate "normal" behavior (in other words, the exact goal of psychosocial intervention) is preferable to using drugs to alter an individual's behavior. Increased life expectancy and the resultant medical comorbidity may complicate the use of pharmacotherapy among a large percentage of elderly patients. This therefore suggests each individual has a unique interaction between their own health and social care needs, therefore, requiring personalised responses from mental health services. That is not saying that drugs are the first thing therapists should try. 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. For example, an intervention may be designed to reduce-the. For example, homosexuality was once considered a psychological ailment, but that has largely changed in mainstream psychology. The psychosocial impacts of emergencies are like ripples in a pond, with consequences reaching out well beyond the main location of the event. Social Psychiatry and Psychiatric Epidemiology. 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.. These complexities have been recognised by the government and national drivers have been produced to guide mental health professionals and services to enable delivery and provision of the best services. This discussion is then focused on particular interventions for dual diagnosis that show promise for enhancing service user and carer experience, namely a integrated treatment approach of cognitive-behavioural therapy, motivational interviewing and family therapy. This number cannot be too dissimilar to mental health literature. (2008) Influence of Family Involvement and Substance Use on Sustained Utilization of Services for Schizophrenia. However from the results these improvements appear minimal. 10, 352-360 Fischer, E.P. Different types of complexity are discussed with a more detailed examination of a specific complexity; the relationship between substance misuse and psychosis (dual diagnosis). Also the CBT that is delivered to the participants within the studies has been adapted to suit the needs of those with dual diagnosis. (eds) (2004) The Art and Science of Mental Health Nursing: A Textbook of Principles and Practice. J.I. Psychosocial interventions have a greater or more direct focus on a person's social environment in interaction with their psychological functioning.. Although, this often takes a lot of guidance and motivational interviewing techniques. Laura lost touch with all her family and friends, her physical health suffered and she ended up very underweight and her voices became worse. 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