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Article
Publication date: 1 June 2008

Steven Jones, Fiona Lobban, Kate Evershed, Lee Taylor and Anja Wittkowski

A significant number of people with psychosis require inpatient admission under the Mental Health Act. Department of Health documents have highlighted the importance of…

Abstract

A significant number of people with psychosis require inpatient admission under the Mental Health Act. Department of Health documents have highlighted the importance of delivering effective care to individuals with psychosis treated in low secure conditions. Research into patient outcomes in these settings has so far been neglected. The aim of the research reported here was to assess outcomes for patients tested at three six‐monthly assessments during their residence at a new community low secure facility for people with psychosis and challenging behaviour. Although there were numerical reductions on many of the outcome measures over time, few were statistically significant. The main significant improvements were in Positive and Negative Syndrome Scale total and delusions scores over time. Initial evidence indicates that this type of care may have promise, but further research is needed to extend these findings.

Details

The British Journal of Forensic Practice, vol. 10 no. 2
Type: Research Article
ISSN: 1463-6646

Keywords

Article
Publication date: 18 September 2017

Julian Ashton

The purpose of this paper is to examine the progress in public and patient involvement (PPI) in public health research, and identify the relevant problems and solutions.

2802

Abstract

Purpose

The purpose of this paper is to examine the progress in public and patient involvement (PPI) in public health research, and identify the relevant problems and solutions.

Design/methodology/approach

To explore the advantages and drawbacks of PPI in health research, drawing on studies which have looked at the barriers to effective PPI, as well as the benefits to all parties.

Findings

Guidelines have emerged from recent research for the process of PPI throughout a project; however different schemes for PPI will apply, depending on the context.

Research limitations/implications

There are not many well-researched studies into PPI in this area. A frequent limitation in research projects is that there is not sufficient provision for PPI. The implication is that more time and funding should be made available for well-planned PPI.

Practical implications

Researchers need to find more ways for involvement, as well as optimising current methods.

Social implications

The growth of PPI has opened up channels of communication and developed new roles for people in research, who would not otherwise be involved.

Originality/value

The paper draws together a range of studies in an original way, as well as using some unpublished material. It is an area of current interest.

Details

Journal of Public Mental Health, vol. 16 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 10 August 2018

Frank R. Burbach, Hannah Sherbersky, Ragni Whitlock, Estelle H. Rapsey, Kim A. Wright and Rachel V. Handley

The purpose of this paper is to describe the University of Exeter Family Interventions (FIs) training programme for the South West region which was commissioned as part of…

Abstract

Purpose

The purpose of this paper is to describe the University of Exeter Family Interventions (FIs) training programme for the South West region which was commissioned as part of the NHS England Access and Waiting Times standards (A&WTS) initiative for early psychosis. This programme (10 taught days and 6 months of supervised practice) is designed to maximise implementation in practice.

Design/methodology/approach

The programme introduces students to a flexible, widely applicable FI approach which integrates cognitive behavioural/psycho-educational and systemic approaches. It refreshes and develops CBT-based psycho-social intervention skills, so that clinicians feel confident to use them in family sessions and integrate these with foundation level family therapy skills. The approach facilitates engagement, and it is designed so that every session is a “mini intervention”. This enables clinicians to offer standard NICE-concordant FI or a briefer intervention if this is sufficient to meet the particular needs of a family.

Findings

This paper provides details of the regional training programme and evaluates the first four training courses delivered to nine early intervention in psychosis teams. It considers how a combination of training a critical mass of staff in each service, ongoing supervision, regional events to maintain skills and motivation to deliver FI, and the national and regional auditing of FI as part of the A&WTS all contribute to clinical implementation.

Originality/value

The unique design of this programme maximises implementation in practice by virtue of its widely applicable integrated FI approach, the focus on ongoing skills development and by embedding it within regional and local service support structures.

Details

The Journal of Mental Health Training, Education and Practice, vol. 13 no. 5
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 4 February 2014

Emma Williams, Martha Ferrito and James Tapp

The efficacy of cognitive-behavioural therapy (CBT) for schizophrenia in community and general psychiatric settings has been widely investigated and its practice…

1525

Abstract

Purpose

The efficacy of cognitive-behavioural therapy (CBT) for schizophrenia in community and general psychiatric settings has been widely investigated and its practice recommended in primary and secondary care. In secure forensic mental health services the evidence is less established. The purpose of this paper is to evaluate the effectiveness of group CBT for schizophrenia in a high secure hospital.

Design/methodology/approach

In all, 27 male forensic patients completed a manualised CBT group and were compared on primary and secondary outcomes to patients receiving treatment as usual (TAU). Primary outcomes were positive and negative symptoms as measured by the Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS) and the Psychotic Symptom Rating Scales (PSYRATS). A secondary outcome was interpersonal functioning as measured by the Inventory of Interpersonal Problems (IIP-64).

Findings

CBT participants showed improvement on negative symptoms; affective flattening, alogia, anhedonia and avolition; in comparison to participants in TAU. CBT participants also showed reductions in delusions and hallucinations on the SAPS but not the PSYRATS. TAU participants improved on positive symptoms as measured by the PSYRATS. CBT participants showed reductions in overall interpersonal problems, and most notably in being socially inhibited and self-sacrificing. No iatrogenic effects of treatment were found; improvements in depression anxiety and stress were reported by group completers, which contrasted to experiences of the TAU group.

Research limitations/implications

Absence of random allocation to CBP or TAU groups retains the risk of recruitment bias. Findings are preliminary given the sample size. Multiple outcome assessments increase risk of a type I error.

Practical implications

CBT for schizophrenia can be effective with clients in secure forensic mental health settings. Improvements in negative symptoms and interpersonal functioning appear to be particular gains. Self-report measures might be subject to specific demand characteristics in such settings.

Originality/value

The evaluation includes a comparator group in a high secure setting, which is typically absent in reported evidence for this population (Blackburn, 2004). The study also investigated changes in interpersonal functioning, which has previously been noted as an important but absent outcome in CBT for psychosis (Haddock et al., 2009). Iatrogenic outcomes were also considered in the evaluation to ensure no adverse effects were experienced from treatment.

Details

Journal of Forensic Practice, vol. 16 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

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