Evidence-Based Practices in Mental Health Care


Book Description

As the first attempt to synthesize the movement toward widespread implementation of evidence-based mental health practices, this groundbreaking collection articulates the basic tenets of evidence-based medicine and shows how practices proven effective by clinical services research could improve the lives of many people. Intended to stimulate much-needed public discussion, these remarkable contributions cover both general issues, such as Implementing practices in routine mental health settings, including strategies for disseminating evidence-based practices to staff members Ensuring that efforts to implement such practices are informed by the knowledge and experience of administrators, clinicians, patients, and advocates Integrating evidence-based practices with the recovery model and focusing on guidelines and algorithms for pharmacologic treatment of people with severe mental illness Identifying the policy implications of the movement, particularly in public-sector settings, and describing eight courses of action for addressing the gap between science and practice and specific practices, such as Describing critical components of practices for which substantial evidence exists, such as supported employment, dual diagnosis services, and assertive community treatment Developing an evidence base for particular populations, such as children and adolescents and geriatric patients; and for clinical subgroups, such as patients with severe mental illness and posttraumatic stress disorder-and implementing a range of practices for each population Debate in public forums is critical to explaining the benefits of evidence-based care and allaying the fears of patients, practitioners, administrators, policy makers, and vested interest groups that evidence-based care excludes them from the decision-making process. Patients need to know that their individual characteristics, preferences, and autonomy are highly valued and won't be discounted by rigid adherence to the particular treatments. Practitioners need to know about the credibility of the evidence base and about new techniques and responsibilities and to understand that their favorite practices won't necessarily be excluded during initial attempts to implement evidence-based practices. Administrators and policy makers need to know about financing, organizing, implementing, and sustaining new practices. Finally, vested interest groups need to know that the introduction of evidence-based practices doesn't mean that what they do now is ineffective. This unique and densely informative volume will be welcomed by mental health care professionals and by lawmakers, planners, administrators, and others who are charged with the responsibility of providing effective care to vulnerable populations.




Ending Discrimination Against People with Mental and Substance Use Disorders


Book Description

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.







Culturally Informed Therapy for Schizophrenia


Book Description

"This book is primarily designed for clinicians and researchers interested in learning how to conduct an empirically supported, Culturally Informed Therapy for Schizophrenia (CIT-S) that integrates core components of evidenced based family therapy. It is estimated that approximately one percent of adults in the United States will be diagnosed with schizophrenia or a related schizophrenia spectrum disorder (SSD). Without treatment, prognosis is generally poor. Fortunately, traditional family therapies have shown increasing promise in reducing relapse rates and improving mental health for this population. As more and more societies become multicultural, however, there is an increasing expectation that mental health providers will also be prepared to meet the needs of unique and culturally diverse clients in an efficient, skillful, and culturally relevant manner. CIT-S is a 15-week, family-focused, cognitive behavioral approach for managing schizophrenia spectrum disorders. The intervention draws upon clients' cultural beliefs, practices, and traditions to help them conceptualize and manage mental illness. It aims to improve the quality of clients' lives in a manner that is in line with their values and takes into account their cultural norms when discussing important issues and addressing challenges (such as mental illness) within the family. CIT-S contains five distinct modules: 1) Family Collectivism 2) Psychoeducation 3) Spirituality 4) Communication Training and 5) Problem Solving. For each module, a detailed rationale, background information, therapy instructions, suggested homework assignments, and a sample case vignette is provided in an accessible, easy-to-use, manner"--




Cognitive-Behavioral Social Skills Training for Schizophrenia


Book Description

This unique manual presents cognitive-behavioral social skills training (CBSST), a step-by-step, empirically supported intervention that helps clients with schizophrenia achieve recovery goals related to living, learning, working, and socializing. CBSST interweaves three evidence-based practices--cognitive-behavioral therapy, social skills training, and problem-solving training--and can be delivered in individual or group contexts. Highly user friendly, the manual includes provider scripts, teaching tools, and engaging exercises and activities. Reproducible consumer workbooks for each module include skills summaries and worksheets. The large-size format facilitates photocopying; purchasers also get access to a Web page where they can download and print the reproducible materials. Listed in SAMHSA's National Registry of Evidence-Based Programs and Practices




Assertive Outreach in Mental Health


Book Description

Assertive Outreach is the treatment of choice for the severely mentally ill in the community. It involves taking services to the patients rather than requiring them to attend hospitals and clinics. The model is one of a high staff-to-patient ratio offering comprehensive health and socialcare. Assertive Outreach is a targeted and refined application of the existing practice of community mental health teams - an evolution of community policy rather than a revolutionary change. Research evidence and outcome data suggests it results in reduced hospitalizations, promotes effectiveengagement with difficult patients and improves patient wellbeing. As a policy, it has been implemented successfully in Australia, the USA and Europe, and it is now being adopted nationally in the UK. This book will equip all members of the multidisplinary Assertive Outreach team with a clear understanding of the essential processes and interventions involved. Tom Burns and Mike Firn are pioneers in this field and have been running an Assertive Outreach team for seven years. They have been awarded Beacon status by the UK Department of Health to reflect their excellence, and are heavily involved in teaching others setting out on the same path.




Treating Psychosis


Book Description

Psychosis can be associated with a variety of mental health problems, including schizophrenia, severe depression, bipolar disorder, anxiety, and post-traumatic stress disorders. While traditional treatments for psychosis have emphasized medication-based strategies, evidence now suggests that individuals affected by psychosis can greatly benefit from psychotherapy. Treating Psychosis is an evidence-based treatment guide for mental health professionals working with individuals affected by psychosis. Using a cognitive behavioral therapy (CBT) approach that incorporates acceptance and commitment therapy (ACT), compassion-focused therapy (CFT) and mindfulness approaches, this book is invaluable in helping clinicians develop effective treatment for clients affected by psychosis. The guide provides session-by-session clinical interventions for use in individual or group treatment on an inpatient, outpatient, or community basis. The book features 40 reproducible clinical practice forms and a companion website with additional downloadable clinical forms and tools, guided exercises, case examples, and resources. The therapeutic approaches presented are rooted in theory and research, and informed by extensive clinical experience working with client populations affected by psychosis. The approaches outlined in this book offer clinicians and clients the opportunity to partner in developing therapeutic strategies for problematic symptoms to enable those affected by psychosis to work toward valued goals and ultimately live more meaningful lives. This guide emphasizes a compassionate, de-stigmatizing approach that integrates empowering and strengths-oriented methods that place the client’s values and goals at the center of any therapeutic intervention.




Cognitive Therapy of Schizophrenia


Book Description

Drawing on the authors' decades of influential work in the field, this highly practical volume presents an evidence-based cognitive therapy approach for clients with schizophrenia. Guidelines are provided for collaborative assessment and case formulation that enable the clinician to build a strong therapeutic relationship, establish reasonable goals, and tailor treatment to each client's needs. Described in thorough, step-by-step detail are effective techniques for working with delusional beliefs, voices, visions, thought disorders, and negative symptoms; integrating cognitive therapy with other forms of treatment; reducing relapse risks; and enhancing client motivation. Special features include reproducible client handouts and assessment tools.




Therapeutic Communities for Psychosis


Book Description

Therapeutic Communities for Psychosis offers a uniquely global insight into the renewed interest in the use of therapeutic communities for the treatment of psychosis, as complementary to pharmacological treatment. Within this edited volume contributors from around the world look at the range of treatment programmes on offer in therapeutic communities for those suffering from psychosis. Divided into three parts, the book covers: the historical and philosophical background of therapeutic communities and the treatment of psychosis in this context treatment settings and clinical models alternative therapies and extended applications. This book will be essential reading for all mental health professionals, targeting readers from a number of disciplines including psychiatry, psychology, social work, psychotherapy and group analysis.




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