CPG for Psychosocial Interventions in Severe Mental ... - GuÃaSalud

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c) SERVICE LEVEL INTERVENTIONS • Which service supply system –day centres and/or psychosocial rehabilitation centres, community Mental Health centres, Assertive Community Treatment, Intensive Case Management (ICM), non-acute day hospitals or Case management (CM)- is more effective in people with SMI? d) INTERVENTIONS WITH SPECIFIC SUB-POPULATIONS • What type of treatment has proven to be most effective in people with SMI and substance abuse: integral or parallel treatment? • Which intervention is more efficient in people with SMI and “homeless”? • Which psychosocial treatment is more effective in people with SMI and a low IQ? 14 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS
Summary of recommendations C C C B 5. PSYCHOSOCIAL TYPE REHABILITATION INTERVENTIONS 5.1. PSYCHOLOGICAL INTERVENTIONS 5.1.1. Cognitive behavioural therapy In people with SMI, cognitive behavioural treatment can be used combined with standard treatment to reduce positive symptomatology, mainly hallucinations. People with SMI and persistent positive symptomatology can be offered a specific cognitive behaviour-orientated psychological intervention for this pathology, lasting for a prolonged period of time (more than one year), in order to improve the persistent symptomatology. Incorporate cognitive therapy into strategies aimed at preventing relapses of depressive symptomatology in people with SMI and diagnosis of bipolar disorder. When the main objetive of the intervention in people with SMI is to improve their social functioning, it is advisable to incorporate social skills training. There is not sufficient evidence to make recommendations in the problem-solving area for people with SMI and diagnosis of schizophrenia and related disorders. 5.1.2. Psychodynamic psychotherapy and psychoanalytic approach Sufficient evidence has not been found to make recommendations related to psychodynamic psychotherapy or the psychoanalytic approach in the treatment of people with SMI. 5.1.3. Interpersonal therapy C The strategies aimed at preventing relapses in people with SMI and a diagnosis of bipolar disorder should evaluate the incorporation of interpersonal and social rhythm therapy (IPSRT) into the treatment. 5.1.4. Supportive therapy Sufficient evidence has not been found to make recommendations related to supportive therapy or counselling in the treatment of people with SMI. 5.1.5. Family interventions B B B For people with SMI and diagnosis of schizophrenia and related disorders and their families, family intervention should be offered as an integral part of the treatment. In family interventions that are carried out with people with SMI and diagnosis of schizophrenia and related disorders, the intervention should be done in a single-family format. The recommended duration in family interventions aimed at people with SMI and diagnosis of schizophrenia and related disorders must be at least 6 months and/or 10 or more sessions. CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 15
Page 1: Clinical Practice Guidelines for Ps
Page 4 and 5: This CPG is an aid for decision mak
Page 7 and 8: Table of Contents Presentation 7 Au
Page 9 and 10: Presentation Healthcare practice is
Page 11 and 12: Authorship and collaborators CPG de
Page 13: José Manuel Lalana Cuenca. Special
Page 18 and 19: A B A A B B B C Psychosocial inter
Page 20 and 21: B B B C A C C 5.3. SERVICE LEV
Page 22 and 23: 20 CLINICAL PRACTICE GUIDELINES IN
Page 24 and 25: independence, quality of life, pers
Page 26 and 27: This guideline is aimed at mental h
Page 28 and 29: Figure 1. Search Strategy Search fo
Page 30 and 31: The highest evidence level found wa
Page 33 and 34: 4. Characteristics of the CPG 4.1.
Page 35 and 36: The main focus of rehabilitation is
Page 37 and 38: 5. Psychosocial type rehabilitation
Page 39 and 40: From another point of view, social
Page 41 and 42: defined as “standard care” or
Page 43 and 44: General global state In the short r
Page 45 and 46: Specific symptoms: when CBT was com
Page 47 and 48: In the systematic review by Kurtz a
Page 49 and 50: Summary of evidence 1- 1- 1- 1- 1-
Page 51 and 52: People with SMI and a diagnosis of
Page 53 and 54: 5.1.3. Interpersonal therapy The li
Page 55 and 56: weekly or fortnightly sessions. The
Page 57 and 58: 5.1.5. Family interventions There a
Page 59 and 60: In the RCT carried out by Hogarty e
Page 61 and 62: A family intervention of more than
Page 63 and 64: After two years’ treatment, and b
Page 65 and 66: Family intervention vs. other psych
Page 67 and 68:
1- 1- 1- 1- 1- 1- 1- 1- 1+ No diffe
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Question to be answered • Are pys
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Summary of evidence Pyschoeducation
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with schizophrenia and that the tre
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With reference to the type of train
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would normally receive and which in
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Hypnosis vs. relaxation No improvem
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Supervised fl ats are a community h
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3 Programmes directed to leisure an
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SMI (schizophrenia, affective schiz
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When PVT is compared with standard
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Patients included in the individual
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1+ 1+ 1++ 1+ 1+ 1+ 1+ The people in
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Music therapy Music therapy + stand
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A series of Case Management systems
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• The satisfaction data originati
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Loss of contact With respect to the
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There is not sufficient evidence, e
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1+ 1+ 1+ 1+ Respect to ICM teams or
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Finally, in the RCT by Cheng et al
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5.4.2. “Homeless” with SMI The
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Patients who access housing with no
Page 111:
ceptive disorders. This series of c
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7. Recommendations for Future Resea
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Appendices
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Appendix 2. Information obtained fr
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Appendix 4. Information for people
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4. Regulatory and legal framework 1
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Several protocols have been publish
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The coordination of these resources
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Social protection systems Pursuant
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Specifi c regulation • (SPANISH)
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Service Management: The first anti-
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on Mental Health and the future Eur
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Spanish Society of Legal Psychiatry
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Appendix 5. Abbreviations ACT Asser
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Appendix 6. Glossary Therapy adhere
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Appendix 7. Declaration of interest
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15 Rossler W. Psychiatric rehabilit
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53 Graeber DA, Moyers TB, Griffi th
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86 Schooler NR, Keith SJ, Severe JB
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117 Sohlberg MM, Mateer CA. Effecti
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154 López M, García-Cubillana P,
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190 Bond GR, Drake RE. Predictors o
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225 Hurley AD. Individual psychothe
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