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

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independence, quality of life, personal well-being, social participation around the concept of personal recovery. Caring for mental illnesses no longer just means relieving symptoms but it also means having to cope with the different resulting needs. All in all, caring for these people requires integrating psychopharmacological interventions and psychosocial interventions into a mental health network comprised of interdisciplinary teams. This text is the full version of the Clinical Practice Guide on Psychosocial Interventions in Several Mental Illness (http://www.guiasalud.es). 22 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS
2. Scope and objectives As mentioned in the introduction, a therapeutic approach to SMI is complex and must include different types of interventions, which require an interdisciplinary team. The last few years have brought about numerous therapeutic novelties in the pharmacological field (new atypical or second-generation antipsychotics, new mood stabilisers, etc.), which have contributed to an improvement in the evolution of people with SMI, but which require other interventions to improve aspects related to functioning in different behavioural, social, occupational and family integration areas. The evidence on the effectiveness of psychopharmacological treatment is specific for each disorder included in the SMI concept, which are unique and can not be extrapolated to other disorders. There are different clinical practice guidelines for people with schizophrenia and for people with bipolar disorders that have been prepared by different institutions where this type of intervention is included. The new therapeutic and rehabilitation approaches commit to the paradigm of recovery and well-being and concepts such as “integral and integrated care” have been introduced, whose aim is to cover the entire deficit and the social disadvantages produced by the impact of mental illness on the person that suffers from it. This represents a shift towards the participation of other agents, apart from health-care personnel, and other interventions apart from the pharmacological intervention. The objective of this CPG is to assess the existing and available evidence, and formulate the appropriate recommendations on the effectiveness of the different psychosocial (therapeutic and rehabilitating) interventions on people who suffer from SMI. This CPG sums up the available evidence for key questions related to psychosocial interventions and intend to facilitate health professionals, the people affected and their families the shared decision making process. These recommendations are not mandatory nor do they replace the clinical opinion of health or social professionals. This CPG is aimed at people who suffer Severe Mental Illness and satisfy the three classification dimensions chosen in this guideline (diagnosis, chronicity and disability). The following cases are excluded from the target population group of this CPG: • People with mental disorders in childhood and adolescence (under 18s). • People over the age of 65 , as they are subject to receiving treatment in different services other than the Mental Health Service. • People affected by mental disorders that are secondary to medical illnesses. • People who have organic psychoses. • People whose disorder is included in psychotic categories but has a transitory or episodic nature. • People whose main diagnosis is substance abuse, moderate-serious intellectual impairment, general development disorders, who reach adult age or organic mental disorder. • People with personality disorders. This does not mean that personality disorders that present a psychotic symptomatology are excluded, but that this diagnosis per se does not mean that it is included. CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 23
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 16 and 17: c) SERVICE LEVEL INTERVENTIONS •
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 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
Page 69 and 70: Question to be answered • Are pys
Page 71 and 72: Summary of evidence Pyschoeducation
Page 73 and 74: with schizophrenia and that the tre
Page 75 and 76:
With reference to the type of train
Page 77 and 78:
would normally receive and which in
Page 79 and 80:
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
Page 89 and 90:
Patients included in the individual
Page 91 and 92:
1+ 1+ 1++ 1+ 1+ 1+ 1+ The people in
Page 93 and 94:
Music therapy Music therapy + stand
Page 95 and 96:
A series of Case Management systems
Page 97 and 98:
• The satisfaction data originati
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Loss of contact With respect to the
Page 101 and 102:
There is not sufficient evidence, e
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1+ 1+ 1+ 1+ Respect to ICM teams or
Page 105 and 106:
Finally, in the RCT by Cheng et al
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5.4.2. “Homeless” with SMI The
Page 109 and 110:
Patients who access housing with no
Page 111:
ceptive disorders. This series of c
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7. Recommendations for Future Resea
Page 117:
Appendices
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Appendix 2. Information obtained fr
Page 122 and 123:
Appendix 4. Information for people
Page 124 and 125:
4. Regulatory and legal framework 1
Page 126 and 127:
Several protocols have been publish
Page 128 and 129:
The coordination of these resources
Page 130 and 131:
Social protection systems Pursuant
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Specifi c regulation • (SPANISH)
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Service Management: The first anti-
Page 136 and 137:
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
Page 154 and 155:
154 López M, García-Cubillana P,
Page 156 and 157:
190 Bond GR, Drake RE. Predictors o
Page 158 and 159:
225 Hurley AD. Individual psychothe
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