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

Summary of evidence
1+
The IPSRT applied to people with a diagnosis of bipolar disorder in acute phase, maintains
these patients without affective episodes for a longer period of time 72 .
Recommendations
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
There are different types of psychotherapies that can be used to treat people with schizophrenia
and that are based on different theoretic and technical models. Despite these differences, they all
share a series of factors, such as the fact that the interventions last for a certain length of time and
have a certain format, and that a therapeutic relationship must be established with the patient.
According to the NICE CPG on Schizophrenia 8 , “supportive therapy” is defined as the psychological
intervention where “the intervention is facilitative, non-directive and relationship-focused,
with the content of sessions largely determined by the service user. For supportive therapy
to be considered, this type of intervention does not have to fulfil the criteria for any other type of
psychological interventions (CBT, psychoanalysis, etc.).
Supportive therapy can include any intervention carried out by one single person, with the
main goal of maintaining the present functioning or helping the patients with their pre-existing
skills, and it can be aimed at individuals or groups of people. The key support elements are to
maintain an existing situation or offer help in connection with pre-existing skills 74 .
Supportive therapy is not a costly technique, and when used correctly and there are professionals
available, it can be useful temporarily and if there is a lack of other more effective treatment
methods.
Question to be answered
• Is supportive therapy effective in the treatment of people with SMI?
The SR by Buckley et al 74 (21 ECA; n =1683), assesses the effectiveness of supportive therapy
in people with schizophrenia compared with standard care (treatment received in the normal
environment, including the patients’ preferences, and is conditioned by them, the professionals’
criterion, and the availability of resources) or other treatments (CBT, pyschoeducation, family
intervention, social rehabilitation programme, etc.). The majority of the studies of this review are
designed to examine specific supportive therapies, such as cognitive-behavioural therapy, and
supportive therapy is used as a comparison group. Normally the trials last from 5 weeks up to 3
years. The results measurements that are presented are short-term (up to 12 weeks), medium-term
(13 to 26 weeks), or long-term (more than 26 weeks).
In the experimental group, all the patients receive supportive therapy as well as standard care
(including antipsychotic medication). The majority of the studies include 2 sessions per week,
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