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

would normally receive and which includes interventions such as medication, hospitalisation,
community psychiatric nursing input and/or day hospital, other psychological treatments (problem
solving therapy, psycho-education, cognitive-behavioural therapy, family therapy or psychodynamic
psychotherapy) or social treatments (including social skills training and life skills training.
In this study, about 30% of all the people included left before study completion. Distraction
techniques did not seem to promote or hinder leaving the study early. it could be argued that the
distraction techniques failed to engage participants in studies in a more meaningful way than
the control activities. The distraction technique is a practice used in the field of mental health in
Spain, which requires specific professional training.
Drama therapy for people with SMI
Drama therapy is a form of treatment that encourages spontaneity and creativity. It can promote
emotional expression, but does not necessarily require the participants to have insight into their
condition or psychological-mindset.
In the study conducted by Ruddy et al 129 (5 RCT, n =120) they compare drama therapy with
standard treatment. All the studies were conducted with hospitalised patients with schizophrenia,
compared the intervention and standard hospital care. Due to the deficiencies of the reports, very
few data could be used from the 5 studies, and there were no conclusive findings about the harm
or benefits of drama therapy for hospitalised patients with schizophrenia. There are differences
between the description of pyschodrama in China, which is where some of the studies included in
this review originate from (Qu et al 130 , and Zhou & Tang 131 ). It must also be taken into account that
the results reflect different versions of drama therapy (psychodrama, social drama and role-playing)
which makes it difficult to generalise the results of these studies to western drama therapy.
Hypnosis for people with SMI
The American Psychological association defines hypnosis as “the procedure during which a health
professional or researcher suggests that a client, patient or subject experience changes in sensations,
perceptions, thoughts or behaviour”. 132
Izquierdo & Khan 132 (3 RCTs, n = 149) assess hypnosis in patients with schizophrenia, comparing
it with standard treatment (the normal level of psychiatric care that is provided in the
area where the trial is carried out: medication, hospitalisations, family intervention, etc.) or other
interventions. The hypnosis intervention consisted in one single 90-minute session. Results are
only provided in this SR when hypnosis is compared with ST or relaxation related to mental state
(these data come from thesis) 133 , as those articles that had large losses (>50%) during the followup
were excluded.
Question to be answered
• Are morita therapy, drama therapy, distraction therapy or hypnosis effective in people with
SMI?
CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 75