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These activities are, per se, a tool and a result at the same time insofar as social integration is a component of the quality of life and this is one of the results to be obtained with psychosocial interventions 156 . This concept of “recreational rehabilitation” has been proposed as a counterpoint to other instrumental rehabilitation interventions, such as occupational or residential interventions, and the characteristic that distinguishes them is that they are designed for one’s own satisfaction 157 . No SR or RCT has been found that refers to the importance of social integration through alternatives that organise leisure and free time as a systematised study. There is a longitudinal study by Petryshen et al 158 that measures the efficacy of a leisure and free time programme, aimed at socially isolated individuals aged 18 to 65, with Severe Mental Illnesses and with a follow-up period of one year. The study has certain limitations with respect to the size of the sample (n = 36), the fact that there is no comparison therapy or group and that it is applied to people with high motivation levels. The results indicate that significant differences have been found respect to: Before and after (3) – General satisfaction with life: (p
3 Programmes directed to leisure and spare time Leisure and free time programmes in people with SMI and with deficiencies perceived in their social relations help improve the general satisfaction with their lives, it reduces the perception of solitude, fosters self-esteem, improves satisfaction with social relations, with leisure activities and improves social functioning 158 . Recommendations D D Daily living skills training programmes could be offered to people with SMI in order to improve their personal independence and their quality of life. For people with SMI who require support to remain in their accommodation it is advisable that the community residential offers include more extensive psychosocial programmes. People with SMI and deficiencies perceived in their social relations should follow community leisure and spare time programmes. During the monitoring of the individualised therapeutic programme, it is advisable to systematically assess the need to use the spare time programmes and offer them to people with SMI who require them. 5.2.4. Programmes aimed at employment Over the last decades in all Mental Health programmes, the employment-oriented programmes and devices for people with SMI are considered to be strategic and form part of the basic rehabilitation objectives. Labour insertion is an instrument to achieve full social integration in conditions of personal autonomy and participation in the community. It also responds to a right, and to an ethical question derived from the permanent exclusion from the work market. The need for labour insertion programmes to include health and social care aspects in their methods, and not just occupational training aspects, is admitted. Work, in the recovery process, is not just an activity that develops generalizable competences and improves personal functioning, but it is also an element for social exchange and economic independence. Remuneration and salaries are considered a key motivational element for a person to stay in a job. In any case, due to the different experiences, it is common to place emphasis on motivation and personal choice and take into consideration, from the onset, personal interests and objectives. Despite the obvious need for these resources, there is no generalised or approved practice. Labour insertion resources have a different typology and experience varies from one country to another. This is due to the differences between the health and social services systems, the different regulations that govern access to employment, social-cultural differences and the actual labour market. By way of analysis, there are two approaches to address a labour rehabilitation intervention. One is the train-then-place or supported employment, which places emphasis on the stability and recovery of skills in prior programmes that permit subsequent generalisation. The other, placethen-train, which places emphasis on immediate occupation of a job, activating the learning and monitoring programmes in the job 161 . CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 81
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Clinical Practice Guidelines for Ps
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This CPG is an aid for decision mak
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Table of Contents Presentation 7 Au
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Presentation Healthcare practice is
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Authorship and collaborators CPG de
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José Manuel Lalana Cuenca. Special
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c) SERVICE LEVEL INTERVENTIONS •
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A B A A B B B C Psychosocial inter
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B B B C A C C 5.3. SERVICE LEV
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20 CLINICAL PRACTICE GUIDELINES IN
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independence, quality of life, pers
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This guideline is aimed at mental h
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Figure 1. Search Strategy Search fo
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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
Page 81: Supervised fl ats are a community h
Page 85 and 86: SMI (schizophrenia, affective schiz
Page 87 and 88: 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
Page 99 and 100: Loss of contact With respect to the
Page 101 and 102: There is not sufficient evidence, e
Page 103 and 104: 1+ 1+ 1+ 1+ Respect to ICM teams or
Page 105 and 106: Finally, in the RCT by Cheng et al
Page 107 and 108: 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
Page 115 and 116: 7. Recommendations for Future Resea
Page 117: Appendices
Page 120 and 121: 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-
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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
Page 154 and 155:
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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