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

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5.2.2 Residential programmes in the community 78 5.2.3 Programmes aimed at leisure and spare time 79 5.2.4 Programmes aimed at employment 81 5.2.5 Other therapeutic interventions: art therapy and music therapy 90 5.3 Service level interventions 92 5.3.1 Day Centres and/or Psychosocial Rehabilitation Centres 96 5.3.2 Community Mental Health Centres (CMHC) 96 5.3.3 Assertive Community Treatment (ACT) 97 5.3.4 Intensive Case Management (ICM) 98 5.3.5 Non-acute Day Hospitals 99 5.3.6 Case Management (CM) 99 5. 4 Interventions with specifi c subpopulations 102 5.4.1 SMI with dual diagnosis 102 5.4.2 “Homeless” with SMI 105 5.4.3 SMI and low IQ /mental retardation 108 6. Dissemination and implementation 111 7. Recommendations for Future Research 113 Appendices 115 Appendix 1. Key to evidence statements and grades of recommendations from SING 117 Appendix 2. Information obtained from working groups with family members and people with SMI 118 Appendix 3. Template to develop recommendations via formal assessment or well-founded judgement 119 Appendix 4. Information for people with SMI and their families 120 Appendix 5. Abbreviations 138 Appendix 6. Glossary 140 Appendix 7. Declaration of interest 142 Bibliography 143 6 CLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS
Presentation Healthcare practice is increasingly more complex due to a multitude of factors, one of the most relevant of which is undoubtedly the exponential increase in scientific information available to us. Science is something that is permanently changing and thus requires permanent updates. This means that clinicians have to constantly refresh their knowledge, objectives and interventions to be able to cover people’s needs. This means that professionals have to face up to the situation of taking clinical decisions each day. These decisions are becoming more and more complicated due to the constant changes and the needs and expectations generated in society. In 2003, the Interterritorial Council of the Spanish National Health Service (SNHS) created the GuiaSalud Project whose ultimate purpose is to improve clinical decision-making based on scientific evidence, through training activities and by setting up a register of clinical practice guidelines (CPG). Since then, the GuiaSalud Project, financed by the Ministry of Health and Consumer Affairs, has evaluated dozens of CPGs, according to explicit criteria determined by its scientific committee. It has registered those guidelines and it has disseminated them over the Internet. At the beginning of 2006, the General Directorate of the Quality Agency of the National Health System prepared the Quality Plan for the National Health System, which is deployed according to twelve strategies. The purpose of this Plan is to increase the cohesion of the National Health System and help guarantee the highest quality healthcare for everyone, regardless of their place of residence. As part of the Plan, the preparation of several CPGs was commissioned to various expert agencies and groups on prevalent pathologies related to health strategies. This project was renewed in 2007 and the guideline on Psychosocial Interventions in Severe Mental Illnesses is the result of this assignment. This guideline follows the common guideline development methodology set for the NHS, which was prepared among the expert groups in CPGs in our country, combining their efforts and coordination. Severe Mental Illness (SMI) encompasses different psychiatric diagnoses that persist in time to a certain extent and present serious difficulties in personal and social functioning as a result of the illness, reducing the quality of life of the person affected. This situation means that it is necessary to work on different areas of the person, incorporating other psychotherapeutic and psychosocial interventions, and not just the pharmacological intervention. This generates a considerable consumption of social health resources, causing an important economic impact. This clinical practice guideline addresses all these aspects in adults who suffer from this disorder and it is the result of the work of a multidisciplinary team of professionals from the social, health and labour areas, who have dedicated many hours to the preparation of the recommendations. The aim of this guideline is to answer many of the questions that arise from the day-to-day care of people who suffer Severe Mental Illnesses, given in the form of systematically prepared recommendations with the best available scientific evidence, the experience of the professionals from the guideline development group, and bearing in mind the needs of the users and families of people who suffer SMI. CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 7
Page 1: Clinical Practice Guidelines for Ps
Page 4 and 5: This CPG is an aid for decision mak
Page 7: Table of Contents Presentation 7 Au
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 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
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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
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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
Page 89 and 90:
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
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)
Page 134 and 135:
Service Management: The first anti-
Page 136 and 137:
on Mental Health and the future Eur
Page 138 and 139:
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
Page 146 and 147:
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,
Page 156 and 157:
190 Bond GR, Drake RE. Predictors o
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225 Hurley AD. Individual psychothe
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