717 research outputs found
Using CORE to research outcome measurement
No full textChris Leach and Mike Lucock have been involved with CORE from its beginning. Jointly responsible for the
development of one of the first large databases of the use of CORE in routine clinical practice, they have
published a number of key papers looking at the relationship between CORE and other outcome measures,
and its use to track client progress during therapy
Nutrition and mental health recovery
No full textThis review examines the relationship between nutrition and mental health recovery. It examined 22 papers and found that there is substantial evidence to show that people with mental health problems are more likely to engage in poor dietary practices compared to the general population. In addition, there is growing evidence supporting the link between diet and mental health and the benefits of the practical applications of nutritional interventions within mental health services. However, many of these studies are of association and do not prove causation. Therefore, further research is needed on nutrition interventions that utilise specific outcome measures and focus on nutrition in isolation to other factors such as physical activity. The implications of these findings are discussed focusing on mental health practice. This review will be relevant to individuals at all levels within the mental health service, including service users, carers, mental health professionals, managers and directors
Evaluating psychological therapies services: A review of outcome measures and their utility
No full textWe describe the use of a number of outcome measures that have been used over the
past eight years to evaluate adult psychological therapies services in the Wakefield &
Pontefract locality of the South West Yorkshire Mental Health NHS Trust. The
psychological therapies service now has a unique database of outcome measures
completed by 5563 clients, which has been used nationally and internationally for
service evaluation and research purposes. Internally, the database has informed the
clinical service, allowing prioritising of referrals and feedback to clinicians and
referral agencies on the quality of the service and appropriateness of referrals.
We describe the properties and intended use of the measures, the way results are fed
back to the service and evaluate the usefulness of the measures in routine service
settings. Implications for psychological therapies and other mental health services are
discussed including:
• Choice of generic or specific outcome measures
• How the measures relate to one another
• Clinical usefulness of the measures, including risk assessment
• Interpretation of results, including availability of norms and how to assess
change
• Practical utility, including cos
Using evidence to improve Psychological Therapies Services
No full textPsychological therapy services offer help to clients with many different sorts of mental health problems using a variety of therapies provided by a range of different professional groups and are supported by a large amount of research evidence. However, applying evidence-based practice in routine clinical settings presents particular challenges. This paper outlines some of the difficulties applying research findings to routine settings and argues for a more inclusive approach to linking evidence with practice. It describes a systematic approach to service evaluation and practice based evidence within a large psychological therapies service. This approach is integrated into the service delivery. It enables clinicians to become engaged in the process of reflecting on evidence in a non-threatening way and allows innovative ways of enhancing reflective practice by linking evidence with practice in routine settings
Anonymity and the Law in Italy
No full textAnonymity is a concept that arouses suspicion, with which obscure activities are usually associated. May anonymity, however, constitute a right? Neither a general right to anonymity nor a duty to reveal oneself exist in the Italian legal system: both are stated with references to particular needs.
While the Italian legal system recognises a general right to a name, it does not recognise a general right to anonymity. Therefore the picture for the Italian jurist is inevitably fragmentary.Anonymity is recognised as a right by some special legislation.
For instance, it is recognised in the case of a drug addict when he enters detox; in the case of a mother who does not want to reveal her identity at the time of the child birth; and for an author, if provided for by contract. In other cases, the legal system states a duty of anonymity. For example, in the case of donation of organs or bone marrow and in certain particular cases provided by tax law.
The chapter examines the legal understanding of anonymity in Italy. In the Italian context, the concept of anonymity does not belong to public or private law but is more of a general concept. The chapter examines the use of concept of anonymity in Italian Constitutional Law, in Criminal, Private and Public Law.
In other cases, anonymity is not a right, but a mere principle. It is meant to protect the impartiality of public administration in case of public examination and public contract. In many other cases, anonymity is an extreme form of protection of personal data
The importance of comparison in a phenomenological study of clients' experience on an assessment group for group psychotherapy
No full textUsing a grounded theory approach, this study explored the experiences of eight clients who attended a group assessment group (GAG) within a UK adult psychotherapy service. The aim of the GAG was to give clients a one off experience of group therapy to enable them to make a more informed decision about the suitability of analytic group therapy. The qualitative analysis revealed comparison to be a key theme for 7 of the 8 clients. Comparison with others was experienced in terms of similarity and dissimilarity of problems and issues and of the behaviour of the group members. These experiences related to issues such as deserving to be there and stigma and this influenced their decisions to opt for group work. Comparisons were also made between the GAG and subsequent group therapy. The issue of social comparison is discussed with reference to previous theory and research and the implications of the study for group therapy and group assessment groups are explored
Rewiring efficacy studies to increase their relevance to routine practice
No full textCurrent efficacy literature relies heavily on the Beck Depression Inventory (BDI) as the gold standard patient self-report measure. In contrast, the evaluation of psychological therapies in routine practice relies heavily on the CORE-OM. Although the two measures are conceptually distinct, they have been shown to be highly correlated. This suggests the possibility of replacing one measure with the other - a procedure we refer to as rewiring - in service of making the results of efficacy studies using the BDI have greater relevance of practitioners who routinely use the CORE-OM. We tested this proposition using transformation tables (Leach et al., in press) to convert BDI-I scores into CORE-OM scores and reran the analysis of a major efficacy study of depression - the Second Sheffield Psychotherapy Project (Shapiro et al., 1994). Results showed a near perfect replication of the original results and examples of benchmarks concerning the overall effects of treatment as well as differences between treatments are provided against which outcomes in routine practice can be contrasted. The implications for bridging efficacy and effectiveness research are discussed
Service users' views of self-help strategies and research in the UK
No full textBackground: Self-help approaches for mental health problems are a research and service development priority within the UK.
Aim: To engage service users in the research process through a consultation exercise, seek their views on the strategies they use to manage their lives and priorities for research into self-help.
Method: Service users were involved in planning and conducting a consultation event and in analysing, interpreting and disseminating the findings. Forty nine service users attended the consultation event. Notes and key points from focus groups discussions were analysed to identify main themes.
Results: Five themes for service user self-help strategies were identified; managing and structuring the day; empowerment; engaging others to help yourself; physical health and well being; and spirituality. Four research priority areas in self-help were identified: the importance of user-led research; research into self-help strategies to improve physical health and well being; mapping of available services and self-help approaches; and what works and why.
Conclusions: Self-help research and developments should take account of these service users' views of research priorities and the strategies they use to manage their lives.
Declaration of interest: The project was initiated by Psychological Therapies Network North (PsyReNN). Funding for the venue and service user expenses was provided by the NIMHE Regional Development Centre, North East, Yorkshire and Humberside and by the Tees and North East Yorkshire Mental Health and Learning Disabilities NHS Trust
Informing the development of services supporting self-care for long term mental health conditions: A mixed method study of community based mental health initiatives in England
No full textBackground
Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems.
Methods
A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together.
Results
Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health.
Conclusions
Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings
Controlled Clinical Trial of a Self-Help for Anxiety Intervention for Patients Waiting for Psychological Therapy
No full textThis study was a controlled clinical trial in which patients were offered a brief low cost, low intensity self-help intervention while waiting for psychological therapy. A CBT based self-help pack was given to patients with significant anxiety problems and no attempt was made to exclude patients on the basis of severity or co-morbidity. The treatment group received the intervention immediately following assessment and the control group after a delay of 8 weeks so comparisons between the two groups were made over 8 weeks. Although there was some support for the effectiveness of the self help intervention, with a significant time x group interaction for CORE-OM scores, this was not significant with the intention to treat analysis, nor for HADS anxiety and depression scores and the effect size was low. A follow up evaluation suggested some patients attributed significant goal attainment to the intervention. The findings suggest the routine use of self-help interventions in psychological therapies services should be considered although further more adequately powered research is required to identify the type of patients and problems that most benefit, possible adverse effects and the effect on subsequent uptake of and engagement in therapy
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