The Theory of Recovery Psychology/Unit 3/Pt2
Evidence-Based Practices (EBP)
1.Assertive Community Treatment (ACT): A multi-disciplinary team provides intensive services to individuals with the most severe mental illnesses. Team services include treatment, help in managing symptoms of the illness, immediate crisis response, case management, peer support, medications, supportive therapy and practical on-site support in coping with day-to-day demands. (ref1)
2.Peer Support and Consumer Run Services:a promising practice whereby individuals with serious mental illness provide supports and services for other adults with serious mental illness. (ref2)
3.Integrated treatment for individuals with co-occurring mental illness and substance abuse: Integrated treatment merges the treatment of serious mental illness with the treatment of a co-occurring substance abuse disorder. Integrated treatment can be provided by mental health programs, substance abuse programs or new programs established up specifically to furnish such care. Integrated treatment may include a residential component (similar to residential treatment for substance abuse) and/or intensive outpatient services. (ref3)
4.Illness Management: Services to assist individuals recognize any deterioration in their condition, to anticipate problems and how to respond so as to manage their illness, develop coping and problem-solving skills, and live successfully in the community despite signs and symptoms of serious mental illness. (ref 4)
5.Medication Management: Atypical antipsychotics and selective serotonin re-uptake inhibitors (SSRIs) have a strong evidence base, but are not always prescribed at optimum therapeutic levels; some individuals are placed on a questionable mix of multiple medications (poly-pharmacy). Guidelines for physicians on appropriate use of medication are available, but not always used. (ref5)
5.Crisis services: Mobile crisis teams, intensive in-home services, short-term or emergency hospitalization and residential placement have all proven effective in addressing crises. Services include evaluation and assessment, crisis intervention and stabilization, and follow-up planning. Programs intervene immediately and often are available 24 hours a day, 7 days a week.
6.Supported housing: Individuals live in their own home (room, apartment, or other location) and receive supportive clinical and psychiatric rehabilitation in order to maintain their stability in the community. Services are available at mental health facilities or can be brought to the individual in their home setting when needed. Disputes with landlords and other tenants are addressed through interventions and social skills training.
7.Supported employment: Individuals are placed in employment and provided back-up psychiatric rehabilitation services that focus on skills needed to maintain employment, such as social skills (i.e. how to get along with supervisors and coworkers, timeliness and appropriate grooming and dressing) and stress management along with mental health treatment (including medications and medication management). Generally, supported employment also includes an on-site job coach.
8. Psychiatric Rehabilitation and Recovery/Psychoeducation for families: Provision of emotional support, information and education on the illness of the family member (in general) and specific information on managing crises and day-to-day problems for the individual consumer (with the consumer's consent), provision of resources during periods of crisis, and teaching of problem-solving skills to families of adults with serious mental illness.
9. Psychiatric Rehabilitation and Recovery/Psychotherapy: Psychotherapy is a process of interaction between a trained professional and an individual or group seeking help to address psychological symptoms by modifying responses, behaviors, thoughts or other processes. Several psychotherapeutic approaches have been found effective, including for example:
a. Cognitive Behavioral Therapy for anxiety disorders, including panic disorder and obsessive compulsive disorder; b. Interpersonal and brief dynamic therapy for depression; c. Dialectical behavioral therapy for individuals with borderline personality disorder.
10. Psychosocial Rehabilitation: These programs combine several services for which the evidence base is strong. Services include: supported employment, supported education, supported housing, disability management, medication education and management, family psychoeducation and case management as well as other services focused on successful community living.
Evidence-Based Practices are procedures which have identified as producing the best outcomes, that is to say these techniques have gone through rigid trials using controlled variables and rigid measurements in research conducted by academic institutions. These EBP have been identified as:
Illness Management and Recovery The Illness Management and Recovery program strongly emphasizes helping people to set and pursue personal goals and to implement action strategies in their everyday lives. The information and skills taught in the program include:Recovery strategies,Practical facts about mental illness, The Stress-Vulnerability Model and strategies for treatment, Building social support, Using medication effectively, Reducing relapses and coping with stress, Coping with problems and symptoms and Getting needs met in the mental health system.
Assertive Community Treatment The goal of Assertive Community Treatment is to help people stay out of the hospital and to develop skills for living in the community, so that their mental illness is not the driving force in their lives. Assertive community treatment offers services that are customized to the individual needs of the consumer, delivered by a team of practitioners, and available 24 hours a day. The program addresses needs related to: Symptom management, Housing, Finances, Employment, Medical care, Substance abuse, Family life and Activities of daily life.
Family Psychoeducation Family Psychoeducation involves a partnership among consumers, families and supporters, and practitioners. Through relationship building, education, collaboration, problem solving, and an atmosphere of hope and cooperation, family psychoeducation helps consumers and their families and supporters to: Learn about mental illness, Master new ways of managing their mental illness, Reduce tension and stress within the family, Provide social support and encouragement to each other, Focus on the future, and Find ways for families and supporters to help consumers in their recovery
Supported Employment Supported Employment is a well-defined approach to helping people with mental illnesses find and keep competitive employment within their communities. Supported employment programs are staffed by employment specialists who have frequent meetings with treatment providers to integrate supported employment with mental health services.
Co-occurring Disorders: Integrated Dual Diagnosis Treatment Integrated Dual Diagnosis Treatment is for people who have co-occurring disorders, mental illness and a substance abuse addiction. This treatment approach helps people recover by offering both mental health and substance abuse services at the same time and in one setting. This approach includes: Individualized treatment, based on a person’s current stage of recovery, Education about the illness, Case management, Help with housing, Money management, Relationships and social support, and Counseling designed especially for people with co-occurring disorders.