A Meta-Analysis of Controlled Research on Social Skills Training for Schizophrenia, Journal of Consulting & Clinical Psychology. 76(3):491-504, June 2008
Abstract: A meta-analysis of randomized, controlled trials of social skills training for schizophrenia was conducted. Outcome measures from 22 studies including 1,521 clients were categorized according to a proximal-distal continuum in relation to the presumed site of action of skills training interventions, with content mastery tests and performance-based measures of skills assumed to be most proximal, community functioning and negative symptoms intermediate, and general symptoms and relapse most distal. Results reveal a large weighted mean effect size for content-mastery exams (d = 1.20), a moderate mean effect size for performance-based measures of social and daily living skills (d = 0.52), moderate mean effect sizes for community functioning (d = 0.52) and negative symptoms (d = 0.40), and small mean effect sizes for other symptoms (d = 0.15) and relapse (d = 0.23). These results support the efficacy of social skills training for improving psychosocial functioning in schizophrenia.
Psychiatric/Mental Health nurses have a long history of being front-line carers of suicidal people, and yet the international epidemiological literature, methodological problems notwithstanding, suggests that contemporary care practices for suicidal people have much room for improvement. As a result, this paper focuses on several areas/issues of care of the suicidal person, and in so doing, critiques the extant literature, such as it is. This critique illustrates that there is a disconcerting lack of empirically induced theory to guide practice and even less empirical evidence to support-specific interventions. The paper concludes, accepting the axiomatic complexity and multi-dimensionality of suicide, and the undeniable fact that suicide is a human drama, played out in the everyday lives of people, that for Psychiatric/Mental Health nurses, caring for suicidal people must be an interpersonal endeavor; and one personified by talking and listening.
ElizabethWhitehead and TomMason, School of Health and Social Care, University of Chester, Chester, UK
Abstract: The use of special observations in psychiatric practice may be employed as an alternative to more restrictive methods such as the use of seclusion and restraint. From the literature, special observations are used for a complex array of signs and symptoms (and risk behaviours) which include suicidal intent, self-injurious behaviour, hallucinatory experiences, and absconding. This paper reports on research into the use of special observations in both forensic and non-forensic psychiatric settings. A comparative approach was adopted to establish if the perceived risk factors leading to the adoption of special observations were similar in both settings. Three groups of nursing staff were requested to assess 30 patients who were placed on special observations. Before this, nurses were requested to rate the risk factors in terms of their severity on a 7-point Likert scale. The rank-ordering analysis revealed a similarity of identified risk factors and anova (one-way, unrelated) and the Jonckheere Trend Test revealed that there were significant differences between the scores in the forensic and the non-forensic settings. The statistical differences existed for risk factors relating to harm to self and others but not for psychiatric symptomatology.
Finding effective nursing interventions for the treatment of mental illness is a major concern for advanced practice psychiatric nurses (APPN). Increasingly, innovative psychotherapeutic treatment modalities are being used for the treatment of individuals with seriuos mental illness. One such innovative approach, mindfulness-based therapeutic interventions, has been shown to relieve distress for individuals with medical and psychiatric illnesses. In part one of this two-part article, the investigators describe principle concepts of mindfulness, review current research in the usefulness of mindfulness practice for treatment of psychiatric illnesses, and outline the theoretical basis for this treatment modality, including mindfulness-based cognitive therapy (MBCT). In Part II, the writers detail the therapy phases of MBCT and present a clinical case in which an advance practice psychiatric nurse integrates mindfulness-based psychotherapeutic approaches into her treatment. This clinical case may inform future clinical nursing research and advanced psychiatric nursing practice.
In Part I of this two-part article, the authors described principle concepts of mindfulness, reviewed current research in the usefulness of mindfulness practice for treatment of psychiatric illnesses. The structure and content of mindfulness-based cognitive therapy (MBCT) was also outlined and provided the theoretical basis for this treatment approach. This alternative therapeutic approach offers potential usefulness for the treatment of individuals suffering from mental illness. Part II of this article presents a more detailed explanation of mindfulness-based therapeutic approaches for all phases of psychotherapy and identifies relevant research questions that will provide an empirical base to guide clinical practice. A case study illustrates mindfulness-based therapeutic interventions.
British scientists have discovered a treatment that appears to slow the progress of Alzheimer’s disease by 81%.
Professor Claude Wischik and colleagues from the University of Aberdeen and TauRx Therapeutics, where he is Chairman, used the drug rember (methylthionium chloride) to act on the tangles present in brains with Alzheimer’s disease.
In the largest ever Phase II clinical trial of a disease modifying treatment, 321 patients with mild and moderate Alzheimer’s disease in the UK and Singapore were found to experience an 81% reduction in cognitive decline over one year when treated with rember. There was no significant decline in mental function over 19 months.
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