How successful are first episode programs? A review of the evidence for specialized assertive early intervention

Nordentoft, Merete; Rasmussen, Jesper Østrup; Melau, Marianne; Hjorthøj, Carsten; Thorup, Anne

doi:10.1097/yco.0000000000000052

Cited by 97 publications

(89 citation statements)

References 32 publications

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“…The former has emerged from experiential knowledge and advocacy from service users, supported later by sound qualitative research, whereas the latter has emerged from a combination of J Psychiatry Neurosci 2015;40(3) a shift in philosophy of delivery of care on the part of service providers, parallel generation of evidence of its effectiveness 26,27 and greater acceptance by service users and their families, who have now joined the movement as advocates. A third emerging movement, the concept of positive mental health, 28,29 may prove to be effective in combating the negative image of mental illness.…”

Section: What Needs To Be Done?mentioning

confidence: 99%

“Mental illness is like any other medical illness”: a critical examination of the statement and its impact on patient care and society

Malla

Joober

Garcia

2015

jpn

101

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Section: What Needs To Be Done?mentioning

confidence: 99%

“Mental illness is like any other medical illness”: a critical examination of the statement and its impact on patient care and society

Malla

Joober

Garcia

2015

jpn

101

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“…With signs that early interventions for severe mental illness [1,2] have at best only a modest impact on longer term outcome [3], a need for a long term care and support system that facilitates recovery and avoids institutionalization [4] is resurfacing [5,6]. Systematic research, however, has yet to promote the use of long-term care programs, such as the clubhouse model, despite their long-standing existence internationally.…”

Section: Introductionmentioning

confidence: 99%

Clubhouse Community Support for Life: Staff–Member Relationships and Recovery

Tanaka

Craig

Davidson

2015

J. Psychosoc. Rehabil. Ment. Health

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With signs that early interventions for severe mental illness have at best only a modest impact on longerterm outcome, a need for a long-term care and support system that facilitates recovery is resurfacing. This article describes a well-established long-term support program, the clubhouse model, drawing on qualitative interview data from 105 users and 25 staff from five clubhouses in the U.S. and Finland, which was analyzed using a grounded theory approach. Recurrent patterns of transformative life changes emerged. Central to these processes was a sense of equality between staff and members that transcended social roles and mental health status and was experienced as embodying trust in human potential and respecting member's choice. This staff-member relationship can be framed by the Aristotelian notion of friendship for life. The clubhouse, offering a home base to which members can return in times of need, may provide a viable safety net for recovery.

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“…The first experience of a psychotic episode in an individual is generally known as the first episode, and this term is applied to both psychosis generally and schizophrenia specifically. In the last 20 years the importance of tailored and intensive intervention in the first 2-5 years of psychosis has been emphasised in achieving good outcomes (Birchwood, Todd, & Jackson, 1998;Nordentoft, Rasmussen, Melau, Hjorthoj, & Thorup, 2014). This has led to the widespread introduction of specialised early intervention services for those in the first 2-5 years of illness.…”

Section: Introduction To Psychosismentioning

confidence: 99%

“…These services apply specialised clinical knowledge to the treatment of early psychosis, including assertive interventions, appropriate low doses of antipsychotic medication, family interventions, and support for substance use (International Early Psychosis Association Writing Group, 2005). In comparison with standard community mental health care such services have been shown not only to improve outcomes, such as reducing the number of days that patients are hospitalised, increasing the percentage of individuals living independently, and reducing suicide rates (Bertelsen et al, 2008;Chen et al, 2011;Nordentoft et al, 2014) but also to be economical (Hastrup et al, 2013;Park, McCrone, & Knapp, 2014).…”

Section: Introduction To Psychosismentioning

confidence: 99%

Future‐directed thinking in first‐episode psychosis

Goodby

MacLeod

2015

British J Clinic Psychol

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ObjectivesThis study employed the Future Thinking Task (MacLeod et al., 2005, Br. J. Clin. Psychol., 44, 495) to investigate whether future‐directed thinking in first‐episode psychosis is significantly different from that of matched controls, and to identify its correlates in this patient group.DesignCross‐sectional, mixed‐model, case–control design.MethodParticipants were 30 patients with first‐episode psychosis and 27 matched controls. The Future Thinking Task was used to assess future‐directed thinking in both groups. Anxiety and depression were also measured as well as self‐report measures of hopelessness, suicide ideation and a measure of negative symptoms.ResultsIndividuals with psychosis were impaired in future‐directed thinking in both positive and negative domains, particularly with respect to the coming year. Increased self‐reported hopelessness was associated with reduced positive future thinking and increased negative future thinking. Increased positive future thinking was also associated with reduced severity of negative symptoms, whilst negative future thinking was associated with suicide ideation.ConclusionsIndividuals with first‐episode psychosis show a reduction in positive future thinking in line with that seen in other clinical groups, but this is accompanied by an unexpected reduction in negative future thinking. The findings suggest a general disengagement with the future in this group that may affect recovery and functioning.Practitioner points Individuals with first‐episode psychosis may benefit from interventions to help them engage with their future, in particular in the mid‐range, up to 1 year. The Future Thinking Task may be a helpful addition to the assessment of suicide risk in those with first‐episode psychosis. Decreased positive future thinking was associated with increased severity of negative symptoms, indicating a potential new treatment angle for this resistant aspect of psychosis. The cross‐sectional design of this study does not allow for conclusions about the causal relationship between psychosis and future‐directed thinking. This study investigated future‐directed thinking in individuals with a range of psychotic illnesses employing a trans‐diagnostic approach; therefore, conclusions cannot be drawn about the nature of future‐directed thinking in individual psychotic disorders.

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How successful are first episode programs? A review of the evidence for specialized assertive early intervention

Cited by 97 publications

References 32 publications

“Mental illness is like any other medical illness”: a critical examination of the statement and its impact on patient care and society

“Mental illness is like any other medical illness”: a critical examination of the statement and its impact on patient care and society

Clubhouse Community Support for Life: Staff–Member Relationships and Recovery

Future‐directed thinking in first‐episode psychosis

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