Integration of Nidotherapy Into the Management of Mental Illness and Antisocial Personality: a Qualitative Study

Abstract

Nidotherapy is an acceptable form of management and was perceived in this study to have largely positive results for both patients and clinical teams as it offered intervention beyond that provided by conventional teams. It was felt to require more than six months of treatment and was less successful when there was inadequate communication between the nidotherapist and clinical teams and when the philosophy of care was not congruent.

Nidotherapy compared with enhanced care programme approach training for adults with aggressive challenging behaviour and intellectual disability (NIDABID): cluster‐randomised controlled trial

“…As both interventions were relatively short and of equivalent length, the likelihood of one form of management being highly more effective than another was relatively low. But the finding that nidotherapy showed indications of greater efficacy later in the study is in keeping with previous qualitative evidence that it takes time for the main principles of the treatment to be embedded into practice (Spencer et al ). It is also standard practice in nidotherapy not to introduce the treatment during the active treatment of acute mental illness (Tyrer ), and it is likely that at least several residents were not able to gain from this form of management until their mental states had stabilised.…”

Nidotherapy in the treatment of substance misuse, psychosis and personality disorder: secondary analysis of a controlled trial

“…The possible difficulties in the separation of the nidotherapist from the main clinical services could have an impact on engagement. 26 …”

“…This may have been an asset with a population that is generally sceptical of any psychiatric intervention because of past experiences. 4 The additional role of advocate is also much appreciated in this group 26 and, by taking every aspect of the patients' wishes seriously and considerately, fits in well with the promotion of recovery. The fact that not only bed usage was reduced in this study but community placements were made relatively cheaply (Table 2) suggests that the role of nidotherapist in 'customising' accommodation so that it makes a better fit for the patient is cost-effective.…”

“…Since it is concerned with getting a better environmental fit for the patient, it could promote more appropriate placements for patients after discharge. The role of the nidotherapist in acting as an advocate for the patient 26 may also be important here, as the ability to get over personal wishes and needs to the clinical team in a coherent and consistent way was useful in effecting change. The wish most fervently expressed by the patients allocated to nidotherapy was that for greater autonomy and this was also taken account of in planning the nidotherapy strategy.…”

The quality gap in mental health treatment in Australia

“…This has already been shown to be acceptable to patients (Spencer et al, 2010), to lead to better community placements and improved social function of the most severely mentally ill (Ranger et al, 2009) and lead to lesser coercion. In the treatment known as nidotherapy, attention is primarily focused on getting a better fit between person and setting by changing the physical, social or personal environment with the full collaboration of the patient.…”