Predictors and profiles of treatment non-adherence and engagement in services problems in early psychosis

Lecomte, Tania; Spidel, Alicia; Leclerc, Claude; MacEwan, G. William; Greaves, Caroline; Bentall, Richard P.

doi:10.1016/j.schres.2008.01.024

Cited by 181 publications

(161 citation statements)

References 39 publications

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“…Previous studies have been equivocal in their findings regarding the relationship between insight and service/ therapy attendance (Álvarez-Jiménez et al, 2009;Lecomte et al, 2008;Startup et al, 2006;Tait et al, 2003). In the current study, although it was true that many of the participants who were not interested in therapy gave as their primary reason their belief that they were not psychotic, many of the participants who did express interest in therapy also held this belief.…”

Section: Discussioncontrasting

confidence: 68%

“…Interestingly, however, although medication non-adherence has been consistently associated with reduced insight (Lacro, Dunn, Dolder, Leckband, & Jeste, 2002), the findings for service/therapy attendance has been equivocal. Only one study that we found reported that insight predicted service non-attendance (Álvarez-Jiménez et al, 2009), whereas others reported that poorer insight did not predict service non-attendance (Lecomte et al, 2008;Tait, Birchwood, & Trower, 2003) or therapy dropout (Startup, Jackson, & Startup, 2006). Additional barriers may be present when attempting to engage patients who are admitted on a psychiatric ward in psychological therapy (e.g., acuity of the current episode, medication stabilization).…”

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confidence: 79%

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Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

Mitchison

Jakes

Kelly

et al. 2013

Clin Psychology and Psychoth

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The reasons why some patients with psychosis are not interested in receiving psychological therapy may relate to past negative experiences with psychologists, negative perceptions of psychologists as a group and low perceived efficacy of therapy. These barriers may be addressed through interactions with psychotic patients during an admission to a hospital that disconfirms these perceptions and provides a positive alternative experience with a psychologist. Patients who are hospitalized with psychosis may be interested in receiving psychological therapy; however, the reason for this likely will not be to address psychotic symptoms. Rather, the therapist should be willing to work with the patient on a range of other presenting problems. If a patient has a lack of insight into their psychotic symptoms, this does not always negate them from perceiving other psychological problems for which they may desire support in addressing. Thus, therapists should be encouraged to approach all psychotic patients on a ward, even when there is an apparent lack of awareness of their psychotic symptoms. The themes related to patients' perspectives were generated from psychologists' summaries of interviews with patients and not directly from verbatim transcripts. Although this meant that the reasons given for participants being interested or not interested in therapy were interpreted by the psychologist, efforts were made to relate the exact reasons provided by the participants. Eighteen (29%) of the potential participants were not interviewed, usually as a result of their being discharged or transferred prior to arrangement of an interview. This meant we were unable to capture the views of these patients. Discharge prior to being seen by a psychologist is a barrier to engaging a patient in therapy and preventing them falling through the gaps of service provision.

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Section: Discussioncontrasting

confidence: 68%

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confidence: 79%

Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

Mitchison

Jakes

Kelly

et al. 2013

Clin Psychology and Psychoth

View full text Add to dashboard Cite

show abstract

“…11,12 Despite and perhaps because of these challenges, effective therapeutic relationships are key predictors of symptom, functional, and service use outcomes in this population. [13][14][15] Previous research has shown that the strength of the therapeutic alliance increases the likelihood of engagement in psychotherapy, medication adherence and improved functional outcomes. 16 Clients with mental illness report a desire to share in decision-making, and such participation is needed, in particular, for those who are not content with their treatment.…”

Section: Introductionmentioning

confidence: 99%

Perspectives of Treatment Providers and Clients with Serious Mental Illness Regarding Effective Therapeutic Relationships

Easter

Pollock

Pope

et al. 2015

J Behav Health Serv Res

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This study explores the nature of clinical therapeutic relationships between mental health treatment providers and high-need clients with serious mental illness who had recently discontinued treatment. Semi-structured qualitative interviews of 56 clients with serious mental illness who had recently discontinued care and 25 mental health treatment providers were completed. Both clients with serious mental illness and treatment providers emphasized the importance of client-focused goal setting, time and availability of treatment providers, a caring approach, and trust and honesty in the relationship. However, clients with serious mental illness placed greater emphasis on goals involving tangible services, a notable area of discord between the two groups. Individuals with serious mental illness and treatment providers agreed regarding several key elements to a positive clinical relationship. Further attention to client goals related to tangible services may serve to improve relationships between treatment providers and high-need clients with serious mental illness.

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“…Outreach 13 services can be labor intensive and may be difficult to fund. However, given the importance of treatment engagement (Lecomte et al, 2008;McGorry et al, 2007), it may be beneficial for more programs to offer outreach services to foster a sense of security and enhance treatment engagement.…”

Section: For Example Recent Interventions Such As Socialville Onlinementioning

confidence: 99%

Essential components of early intervention programs for psychosis: Available intervention services in the United States

White

Luther

Bonfils

et al. 2015

Schizophrenia Research

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Programs providing interventions for early psychosis are becoming commonplace in the United States (U.S.); however, the characteristics of existing services remain undocumented. We examined program characteristics, clinical services, and program eligibility criteria for outpatient early intervention programs across the U.S. using a semistructured telephone interview. Content analysis was used to identify the presence or absence of program components, based in part on a recent list of essential evidence-based components recommended for early intervention programs (Addington, MacKenzie, Norman, Wang and Bond, 2013) as well as program characteristics, including eligibility criteria. A total of 34 eligible programs were identified; 31 (91.2%) program representatives agreed to be interviewed. Of the examined components, the most prevalent were individual psychoeducation and outcomes tracking; the least prevalent were outreach services and communication with inpatient units. The populations served by US programs were most frequently defined by restrictions on the duration of psychosis and age. This study provides critical feedback on services for the early psychosis population and identifies research to practice gaps and areas for future improvement.

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Predictors and profiles of treatment non-adherence and engagement in services problems in early psychosis

Cited by 181 publications

References 39 publications

Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

Are Young People Hospitalised with Psychosis Interested in Psychological Therapy?

Perspectives of Treatment Providers and Clients with Serious Mental Illness Regarding Effective Therapeutic Relationships

Essential components of early intervention programs for psychosis: Available intervention services in the United States

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