Lyric analysis in adult mental health settings: An exploratory interpretivist study of music therapists’ clinical decision-making processes

2020 ◽  
Vol 71 ◽  
pp. 101712
Author(s):  
Melody R.P. Schuldt ◽  
Michael J. Silverman
2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Briana S. Last ◽  
Simone H. Schriger ◽  
Carter E. Timon ◽  
Hannah E. Frank ◽  
Alison M. Buttenheim ◽  
...  

An amendment to this paper has been published and can be accessed via the original article.


2011 ◽  
Vol 35 (11) ◽  
pp. 413-418 ◽  
Author(s):  
Matthew M. Large ◽  
Olav B. Nielssen

SummaryRisk assessment has been widely adopted in mental health settings in the hope of preventing harms such as violence to others and suicide. However, risk assessment in its current form is mainly concerned with the probability of adverse events, and does not address the other component of risk – the extent of the resulting loss. Although assessments of the probability of future harm based on actuarial instruments are generally more accurate than the categorisations made by clinicians, actuarial instruments are of little assistance in clinical decision-making because there is no instrument that can estimate the probability of all the harms associated with mental illness, or estimate the extent of the resulting losses. The inability of instruments to distinguish between the risk of common but less serious harms and comparatively rare catastrophic events is a particular limitation of the value of risk categorisations. We should admit that our ability to assess risk is severely limited, and make clinical decisions in a similar way to those in other areas of medicine – by informed consideration of the potential consequences of treatment and non-treatment.


Author(s):  
SuEllen Hamkins

Narrative psychiatry empowers patients to shape their lives through story. Rather than focusing only on finding the source of the problem, in this collaborative clinical approach psychiatrists also help patients diagnose and develop their sources of strength. By encouraging the patient to explore their personal narrative through questioning and story-telling, the clinician helps the patient participate in and discover the ways in which they construct meaning, how they view themselves, what their values are, and who it is exactly that they want to be. These revelations in turn inform clinical decision-making about what it is that ails them, how they'd like to treat it, and what recovery might look like. The Art of Narrative Psychiatry is the first comprehensive description of narrative psychiatry in action. Engaging and accessible, it demonstrates how to help patients cultivate their personal sources of strength and meaning as resources for recovery. Illustrated with vivid case reports and in-depth accounts of therapeutic conversations, the book offers psychiatrists and psychotherapists detailed guidance in the theory and practice of this collaborative approach. Drawing inspiration from narrative therapy, post-modern philosophy, humanistic medicine, and social justice movements - and replete with ways to more fully manifest the intentions of the mental health recovery model - this engaging new book shows how to draw on the standard psychiatric toolbox while also maintaining focus on the patient's vision of the world and illuminating their skills and strengths. Written by a pioneer in the field, The Art of Narrative Psychiatry describes a breadth of nuanced, powerful narrative practices, including externalizing problems, listening for what is absent but implicit, facilitating re-authoring conversations, fostering communities of support, and creating therapeutic documents. The Art of Narrative Psychiatry addresses mental health challenges that range from mild to severe, including anxiety, depression, despair, anorexia/bulimia, perfectionism, OCD, trauma, psychosis, and loss. True to form, the author narrates her own experience throughout, sharing her internal thoughts and decision-making processes as she listens to patients. The Art of Narrative Psychiatry is necessary reading for any professional seeking to empower their patients and become a better, more compassionate clinician.


2020 ◽  
Author(s):  
Briana Shiri Last ◽  
Simone H Schriger ◽  
Carter E. Timon ◽  
Hannah E Frank ◽  
Alison M. Buttenheim ◽  
...  

Abstract Background : Most studies evaluating the barriers and facilitators to evidence-based practice (EBP) implementation tend to overrely on stakeholder perspectives; underuse theory; and evaluate implementation of entire packages or protocols rather than specific, essential components of EBPs. These approaches make it challenging to generate implementation strategies that mechanistically target the core causes of behavior change. The present study seeks to leverage behavioral insights to identify factors that affect clinical decision-making surrounding the use of the trauma narrative (TN), the most active component of trauma focused-cognitive behavioral therapy (TF-CBT)—the gold standard EBP for youth with posttraumatic stress disorder—and to generate implementation strategies informed by these insights. Methods : Through semi-structured qualitative interviews, we sought the perspectives of trained TF-CBT therapists working in community mental health settings across the city of Philadelphia ( n =17) surrounding their clinical decision-making around when and why they use TNs. We used an iterative process of structured brainstorming and rapid validation informed by behavioral insights to uncover the barriers and facilitators to TN use and to generate implementation strategies using the “Easy Attractive Social Timely” (EAST) framework to increase TN implementation. Results : We generated and validated 9 hypothesized barriers to and facilitators of implementation of the trauma narrative that mapped onto 18 behavioral insights. Hypothesized barriers linked therapist perspectives (i.e., the barriers and facilitators they described) and behavioral insights to design 9 implementation strategies. Conclusions : The study responds to the growing need to identify implementation barriers and facilitators and to design implementation strategies that are informed by stakeholder perspectives, causal theories and that target specific components of EBPs. Our results reveal that behavioral insights of TN implementation can generate strategy designs. In the future, we will test the implementation strategies we designed to evaluate whether this process of developing implementation strategies is effective.


2016 ◽  
Vol 30 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Kristi J. Stinson

Completed as part of a larger dissertational study, the purpose of this portion of this descriptive correlational study was to examine the relationships among registered nurses’ clinical experiences and clinical decision-making processes in the critical care environment. The results indicated that there is no strong correlation between clinical experience in general and clinical experience in critical care and clinical decision-making. There were no differences found in any of the Benner stages of clinical experience in relation to the overall clinical decision-making process.


2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.


Author(s):  
Jan Kalina

The complexity of clinical decision-making is immensely increasing with the advent of big data with a clinical relevance. Clinical decision systems represent useful e-health tools applicable to various tasks within the clinical decision-making process. This chapter is devoted to basic principles of clinical decision support systems and their benefits for healthcare and patient safety. Big data is crucial input for clinical decision support systems and is helpful in the task to find the diagnosis, prognosis, and therapy. Statistical challenges of analyzing big data in psychiatry are overviewed, with a particular interest for psychiatry. Various barriers preventing telemedicine tools from expanding to the field of mental health are discussed. The development of decision support systems is claimed here to play a key role in the development of information-based medicine, particularly in psychiatry. Information technology will be ultimately able to combine various information sources including big data to present and enforce a holistic information-based approach to psychiatric care.


Author(s):  
Skye P. Barbic ◽  
Stefan J. Cano

Clinical outcome assessment (COA) in mental health is essential to inform patient-centred care and clinical decision-making. In this chapter, the reader is introduced to COA as it is evolving in the field of mental health. Multiple approaches to COA are presented, but emphasis is placed on approaches that generate clinically meaningful data. Understanding COA can position clinicians and stakeholders to better evaluate their own practice and to contribute to the ongoing evolution of COA research and evidence-based medicine. This chapter begins with the definitions of assessment and measurement. Conceptual frameworks and models of COA development and testing are then presented. These are followed by a discussion of measurement in practice that reviews measurement issues related to clinical decision-making, programme evaluation, and clinical trials. Finally, this chapter highlights the contribution of metrology to improving health outcomes of individuals who experience mental health disorders.


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