Culturally Informed Therapy for Schizophrenia

2020 ◽  
Author(s):  
Amy Weisman de Mamani ◽  
Merranda McLaughlin ◽  
Olivia Altamirano ◽  
Daisy Lopez ◽  
Salman Shaheen Ahmad
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cultural Beliefs ◽  
The United States ◽  
Behavioral Approach ◽  
Case Vignette ◽  
Background Information ◽  
Schizophrenia Spectrum Disorders ◽  
Culturally Informed ◽  
Schizophrenia Spectrum

This book is primarily designed for clinicians and researchers interested in learning how to conduct an empirically supported culturally informed therapy for schizophrenia (CIT-S) that integrates core components of evidenced-based family therapy. It is estimated that approximately 1% of adults in the United States will be diagnosed with schizophrenia or a related schizophrenia spectrum disorder. Without treatment, prognosis is generally poor. Fortunately, traditional family therapies have shown increasing promise in reducing relapse rates and improving mental health for this population. As more and more societies become multicultural, however, there is an increasing expectation that mental health providers will also be prepared to meet the needs of unique and culturally diverse clients in an efficient, skillful, and culturally relevant manner. CIT-S is a 15-week, family-focused, cognitive behavioral approach for managing schizophrenia spectrum disorders. The intervention draws upon clients’ cultural beliefs, practices, and traditions to help them conceptualize and manage mental illness. It aims to improve the quality of clients’ lives in a manner that is in line with their values and takes into account their cultural norms when discussing important issues and addressing challenges (such as mental illness) within the family. CIT-S contains five distinct modules: (a) family collectivism, (b) psychoeducation, (c) spirituality, (d) communication training, and (e) problem-solving. For each module, a detailed rationale, background information, therapy instructions, suggested homework assignments, and a sample case vignette are provided in an accessible, easy-to-use manner.

Introduction

2020 ◽  
pp. 1-8
Author(s):  
Amy Weisman de Mamani ◽  
Merranda McLaughlin ◽  
Olivia Altamirano ◽  
Daisy Lopez ◽  
Salman Shaheen Ahmad
Keyword(s):  
Cultural Beliefs ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Schizophrenia Spectrum Disorders ◽  
Culturally Informed ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

This chapter serves as an orientation to this book, a 15-week, family-focused, cognitive-behavioral approach for managing schizophrenia spectrum disorders. The chapter begins with an overview of the book’s purpose, which is to offer a how-to approach for conducting culturally informed therapy for schizophrenia (CIT-S). CIT-S is a treatment that draws upon clients’ own cultural beliefs, practices, and traditions to help people with schizophrenia and their loved ones to better manage the illness and improve the quality of their lives. Next, the suggested credentials for individuals who wish to deliver the intervention are discussed. This is followed by a description of the organization of the book and a brief overview of each of the nine chapters. Finally, a glossary of important terms and phrases that are used throughout the book is provided.

scholarly journals Validation and recalibration of OxMIV in predicting violent behaviour in patients with schizophrenia spectrum disorders

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Jelle Lamsma ◽  
Rongqin Yu ◽  
Seena Fazel ◽  
Therese van Amelsvoort ◽  
Agna Bartels-Velthuis ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Interpersonal Violence ◽  
Brier Score ◽  
Schizophrenia Spectrum Disorders ◽  
Violent Behaviour ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

AbstractOxford Mental Illness and Violence (OxMIV) addresses the need in mental health services for a scalable, transparent and valid tool to predict violent behaviour in patients with severe mental illness. However, external validations are lacking. Therefore, we have used a Dutch sample of general psychiatric patients with schizophrenia spectrum disorders (N = 637) to evaluate the performance of OxMIV in predicting interpersonal violence over 3 years. The predictors and outcome were measured with standardized instruments and multiple sources of information. Patients were mostly male (n = 493, 77%) and, on average, 27 (SD = 7) years old. The outcome rate was 9% (n = 59). Discrimination, as measured by the area under the curve, was moderate at 0.67 (95% confidence interval 0.61–0.73). Calibration-in-the-large was adequate, with a ratio between predicted and observed events of 1.2 and a Brier score of 0.09. At the individual level, risks were systematically underestimated in the original model, which was remedied by recalibrating the intercept and slope of the model. Probability scores generated by the recalibrated model can be used as an adjunct to clinical decision-making in Dutch mental health services.

scholarly journals Design and pilot evaluation of an evidence-based worksheet and clinician guide to facilitate nutrition counselling for patients with severe mental illness

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura LaChance ◽  
Monique Aucoin ◽  
Kieran Cooley
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Clinical Practice ◽  
Lived Experience ◽  
Premature Mortality ◽  
Mental Illnesses ◽  
Psychiatric Training ◽  
Schizophrenia Spectrum Disorders ◽  
Nutritional Counselling ◽  
Schizophrenia Spectrum

Abstract Background Schizophrenia spectrum disorders (SSD) are severe, persistent mental illnesses resulting in considerable disability and premature mortality. Emerging evidence suggests that diet may be a modifiable risk factor in mental illness; however, use of nutritional counselling as a component of psychiatric clinical practice is limited. The objective of this project is the design and evaluate a worksheet and clinician guide for use in facilitating nutritional counseling in the context of existing mental health care. Methods The worksheet and clinician guide were developed based on the results of a recent scoping review on the relationship between diet and mental health symptoms among individuals with SSD. A feedback process involved a focus group with psychiatrists and interviews with individuals with lived experience with psychosis. Participants were asked a series of structured and open-ended questions. Interviews were transcribed and data units were allocated to categories from an existing framework. The comments were used to guide modifications to the worksheet and clinician guide. A brief interview with all participants was completed to gather feedback on the final version. Results Five psychiatrist participants and six participants with lived experience completed interviews. Participants provided positive comments related to the worksheet design, complexity and inclusion of interactive components. A novel theme emerged relating to the lack of nutritional counselling in psychiatric training and clinical practice. Many constructive comments were provided which resulted in meaningful revisions and improvements to the worksheet and clinician guide design and content. All participants were satisfied with the final versions. Conclusions A worksheet and clinician guide designed to facilitate nutritional counselling with individuals with SSD was found to be acceptable to all participants following a process of feedback and revision. Further research and dissemination efforts aimed at increasing the use of nutritional counselling in psychiatric practice are warranted.

Effective e-health design for those with, and without, mental health disorders: shallow navigation, concentrated contents, modest number of links, one screen area for links. (Preprint)

2018 ◽  
Author(s):  
Armando Rotondi ◽  
Jonathan Grady ◽  
Barbara H. Hanusa ◽  
Michael R. Spring ◽  
Kaleab Z. Abebe ◽  
...  
Keyword(s):  
Mental Illness ◽  
Severe Mental Illness ◽  
Success Rate ◽  
Fractional Factorial ◽  
Mental Illnesses ◽  
Schizophrenia Spectrum Disorders ◽  
Design Elements ◽  
Website Usability ◽  
Schizophrenia Spectrum ◽  
Health Applications

BACKGROUND E-health applications are an avenue to improve service responsiveness, convenience, and appeal, and tailor treatments to improve relevance, engagement, and use. It is critical to user engagement that the designs of e-health applications are intuitive to navigate. Limited research exists on designs that work for those with a severe mental illness, many of whom infrequently seek treatment, and tend to discontinuation medications and psychosocial treatments. OBJECTIVE The purpose of this study was to evaluate the influence of 12 design elements (e.g., website depth, reading level, use of navigational lists) on the usability of e-health application websites for those with, and without, mental health disorders (including severe mental illness). METHODS A 212-4 fractional factorial experimental design was used to specify the designs of 256 e-health websites, which systematically varied the 12 design elements. The final destination contents of all websites were identical, only the navigational pages varied. Three subgroups of participants comprising 226 individuals, were used to test these websites (those with schizophrenia-spectrum disorders, other mental illnesses, and no mental illness). Unique to this study was that the 12 design elements were manipulated systematically to allow assessment of combinations of design elements rather than only one element at a time. RESULTS The best and worst designs were identified for each of the three subgroups, and the sample overall. The depth of a website’s navigation, that is, the number of screens/pages users needed to navigate to find desired content, had the strongest influence on usability (ability to find information). The worst performing design for those with schizophrenia-spectrum disorders had an 8.6% success rate (ability to find information), the best had a 53.2% success rate. The navigational design made a 45% difference in usability. For the subgroup with other mental illnesses the design made a 52% difference, and for those with no mental illness a 50% difference in success rate. The websites with the highest usability all had several key similarities, as did the websites with the poorest usability. A unique finding is that the influences on usability of some design elements are variable. For these design elements, whether they had a positive or negative effect, and the size of its effect, could be influenced by the rest of the design environment, that is, the other elements in the design. This was not the case for navigational depth, a shallower hierarchy is better than a deeper hierarchy. CONCLUSIONS It is possible to identify evidence-based strategies for designing e-health applications that result in a high level of usability. Even for those with schizophrenia, or other severe mental illnesses, there are designs that are highly effective. The best designs have key similarities, but can also vary in some respects. Key words: schizophrenia, severe mental illness, e-health, design, website, usability, website design, website usability, fractional factorial design.

scholarly journals Holistic Health: Does It Really Include Mental Health?

2006 ◽  
Vol 6 ◽  
pp. 2092-2099 ◽  
Author(s):  
Kimberly K. McClanahan ◽  
Marlene B. Huff ◽  
Hatim A. Omar
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Physical Health ◽  
The United States ◽  
Holistic Health ◽  
Public Perceptions ◽  
The Past ◽  
Mind And Body ◽  
Mental And Physical Health ◽  
The U.S

Holistic health, incorporating mind and body as equally important and unified components of health, is a concept utilized in some health care arenas in the United States (U.S.) over the past 30 years. However, in the U.S., mental health is not seen as conceptually integral to physical health and, thus, holistic health cannot be realized until the historical concept of mind-body dualism, continuing stigma regarding mental illness, lack of mental health parity in insurance, and inaccurate public perceptions regarding mental illness are adequately addressed and resolved. Until then, mental and physical health will continue to be viewed as disparate entities rather than parts of a unified whole. We conclude that the U.S. currently does not generally incorporate the tenets of holistic health in its view of the mental and physical health of its citizens, and provide some suggestions for changing that viewpoint.

scholarly journals Bibliotherapy for Mental Health

2017 ◽  
Vol 2 (2) ◽  
pp. 67
Author(s):  
Jennifer Yontz-Orlando
Keyword(s):  
Mental Health ◽  
United States ◽  
Mental Illness ◽  
Medical Condition ◽  
Action Plan ◽  
The United States ◽  
World Health ◽  
Group Setting ◽  
Health Crisis ◽  
The Uk

The United States is facing an epidemic of mental illness, affecting nearly 60 million Americans annually (http://www.nami.org/ ). The World Health Organization describes mental health as “a long neglected problem” and has established an action plan for 2013-2020 (http://www.who.int/mental_health/action_plan_2013/en/). One way to combat mental illness is through bibliotherapy, which is the use of written materials including fiction, nonfiction, and poetry to support emotional and psychiatric healing.Bibliotherapy has been in existence since ancient times, but began in earnest in the United States in the 1850’s during the “Great Awakening.” At that time, mental illness began to be seen as a medical condition rather than a supernatural phenomenon. Since then, due to the changing nature of our institutions, interest in bibliotherapy waned until the 1950’s when there was a slight resurgence in its practice. However, in the last 20 years, bibliotherapy has gained a stronghold in the United Kingdom. To relieve the stress of an overcrowded mental health system, public policy in the UK has supported the use of bibliotherapy in a variety of its institutions. There are many ways to conduct bibliotherapy, but studies show that when the process is interactive, such as in a support group setting, the results are better. Also, bibliotherapy can be conducted by many sorts of professionals, including doctors, therapists, social workers, teachers, and librarians. Studies also show that when the bibliotherapists are trained in the best practices of bibliotherapy, results improve. Bibliotherapy is an effective, low-cost alternative for people in need of therapeutic assistance. The UK model should be studied and implemented in the United States and in other nations to help solve the mental health crisis.

scholarly journals T194. SUBJECTIVE ANOMALIES OF IMAGINATION AGGREGATE IN SCHIZOPHRENIA-SPECTRUM DISORDERS AND ARE ASSOCIATED WITH DISORDERS OF BASIC SELF

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S305-S305
Author(s):  
Andreas Rosén Rasmussen ◽  
Josef Parnas
Keyword(s):  
Mental Illness ◽  
Cross Sectional Study ◽  
Multivariate Linear Regression Analysis ◽  
Healthy Controls ◽  
Schizophrenia Spectrum Disorders ◽  
Sectional Study ◽  
Cross Sectional ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Schizotypal Disorder

Abstract Background Imagination is the formation of ideas or images of something known not to be present to the senses. Clinical psychopathology has few notions addressing this domain apart from obsession and rumination. Some classic psychopathological notions such as Jaspers’ concept of pseudohallucination or the pseudo-obsession are relevant to this area. In a recent research project, informed by contemporary philosophy of mind and phenomenology, we have developed novel concepts targeting subjective disturbances of imagination and fantasy life with a focus on the schizophrenia-spectrum. Patients describe a spatialization of images, i.e., stable imagery with an articulated spatial structure being liable to inspection ‘from afar in the mind’ and often undergoing an autonomous development independently of the will of the patient (‘like watching a movie in the head’). Other notions address tacit, non-psychotic erosions of the demarcation of fantasy life from perception and memory. A broad range of ideations (such as ‘daydreams’, ‘fears’, anticipations, intrusions, paranoid or suicidal ideation) may involve such structural disturbances of experience. Here, we present data from the first, cross-sectional study investigating the distribution of anomalies of imagination in different diagnostic groups and healthy controls as well as their association with positive symptoms, negative symptoms and disorders of basic selfhood. Methods The sample (N=81) included in- and outpatients with schizophrenia or another non-affective psychosis (N=32), outpatients with schizotypal disorder (N=15) or other mental illness (N=16) and healthy controls (N=18). The sample was 70% female with mean age 29.9 (SD 6.8; range 18–42) years. Anomalies of imagination were assessed with the Examination of anomalous fantasy and imagination (EAFI), which is an instrument recently developed in our group for a semi-structured interview exploring these experiences. The EAFI has shown very good reliability with average Kappa of 0.84. Disorders of basic self were assessed with the Examination of anomalous self experience (EASE) and positive, negative and general symptoms with the Positive and Negative Syndrome Scale (PANSS). Results Anomalies of imagination aggregated significantly (p < 0.000, Kruskall-Wallis test) in the schizophrenia-spectrum disorders compared to other mental illness with no significant difference between schizophrenia and schizotypal disorder. The group of healthy controls very rarely reported these anomalies and scored significantly lower (p < 0.000) than all diagnostic groups. In multivariate linear regression analysis (R2 = 0.66), EAFI score was significantly associated with EASE score (β = 0.62, p < 0.000), PANSS positive (β = 0.34, p = 0.01) and PANSS negative (β = 0.29, p = 0.02), but not PANSS general score (β = -0.29, p = 0.07). More than 79% of the schizophrenia-spectrum patients retrospectively reported the onset of these experiences to adolescence or earlier. Discussion The results of this cross-sectional study support that the subjective anomalies of imagination, targeted with the EAFI, are associated with the schizophrenia-spectrum. The association with disorders of basic self, which has been shown to have trait-like characteristics and to predict transition to schizophrenia-spectrum disorders, may reflect that the anomalies of imagination share a common experiential core-structure with self disorders. We suggest that the anomalies of imagination belong to an early onset level of psychopathology in the schizophrenia-spectrum and may have a relevance for differential diagnosis and early detection.

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