Enabling choice, recovery and participation: evidence-based early intervention support for psychosocial disability in the National Disability Insurance Scheme

2018 ◽  
Vol 26 (6) ◽  
pp. 578-585 ◽  
Author(s):  
Laura Hayes ◽  
Lisa Brophy ◽  
Carol Harvey ◽  
Juan Jose Tellez ◽  
Helen Herrman ◽  
...  
Keyword(s):  
Early Intervention ◽  
Supported Employment ◽  
Disability Insurance ◽  
Skills Training ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Supported Housing ◽  
Evidence Based ◽  
Insurance Scheme ◽  
Psychosocial Disability

Objectives: The aim of this study was to identify the most effective interventions for early intervention in psychosocial disability in the National Disability Insurance Scheme (NDIS) through an evidence review. Methods: A series of rapid reviews were undertaken to establish possible interventions for psychosocial disability, to develop our understanding of early intervention criteria for the NDIS and to determine which interventions would meet these criteria. Results: Three interventions (social skills training, supported employment and supported housing) have a strong evidence base for effectiveness in early intervention in people with psychosocial disability, with the potential for adoption by the NDIS. They support personal choice and recovery outcomes. Illness self-management, cognitive remediation and cognitive behavioural therapy for psychosis demonstrate outcomes to mitigate impairment. The evidence for family psycho-education is also very strong. Conclusions: This review identified evidence-based, recovery-oriented approaches to early intervention in psychosocial disability. They meet the criteria for early intervention in the NDIS, are relevant to participants and consider their preferences. Early intervention has the potential to save costs by reducing participant reliance on the scheme.

The National Disability Insurance Scheme: Administrators' Perspectives of Agency Transition to ‘User Pay’ for Early Intervention Service Delivery

2017 ◽  
Vol 42 (3) ◽  
pp. 46-53 ◽  
Author(s):  
Alison M. Marchbank
Keyword(s):  
Early Intervention ◽  
Phenomenological Study ◽  
Disability Insurance ◽  
Insurance Scheme ◽  
Parent Choice ◽  
Community Agencies ◽  
Intervention Service ◽  
Young Children With Disabilities ◽  
Personal Philosophy

THE LAUNCH OF THE National Disability Insurance Scheme (NDIS) in Australia announced changes to the ways people with disabilities and families access services. These changes cover delivery of early childhood early intervention to families with infants and young children with disabilities. In July 2013, the NDIS was rolled out nationally in three pilot sites. This funded phenomenological study was conducted in one pilot rollout site with administrators from two agencies delivering such services. Analysis of the data identified factors that challenged professional practice and personal philosophy. The findings suggest that the long-term financial viability of community agencies is at risk. A crucial dilemma emerged concerning parent choice: to what extent does a ‘user pay’ system impose limitations to services being delivered in a family centred way?

scholarly journals What are the benefits of evidence-based supported employment for patients with first-episode psychosis?

2004 ◽  
Vol 28 (8) ◽  
pp. 281-284 ◽  
Author(s):  
Miles Rinaldi ◽  
Karen Mcneil ◽  
Mike Firn ◽  
Marsha Koletsi ◽  
Rachel Perkins ◽  
...  
Keyword(s):  
Early Intervention ◽  
Supported Employment ◽  
First Episode Psychosis ◽  
Educational Activity ◽  
First Episode ◽  
Evidence Based ◽  
Early Intervention Service ◽  
Model Fidelity ◽  
Intervention Service ◽  
Episode Psychosis

Aims and MethodTo examine the effectiveness of integrating evidence-based supported employment into an early intervention service for young people with first-episode psychosis. Demographic, clinical and vocational data were collected over a 12-month period to evaluate the effect on vocational outcomes at 6 months and 12 months of the employment of a vocational specialist, and to assess model fidelity.ResultsFollowing vocational profiling and input from the vocational specialist and the team, there were significant increases in the proportion of clients engaged in work or educational activity over the first 6 months of the intervention, and in a subsample over a second 6-month period. The evidence-based Supported Employment Fidelity Scale was used to measure the degree of implementation, which scored 71, signifying ‘good implementation’.Clinical ImplicationsThe results suggest that implementing evidence-based supported employment within an early intervention service increases employment and education opportunities for patients within the service.

Perceived Evidence and Use of Autism Intervention Strategies in Early Intervention Providers

2019 ◽  
Author(s):  
Jessica Paynter ◽  
Sarah Luskin-Saxby ◽  
Deb Keen ◽  
Kathryn Fordyce ◽  
Grace Frost ◽  
...  
Keyword(s):  
Early Intervention ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Self Report ◽  
Future Research ◽  
Accurate Information ◽  
Evidence Based ◽  
Empirically Supported

Background. Continued use of practices not supported by empirical evidence is an ongoing challenge in the field of autism spectrum disorder (ASD). Knowledge and individual attitudes to evidence-based practice, as well as accuracy of categorization of practices on their evidence base, have been linked to practice selection in allied health professionals. This study aimed to extend this research to early intervention staff, and investigated perceived evidence base of practices, and links to intended future use, along with individual attitudes and sources of information accessed.Method. Participants included 86 early intervention staff who completed an online survey. They rated the evidence base of six ASD intervention practices (three unsupported by research, three empirically supported), along with current and intended future use of these, as well as attitudes to research and to evidence-based practice. Results. At a group level, participants reported using, and intending to use in future, the empirically supported practices more than unsupported practices, and generally accurately reported a higher evidence base for the empirically supported practices. However, a number of individual participants showed inaccuracy in ratings varying by practice. Perceived evidence was linked to greater intention to use practices in the future, while few links to individual attitudes were found. Conclusions. Our findings point to the influence of perceived evidence on intended use of practices. Perceived evidence may be impacted by lack of awareness and/or misinformation regarding the evidence base of practices. The need for accurate information about both empirically supported and unsupported practices, as well as strategies to seek and evaluate information are highlighted. Limitations of the self-report methodology, and future research directions including broader clinical decision-making processes are overviewed.

OPUS -trial: Five-year Follow-up of a RCT of Specialized Treatment for Patients with First Episode Psychosis

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
M. Nordentoft ◽  
M. Bertelsen ◽  
P. Jeppesen ◽  
L. Petersen ◽  
A. Thorup ◽  
...  
Keyword(s):  
Early Intervention ◽  
Family Involvement ◽  
Skills Training ◽  
Supported Housing ◽  
First Episode ◽  
Long Term Effects ◽  
Intervention Programme ◽  
Treatment Groups ◽  
Episode Psychosis

Objective:To determine long term effects of intensive early intervention programme (OPUS)for first episode psychotic patients.Design:RCT of two years of intensive early-intervention programme versus standard treatment. Follow-up was two and five years.Patients:547 first-episode psychotic patients were included and interviewed after two years (N=369) and five years (N=301). Registerbased information was available for all patients.Interventions:The intensive early intervention programme OPUS consisted of ACT with family involvement and social skills training.Results:At five-year follow-up, the positive effect of the OPUS treatment seen after two years had equalized between treatment groups. A significantly smaller percentage of patients from the experimental group were living in supported housing (4% vs. 10%, OR 2.3, 95% CI 1.1 to 4.8, P =0.02) and were hospitalized fewer days (mean days 149 vs. 193, mean difference 44, 95% CI 0.15 to 88,12 P= 0.05) during the five-year period.Conclusions:The OPUS treatment improved clinical outcome after two years, but the effects were not sustainable up to five years after. A difference on supported housing and use of bed days were found after five years in favour of the OPUS treatment.

scholarly journals An Investigation of Service Providers’ understanding, perspectives and implementations of the Transdisciplinary model in Early Intervention settings for Children with Disabilities

2017 ◽  
Author(s):  
Eimear Fitzmaurice ◽  
Janet Richmond
Keyword(s):  
Early Intervention ◽  
Best Practice ◽  
Children With Disabilities ◽  
Service Providers ◽  
Disability Insurance ◽  
Structured Interviews ◽  
Insurance Scheme ◽  
Practice Model ◽  
Transdisciplinary Approach ◽  
Electronic Search

Purpose: The transdisciplinary practice model is currently being promoted as best practice in early intervention therapy for children with disabilities. However, supporting literature is limited. Thus, the question is asked, “What are service providers' understanding and perception of the transdisciplinary model in early intervention settings for children with disabilities?” Method: A systematic review was carried out using the Preferred Reporting Items for Systematic Reviews. An electronic search was conducted via six databases. Eight articles were selected. Results: Four studies predominantly focused on service providers’ perspectives of the model using semi-structured interviews or surveys. Many studies were of adequate to low quality, and the methods of implementing the transdisciplinary approach varied across organisations. It is therefore difficult to draw valid conclusions based on service provider’s viewpoints of the model. Conclusions: This review attempted to determine if the transdisciplinary model is best practice. The inconsistencies in the transdisciplinary teams indicates that overall, the general understanding of the model and its framework amongst organisations is poor. Further research is needed to establish service providers’ understanding of the model and how transdisciplinary teams are functioning since the introduction of the National Disability Insurance Scheme.

‘It’s your problem, not mine’: does competence have anything to do with desire and aspiration to self-direct?

2013 ◽  
Vol 37 (5) ◽  
pp. 621 ◽  
Author(s):  
Michelle Crozier ◽  
Heidi Muenchberger
Keyword(s):  
Research Evidence ◽  
Disability Insurance ◽  
Evidence Base ◽  
Disability Policy ◽  
Insurance Scheme ◽  
Policy Paradigm ◽  
Fundamental Needs

The current disability policy paradigm operating across all states in Australia is self-direction. This central movement is closely linked to preparations for a National Disability Insurance Scheme called DisabilityCare. We provide one perspective in relation to self-direction in Australia including assumptions about aspirations to self-direct and the limited research evidence base that is available even though anecdotally self-direction practices have been occurring for many years. We conclude that by developing a funding platform, such as DisabilityCare, that empowers people with a disability to make decisions about their own fundamental needs and the fulfilment of them, it will lead to a society that supports people to access and achieve a ‘typical’ and desired life.

scholarly journals NICE CG178 Psychosis and Schizophrenia in Adults: Treatment and Management – an evidence-based guideline?

2015 ◽  
Vol 206 (5) ◽  
pp. 357-359 ◽  
Author(s):  
Mark Taylor ◽  
Udayanga Perera
Keyword(s):  
At Risk ◽  
Cognitive Behavioural Therapy ◽  
Clinical Guideline ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Evidence Based ◽  
Nice Guidelines ◽  
Cognitive Behavioural ◽  
Evidence Based Guideline ◽  
Nice Clinical Guideline

SummaryNational Institute for Health and Care Excellence (NICE) clinical guideline (CG)178 was published in 2014. NICE guidelines occupy an important international position. We argue that CG178 overemphasises the use of cognitive–behavioural therapy for schizophrenia and those ‘at risk’ of psychosis, with recommendations that do not always reflect the evidence base. The CG178 recommendations on medications are limited.

The National Disability Insurance Scheme and people with severe and persistent mental illness/psychosocial disability: A review, analysis and synthesis of published literature

2020 ◽  
Vol 54 (12) ◽  
pp. 1162-1172
Author(s):  
Debra Hamilton ◽  
Nicola Hancock ◽  
Justin Newton Scanlan ◽  
Michelle Banfield
Keyword(s):  
Qualitative Analysis ◽  
Disability Insurance ◽  
Future Research ◽  
Insurance Scheme ◽  
Persistent Mental Illness ◽  
External Data ◽  
Barriers To Access ◽  
Wide Range ◽  
Analysis And Synthesis ◽  
Psychosocial Disability

Objectives: The aim of this scoping review was to map and synthesise peer-reviewed literature reporting on the Australian National Disability Insurance Scheme and psychosocial disability. Method: The review followed the rigorous and systematic protocol of Arksey and O’Malley. Five databases were searched and, using strict inclusion and exclusion criteria, publications were identified for inclusion. Data were extracted from publications, tabulated and graphically presented. A qualitative analysis was also completed. Results: Twenty-eight publications were included. While a wide range of issues were covered across this literature, only eight publications specifically focused on the National Disability Insurance Scheme. Almost half of publications were only author commentary without analysis of external data. There were no evaluations and a paucity of publications documenting the lived experiences of people with psychosocial disability or their families. Qualitative analysis identified 59 separate themes. These were grouped using a modified strengths, weakness, opportunities and threats framework. While it was acknowledged that the Scheme has the capacity to enrich people’s lives and enhance service integration, themes relating to weakness and threats dominated within this literature. These included a variety of existing or predicted problems such as poor integration of a recovery philosophy into the National Disability Insurance Scheme, complex application processes creating barriers to access, concern for those ineligible or not accessing the National Disability Insurance Scheme, the need to ensure National Disability Insurance Scheme plans address specific, changing participant needs and that services will be available to provide required supports. Conclusion: Given the significant impact of the National Disability Insurance Scheme on the lives of individuals and the wider mental health service system, there continues to be surprisingly limited peer-reviewed literature reporting on experiences and outcomes of the Scheme for people living with psychosocial disability. Future research examining outcomes and shedding light on National Disability Insurance Scheme experiences of people with psychosocial disability and their families are particularly important for ongoing development and evaluation of the Scheme.

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