Early Intervention in Psychosis Service User Recovery - Essay Example

How Does Early Intervention in Psychosis Service User Recovery? Table of Contents Introduction 3 Specialist Services 4 Child and Adolescent Mental Health Service (CAMHS) 6 Community Mental Health Team (CMHT) in early intervention in psychosis service (EIP) 7 General Practitioner 8 St Ann’s Hospital 8 Therapeutic Approaches Used 9 Medications 9 Pros of Medications 9 Cons of Medications 10 Social Interventions 11 Main Therapeutic Approach 12 CBT 12 Pros of CBT 13 Cons of CBT 14 Literature Support 15 Literature Criticism 15 Recovery 16 Reason of Conducting CBT 16 Process of CBT Contributing to Psychotic Patients Recovery 16 Conclusion 18 References 20 Introduction Psychosis is the abnormal condition of an individual, where an individual loses contact with the reality of the world. Some of the early signs of psychosis include the feeling of anxiousness, depression, anger, suspiciousness, irritable and confusions (Ellwood, 1995). Some of the other early signs of the disease are evident from the unusual experience and behaviour of an individual including sleep disturbance, loss of motivation and energy, and change of appetitive (Twomey, 2009). There are some of the symptoms of psychosis, which considerably supports in the identification of the disease. These include hallucinations, delusions and difficulties in organised thinking Bentall, 2003). In this regard, it is important to conduct Early Intervention in psychosis patients. The approach of Early Intervention in psychotic patients attempts to early detect and provide treatment by identifying the early symptoms of the disease. Contextually, the first 3 to 5 years are considered as the most critical for effective early interventions to the disease. Early Intervention in psychosis is identified to be adopted in an effective way with the aim of detecting psychosis early, so that time span of untreated psychosis can be reduced. In addition, interventions are to be provided based on psychosocial interventions as well as anti-psychotic medications. Early Intervention in psychosis is an effective measure for the recovery of psychotic issues in youths for providing inpatient care, home treatment, risk management, self-management approach, physical well-being and relapse management (Masi, 2009). The prime objective of early interventions is to reduce the delay in the treatment process and successfully recover from the disease. Contextually, the objective of the current study is to identify and discuss the process through which Early Intervention in psychosis contributes to the recovery of psychotic patients from 14 to 35 years. In addition, the essay attempts to identify the most suitable theoretical approach used to recover from psychosis. Specialist Services In order to recover from psychosis, it is important to conduct a specialist services. In this regard, Early Intervention in Psychosis is considered as the decisive service that leads to the recovery of the disease (Williams, 2001). The patients are generally referred by his/her family members or community members during the early intervention period. Correspondingly, such individuals are mostly notable to admit the patients to the specialist service centres. The patients are notable to be admitted in the health care centres or at several instances are cured at his/her home (Twomey, 2009). It is worth mentioning that several services have been introduced for complying with the requirements of the young adults who suffered with first-episode of psychosis. In this regard, based on the report published by Heinssen & et. al. (n.d.), it can be apparently observed that the services including behavioral as well as cognitive psychotherapy and minimum doses of uncharacteristic antipsychotic medications are certain services, which have been introduced for treating the young adults suffering with first-episode of psychosis. It must be mentioned in this similar context that several nations including Australia, New Zealand, North America and Scandinavia have also adopted certain initiatives for determining the effectiveness of early intervention in relation to the domain of psychosis. For instance, in Australia along with New Zealand, the initiative of EPPIC is noted to deliver early intervention services relating to the problem concerning first-episode of psychosis. On the other hand, in Scandinavia, the distinct psychosis programs that have been introduced earlier are continuing to address and mitigate the above stated complex problem for deriving positive results in terms of offering quality as well as effective care to the patient suffering from such problem. Finally, in North America, certain already established clinically based services and comprehensive academic researches are acting as effective intervention measures for coping up with the adverse effects rising from such problem (World Public Library, 2015). Early intervention to psychosis is highly decisive, as it leads to effective recovery of the patients. Early interventions as mentioned by the National Service Framework (1999) include assertive approach to engage patients with the society, which leads to the elimination of the barriers in the recovery process of the individual. Furthermore, it is notable that the patients are discharged from the healthcare centres dealing with early intervention within psychosis services after a certain period. However, it is necessary to continue to the treatment even after the discharge from health care centres for complete recovery from the disease. In Early Intervention in Psychosis, there are two forms of treatment; one is the medication, while the other is the psychological counselling or social interventions. Medications are required for a shorter period, while it is necessary to continue social interventions for a longer duration (Twomey, 2009). It is also notable that certain discharge planning process including suggesting of the manner of managing the patients at home. The discharge plan is also suggested to the relatives, family members and friends, so that effective care can be ensured of the patient. It also plans to prepare a goal for the patients in his/her career, which considerably supports in the effective recovery of the patients (Heinssen & et. al., n.d.). Early intervention in psychosis (EIP) service is a service model for recovering patients suffering from psychosis with ages from 14 to 35 years. This specialist service has some of the principles based upon which the service process is conducted. One of such principle is based on the age of the individual i.e. the service is primarily to the youth (Masi, 2009). Moreover, it is worth mentioning that the service is largely family oriented, wherein the support of the expert management team is a critical factor to success. Early Intervention in Psychosis also attempts to promote maximum recovery to the patients and setbacks during critical period in order to attain effective recovery (Bentall, 2003). Early Intervention in Psychosis has certain assessment strategies to recover the psychotic patients effectively. This includes providing appropriate services based on gender, age, and culture and establishment of a youth friendly environment (World Public Library, 2015). Furthermore, the specialist service assesses the issue by understanding the detailed information regarding the patient from his/her infant stage (Twomey, 2009). Besides this, the specialist service is needed to be assessed comprehensively in order to identify the risk factors that might further affect the patients. The assessment is also conducted based on the perspective of the family of an individual (Heinssen & et. al., n.d.). For performing Early Intervention in Psychosis effectively, it is important to possess individual and family engagement. This has been the most important factor that contributes to the recovery of psychotic patients in an effective manner (Bentall, 2003). Child and Adolescent Mental Health Service (CAMHS) Early intervention in psychosis (EIP) service is considerably related to the treatment provided in different healthcare centres. One of such is the Child and Adolescent Mental Health Service (CAMHS), which has been considerably effective for the recovery of the child and adolescent patients, who have mental ill healthiness (YoungMinds, 2015). Treatment is offered on either hospital basis or outpatient basis, where the patients’ treatment is conducted at his/her home. This form of treatment generally consists of psychological interventions and effective medications. Psychological treatment provided is generally in the form of counselling to the patients and at instances to his/her family members. Thus, it is eminent that an individual and his/her family members considerably receive education for the purpose of recovery of the patients (NHS, 2014). Besides the psychological interventions, CAMHS also provides considerable importance to medications, which is also known as antipsychotics. Medications support in restricting the further consequences of the illness (YoungMinds, 2015). Community Mental Health Team (CMHT) in early intervention in psychosis service (EIP) Community Mental Health Team (CMHT) is another organisation, which is related to early intervention in psychosis service (EIP). In this regard, it is notable that the organisation providing multidisciplinary approach to recover the psychotic patients, who are in the early stage. This includes short-term interventions programme, wherein mood, personality and anxiety among the patients are considered and treated. The organisation considers treatment to the patients between 14 and 35 years of age (Northumberland Tyne & Wear NHS Foundation Trust, 2015). Furthermore, it suggests of the needs of social care to the individuals to recover completely from psychosis. The specialist service evident in CMHT suggests that the individuals need to have adequate support from the society or community for successful recovery. Besides this, it suggests to the individual patients to identify opportunities in order to get involved with the local communities (Northumberland Tyne and Wear NHS Foundation Trust, 2015). In addition, it educates individuals to maintain their health and further suggests individuals to live independently in the society. This considerably supports in the effective recovery of the individual patients (Northumberland Tyne and Wear NHS Foundation Trust, 2015). Thus, it is eminent that CMHT is highly effective in providing adequate recovery of psychosis patients through early interventions. General Practitioner General Practitioner (GP) is deemed to be considerably related to specialist services and significantly effective in the treatment of psychosis. In this regard, it is notable that GPs also suggest of the importance of family care for effective treatment of psychotic patients (Orygen Youth Health, 2002). In addition, it suggests the individuals to remain in contact with his/her family members and community, which is extremely necessary for effective early interventions. This would considerably support in the enrichment of motivation among the patients, which largely contributes to effective treatment (Byrne & Rosen, 2014). Furthermore, it supports the patients in overcoming from the trauma of the disease. The treatment from GPs also involves the redevelopment of the cognitive skills of the patient, which is lost from the disease (Orygen Youth Health, 2002). Medications are also notable for effective treatment of psychosis patients during the early intervention period (Byrne & Rosen, 2014). Thus, specialist service for psychosis patients is considerably related to the treatment offered by general practitioners. St Ann’s Hospital Specialist service is related to psychosis treatment in St Ann’s Hospital. The care team of the hospital supports patients from mental ill health diseases. The service provider of the organisation includes psychiatrists, psychotherapists, occupational therapists, psychologists, psychological therapists, social workers, nurses and associate mental health workers (Steward Health Care, 2015). In order to recover the patients effectively, the organisation provides Cognitive Behavioural Therapy (CBT) and psychotherapy to its patients. These are the integral part of early interventions in psychosis recovery. Besides this, it provides group therapy to the individuals, which is generally for 6-10 weeks on weekly basis (Bentall, 2009). Furthermore, the hospital provides CBT as treatment during the post trauma period. This significantly supports the individual patients to recover completely from the disease (Steward Health Care, 2015). Thus, it is eminent that the treatment from St Ann’s Hospital is considerably related to specialist services in psychosis. Therapeutic Approaches Used Medications With the objective of recovering a psychosis patient, it is notable that the therapists recommend several medications. This is evident from the above discussions related to CAMHS and GP that provides specialist services relating EIP (Centre for Addiction and Mental Health, 2012). There are some of the oral medications, which are extensively recommended to the psychotic patients that include haloperidol, chlorpromazine, fluphenazine, Haldol and haloperidol lactate, among others (Orygen Youth Health, 2002). Moreover, it is notable that CAMHS and GP also recommend injections to its patients. These include fluphenazine decanoate, haloperidol lactate and fluphenazine (YoungMinds, 2015). The reason behind the recommendations of medications to the psychotic patients is the associated pros through which the patients are benefited. However, it is also deemed that medications to the psychotic patients have some of the significant cons, which considerably affects the patients (Centre for Addiction and Mental Health, 2012). The underneath subheads illustrates the pros and cons of medications to a psychotic patient. Pros of Medications Medications to psychotic patients have some of the significant benefits, which encourage therapists to recommend certain medications. In this regard, it is widely notable that one of the benefits of medication is the quick fixation of the temporary issues. It is eminent that the psychosis individuals, who at instances creates chaos and weird behaviour and attitudes, medications is believed to provide immediate effective result (Freudenreich, 2007). Proper medications during such circumstances provide an opportunity to control over the behaviour and attitude of the individual. The psychosis individuals who have issues regarding improper sleep, medications is also effective in such instances (Rothschild, 2010). Furthermore, it is also worth mentioning that medications provide similar benefit during instances of high depression and anxiety among the psychotic patients. It provides a quick relief to the excited mental state of the patients (Rothschild, 2010). Another benefit of medications to psychotic patients is that medications are easily accessible in comparison to psychological counselling. At immediate instances, it is difficult to provide proper effective counselling to the patients (Rothschild, 2010). However, during such extreme instances, providing medications is relatively easy. Moreover, it is notable that medications are comparatively cheaper than psychological counselling (Freudenreich, 2007). Cons of Medications Although there are some of the pros of medications to psychotic patients, there are some of the decisive cons related to medications for a psychosis patient that implies of its ineffectiveness in recovering individuals from the disease. Medications to the psychotic patients only provide relief to the patients’ body and not to his/her mental state (Rothschild, 2010). In this context, it is important to note that mental disorder is the prime reason for psychosis and thus, ineffectiveness of medications in recovering from such mental disorder has been its major cons (Rothschild, 2010). Furthermore, it is notable that medications only provide temporary relief to the psychotic patients. It is worth mentioning that even though the patients receive relief at extreme situations, the relief is for a temporary basis. The issue rises again after the effect of the medications. Thus, it is eminent that medications to psychosis do not completely recover the patients, which is considered as its major cons (Freudenreich, 2007). Moreover, it is notable that the medications consumed by psychotic patients have some of the considerable side effects. It likely damages the different body organs of an individual. Some of the prominent side effects of medications to psychotic patients include improper kidney functionality, obesity, urinary issues, extreme blood pressure levels, rise or fall in blood sugar level and thyroid diseases among others (Freudenreich, 2007). This significantly discourages some of the psychosis specialist-service organisations like St Ann’s Hospital and CMHT to recommend medications to the patients. In addition, it is worth mentioning that the effectiveness of the medicines reduces in the consequent stages and the issues further increase rapidly. This also implies of the cons of medications to a psychosis patient (Freudenreich, 2007). Social Interventions Social intervention is considered as one of the most effective therapeutic approaches for the effective recovery of a psychosis patient. In this regard, it is notable that all the above-mentioned organisations that provide EIP services to the psychotic patients recommend of the importance of social interventions (Lobban & Barrowclough, 2009). These organisations include CMHT, CAMHS, GP and St Ann’s Hospital. The social interventions provided by these organisations have been considerably effective in appropriate recovery of the psychotic patients. It is also evident that one of the most decisive aspects of social intervention is the family support, which is known as family therapy. The reason behind the effectiveness of social interventions is that it supports the patients to gain confidence in order to recover from the disease (Meaden and Fox, 2015). This is extremely important, as it provides mental relief to the patient. The patients also receive mental relief through enrichment of motivation. In this regard, it is worth mentioning that family members, friends and closed ones are the key individuals, who motivate the patients to recover effectively. It is believed that these individuals are more effective in motivating the patients in comparison to the therapists and nurses. The reason behind such is that the individuals are emotionally attached to his/her family members and the members in his/her community than to the therapists and nurses. Besides this, it is eminent that social interventions including family support to the psychotic patients considerably supports the patients to recover from the disease completely. It supports an individual to revive to his/her normal life (Killackey & et. al., 2008). Killackey & et. al. (2008) also conveyed that social intervention is of considerable use from the perspective of early interventions to psychosis patients. Social interventions supports in the reduction of stress level of the patients. Meaden and Fox (2015) also commented that social interventions are of considerable use in reducing anxiety level. It supports psychotic patients to recover effectively, who are also affected from schizophrenia. Killackey & et. al. (2008) suggested that the psychosis patients within 14 to 35 years have the tendency to be addicted to hallucinogenic drugs. This correspondingly affects the life of the individual up to a considerable extent. In this regard, Killackey & et. al. (2008) commented that social interventions are extremely useful in effective recovery of the individuals. Main Therapeutic Approach Thus, from the above discussion, it is eminent that social intervention and family support is the most suitable approach that leads to the effective recovery of psychotic patients. In this regard, it is worth mentioning that CBT is one of such approaches related to social intervention, which is considered as the main therapeutic approach used by the specialist service providing organisations dealing with EIP (Whitfield & Davidson, 2007). CBT CBT is a type of psychotherapy, which was majorly designed to assist individuals from depression (Westbrook et al, 2011). In the current day context, it is effective against several mental illnesses including psychosis. CBT has been used as an effective intervention process with the aim of mitigating real life issues. In addition, CBT is identified to be a procedure of teaching individuals with psychosis problem to recover from dysfunction behaviour, distress and distorted thinking (Whitfield & Davidson, 2007). It is worth mentioning that psychosis has some of the significant medical uses, which considerably supports in the effective recovery of a psychosis patient. One of such is with regard to anxiety disorders. It is also important to note that CBT supports in dealing with the issues related to psychosis in a positive way based on the interventions provided with the aim of developing skills relating to behaviour, emotion and cognitive aspects (Westbrook et al, 2011). It supports the individual patients to omit negative thoughts and perceptions, which considerably supports in the behavioural change of the individuals. Eventually, it supports individuals to recover from the disease effectively (Whitfield & Davidson, 2007). Pros of CBT There are several and most significant pros of CBT, which considerably encourages psychosis therapists to conduct such practices in order to recover patients. One of such pros is that the process can be executed in a relatively short period of time in comparison to the other therapies such as talking therapy (Westbrook et al, 2011). Thus, the recovery of the patients takes place at a considerably shorter period of time. Besides this, it is worth mentioning that another major advantage of CBT is its effectiveness in recovering psychotic patients in a most effective manner. CBT is considerably effective than medications that are used for recovering psychosis (Westbrook et al, 2011). CBT provides permanent cure to the disease, while medications for psychosis provides temporary relief. Furthermore, another advantage of CBT is that the therapy can be implemented easily. The CBT programme is highly structured and can be implemented in different formats as per the requirements (Hagen et al, 2013). Generally, for recovering psychotic patients, CBT is implemented through groups, computer programmes and self-help books (Wills, 2012). In addition, another benefit of CBT is that the strategies involved in it can be continued after the recovery of the patients. It supports individuals to live in a better manner even after the successful recovery from psychosis. It is also equally important from the perspective of a normal individual to live his/her life in a better way (Whitfield & Davidson, 2007). Cons of CBT Although there are some of the decisive pros related to CBT that encourages therapists to execute such process, there are some of the cons of it, which cannot be avoided. One of such disadvantage of CBT is that it requires considerable amount of commitment and involvement (Westbrook et al, 2011). The psychotic patients and his/her family members require this higher degree of commitment and involvement. At several instances, the community members also require to express higher degree of commitment and involvement. The individuals who are not as effective in expressing such commitments and involvements, correspondingly restricts in effective execution of the CBT process (Hagen et al, 2013). Furthermore, another cons of CBT is that the structured nature of the programme, which restricts the individuals having learning difficulties to incorporate with the strategies. Moreover, it is notable that at instances, CBT is ineffective in identifying the prime cause of the psychosis disease on an individual basis. It is prominently observed that the therapists are ineffective in identifying the unhappy childhood of the patient and other instances, which has caused the disease (Whitfield & Davidson, 2007). Literature Support There are several scholarly articles, which are published in favour of CBT and supports regarding its effectiveness. In this regard, the scholarly article written by Arch & Craske (2009) suggests that the therapeutic treatment is completely on scientific basis and the recovery of the patients through this technique is evidential. Moreover, the recovery of an individual is for long term and there are very few instances, where such an individual recovered through CBT has again affected by psychosis. Meichenbaum et al (2014) also cited that group discussions involved in CBT is one of the best approaches that significantly support individuals to recover from psychosis. The individuals through general interactions and engagement in the society are able to forget the negative perceptions and are effective in recovering from the disease. Kaltenthaler & Cavanagh (2010) suggested that with the advancement of technology, CBT application has been also modified. CBT in the current day context is digitalised, which has been considerably being effective in educating the individuals. Literature Criticism Although there are literature articles that have considerably supported the approach of CBT, some has disregarded the same by starting its limitations and ineffectiveness. In this regard, Ehde et al (2014) suggested that CBT is a complex process and is not understood by many. Moreover, it is eminent that throughout the world, there are considerable numbers of illiterates and thus, digitalisation of CBT as suggested by Kaltenthaler & Cavanagh (2010) is not being effective. Besides this, Ehde et al (2014) also suggested that CBT requires considerable amount of commitment from the patients and his/her family members. In addition, some of the patients are incapable of providing adequate amount of commitment. This restricts to the effectiveness of CBT in recovering psychotic patients. Recovery From the perspective of a psychosis patient, recovery is the retrieval of a psychosis-affected individual to live his/her life in a meaningful and satisfying manner (Wills, 2012). It is the control over self-life by an individual, who has been affected through psychosis. In simpler form, recovery of a psychosis patient is the return of an individual to a normal life (Hagen et al, 2013). Reason of Conducting CBT The prime reason behind CBT is to recover patient from the psychosis disease. It supports individuals to completely recover from the disease and thereby, lead a normal healthy and happy life (Wills, 2012). CBT can also be conducted after the recovery from the disease and considerably supports in leading a healthy life. CBT treatment is provided on the basis of certain phases that include psychological assessment, skills acquisition, generalisation, reconceptualization, skills consolidation and post-treatment examination (Roberts, 2006). Furthermore, it is important to note that CBT is not only practiced among the mentally affected psychotic patients, but to the normal individuals. This also supports the normal individuals to lead a healthy life. Thus, the reason behind conducting CBT is to establish a healthy society throughout the world (Hagen et al, 2013). Process of CBT Contributing to Psychotic Patients Recovery There is a certain process through which CBT is conducted in order to effectively recover psychotic patients. In this regard, there are some of the most effective techniques involved in CBT, which considerably supports in the recovery from psychosis. One of the most decisive techniques is to identify the problem and thereby, brainstorm effectively in order to arrive at a solution to such issues. This is considered as the most effective solution and attribute of CBT in order to recover individuals from psychosis, since it implies of rectifying the root cause for the issue (Whitfield & Davidson, 2007). The technique can be best understood by undergoing a real life instance, wherein if an individual is battling loneliness and has successfully identified the issue. In this respect, effective brainstorming would support an individual to identify an appropriate solution. Contextually, joining a local club or engaging in a sports event would considerably support in resolving the issue (Hagen et al, 2013). Another decisive technique related to CBT that considerably supports in the effective recovery of the individuals affected with psychosis is the determination of a self-statement in order to counter attack the negative thoughts that the individuals possess. This would significantly support the individuals to omit the negative thoughts from his/her perceptions. Furthermore, it would correspondingly support the individuals to possess positive thoughts in place of the negative thoughts (Wills, 2012). Moreover, another technique of CBT includes the identification of the positive thoughts. This would largely motivate an individual to lead his/her life in a better manner. Correspondingly, it would support the individuals to gain confidences and would support to establish a new vision in his/her life (Roberts, 2006). In addition to the above techniques, some of the other attributes of CBT, which supports psychosis-affected individuals to recover effectively includes visualisation of the best parts of each day. This visualisation of the best part of the day is most suitable during night, when an individual is alone or before sleep. This would considerably support the individual to gain confidence and motivation and lead his/her life in a better manner (Simos, 2014). Additionally, another attribute of CBT, which significantly supports in effective recovery of individuals suffering from psychosis, is the acceptance of disappointment from life. It is notable that during the post recovery stage, most of the individuals possess a considerable amount of disappointment regarding his/her activities. However, such disappointments restrict the complete recovery of the individuals (Westbrook & et. al., 2011). Thus, CBT recommends the individuals to learn towards accepting disappointments as a part of life. Conclusion From the course of the study, it is eminent that psychosis has evolved as one of the most decisive issues in the modern era, which is more prominent among individuals between late teen to early thirties. In this regard, it is worth mentioning that psychosis is the mental disorder, wherein an individual losses his/her connections with the reality of life. In order to recover from the disease, specialist service is considered as the most effective treatment for such patients. It is also eminent that specialist service is provided in CAMHS, CMHT, GP and St Ann’s Hospital among several other organisations. By understanding the specialist services, it is identified that there are two forms of therapeutic approach that include medications and social interventions. In addition, from the above study, it can be comprehended that social interventions are more effective than medications with the aim of recovering psychotic patients. Thus, social interventions are practiced in almost every healthcare organisation throughout the world. One of the decisive techniques of social interventions is CBT, which attempts to omit the negative thoughts and perceptions of an individual and simultaneously, attempts to focus on positive thoughts and perceptions. The prime advantage of CBT is its effectiveness in recovering patients in comparison to medications. Moreover, the technique is easily accessible and quickly implemented in recovering the patients. It has been recognised that CBT is ineffective for the individuals who have poor learning capacity. Despite this limitation, it is prominent that CBT is the most effective technique for the recovery of psychotic patients in an effective manner and correspondingly, supports the individuals to live a better life. 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