THERAPUTIC-MODALITIES.pptx
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This document discusses different approaches in therapeutic modalities. It notes that therapeutic modalities focus on overall lifestyle changes and recovery rather than just interpreting drug use or attaining abstinence. Building good therapeutic relationships through mutual trust, respect, shared decision-making and engagement is discussed. The costs of different modalities are justified by reduced admissions to institutions. Establishing networks of therapeutic modalities can provide evidence-based practices and quality improvement. Different components and practices of therapeutic modalities approaches are also outlined.
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*Lecturer in Qualitative Mental Health Research, Division of Psychiatry, UCL, London, tLecturer Jn Psychology, Department of
Psychology, Anglia Ruskin University, Cambridge and tProfessor, Department of Education and Social Care, Anglia Ruskin
University, Cambridge, UK
Correspondence
Nicola Morant PhD
Division of Psychiatry
UCL
Maple House
149 Tottenham Court Road
London WlT 7NF
E-mail: [email protected]
Accepted for publication
9 July 2015
Keywords: doctor-patient
communication, mental health, patient
involvement, psychiatric medication,
psychiatry, shared decision making
Abstract
Background Mental health care has lagged behind other health-care
domains in developing and applying shared decision making (SOM)
for treatment decisions. This is despite compatibilities with ideals of
modern mental health care such as self-management and recovery-
oriented practice, and growing policy-level interest. Psychiatric med-
ication is a mainstay of mental health treatment, but there are
known problems with prescribing practices, and service users report
feeling uninvolved in medication decisions and concerned about
adverse effects. SOM has potential to produce better tailoring of
psychiatric medication to individuals' needs.
Objectives This conceptual review argues that several aspects of
mental health care that differ from other health-care contexts (e.g.
forms of coercion, questions about service users' insight and disem-
powerment) may impact on processes and possibilities for SOM. It
is therefore problematic to uncritically import models of SOM devel-
oped in other health-care contexts. We argue that decision making
for psychiatric medication is better understood in a broader way that
moves beyond the micro-social focus ofa medical consultation. Con-
textualizing specific medication-related consultations within longer
term relationships, and broader service systems enables recognition
of the multiple processes, actors and agendas that shape how psychi-
atric medication is prescribed, managed and used, and which may
facilitate or impede SOM.
Conclusion A broad conceptualization of decision making for psy-
chiatric medication that moves beyond the micro-social can account
for why SOM in this domain remains a rarity. It has both conceptual
and practical utility for evaluating research evidence, identifying
future research priorities and highlighting fruitful ways of develop-
ing and implementing SOM in mental health care.
1002 © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd., 19, pp.1002-1014
This is an open access article under the terms of the Creative Commons Attribution license,
which permits use, distributlon and reproduction in any medium, provided the original work Is properly cited.
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psychiatry, shared decision making
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Background Mental health care has lagged behind other health-care
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oped in other health-care contexts. We argue that decision making
for psychiatric medication is better understood in a broader way that
moves beyond the micro-social focus ofa medical consultation. Con-
textualizing specific medication-related consultations within longer
term relationships, and broader service systems enables recognition
of the multiple processes, actors and agendas that shape how psychi-
atric medication is prescribed, managed and used, and which may
facilitate or impede SOM.
Conclusion A broad conceptualization of decision making for psy-
chiatric medication that moves beyond the micro-social can account
for why SOM in this domain remains a rarity. It has both conceptual
and practical utility for evaluating research evidence, identifying
future research priorities and highlighting fruitful ways of develop-
ing and implementing SOM in mental health care.
1002 © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd., 19, pp.1002-1014
This is an open access article under the terms of the Creative Commons Attribution license,
which permits use, distributlon and reproduction in any medium, provided the original work Is properly cited.
Psychiatr ...
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- 2. APPROCHES IN THERAPEUTIC MODALITIES Approaches in therapeutic modalities have recovery orientation, focusing in the whole person and overall lifestyle changes. A RECOVERY ORIENTATION is different from an acute care model which focuses on interpreting drug use and helping the patient attain abstinence during treamet episodes rather than overall lifestyle. 2
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