Treatment Models (treatment + models)

Distribution by Scientific Domains

Selected Abstracts

Treatment models, brand names, acronyms and evidence-based practice

Ivan Eisler
No abstract is available for this article. [source]

Behaviour problems in childhood and adolescence in psychotic offenders: an exploratory study

Kris Goethals
Background,Several studies have shown that adults who develop schizophrenia and commit a criminal offence may already have shown behaviour problems in childhood or adolescence. It is less clear whether such problems follow a particular pattern in such patients. Aims,To examine the utility of the Child Behavior Checklist (CBCL) among offenders, to test whether externalizing behaviour problems, as measured by the CBCL, are more frequent in psychotic offenders than in non-offenders with psychosis, and to investigate relationships between early behavioural problems and adult personality disorder in psychotic offenders. Methods,Three groups of violent offenders detained under the Dutch Entrustment Act (TBS-detainees)(n = 78) and one group of psychotic patients in general psychiatry (n = 16) were rated from case records on the CBCL. Results,There was a significant difference between psychotic offenders with a personality disorder (n = 25) and the non-offender patients with psychosis (n = 16) on the ,delinquent behavior' scale, but no such difference between psychotic offenders with (n = 25) and without (n = 21) personality disorder. A hierarchic cluster analysis revealed significantly higher scores for externalizing behaviour in all TBS-detainees with a personality disorder. Those starting to offend early had higher scores for externalizing behaviour than late starters. Conclusions,Psychotic and non-psychotic offenders with personality disorder resemble one another in their early childhood behaviour problems; psychotic offenders without a personality disorder differ from these two groups but resemble non-offenders with psychosis. In contrast to findings in non-forensic populations, there were no differences on other problem scales of the CBCL. Given the small sample sizes, replication is needed, but the findings lend weight to treatment models which focus on the psychosis in the latter two groups but extend also to personality disorder in the former. Copyright 2008 John Wiley & Sons, Ltd. [source]

Neurodevelopmental outcomes of children with low-grade gliomas

M. Douglas Ris
Abstract As a group, children with low-grade gliomas (LGGs) enjoy a high rate of long-term survival and do not require the intensity of neurotoxic treatments used with higher risk pediatric brain tumors. Because they are generally considered to have favorable neurobehavioral outcomes, they have not been studied as thoroughly as higher-grade brain tumors by late-effects researchers. In this article, we review the literature on the neurobehavioral effects associated with low-grade gliomas and conclude that, (1) this is a large, understudied group of survivors of pediatric brain tumors; (2) recent small- and large-scale studies document increased risk in multiple cognitive-behavioral domains after treatment for LGGs compared with healthy peers; (3) such risk is not uniform but varies with tumor location and treatments; and (4) a life span development perspective is essential to a complete understanding of the risks faced by these children. More research on the most efficacious biopsychosocial treatment models for improving the outcomes of survivors of low-grade glioma is recommended, informed by a better understanding of theireducational needs. Investigations of genetic influences on outcome as well as prospective studies of these patients as they age are also recommended. 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:196,202. [source]

Community forensic psychiatry: restoring some sanity to forensic psychiatric rehabilitation

J. Skipworth
Objective:, To review clinical and legal paradigms of community forensic mental health care, with specific focus on New Zealand, and to develop a clinically based set of guiding principles for service development in this area. Method:, The general principles of rehabilitating mentally disordered offenders, and assertive community care programmes were reviewed and applied to the law and policy in a New Zealand forensic mental health setting. Results: There is a need to develop comprehensive community treatment programmes for mentally disordered offenders. The limited available research supports assertive community treatment models, with specialist forensic input. Ten clinically based principles of care provision important to forensic mental health assertive community treatment were developed. Conclusion:, Deinstitutionalization in forensic psychiatry lags behind the rest of psychiatry, but can only occur with well-supported systems in place to assess and manage risk in the community setting. The development of community-based forensic rehabilitation services in conjunction with general mental health is indicated. [source]

Eating disorders in adults with intellectual disability

S. Gravestock
Abstract There is an increasing focus on the nutrition of people with intellectual disability (ID), but less interest in the range of eating disorders (EDs) that they may exhibit and the bio-psycho-social impact of these conditions. Despite diagnostic and methodological difficulties, psychopathology and ED research studies suggest that 3,42% of institutionalized adults with ID and 1,19% of adults with ID in the community have diagnosable EDs. Weight surveys indicate that 2,35% of adults with ID are obese and 5,43% are significantly underweight, but the contribution of diagnosable EDs is unknown. Such data and case reports suggest that EDs are associated with considerable physical, behavioural, psychiatric and social comorbidity. Review papers have focused on the aetiology and treatment of pica, rumination, regurgitation, psychogenic vomiting and food faddiness/refusal. Emerging clinical issues are the development of appropriate diagnostic criteria, multimodal assessment and clinically effective treatment approaches. Key service issues include staff training to improve awareness, addressing comorbidity and access issues, and maintaining support for adults with ID and EDs, and their carers. Research should confirm the multifaceted aetiology and comorbidity of EDs. Then multicomponent assessment and treatment models for EDs can be developed and evaluated. [source]

Service delivery in older patients with bipolar disorder: a review and development of a medical care model

Amy M Kilbourne
Objectives:, Medical comorbidities, especially cardiovascular disease (CVD), occur disproportionately in older patients with bipolar disorder. We describe the development, implementation, and feasibility/tolerability results of a manual-based medical care model (BCM) designed to improve medical outcomes in older patients with bipolar disorder. Methods:, The BCM consisted of (i) self-management sessions focused on bipolar disorder symptom control, healthy habits, and provider engagement, (ii) telephone care management to coordinate care and reinforce self-management goals, and (iii) guideline dissemination focused on medical issues in bipolar disorder. Older patients with bipolar disorder and a CVD-related risk factor (n = 58) were consented, enrolled, and randomized to receive BCM or usual care. Results:, Baseline assessment (mean age = 55, 9% female, 9% African American) revealed a vulnerable population: 21% were substance users, 31% relied on public transportation, and 22% reported problems accessing medical care. Evaluation of BCM feasibility revealed high overall patient satisfaction with the intervention, high fidelity (e.g., majority of self-management sessions and follow-up contacts completed), and good tolerability (dropout rate <5%). Use of telephone contacts may have mitigated barriers to medical care (e.g., transportation). Conclusions:, The BCM is a feasible model for older, medically ill patients with bipolar disorder, and could be an alternative to more costly treatment models that involve co-location and/or additional hiring of medical providers in mental health clinics. Future research directions pertinent to the development of the BCM and other medical care models for older patients with bipolar disorder include assessment of their long-term effects on physical health and their cost-effectiveness across different treatment settings. [source]