Psychological intervention

About: Psychological intervention is a research topic. Over the lifetime, 82654 publications have been published within this topic receiving 2608356 citations.

From the World Health Organization. Mental health: new understanding, new hope.

Abstract: As I write these words in mid October I reflect on the way in which we have, during the past 4 weeks, expressed our shared grief in understanding, sympathy, and support for those affected by posttraumatic stress. We are reminded of the extraordinary ability of humans tocopewithextremesofemotion,tohelp each other, and to handle fear, pain, and loss. We work together to preserve our mental health. We see nothing wrong, or mysterious, in our coping mechanisms. But we do not expect people to have to cope alone, in isolation. We understandtheneedforhelpandguidance. As health care professionals, we know that mental illness is not a personal failure. If there is failure, it is in the way society in general and the health sector in particular have responded to people with mental and neurological disorders. By separating mental health care from physical health care—and often separating those who have mental illness from society—the health care profession has reinforced stigma, making successful treatment much harder. I see this as a time of opportunity for change, and I agree strongly with an earlier JOURNAL article by US Surgeon General David Satcher ( JAMA. 2001; 285:1697). Every country can and should begin now to improve its efforts to treat people with mental illness. A recent WHO global survey of mental health policy issues, Atlas of Mental HealthResources in theWorld2001 (http:// www.who.int/mental health/Publication Pages/Pubs 2001.html), found that 40% of the 185 countries surveyed have no national mental health policy, 30% have no programs to improve mental health conditions, and 25% have no specific mental health legislation. Well over one third (37%) of the countries have no community care facilities. The global toll of mental illness and neurological disorders is staggering. Neuropsychiatric disorders account for 31% of the disability in the world— and they affect rich and poor nations and individuals alike. According to the World Health Report 2001, Mental Health: New Understanding, New Hope (http://www.who.int/whr/), 450 million people have a mental or neurological disorder. Of these, 121 million have depression and 50 million have epilepsy. Every year, 1 million people commit suicide and 10 million to 20 million attempt suicide. A great deal of this suffering is unnecessary. We know, for instance, that 60% of those with major depression can fully recover if treated. However, in both industrialized and developing countries, less than 25% of those affected receive treatment, for reasons that include stigma, discrimination, scarce resources, lack of skills in primary health care, and deficient public health policies. The treatment gap is similar or greater for many other easily treatable mental and neurological disorders. Because people do not get the care they need, these disorders impose a range of social and economic costs on individuals, households, employers, and society, ranging from the cost of care to the cost of lost productivity. Solutions based on scientific evidence are available and affordable. Through recent advances in neuroscience, neuroimaging, genetics, and behavioral sciences, we know more about brain functioning and behavior than ever before. Breakthroughs in therapy and medication have occurred. In the World Health Report 2001, WHO summarizes current knowledge about mental and neurological disorders: the global burden, current level of care, latest knowledge about causes and treatment, and ongoing efforts to reform mental health care. The report concludes with 10 recommendations on how governments can strengthen their country’s mental health care: • provide treatment for mental disorders within primary care; • ensure that psychotropic drugs are available; • replace large custodial hospitals with community care facilities backed by general hospital psychiatric beds and home care support; • launch public awareness campaigns to overcome stigma and discrimination; • involve communities, families, and consumers in decision making on policies and services; • establish national policies, programs, and legislation; • train mental health professionals; • link mental health with other social sectors; • monitor community mental health; and • support more research. The report outlines three scenarios to help guide countries and population groups, depending on the resources available and the current status of mental health care in each country. Regarding treatment, for example, if even the poorest countries could ensure that the five most needed psychotropic drugs were available in all health care settings, we could ease the suffering of millions of people. If many middle-income countries could use the experiences of others as a guide and initiate pilot projects for community care, parts of or entire custodial institutions could be shut down, and the financial savings could strengthen further community care activities. If some of the richest countries could review their health care financing rules to ensure parity between mental and physical health problems, a major obstacle to treatment could be removed. We need to speed up and strengthen care for the mentally ill. —Gro Harlem Brundtland, MD, MPH Director-General World Health Organization FROM THE WORLD HEALTH ORGANIZATION

Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood.

Abstract: Is early preventive intervention effective in enhancing parental sensitivity and infant attachment security, and if so, what type of intervention is most successful? Seventy studies were traced, producing 88 intervention effects on sensitivity (n = 7,636) and/or attachment (n = 1,503). Randomized interventions appeared rather effective in changing insensitive parenting (d = 0.33) and infant attachment insecurity (d = 0.20). The most effective interventions used a moderate number of sessions and a clear-cut behavioral focus in families with, as well as without, multiple problems. Interventions that were more effective in enhancing parental sensitivity were also more effective in enhancing attachment security, which supports the notion of a causal role of sensitivity in shaping attachment.

Interprofessional education: effects on professional practice and healthcare outcomes (update)

Abstract: BACKGROUND: The delivery of effective, high-quality patient care is a complex activity. It demands health and social care professionals collaborate in an effective manner. Research continues to suggest that collaboration between these professionals can be problematic. Interprofessional education (IPE) offers a possible way to improve interprofessional collaboration and patient care. OBJECTIVES: To assess the effectiveness of IPE interventions compared to separate, profession-specific education interventions; and to assess the effectiveness of IPE interventions compared to no education intervention. SEARCH METHODS: For this update we searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE and CINAHL, for the years 2006 to 2011. We also handsearched the Journal of Interprofessional Care (2006 to 2011), reference lists of all included studies, the proceedings of leading IPE conferences, and websites of IPE organisations. SELECTION CRITERIA: Randomised controlled trials (RCTs), controlled before and after (CBA) studies and interrupted time series (ITS) studies of IPE interventions that reported objectively measured or self reported (validated instrument) patient/client or healthcare process outcomes. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed the eligibility of potentially relevant studies. For included studies, at least two review authors extracted data and assessed study quality. A meta-analysis of study outcomes was not possible due to heterogeneity in study designs and outcome measures. Consequently, the results are presented in a narrative format. MAIN RESULTS: This update located nine new studies, which were added to the six studies from our last update in 2008. This review now includes 15 studies (eight RCTs, five CBA and two ITS studies). All of these studies measured the effectiveness of IPE interventions compared to no educational intervention. Seven studies indicated that IPE produced positive outcomes in the following areas: diabetes care, emergency department culture and patient satisfaction; collaborative team behaviour and reduction of clinical error rates for emergency department teams; collaborative team behaviour in operating rooms; management of care delivered in cases of domestic violence; and mental health practitioner competencies related to the delivery of patient care. In addition, four of the studies reported mixed outcomes (positive and neutral) and four studies reported that the IPE interventions had no impact on either professional practice or patient care. AUTHORS' CONCLUSIONS: This updated review reports on 15 studies that met the inclusion criteria (nine studies from this update and six studies from the 2008 update). Although these studies reported some positive outcomes, due to the small number of studies and the heterogeneity of interventions and outcome measures, it is not possible to draw generalisable inferences about the key elements of IPE and its effectiveness. To improve the quality of evidence relating to IPE and patient outcomes or healthcare process outcomes, the following three gaps will need to be filled: first, studies that assess the effectiveness of IPE interventions compared to separate, profession-specific interventions; second, RCT, CBA or ITS studies with qualitative strands examining processes relating to the IPE and practice changes; third, cost-benefit analyses.

Psychosocial work environment and mental health--a meta-analytic review

Abstract: Objectives To clarify the associations between psychosocial work stressors and mental ill health, a meta-analysis of psychosocial work stressors and common mental disorders was undertaken using longitudinal studies identified through a systematic literature review. Methods The review used a standardized search strategy and strict inclusion and quality criteria in seven databases in 1994–2005. Papers were identified from 24 939 citations covering social determinants of health, 50 relevant papers were identified, 38 fulfilled inclusion criteria, and 11 were suitable for a meta-analysis. The Comprehensive Meta-analysis Programme was used for decision authority, decision latitude, psychological demands, and work social support, components of the job-strain and iso-strain models, and the combination of effort and reward that makes up the effort–reward imbalance model and job insecurity. Cochran’s Q statistic assessed the heterogeneity of the results, and the I2 statistic determined any inconsistency between studies. Results Job strain, low decision latitude, low social support, high psychological demands, effort–reward imbalance, and high job insecurity predicted common mental disorders despite the heterogeneity for psychological demands and social support among men. The strongest effects were found for job strain and effort–reward imbalance. Conclusions This meta-analysis provides robust consistent evidence that (combinations of) high demands and low decision latitude and (combinations of) high efforts and low rewards are prospective risk factors for common mental disorders and suggests that the psychosocial work environment is important for mental health. The associations are not merely explained by response bias. The impact of work stressors on common mental disorders differs for women and men.