Innovative Approaches for Difficult-to-treat Populations

Innovative Approaches for Difficult-to-treat Populations
Author: Scott W. Henggeler
Publisher: American Psychiatric Pub
Total Pages: 868
Release: 1997
Genre: Medical
ISBN: 9780880486804

Innovative Approaches for Difficult-to-Treat Populations makes recommendations for developing and disseminating innovative mental health services. It is geared toward clinicians, administrators, and policy-makers struggling to develop both clinically effective and cost-effective mental health and substance abuse services, and it focuses on services for individuals who use the highest proportion of mental health resources and for whom traditional services have not been effective. These target populations include youth with serious behavioral and emotional disturbances and adults with severe and persistent mental illnesses. The innovative approaches reviewed include diverse treatment methods for differing clinical populations. These varied approaches have several common elements: * Social-ecological theory frameworks* An emphasis on delivering flexible, comprehensive, pragmatic, and goal-oriented interventions in persons' natural environments* Increased accountability on the part of service providers* The transition from centralized to community-based care is discussed, and normalizing a patient's daily routine as an important factor in the success of state-of-the-art community support programs is emphasized Innovative Approaches for Difficult-to-Treat Populations offers mental health professionals and students a firsthand look at the future direction of clinical services. Policy issues necessary to developing and disseminating progressive treatments are addressed, including the downsizing of state psychiatric hospitals, strategies for reforming state mental hospital systems, and ethical issues in research on child and adolescent mental disorders.

Field Trials of Health Interventions

Field Trials of Health Interventions
Author: Peter G. Smith
Publisher:
Total Pages: 479
Release: 2015
Genre: Health & Fitness
ISBN: 0198732864

This is an open access title available under the terms of a CC BY-NC 4.0 International licence. It is free to read at Oxford Scholarship Online and offered as a free PDF download from OUP and selected open access locations. Before new interventions are released into disease control programmes, it is essential that they are carefully evaluated in field trials'. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. Descriptions of the detailed procedures and methods used in the trials that have been conducted have rarely been published. A consequence of this, individuals planning such trials have few guidelines available and little access to knowledge accumulated previously, other than their own. In this manual, practical issues in trial design and conduct are discussed fully and in sufficient detail, that Field Trials of Health Interventions may be used as a toolbox' by field investigators. It has been compiled by an international group of over 30 authors with direct experience in the design, conduct, and analysis of field trials in low and middle income countries and is based on their accumulated knowledge and experience. Available as an open access book via Oxford Medicine Online, this new edition is a comprehensive revision, incorporating the new developments that have taken place in recent years with respect to trials, including seven new chapters on subjects ranging from trial governance, and preliminary studies to pilot testing.

Small Clinical Trials

Small Clinical Trials
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 221
Release: 2001-01-01
Genre: Medical
ISBN: 0309171148

Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.

Oxford Textbook of Community Mental Health

Oxford Textbook of Community Mental Health
Author: Graham Thornicroft
Publisher: Oxford University Press, USA
Total Pages: 408
Release: 2011-08-18
Genre: Medical
ISBN: 019956549X

Community mental health care has evolved as a discipline over the past 50 years, and within the past 20 years, there have been major developments across the world. The Oxford Textbook of Community Mental Health is the most comprehensive and authoritative review published in the field, written by an international and interdisciplinary team.

Human Services as Complex Organizations

Human Services as Complex Organizations
Author: Yeheskel Hasenfeld
Publisher: SAGE
Total Pages: 1217
Release: 2010
Genre: Business & Economics
ISBN: 1412956935

This new edition looks at the many recent changes in the arena of Human Sevices Organizations.

Empowering People with Severe Mental Illness

Empowering People with Severe Mental Illness
Author: Donald M. Linhorst
Publisher: Oxford University Press
Total Pages: 368
Release: 2005-09-08
Genre: Social Science
ISBN: 0198038364

The concept of empowerment has become increasingly popular with mental health professionals. But while it is a frequently cited goal in the helping professions, empowerment is often nothing more than a buzzword that lacks specificity and grounding in real-world applications. Consequently, little practical guidance exists demonstrating how to achieve it in specific instances with specific groups of people. This book is the first professional guide that operationalizes the theory of empowerment, outlines the conditions under which it is likely to occur, and applies a practical model for working with people with severe mental illness. In this unique and thoroughly researched volume, Donald Linhorst analyzes the conditions that facilitate empowerment and provides the framework necessary to bolster this historically powerless population's access to the material and cultural resources they need to regain control of their lives. Chapters illustrate how to foster empowerment in treatment planning, housing selection, organizational decision making, mental health service planning and policy making, employment, participation in research and evaluation, and consumer provision of mental health and support services. Case studies from a public psychiatric hospital and a community mental health agency illustrate each of the seven areas and present evidence of the model's efficacy. Finally, the book maps out the roles that service providers, administrators, policy makers, advocacy groups, researchers, and clients can play in the empowerment process. Checklists, step-by-step instructions, historical overviews, and vivid examples make this a valuable teaching tool, planning guide, and everyday reference for mental health professionals seeking an innovative and evidence-based approach to working with their clients with severe mental illness.

The Prevention and Treatment of Missing Data in Clinical Trials

The Prevention and Treatment of Missing Data in Clinical Trials
Author: National Research Council
Publisher: National Academies Press
Total Pages: 163
Release: 2010-12-21
Genre: Medical
ISBN: 030918651X

Randomized clinical trials are the primary tool for evaluating new medical interventions. Randomization provides for a fair comparison between treatment and control groups, balancing out, on average, distributions of known and unknown factors among the participants. Unfortunately, these studies often lack a substantial percentage of data. This missing data reduces the benefit provided by the randomization and introduces potential biases in the comparison of the treatment groups. Missing data can arise for a variety of reasons, including the inability or unwillingness of participants to meet appointments for evaluation. And in some studies, some or all of data collection ceases when participants discontinue study treatment. Existing guidelines for the design and conduct of clinical trials, and the analysis of the resulting data, provide only limited advice on how to handle missing data. Thus, approaches to the analysis of data with an appreciable amount of missing values tend to be ad hoc and variable. The Prevention and Treatment of Missing Data in Clinical Trials concludes that a more principled approach to design and analysis in the presence of missing data is both needed and possible. Such an approach needs to focus on two critical elements: (1) careful design and conduct to limit the amount and impact of missing data and (2) analysis that makes full use of information on all randomized participants and is based on careful attention to the assumptions about the nature of the missing data underlying estimates of treatment effects. In addition to the highest priority recommendations, the book offers more detailed recommendations on the conduct of clinical trials and techniques for analysis of trial data.

Therapy in the Real World

Therapy in the Real World
Author: Nancy Boyd-Franklin
Publisher: Guilford Press
Total Pages: 402
Release: 2013-06-03
Genre: Psychology
ISBN: 1462510345

Helping beginning and experienced therapists cope with the myriad challenges of working in agencies, clinics, hospitals, and private practice, this book distills the leading theories and best practices in the field. The authors provide a clear approach to engaging diverse clients and building rapport; interweaving evidence-based techniques to meet therapeutic goals; and intervening effectively with individuals, families, groups, and larger systems. Practitioners will find tools for addressing the needs of their clients while caring for themselves and avoiding burnout; students will find a clear-headed framework for making use of the variety of approaches available in mental health practice.

Home Treatment for Acute Mental Disorders

Home Treatment for Acute Mental Disorders
Author: David S. Heath
Publisher: Routledge
Total Pages: 299
Release: 2005-09-26
Genre: Medical
ISBN: 1135953066

In the U.S., when a patient is in need of rigorous psychiatric care, the first step is hospitalization. However, elsewhere in the world, psychiatric home treatment is proposed as an alternative. Model programs in Canada and the United Kingdom are publicly administered by community health agencies or teaching hospitals. Home Treatment for Acute Mental Disorders provides a review of the literature on home care and describes working programs around the world. This timely volume reviews treatment plans for different disorders with case illustrations, explains the administration of a PHC program and offers guidelines to case workers. It will be of interest to psychiatrists and policy makers working on the issue of patient hospitalization.