2013 Up Coming SUNLOWS
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The document summarizes seminars from the SUNLOWS 2013 seminar series on research studies related to mental health. It describes 6 studies presented at various seminars, including studies on caregiving for those with psychosis, interventions to assist caregivers of people with anorexia nervosa, service users' experiences of recovery programs, and a study comparing family therapy approaches for at-risk youth. The studies covered topics like developing models of caregiver relationships, how caregiver traits impact patient functioning, reducing caregiver distress and improving coping skills, and investigating treatment approaches for conditions like anorexia nervosa and antisocial behavior in youth.
2013 Up Coming SUNLOWS
- 1. The Mental Health Research Network is part of the National Institute for Health Research and supports studies in England. SUNLOWS 2013 SEMINARS A collaboration between the North London and the South London & South East Hub of the NIHR MHRN www.sunlows.org.uk ■ May 31 2013 2pm - 4pm Dr Juliana Onwumere will present two studies relating to improving relationships in psychosis. Study Status: Closed A cognitive model of caregiving in psychosis: There is a long history of research into the attributes of carers of people with psychosis, but few interventions target their distress or their difficulties. The study aims to describe an empirically based model of the relationships of those caring for people with psychosis to inform clinical and theoretical advances. The study team developed a model of informal carer relationships in psy- chosis, based on an integration of the literature and elaborating on the concept of expressed emotion. The model accounts for divergent outcomes of three relationship types: positive, over- involved and critical/hostile relationships. Needs for closure in caregivers of people with psychosis: The aim of the study was to determine how carer need for closure relates to expressed emotion. It also examined the links between carer need for closure and patient functioning including patient need for closure. In a cross-sectional study, 70 caregivers of patients with psychosis completed the Need for Closure Scale (NFCS), the Camberwell Family Interview (CFI) and measures of distress, burden, coping and social network. The NFCS was assessed in terms of its two pri- mary dimensions: a need for simple structure (NFSS) and Decisiveness. Patients also completed measures of psychotic symptoms and affect, and in 50 matched caregiver patient dyads, direct comparisons were undertaken between caregiver and patient NFCS scores. ■ June 28 2013 24th 2pm - 4pm ECHO/CASIS – A presentation by Charlotte Rhind and Rebecca Hibbs Both studies relate to interventional research into assisting those caring for someone diagnosed with Anorexia Nervosa. ECHO Status of Study: Open Carers of people with Anorexia Nervosa (AN) experience high levels of distress and burden and as well can respond to the illness in ways that can maintain the symptoms of AN. Also, family interven- tions have the most success in AN but it is unclear how they work and there is a need for research to define the process by which interventions exert their effects. Expert Carers Helping Others (ECHO) is a self directed intervention for carers that aims to reduce their distress, burden and improve their self efficacy and coping skills. In addition, specific communication strategies are taught to enable carers to encourage behaviour change within the person they care for. Previous research has found
- 2. ECHO benefits community samples of carers but there is no objective data from patients so it is unclear whether they intervention has subsidiary effects on those with AN. This pilot study (ECHO) will examine whether ECHO is helpful for a sample of carers who care for a young person with AN who is receiving outpatients, and whether the patients benefit at 12 month follow up. In addition, this project will test whether additional telephone support enhances the effects of the self help version of the intervention. CASIS Status of Study: Closed Anorexia nervosa is one of the commonest chronic conditions in adolescence and has profound physical, psychological, developmental and psychosocial effects on the individual and her/his family and has large care costs for society. The NICE guidelines concluded that there was insufficient evi- dence to make confident treatment recommendations for anorexia nervosa. One factor that makes interpretation of RCT evidence difficult is poor adherence to treatment. In part this is because of poor patient acceptability for interventions including nutritional advice, medication, inpatient treat- ment and CBT but in addition clinicians intervene to change treatment (increase the intensity eg in- patient treatment) if treatment effectiveness is poor. In contrast to individual interventions those that involve the family are effective and acceptability appears to be less of a problem. Eating disorders have a profound interpersonal impact. The quality of life of family members is severely impaired and stress levels are high. This contributes to high expressed emotion, which in turn has been found to impact negatively on the course of the illness. In addition families accommodate to eating disorder behaviours and this can also maintain the disorder. Educational interventions for families in the form of groups or training materials have been shown to improve the wellbeing of family members and possibly also positively impact on the course of the eating disorder. A period of partnership working between academics in the UK, BEAT and individual carers and users has led to the development of a variety of training and self help materials (books, DVD, web) to facilitate the care giving role. These materials supplemented with guidance (telephone coaching, workshops, CASIS) improve carer well being and reduce factors that negatively impact on the course of the illness. ■ July 26 2013 2pm - 4pm CPA and Recovery – A presentation by Dorothy Gould Service users’ experiences of recovery under the 2008 Care Programme Approach Status of Study: Closed This study was set up to explore how effective service users find the 2008 Care Programme Ap- proach in promoting recovery as they understand it, to put forward their views and recommenda- tions about the recovery role of the Approach as well as to produce a checklist of good practice for mental health professionals involved in this Approach. Dorothy Gould will present the results of the study. ■ August 30 2013 2pm - 4pm START: ‘Systemic Therapy For At Risk Teens’ presented by Dr. Stephen Butler and Angeline Dharmaindra Status of Study: Closed START is a major research study spread across 9 areas in the UK investigating a form of interven- tion for young people and their families who are experiencing difficulties at home, at school and sometimes with the law. This way of helping young people and their families is new to the UK. The research team aim to compare Multisystemic Therapy (MST) with other services that are currently offered to young people and their families who are considered to be at ‘high risk’ of requiring out-of-home care such as foster- ing, social care or custody if associated with antisocial behaviour such as conviction as a young offender. For more information please contact: [email protected]