Short course
2.3
Collaborative care
Full text
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© 1998 MJA
| Treating the whole problem: targets and interventions for patients
with chronic psychiatric illness
The treatment of patients with chronic psychiatric disorders has to address not only symptoms, but the consequences of the illness in social and occupational domains.
|
Target for intervention | Intervention |
|
| Psychosis (delusions, hallucinations, disordered thinking)
| Antipsychosis medication; counselling -- reality reinforcement,
support
|
| Social and emotional deficits (flat affect, poverty of thinking, social
withdrawal, lack of motivation) | Counselling,
encouragement to join activity groups/programs, case management to access
rehabilitation activities
|
| Cognitive deficits (poor concentration, memory problems, poor
problem-solving and executive function)
| Counselling -- assistance with planning for goals, memory prompts, assistance in
task performance by allied health/nursing professionals
|
| Mood disorder (depression, mania, anxiety)
| Medication,
counselling, cognitive psychotherapy
|
| Functional deficits (in intimate relationships, social network,
occupation, basic living skills) | Assistance
to engage in occupational therapy, social skills training, training in activities
of daily living, occupational rehabilitation (e.g., job support
clubs)
|
| Physical state (including alcohol/drug use)
| Assessment, treatment
for specific physical disorders (e.g., heart disease and airway
disease -- more common in alcoholics), nutritional and dental
hygiene, encouragement to reduce alcohol/drug use
|
| Effects on carers and community
| Support groups (service-initiated
and self-help), education about illness, counselling -- assistance
with problem-solving, psychotherapy (e.g., for the family)
|
| Social handicaps (financial resources, housing, stigma) | Financial
assistance, housing, assistance with good attainment (e.g.,
finding and joining a social program)
|
|
|
