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Examined the public's perceptions relative to the effectiveness of psychotherapy and counselling, expectations of treatment efficacy for different psychotherapy and counselling providers, professional characteristics, and factors influencing treatment utilization. 173 adults were administered questionnaires to assess global perception of 8 psychotherapy and counselling fields in the treatment of 26 mental problems. Results show that psychotherapy/counselling was perceived to be moderately effective. The perceived amount of time necessary for significant improvement in psychotherapy was 4 mo, and the expected length of treatment was 8 mo. Ss reported discernible differences among the 8 psychotherapy/counselling providers in terms of treatment efficacy. Differences were also found in the relative perception of providers' personal/professional qualities and characteristics.  

Cost-effectiveness of referral for generic care or problem-solving treatment from community mental health nurses, compared with usual general practitioner care for common mental disorders.

Kendrick, T., Simons, L., Mynors-Wallis, L., Gray, A., Lathlean, J. & Pickering, R. (2006). British Journal of Psychiatry, 189(1), 50-59.

Background: UK general practitioners (GPs) refer patients with common mental disorders to community mental health nurses. Aims: To determine the effectiveness and cost-effectiveness of this practice. Method: Randomised trial with three arms: usual GP care, generic mental health nurse care, and care from nurses trained in problem-solving treatment; 98 GPs in 62 practices referred 247 adult patients with new episodes of anxiety, depression and life difficulties, to 37 nurses. Results: There were 212 (86%) and 190 (77%) patients followed up at 8 and 26 weeks respectively. No significant differences between groups were found in effectiveness at either point. Mean differences in Clinical Interview Schedule-Revised scores at 26 weeks compared with GP care were -1.4 (95% CI -5.5 to 2.8) for generic nurse care, and 1.1 (-2.9 to 5.l)for nurse problem-solving. Satisfaction was significantly higher in both nurse-treated groups. Mean extra costs per patient were £283 (95% CI 154-411) for generic nurse care, and £315 (183-481) for nurse problem-solving treatment. Conclusions: GPs should not refer unselected patients with common mental disorders to specialist nurses. Problem-solving should be reserved for patients who have not responded to initial GP care.  

Effectiveness of training of non-mental health care providers in mental health in low- and middle-income countries: A systematic review

Painuly, N. & Sharan, P. (2008). Primary Care & Community Psychiatry, 13(2), 83-89.

Objectives: (1) To review the available studies on training of non-mental healthcare providers in mental health in low- and middle-income countries. (2) To assess the combined effect of training in knowledge and skills of the participants through meta-analysis. Methods: A literature search yielded 10 studies that matched the inclusion criteria. Meta-analysis was carried out to assess the change (pre-post) in knowledge and diagnostic ability of the participants. Results: Very few studies are available in this area and their methodologies are not robust. Participants are mostly general physicians or nurses and other health workers or a combination of these. Content and schedule of training was variable across studies. Analysis of pooled data based on a fixed-effect model demonstrated a significant improvement in participants' knowledge. However, there was significant heterogeneity among studies assessing diagnostic skills of the participants. A reanalysis utilizing the random-effect model demonstrated a significant improvement in diagnostic sensitivity of the participants but no significant change in diagnostic specificity. Number needed to train analysis showed that training made one in three participants-significantly better with regard to their knowledge and ability (sensitivity) to diagnose mental illness. However, training had a very limited effect on improvement of specificity of diagnosis.

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