Care in the Community (Social Approach) A treatment for schizophrenia.

Map to Spec – Page Content i. Describe and evaluate one treatment/therapy from each of the following approaches: Care in the Community  The Social Approach: either Family Therapy or Care in the Community programmes (Schizophrenia – biological and cognitive, anorexia – psychodynamic and learning)

care in the community  What do you think a care in the community treatment programme is likely to involve?  What will the main aim/focus be?

Background  50s/60s – traditional treatment of patients in mental hospitals was criticised  What criticisms of mental institutes do you think could be made? (think in terms of effect on patients)

Background  70s/80s – move towards treating patients in the community  Thought to be better at rehabilitating patients so that they can cope in society and maintain independence

Care in the Community  According to the social approach, mental disorders can be triggered by factors in our environment.  Support is provided so clients are able to deal with the environmental factors thought to trigger/exacerbate their mental illness

Care in the Community  Aims to rehabilitate the patient and ensures that they can function as normal as possible in society, independently.  Includes sheltered accommodation, with 24 hour care available for those who can’t cope on their own.  Care staff provide help and support when it is needed although residents are encouraged to be as independent as they can.  Those who need to be admitted to hospital are done so but only on a short-term basis, with the aim of getting them back into the community as soon as possible – REVOLVING DOOR POLICY

Assertive Community Therapy (ACT)  “Hands-on” therapy – a form/model of care in the community  Focuses on patients that need the most support – poor social skills, can’t live independently  HOLLISTIC APPROACH – looks at all the individual’s needs, works with other professionals, offers support/counselling etc…

Task  Complete the gap-fill activity

advertise A local clinic wants to advertise for lead workers for their community care programme. job description TASK - Write a job description for the role of a staff member within a care in the community programme. (HINT: Think about skills/qualities needed, possible hours, relationship with clients, tasks, responsibilities, etc…)

Job description of staff within Care in the Community Programmes  You will need to work within a professional team to support clients so good personal skills are essential  You will need to learn what the specific needs of a client are including the signs/symptoms of disorders  You will need to build up trust so that the client is willing to turn to you for support  It is important to work to the best interests of the client such as realising when and when not to keep confidentiality  You must be willing to work flexible hours as sometimes a crisis develops and you will be on call  You may be required to deliver other support such as counselling or checking a client is taking their medication

Task  Imagine you are a service manager,  What questions would you want answered before investing in care in the community training for your staff?

Suitable themes would include:  cost-effectiveness,  extent that patients experience improvement  effects on staff delivering the programme,  patient satisfaction,  patient empowerment,  ability to meet needs of a diverse community

Do care in the community programmes work?  tDpWHVFY tDpWHVFY

Task  What questions would you want answered before investing in care in the community training for your staff?  Use the evidence provided to attempt to answer your questions  Draw conclusions – will you invest?

Strengths of Care in the Community  Trauer et al. (2001) found that it improved the quality of life of patients.  Leff (1997) found that schizophrenics had less severe symptoms when they were put in long term sheltered accommodation as opposed to hospitalisation.  It has been shown that patients prefer care in the community to hospitalisation.

Weaknesses of Care in the Community  Lack of co-ordination can leads to inconsistent information being given to patients which they will find confusing.  Massively underfunded - can lead to workers becoming overstretched which can negatively impact the recovery of the patients in their care.  Leff (1994) found that their weren’t enough hospital beds or residential places for patients.  Kuno (2005) found that where you live affects the quality of care patients receive. Affluent areas receive better care.

Exam Questions 1 (a) You have learned about either family therapy or care in the community (Social Approach) as ways of treating mental disorders. Describe one of these treatments/therapies. (4) (b) Evaluate the treatment/therapy you have described in (a). (4)

Extension Activities  Compare and contrast care in the community with one of the other treatments we have covered this unit (CBT or drug treatment)  What are the similarities? What are the differences?