Monthly Archives: December 2012

Manualised CBT for Psychosis

In Western Australia, the Centre for Clinical Interventions has provided a manual for the delivery of CBT for psychosis which is available for download here. Their website is also worth considering – http://www.cci.health.wa.gov.au

Another freely available resource related to this theme is an article in Schizophrenia Bulletin from 2009, by Sara Tai and Douglas Turkington – The Evolution of Cognitive Behavior Therapy for Schizophrenia: Current Practice and Recent Developments 

Get Behind Open Dialogue Movement for Mental Health

A petition the SAMHSA (the United States government’s Substance Abuse and Mental Health Services Administration) has been established to promote approaches to disturbed minds focussing on the mind and human relatedness, as opposed to the brain as a chemical factory.

You can support this petition here: http://www.thepetitionsite.com/791/238/081/get-behind-open-dialogue-treatment-for-mental-ilness/

Sibling Relationships – freely available articles

Wiley are offering a free “Virtual Issue on Sibling Relationships”, from their Family & Child Studies collection

Topics include conflict, socialisation,  mental health, etc.

Link to the virtual issue is here

New York Times: “Our Failed Approach to Schizophrenia”

Psychiatrist Paul Steinberg writes:

“Psychosis” — a loss of touch with reality — is an umbrella term, not unlike “fever.” As with fevers, there are many causes, from drugs and alcohol to head injuries and dementias. The most common source of severe psychosis in young adults is schizophrenia, a badly named disorder that, in the original Greek, means “split mind.” In fact, schizophrenia has nothing to do with multiple personality, a disorder that is usually caused by major repeated traumas in childhood. Schizophrenia is a physiological disorder caused by changes in the prefrontal cortex, an area of the brain that is essential for language, abstract thinking and appropriate social behavior. This highly evolved brain area is weakened by stress, as often occurs in adolescence.

“Too many people with acute schizophrenia have gone untreated. There have been too many Glocks, too many kids and adults cut down in their prime. Enough already.”

Read more at http://www.nytimes.com/2012/12/26/opinion/our-failed-approach-to-schizophrenia.html

A new Australian devised clinical practice guideline for the management of borderline personality disorder (BPD)

In 2010, the Australian Department of Health and Ageing commissioned the NHMRC to develop a clinical practice guideline for the management of borderline personality disorder (BPD).

The guideline has been developed by a multi-disciplinary Guideline Development Committee of clinical, consumer and carer representatives with expertise in BPD. Recommendations cover diagnosis, treatment and management of BPD in adolescents and adults. This guideline has now been finalised and is expected to be released in early 2013.

The NHMRC now seeks your feedback on the most effective ways to disseminate the guideline, and a short online survey has been developed to gather views from consumers and health professionals. It should take approximately ten minutes to complete.

The survey can be accessed using the following link: BPD survey link

More information regarding the development of the guidelins is avaliable at http://nhmrc.gov.au./nics/nics-programs/clinical-practice-guideline-management-borderline-personality-disorder

Please note that all responses will be de-identified to protect the identity of the participants.

The survey closes on Friday 11th January 2013. If you have any questions regarding this survey, please contact Kristie Adams at bpd@nhmrc.gov.au.

Thank you in advance,

BPD Guideline Team

NHMRC

MDMA assisted psychotherapy for PTSD & FREE access to some articles from the Journals of the British Psychological Society

PTSD is a common comorbidity with psychosis, with some asserting that post-traumatic dissociative symptoms are often misdiagnosed as psychosis.

This makes treatment for PTSD symptoms an important response to traumatised patients, whatever their diagnosis. The current freely-available paper by Mithoeffer et al (Durability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study) shows there was significant improvement and no adverse outcomes from the treatment:

“In the initial study (Mithoefer et al., 2011), 20 subjects with treatment-resistant PTSD (in most cases from sexual abuse or assault) were randomly assigned to psychotherapy with the active drug (n = 12) or with an inactive placebo (psychotherapy-only; n = 8), each administered during two 8-hour sessions scheduled 3–5 weeks apart, accompanied by weekly non-drug sessions. The MDMA-assisted sessions were conducted in a comfortable setting, in which participants were encouraged to spend considerable time focused inward without talking, alternated with time spent talking to the therapists. The therapists took a non-directive approach to supporting their subjects in processing trauma-related material. More information concerning the nature of the psychotherapy is found in the Mithoefer et al. (2011) study, as well as in the author’s treatment manual (MAPS, 2011).

“At the end of this controlled study, the participants who had received the psychotherapy-only treatment were offered openlabel MDMA-assisted psychotherapy, using the same schedule of sessions as were used in the controlled study protocol. Of the eight therapy-only subjects, seven accepted and completed the crossover arm of the study, which resulted in 19 of the 20 study subjects receiving the MDMA-assisted psychotherapy treatment. The one therapy-only subject had recovered from PTSD symptoms with psychotherapy alone, and did not participate in the crossover. As allowed by a protocol amendment, the last eight subjects recruited (five in the double-blind stage and three in the crossover stage) also received a third MDMA-assisted psychotherapy session. This protocol change was sought because of tentative clinical impressions by the investigators that a third session would likely enhance the processing of trauma and the integration process that were essential to the treatment.

MDMA-assisted-psychotherapy

PLUS

FREE access to recent most read* and most cited† articles from the Journals of the British Psychological Society

Best wishes for the Holiday Season (and take care!)

Abstracts, papers and recordings from World Hearing Voices Congress, 2012

These are available at the Working to Recovery web site:

“It was an amazing three days in Cardiff, with lots of learning, sharing and connections.  Looking at the past 25 years, learning about the present and planning for the future.”

The next World Hearing Voices Conference will be in Melbourne, Australia, 20 – 22 November 2013.

“Working in partnership with Intervoice, the international hearing voices network, and the Hearing Voices Network of Australia, this consumer-led event will bring to Melbourne all of the world’s leaders in working with voices.”

“The congress will feature a broad range of perspectives about voices and recovery, including indigenous and multicultural views, trauma and voices, lived experiences of recovery, innovative youth programs, a new clinical research stream, and opportunities for collaborative panels and discussion groups between voice hearers, carers/family, workers and academics.”

New Edition announced: “Models of Madness: Psychological, Social and Biological Approaches to Psychosis”

To be published 24th May, 2013:

Models of Madness: Psychological, Social and Biological Approaches to Psychosis

Edited by John Read and Jacqui Dillon

“This edition updates the now extensive body of research showing that hallucinations, delusions etc. are best understood as reactions to adverse life events and that psychological and social approaches to helping are more effective and far safer than psychiatric drugs and electroshock treatment.”

SAMHSA seeking input on Trauma Informed Care Guidelines

SAMHSA (Substance Abuse & Mental Health Services Administration) is the US government’s body setup to “support States, Territories, Tribes, communities, and local organizations through grant and contract awards and provide national leadership in promoting the provision of quality behavioral health services”.

“Behavioral Health” – this it the term used in the USA to refer to mental (or emotional, or psychological) health.

However, SAMHSA has a long history of recognising the links between trauma and distressing symptoms and “mental illness”., and are committed to the promotion of a recovery orientation – see, for example, their Recovery Guiding Principles Whitepaper.

Now, they are promoting Trauma Informed Care, through promotion of information, for example, on the prevalence and treatment approaches for women in jail and substance abuse programmes at http://gainscenter.samhsa.gov/pdfs/Women/series/AddressingHistories.pdf

SAMHSA is now seeking feedback on their proposed Guidelines for Implementing a Trauma Informed Approach (to mental health care…) at http://www.samhsa.gov/traumajustice/traumadefinition/index.aspx

This page references a title which looks to be worth following up for those interested in constructing trauma informed services: New Directions for Mental Health Services, Using Trauma Theory to Design Service Systems, No. 89 Spring 2001, Maxine Harris & Roger D. Fallot (Eds.) 

Another important agency in the USA with a strong emphasis on trauma informed care is the NASMHPD (National Association of State Mental Health Program Directors) which has been promoting this form of care for more than twenty years! Links to many of their resources are at http://www.nasmhpd.org/TA/NCTIC.aspx

The role of bullying in the development of psychotic symptoms

Among the psychosocial correlations to psychosis, bullying is emerging as significant factor.

This current article – van Dam, D. S., van der Ven, E., Velthorst, E., Selten, J. P., Morgan, C., & de Haan, L. (2012). Childhood bullying and the association with psychosis in non-clinical and clinical samples: a review and meta-analysis. Psychological Medicine, FirstView, 1-12. doi: doi:10.1017/S0033291712000360, concludes:

“Although there is some evidence of an association between bullying and psychosis in clinical samples, the research is too sparse to draw any firm conclusions. However, population-based non-clinical studies support the role of bullying in the development of psychotic symptoms later in life. These findings are consistent with findings of an increased risk of psychotic symptoms among those exposed to other types of abuse.”

The AustralianNo 2 Bullying” Conference will be held at the Outrigger Surfers Paradise [Queensland, Australia] from Wednesday the 22nd to Friday the 24th of May 2013. It is an initiative of the “not for profit” Australian and New Zealand Mental Health Association Inc.