Care in the Community (Social Approach)

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

Map to Spec – Page 60 3. Content i. Describe and evaluate one treatment/therapy from each of the following approaches: • The Social Approach: either Family Therapy or Care in the Community programmes (Schizophrenia – biological and cognitive, anorexia – psychodynamic and learning)

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

A local clinic wants to advertise for lead workers for their community care programme. 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? • http://www.youtube.com/watch?v=V2-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. Describeone 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?

Care in the Community (Social Approach)