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AGENDA
Introductions and Aims Songs Model of Service How Do We Make Decisions-Risks,
Rights and Responsibilities Team Approach and Statistics
Engagement
Shaping an effective
working alliancePsycho-social Interventions
Medication and symptom
management
ENGAGEMENTShaping an effective working alliance
Conduct outreach to establish regular contact
Being useful-provide practical help and support
Establish open, honest communication through active listening, getting to know the person behind the illness.
ENGAGEMENTPsychosocial interventions
Gaining knowledge of family Starting to assess Activities of Daily
Living Awareness of physical health Awareness/assessment of substance
misuse ‘Accepting’ conversations regarding
perceptions of mental health
ENGAGEMENT Medication/Symptom Management
Medication delivery
Ensure medication available
Monitoring medication compliance
ENGAGEMENT Medication/Symptom Management
Starting to assess side effects
Symptom acknowledgement and monitoring
Weekly medication supervision and review if necessary
DEVELOPING A PARTNERSHIP Psychosocial interventions
Continue regular contact start to negotiate continued contact
Building a trusting relationship through reliability and advocacy
Working more in collaboration towards resolution of practical tasks
DEVELOPING A PARTNERSHIP
Psychosocial interventions Information re: illness/medication if
wanted Introduction to stress/vulnerability model
through informal conversation
Informal coping strategies
Establishing relationships with family/carers as appropriate to include carers assessment, if appropriate
DEVELOPING A PARTNERSHIP
Psychosocial interventions
Identifying interests, strengths, skills and aspirations
Monitor any physical health changes.
Consider Motivational Interviewing intervention at contemplation stage re substance misuse if appropriate
DEVELOPING A PARTNERSHIP Medication/Symptom Management
Assessment of side effects
Assessment of symptoms
Reality checking
Ongoing monitoring and management of medication compliance
ACTIVE TREATMENTShaping an effective working alliance
Regular agreed contact
Supporting progress and concordance with the plan
ACTIVE TREATMENT
Psychosocial interventions
Reinforce coping strategies
Consider Occupational Therapy assessment
Consider ‘family work’ if appropriate
Physical health education and support
ACTIVE TREATMENT
Psychosocial interventions
Goal setting – strengths based/solution focused interventions-future plans-timetable for activities
Help service user to repair burnt bridges to re-establish relationships
Enlist family support for sustained lifestyle changes
Engage in MI re: Substance Misuse if appropriate
ACTIVE TREATMENT
Medication/Symptom Management
On-going support
Development of relapse indicators with service users, steps to be taken and advance directives
RELAPSE PREVENTIONShaping an effective working alliance
Maintain/consider reduction in contact
Promote development of their supportive relationships
Boost self efficiency/positive reinforcement and consider other areas of development – move towards independence
RELAPSE PREVENTION
Psychosocial interventions
Develop a formal relapse prevention plan
Continue with Psychoeduction Provide information related to health,
well being and lifestyle change Help service users learn how to obtain
information themselves Explore a service user becoming a peer
educator for others
RELAPSE PREVENTION
Medication/Symptom Management
Promote independence with medication compliance
Psychoeduction on long term use and effects of medication
Continued symptom monitoring.
SENARIO
What risks do we need to consider
What and whose rights should be influencing our decision making?
Who holds responsibility and for what?
HOW DO WE DELIVER OUR SERVICE
Daily handover Weekly team meeting-psychiatrist 3 monthly review of risk
management plan at team meeting 3 monthly CPA 6 month review of relapse indicators
HAS IT WORKED?Service user- Evaluations
Understand my problems They lift my spirit when I see them They are fascinated by my beliefs They treat me with respect I don’t feel isolated I need to be in my community, the AOT
helps with speaking to the benefit agency I haven’t got any bad things to say
except I’d like to get off the depot-they are doing their best.