Care in the Community(Social Approach)

A treatment for schizophrenia.

Map to Spec – Page 60

3. Contenti. 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.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?