Table 1.
EBPI | Definition and aims (from literature and CPGs) | Corresponding 2010 national psychosis survey (SHIP) question | Evidence-based level adopted | ‘Strong’ eligibility indicators from literature | Eligibility indicators available in SHIP | ‘Strong’ suitability indicators from literature | Suitability indicators derived from SHIP variables |
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CBT for psychosis (CBTp) | Reduce distress and increase adaptive behaviour by working with thoughts and beliefs that mediate emotional and behavioural responses, and by enhancing adaptive coping | Did you receive any therapy where you and your therapist explored your thoughts, feelings and beliefs about your symptoms and illness and came up with new ways of understanding and coping with them? | Eight or more sessions | None | N/A | Persisting positive symptoms, fewer negative symptoms and absence of co-morbid substance abuse | identifying ‘uncontrolled symptoms of mental illness as a top three challenge in the next year’; ‘lack of relief from medication for mental health’; low Carpenter negative syndrome score in past year (less than 2); absence of ‘any substance use in past year’ |
Family Psycho-Education (FPE) | Reduce consumer relapse and carer burden by bringing together the consumer and their family or other carers to learn together about the disorder, and build skills such as communication, problem solving and crisis support | Have you and your family met together regularly with a mental health clinician to learn about mental illness and improve your communication and problem-solving skills? | Six or more sessions | Some contact with family | Has some ‘contact with family during past year’ | Frequent contact with family | Composite indicator created: ‘living with any relative’ and ‘at least weekly face to face contact with any family’ |
Relapse Prevention Planning (RPP) | Pick up early warning signs of relapse in time for treatment and support changes that might prevent a relapse, treat it early or mitigate its full impact | Have you done some future planning with a mental health worker in which you discussed your past experiences of being unwell and identified warning signs that a relapse may occur? AND Have you made a written plan about what you and a significant other person in your life, and the mental health service could do if those warning signs return? |
A written plan in addition to the discussion | None | N/A | Recent history of relapse and past history of relapse | ‘any mental health admission in past year’; ‘multiple episodes or continuous illness in the course of their disorder’ |
Skills Training (ST) | Address functional skill difficulties through use of behavioural skill training or educational skill teaching models of change | Have you participated in a group or individual training program for improving social skills or independent living skills, that included assessment of your skills, teaching and practicing new skills, then trying them out in your daily life? | Six or more sessions | Functional skills deficits | Greater than ‘only mild difficulties’ on the Personal and Social Performance scale (i.e., PSP < 71) | ‘illness interferes with desired relationships’; ‘dysfunction in overall socialising’; ‘relationships deteriorated due to illness’; MSIF overall global residential rating: moderate or lower role performance |
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Supported Employment (SE) | Assists the individual to find a job in the open labour market and provides support to keep them in that job, including advice, assistance with making necessary adjustments in the workplace (e.g. changing work schedules) and with managing their health and sources of stresses within the workplace | Did an employment support worker provide you with support, advice, counselling or speak with your case manager about your mental health needs? | Six or more sessions | Desire to work | ‘Looking for work’ or ‘employed during past year’ | Better prior work history and education beyond secondary level | ‘wanted help to work or use one's time’; ‘educated beyond secondary level’ |
Assertive Community Treatment (ACT) | Service model defined by a discrete team with a small fixed caseload, enabling intensive practice characterised by in vivo and extended hours delivery of interventions through assertive outreach, medication supervision, problem resolution and individualised rehabilitation | Was there a period of time when your main mental health care was provided by a team from the mental health services who regularly visited you in your home, in the daytime and evenings, to help with your mental health? | N/A | Difficulties in providing treatment in the context of prolonged and complex illness | Exclude persons with ‘single episode with good recovery’ | Difficulties with engagement, frequent hospital admissions, co-morbid substance use, poor course of disorder and poor functioning | ‘poor functioning according to PSP (i.e. PSP < 31)’; ‘very unconfident that current medication is a good thing for their mental health’; ‘multiple episodes of illness with partial recovery or a continuous illness in the course of their disorder’; ‘two or more admissions for mental health in past year’; ‘any substance use in past year’; ‘very dissatisfied with help and support received from case manager’. |