Treatment and outcomes of crisis resolution teams: a prospective multicentre study

<p>Abstract</p> <p>Background</p> <p>Crisis resolution teams (CRTs) aim to help patients in acute mental health crises without admitting them to hospital. The aims of this study were to investigate content of treatment, service practice, and outcomes of crises of CRTs in Norway.</p> <p>Methods</p> <p>The study had a multicentre prospective design, examining routine data for 680 patients and 62 staff members of eight CRTs. The clinical staff collected data on the demographic, clinical, and content of treatment variables. The service practices of the staff were assessed on the Community Program Practice Scale. Information on each CRT was recorded by the team leaders. The outcomes of crises were measured by the changes in Global Assessment of Functioning scale scores and the total scores on the Health of the Nation Outcome Scales between admission and discharge. Regression analysis was used to predict favourable outcomes.</p> <p>Results</p> <p>The mean length of treatment was 19 days for the total sample (N = 680) and 29 days for the 455 patients with more than one consultation; 7.4% of the patients had had more than twice-weekly consultations with any member of the clinical staff of the CRTs. A doctor or psychologist participated in 55.5% of the treatment episodes. The CRTs collaborated with other mental health services in 71.5% of cases and with families/networks in 51.5% of cases. The overall outcomes of the crises were positive, with a small to medium effect size. Patients with depression received the longest treatments and showed most improvement of crisis. Patients with psychotic symptoms and substance abuse problems received the shortest treatments, showed least improvement, and were most often referred to other parts of the mental health services. Length of treatment, being male and single, and a team focus on out-of-office contact were predictors of favourable outcomes of crises in the adjusted model.</p> <p>Conclusions</p> <p>Our study indicates that, compared with the UK, the Norwegian CRTs provided less intensive and less out-of-office care. The Norwegian CRTs worked more with depression and suicidal crises than with psychoses. To be an alternative to hospital admission, the Norwegian CRTs need to intensify their treatment and meet more patients outside the office.</p

'That boy needs therapy' : constructions of psychotherapy in popular song lyrics

Despite a plethora of academic and clinical descriptions of psychotherapy, less research attention has been focused on the ways in which psychotherapy is talked about and represented in popular culture. This study investigates constructions of psychotherapy in the lyrics of popular songs and identifies the vocabularies, versions and relevant discourses that are invoked or crafted. A critical discourse analysis was applied to 24 songs and yielded three broad themes: 'Banal therapy', the 'Non-therapeutic relationship' and 'I know therefore I can'. These discursive objects are examined in light of a constructionist understanding of knowledge and power within a discussion of how their interplay is implicated in the status of psychotherapeutic concepts and practices as 'expert knowledge'. Some clinical implications are attended to without making claims that this study has identified ontological representations of psychotherapy in popular culture

Constructions of Homosexuality in the Art of Francis Bacon

In this article, I contextualise Bacon's representations of homosexuality -- that is, same-sex relations between men. The male nude made its appearance in Bacon's work in the early 1950s, a time when the nude was not a popular subject in painting and when, perhaps more critically, homosexuality was illegal in Britain. Other British contemporary homosexual artists, such as Robert Colquhoun and Robert MacBryde, steered clear of representing homosexuality, whilst others, such as Keith Vaughan, depicted homosexuality in their art in an ambiguous and diffuse fashion, often with recourse to the homoerotic. Vaughan's studies of men exercising focused on the strength and virility of the male nude, and were erotically charged without being overtly sexual. In contrast, Bacon chose to be more explicit in his depictions. He did not simply allude to, but pointed to the homosexual act of copulation. Given that Bacon was painting at a time before the legalisation of homosexuality, how can these images be explained and what was Bacon attempting to do? His representations of the homoerotic and homosexual convey social attitudes of the time and are important constructions and mediations of homosexual desire. I explain my motivations by drawing on Bacon's cultural and theoretical background. What is evident is that there is not one homogeneous interpretation of Bacon's depiction of homosexuality, but multiple readings, which are interdisciplinary. His depictions can be explained with recourse to his biography, art historical influences, political activism and his existential awareness of death. I also demonstrate how changes in the political landscape affected Bacon's portrayals in the delineation of what I describe as four thematic phases in Bacon's art

Generic Containment: Detailed comparison of containment simulations performed on plant scale

One outcome of the OECD/NEA ISP-47 activity was the recommendation to elaborate a 'Generic Containment' in order to allow comparing and rating the results obtained by different lumped-parameter models on plant scale. Within the European SARNET2 project (http://www.sar-net.eu), such a Generic Containment nodalisation, based on a German PWR (1300MWel), was defined. This agreement on the nodalisation allows investigating the remaining differences among the results, especially the 'user-effect', related to the modelling choices, as well as fundamental differences in the underlying model basis in detail. The methodology applied in order to compare the different code predictions consisted of a series of three benchmark steps with increasing complexity as well as a systematic comparison of characteristic variables and observations.This paper summarises the benchmark series, the lessons learned during specifying the steps, comparing and discussing the results and finally gives an outlook on future steps