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- PublicationThe Clonmel Project. Mental Health Service Needs of Children and Adolescents in the South East of Ireland: Final ReportThe aim of this project was to determine the prevalence of mental health problems among children and adolescents in the South East of Ireland and make recommendations for service development.
- PublicationEvaluation of the Genesis Counselling ServiceCorduff Counselling Service was the forerunner of the Genesis Psychotherapy Family Therapy Service (hereafter referred to as Genesis). It was established in 1993 by the Corduff Community Core Group as a community service to provide psychotherapy and counselling to individuals, couples and families in Corduff and the Greater Blanchardstown area. It was initially set up and managed by voluntary staff, who had trained at the Clanwilliam Institute, to provide a systemic family therapy service to clients in the local community. Over an 11 year period the service has developed considerably in size and professionalism and now serves the Dublin 15 area or Community Care Area 6. The aim of this service evaluation and review was to assess the effectiveness of Genesis and identify the optimal path for future development.
- PublicationThe Psychological Effects in Adulthood of Institutional Living. Report prepared for the Commission to Inquire into Child Abuse (CICA)(Stationery Office, 2009-05-20)In 2005 and 2006 247 adult survivors of institutional abuse in industrial and reformatory schools recruited through CICA were interviewed. Other witnesses to the Commission who reported institutional abuse in other institutions and out-of-home care settings were not included in this study. There were approximately equal numbers of men and women who were about 60 years of age, and who had entered institutions run by nuns or religious brothers due to family adversity or petty criminality. Participants had spent, on average, about 5 years living with their families before entering institutions and about 10 years living in institutions. More than 90% had experienced institutional physical and emotional child abuse and about half, institutional child sexual abuse. Just over a third of those who had memories of having lived with their families reported family-based child abuse or neglect. All participants had experienced one or more significant life problems with mental health problems, unemployment and substance use being the most common. More than four fifths of participants had an insecure adult attachment style, indicative of having problems making and maintaining satisfying intimate relationships. About four fifths of participants at some point in their life had had a psychological disorder including anxiety, mood, substance use and personality disorders. The overall rates of psychological disorders among survivors of institutional living, for most disorders, were double those found in normal community populations in Europe and North America.
- PublicationA Summary of Research on the Effectiveness of Psychological Treatments of Offenders: Submission to the Prison Clinical Psychology Service Review Group(Stationery Office, 1999-08)The aim of this paper is to summarize the effectiveness of psychological interventions in the treatment of offenders with reference to up-to-date authoritative reviews.
- PublicationPsychotherapy: evidence for its importance in recovery from schizophrenia(Schizophrenia Ireland, 2008-07)Clients with schizophrenia should be offered multimodal treatment programmes which integrate effective pharmacological and psychotherapeutic interventions. In this paper evidence is reviewed which shows, unequivocally, that psychotherapeutic and psychological interventions improve recovery from schizophrenia. These interventions include psychoeducational family therapy to promote family support, medication adherence and prevent relapse; cognitive behaviour therapy to help clients manage residual positive symptoms; social skills training to enhance social competence and reduce social isolation; cognitive rehabilitation to help clients overcome or compensate for cognitive deficits; and individual placement and support or supported employment to promote vocational adjustment. Where service users have difficulty retaining contact with routine outpatient services, treatment should be offered by an assertive community treatment team. These conclusions are broadly consistent with the importance accorded to psychological interventions for schizophrenia in international best practice guidelines
- PublicationPutting families first: An evaluation of Functional Family Therapy in an Irish contextCurrent evidence suggests that up to 20% of Irish adolescents have significant behavioural problems, a figure consistent with results of epidemiological studies of youth mental health problems in other countries.Functional Family Therapy (FFT) has consistently been identified in authoritative international reviews as a family-therapy programme for treating adolescents at risk for juvenile delinquency with a particularly strong evidence-base including many controlled trials, and a well developed training and monitoring system for implementing FFT in new community-based sites.Between 2010 and 2014, a research programme to evaluate the effectiveness and implementation of FFT at Archways Families First was conducted by a research team at University College Dublin, in collaboration with Indiana University, and the team of FFT therapists at Archways Families First. The results of this programme, described in this summary report, provide strong support for the effectiveness of FFT as practiced at Archways Families First in reducing behaviour problems and the risk of juvenile delinquency.
- PublicationThe Effectiveness of Psychotherapy. A Review of Research prepared for the Irish Council for Psychotherapy(Irish Council for Psychotherapy, 2007-06)One in four people suffer from mental health problems, so mental health problems are a major national and international challenge. Psychotherapy is an effective intervention for a wide range of mental health problems in people of all ages. The average success rate for treated cases ranges from 65 to 72%.
- PublicationThe Waterford mental health surveyThe primary objective of the Waterford Mental Health Survey was to document the prevalence of co-morbid personality disorders in a sample of inpatients and outpatients attending the HSE mental health service in Waterford and outline the implications of this for service development. Between July 2011 and June 2014, 100 inpatients and 99 outpatients were evaluated with the Structured Clinical Interviews for DSM-IV axis I and II disorders, the Childhood Trauma Questionnaire, the Global Assessment of Functioning rating scale, the SCORE family assessment instrument, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Participants were consenting, consecutive referrals who were not too unwell to engage with the study. The sample interviewed was probably slightly higher functioning than all cases attending the service. With regard to the primary objective of the study, we found that 98.4% of cases had DSM-IV axis I psychiatric disorders and 39.3% of these had comorbid axis II personality disorders. Between approximately a half and three-quarters of cases with personality disorders had comorbid anxiety, depressive or alcohol and substance use disorders. Compared to those without personality disorders, cases with personality disorders had experienced more child maltreatment; had poorer personal and family functioning and more severe presenting problems; and reported greater unmet service needs and motivation for psychotherapy. In terms of service development, approximately 2 out of 5 patients attending the public mental health services in Waterford require specialist psychological therapy for personality disorders which addresses low levels of personal and family functioning and past history ofchild maltreatment. Specialist psychological therapies include dialectical behaviour therapy (Linehan, 1993. 2014), schema therapy (Young et al., 2007), cognitive behaviour therapy (Beck et al., 2004) and brief psychodynamic psychotherapy such as mentalization-based treatment (Bateman & Fonagy, 2006; Clarkin et al., 2010). A review of psychology staffing levels is required to determine the number of psychologists required to provide this type of service in line with recommendations in the national mental health policy - Vision for Change (Department of Health & Children, 2006) - and the HPSI Psychology briefing paper for the HSE mental health division (Heads of Psychology Services Ireland, 2014). Intensive initial staff training and ongoing supervision are required for psychologists to provide these specialist evidence-based interventions.