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.Diabysis closed down as a result of budget cutbacks in the mental health system.The average length of stay was 48 days.Perry reported that severely psychotic clientsbecame coherent within 2–6 days without medication.The outcomes appearedbetter for those who had had fewer than three previous psychotic episodes.Unfortunately, other quantitative data were not collected for this sample.A similar programme, Soteria House, located in San Jose, California, providedmore empirical support for this model (Mosher, Hendrix and Fort, 2004).SoteriaHouse ran from 1971 to 1983, roomed six clients, with 3–4 staff on premises at onetime.Most staff were non-professionals, chosen because of their lack of exposure tothe medical model in mental health treatment (to which Soteria House did notadhere).Other criteria for staff included being ‘psychologically tough’ (willing to sitwith unusual behaviours and beliefs) and good at listening.The staff were trainedto recognise that psychotic experiences were a developmental stage that can lead togrowth, often containing a spiritual component of mystical experiences and beliefs.Medication was typically not prescribed unless a client showed no improvement after6 weeks (only 10% of clients used medication at Soteria), because it was believed tostunt the possible growth-enhancing process of the psychotic episode.Limits wereset if clients became a danger to themselves or others.A project director and quarter-time psychiatrist were also employed.Outcomes from Soteria were compared with a ‘traditional’ programme,a community mental health centre inpatient service consisting of daily pharmaco-therapy, psychotherapy, occupational therapy and group therapy.After a few weeksclients in the traditionalprogramme were referred for outpatient care, including partialhospitalisation orhalfwayhouses.Criteriaforadmissiontoeitherprogramme requiredpatients to be unmarried, between the ages of 15 and 30, diagnosed with schizophreniaand in need of hospitalisation.Because of practical considerations, random assignmentof clients to each treatment programme was not used (at times, there were no bedsavailable in the Soteria programme).However, there were no significant differencesacross demographic and psychopathological variables at admission between the twogroups (Bola and Mosher, 2003).Clients’ length of stay was longer at Soteria than in the comparison programme (mean of 166 days versus 28 days).But most of the patientsrecovered in 6–8 weeks without medication (Mosher, Hendrix and Fort, 2004).Bola and Mosher’s (2003) 2-year follow-up study compared client outcomesacross the two programmes.Thirty-three clients from Soteria were compared with30 clients from a psychiatric hospital.An independent outside evaluation teamconducted the assessment, although the authors report it was impossible to make212Psychosis and Spiritualitythem blind to the treatment.Four major differences were found.First, fewer Soteriasubjects were using antipsychotic medication (4%) 2 years after admission thancontrol subjects (43%).Second, Soteria participants were less likely to be usingmental health services; this could be interpreted as an indication that clients were notin need of these services.However, an alternative conclusion is that clients were inneed of these services but did not utilise these resources.A third divergence betweenthe two groups was that Soteria clients had significantly higher ratings on occupa-tional status at the end of the two-year time period compared with individualstreated in the control programme.The fourth significant distinction was that Soteriaclients were more likely to be living on their own or with a peer at 2-year follow-upthan were members of the control programme, who were more likely to be living athome with their parents.While both groups had significant declines in symptomsover the 2-year time span, there was not a significant difference on clients’ level ofpathology.It appears that treatment that allows psychosis to be ‘worked through’ bytreating it as a powerful transformative process can work as well as currentmainstream forms of intervention.A recent meta-analysis of data from two carefully controlled studies of Soteriaprogrammes found better 2-year outcomes for the randomly assigned Soteriapatients in the domains of psychopathology, work and social functioning than forsimilar clients who were treated in a psychiatric hospital (Bola and Mosher, 2003).Itdoes not seem that any residential programmes using this approach exist in the USA,but there are several Soteria homes in Europe (Turner, 2005).InterventionsThe following eight interventions are based on the approaches from Diabysis andSoteria along with case reports of people who have recovered from a VSE (Kornfield,1993; Lukoff, 1996), personal communications with others who have worked withpeople in a VSE, consultation with Robert Turner (2005), a psychiatrist andhomeopath, on dietary recommendations.However, few systematic studies com-paring treatments for VSEs have been conducted.NormalisePeople in the midst of VSEs need a framework of understanding that makes sense tothem.The most important task is to give people in crisis a positive context for theirexperiences and sufficient information about the process that they are goingthrough [ Pobierz całość w formacie PDF ] |
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