# Service Delivery – What Treatment and Services Can One Expect – CBT OT Support Education

Service
Detect

- What do people receive?
- People referred will be contacted by a DETECT clinician within 72 hours. We will arrange a mutually convenient appointment from 9 to 5 Monday to Friday. With consent we also arrange to meet the patient's family where possible.
- The purpose of the assessment is to clarify whether the person has a psychotic illness, and if so, which type of psychotic illness it is. We measure psychotic symptoms, anxiety and depressive/manic symptoms and look at a range of other factors that might influence the situation. We then provide an informative, rapid feedback report to the community mental health team and the person's GP.
- Cognitive Behavioural Therapy Cognitive behavioural therapy (CBT) aims to help people to manage distress and to enhance emotional well-being. CBT encourages examination of how thoughts and beliefs are connected to our moods, behaviours, physical experiences, motivation and life events. It is based on the idea that a person learns to think and act in a certain way as a result of their life experiences and their perceptions of those experiences. CBT provides a rationale to explain symptoms of psychosis by examining thinking errors, also known as cognitive biases, for example jumping to conclusions. The goal of CBT for psychosis is not specifically to reduce symptoms, in the way that an anti-psychotic medication might, although studies have reported significant symptom reduction. The goal is to reduce the distress you may be experiencing, such as stress, anxiety, depression and/or low self-esteem. CBT skills are helpful in managing the distress associated with hearing voices. CBT also aims to help individuals develop problem solving strategies in order to reduce the chances of relapse.
- Occupational Therapy As psychosis often affects our occupation, our relationships and our self confidence, some recovery time is often helpful. To assist those who attend DETECT to maximize their recovery we have an occupational therapist to discuss plans on an individual basis. Occupational therapy sessions will assist people in identifying and achieving their goals in relation to work, training, education, leisure and daily structure. The occupational therapist can assist people in getting involved in day-to-day activities and in getting back to work or education. Occupational therapy has been shown to be beneficial to people recovering from their first episode of psychosis.
- Supported Employment Supported employment (SE) is a type of vocational rehabilitation with a strong evidence base (Campbell, Bond and Drake, 2011). In this model a job coach who is a member of the mental health team works on a one-to-one basis with any person who is motivated to return to work. Since 2009 DETECT has had a job coach on its team through funding provided by the Mental Health Commission to UCD. Although this funding is time limited it is hoped that further funding will be obtained so that the post can be retained.
- Carer Education When someone in the family is affected by psychosis their relatives often report feeling confused, uncertain and pessimistic about the future. Families can help themselves and their affected relative by attending family interventions such as carer education courses. Research shows that families who attend these courses gain knowledge, experience less burden and importantly, their affected relative is less likely to relapse and be admitted to hospital. DETECT provides an education course with reliable information about psychosis, and with advice and discussion on dealing with some of the problems you may encounter.

Service
Detect