Evidence map›Paper›PMID 35379290›Full record

ArticleInternational journal of mental health systems2022

How can we best help this patient? Exploring mental health therapists' reflections on medication-free care for patients with psychosis in Norway.

Christine Henriksen Oedegaard, Ana Lorena Ruano, Anne Blindheim, Marius Veseth, Brynjulf Stige, Larry Davidson, Ingunn Marie Stadskleiv Engebretsen

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of mental health systems, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Christine Henriksen OedegaardCentre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. christinehodegaard@gmail.com.ORCID http://orcid.org/0000-0003-4738-7962
Ana Lorena RuanoCentre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Anne BlindheimDivision of Psychiatry, Haukeland University Hospital, Bergen, Norway.
Marius VesethDepartment of Clinical Psychology, University of Bergen, Bergen, Norway.
Brynjulf StigeThe Grieg Academy, University of Bergen, Bergen, Norway.
Larry DavidsonDepartment of Psychiatry, Yale Medical School, 319 Peck Street, Building 1, New Haven, CT, 06513, USA.
Ingunn Marie Stadskleiv EngebretsenCentre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
University of Bergen · NOHaukeland University Hospital · NOYale University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSince 2015, Norwegian Regional Health Authorities have followed new government policy and gradually implemented medication-free services for patients with psychosis. The aim of this qualitative study was to explore the tension between policy and practice, and how health care workers in Bergen reflect on their role in implementing medication-free treatment.

methodsWe performed three focus group discussions including 17 therapists working within medication free services, asking about their experiences with this new treatment program. We used Systematic Text Condensation for data analysis. The findings were discussed using Michael Lipsky's theoretical framework on the role public health workers play in policy implementation.

findingsFollowing Norway's new policy was challenging for the therapists in our study, particularly balancing a patient's needs with treatment guidelines, the legal framework and available resources. Therapists had an overarching wish to help patients through cooperation and therapeutic alliance, but their alliance was sometimes fragile, and the therapists worried about patients' conditions worsening.

conclusionsDemocratization of treatment choices, with the aim of empowering patients in mental health care, challenges the level of professional discretion given that patients and therapists might have conflicting goals. Balancing the desire to help, professional responsibility, the perceived lack of resources, and certain patient choices created conditions that can leave therapists feeling disempowered in and alienated from their work.

trial registrationN/A.

Indexed as

Health care deliveryMedication-free treatmentNorwayPolicy implementationPsychosisStreet-level bureaucrats

Identifiers

PMID35379290
PMCPMC8978409
OpenAlexW4225697764

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.