Solution-focused assessment tools
Topic Status Complete
Solution-focused assessment tools for improving the treatment of people with severe mental illness within secondary mental health services.
Outcome of the appraisal
The evidence supports the routine adoption of DIALOG+ for people receiving treatment for psychosis and schizophrenia in a secondary mental health setting.
The use of DIALOG+ is shown to improve overall quality of life when compared with standard care but its impact on psychological symptoms, treatment satisfaction and addressing health and social needs remain uncertain.
Economic evidence indicates that DIALOG+ is unlikely to increase overall health and social care costs compared to standard care.
Psychosis and schizophrenia are severe, long-term mental illnesses that affect a person’s perception, mood and behaviour, often leading to a major detrimental impact on their lives and
relationships. A strong relationship with healthcare professionals is essential to ensure treatment is effective across all areas of life. DIALOG+ is a free to use, open-source assessment
tool informed by the principles of solution-focused therapy (SFT). People receiving care are asked to rate their satisfaction with 11 domains of life in conjunction with their healthcare professionals to develop future treatment goals and judge their progress in a structured way.
This topic was proposed by a Consultant Nurse and Senior Lecturer at Cardiff and Vale University Health Board and Cardiff University.
Plain language summary
Psychosis is when a person experiences and interprets reality in a very different way to the people around them. It’s one of several symptoms of schizophrenia, a mental health disorder. However, people can also have psychosis without schizophrenia. Schizophrenia is one of several psychotic disorders. In addition to psychosis, schizophrenia may include other symptoms, such as disorganized thinking, difficulties in speech and movement and changes in emotional responding.
People with psychosis and schizophrenia will often have support from healthcare professionals in the community. This includes having regular appointments with a therapist. When this is done well, it can lead to improvements in a person’s wellbeing, helping them to achieve their goals and improving their circumstances. However, it can be difficult to make the most out of these appointments, as care varies across settings.
Solution-focused therapy (SFT) tools can be used to help people communicate well with their therapists. SFT aims to help people find solutions to difficulties they face as a result of a mental health condition. The person using the mental health service is encouraged to work toward the future by supporting their existing skills, strategies and ideas. They are seen as the expert in their own lives, and work together with clinicians to find ways forward.
DIALOG+ is an example of a SFT tool which looks at a person’s quality of life and satisfaction with their treatment. It involves a person rating their satisfaction with eight life areas and three treatment aspects on a 7-point scale, using a device such as a computer or tablet. These measures are used to monitor progress and develop future treatment goals.
Health Technology Wales searched for evidence on the use of DIALOG+ and similar tools for people with psychosis and schizophrenia in secondary mental health service settings. The evidence supports the routine adoption of DIALOG+ for people receiving treatment for psychosis and schizophrenia in a secondary mental health setting.
Topic Exploration Report
TER386 08.2022
Evidence Appraisal Review
EAR050 09.2023
Guidance
GUI050 09.2023
