Looking Forward to the Future
We are thrilled to announce that the PIECEs project will be entering its final year, marking a significant chapter in our journey towards enhancing mental healthcare for people with psychosis in India and Pakistan. As we approach the final year, let’s delve into the exciting developments that lie ahead: RCT Activities: Valuable Insights and Outcomes Our dedicated teams are diligently working on completing participants’ sixth and twelfth-month follow-up assessments. Through in-depth interviews, we aim to understand the unique experiences of individuals who have received the intervention. We will also be finalizing our economic evaluation which will provide valuable insights to decision-makers in India and Pakistan. By highlighting the incremental cost and associated health outcomes of implementing DIALOG+ in routine psychosis management, it will offer a comprehensive perspective from the healthcare system’s point. Implementation and Scaling up DIALOG+: Transformative Workshops on the Horizon Anticipation fills the air as our teams gear up to conduct quality improvement and Support, appreciate, listen team approach (SALT) workshops in the coming year. These workshops represent a pivotal aspect of our scale-up activities, initiating the training of clinicians on DIALOG+. By integrating quality improvement methodologies and SALT principles, we aim to ensure a seamless and effective implementation of this innovative intervention. Small-Scale Research Grants: Nurturing Early Career Researchers Our team of early career researchers from India and Pakistan is set to complete their projects in the upcoming year. We eagerly look forward to their showcase presentations, where the fruits of a year-long capacity-building journey will be on display. These early career researchers have been pivotal in advancing our understanding of mental health, and their contributions promise to make a lasting impact. Community Engagement Initiatives: Amplifying Impact through Arts-Based Methodologies Teams in India and Pakistan continue to foster community engagement through theatre-of-the-art performances. In an exciting development, they are actively crafting an evaluation framework to assess the impact of community-based initiatives. Simultaneously, efforts are underway to develop a comprehensive community engagement toolkit, setting the stage for a more profound and sustainable impact on mental health at the grassroots level. Dissemination: Sharing Insights and Shaping Futures Our journey wouldn’t be complete without sharing our learnings and experiences. To facilitate this, we plan to host dissemination and knowledge exchange events, bringing together a diverse array of stakeholders. Academics, clinicians, policy-makers, service managers, patients, carers, and the local community will converge to engage in a dialogue that transcends boundaries. As our team diligently works on crafting a three-year project report, we aim to highlight our journey – from setting up the trial and initiating community engagement initiatives to fostering the growth of early career researchers. Join us in marking the meaningful conclusion of the PIECEs project in the next year!
First Impressions: Using DIALOG+ in PIECEs pilot phase
*written by Dr. Padmavati Ramachandran, Co-Investigator on PIECEs and Director at Schizophrenia Research Foundation (SCARF) Psychosocial interventions, that impact recovery for persons with psychosis, are contingent upon several aspects – the person with psychosis, family, the care provider, available resources and in all likelihood, the passage of time! Hence, development of a new comprehensive intervention in the field of psychosocial interventions is in itself a challenge and testing the intervention even more so. The DIALOG + an intervention designed to promote better patient-clinician interaction, brings in a structure to the conversations in routine clinical interactions. Being a part of the team piloting the tool at SCARF, it became very clear, right at the outset that tool was actually facilitating a dialogue with the patient that would not just improve conversation , but also facilitate a solution focussed discussion. The first participant, a 43 year old women, was someone I have occasionally met in clinical encounters. She would always complain that she had a lot to speak about – but the doctors were so busy in the OPD, that she didn’t think it was right for her to take more time. The first session with the app – actually left her feeling that she was listened to – in her own words “l feel that for the first time – I have said all that has been bothering me in terms of my functioning” And, she adds, “you have spoken to me and not my husband… that makes me feel even better” One interesting observation with the third participant was something that I least anticipated. In the domain related to Job situation – the participant a home maker, spontaneously stated that her action plan would be to learn to create an email id for herself – so that she can apply for jobs. This was something that was never picked up during clinical interactions! Similarly, a male participant who works as a tailor, who wanted to feel more energetic – reported that he could exercise and we then engaged in a discussion of what he could do to exercise. He left the session , saying that he liked the idea of exercising – an activity that he had not thought of before! The experience of handling a gadget – the tablet in this case – is a very new experience, even for me as a clinician! While I do use the electronic medical records system for client data storage, using the tablet as a medium to communicate to the client is quite a task, especially when the participant is not very familiar with using the electronic medium. But as I realised over the next few sessions , it was a matter of practice. The app driven technology is very user friendly and simple. This enables the participant to be able to read and relate easily to the visual analogue scale. The use of the Tamil language has made the interaction even more suitable! There are of course, sections that will need adaptation to the Indian lifestyle and the PIECES project aims to do just that! Overall, I feel pretty excited at using this tool – it has brought in a structure to a patient centric engagement, meaningful enough to hopefully improve on functioning. Alongside with Dr. Padmavati’s first impressions in India, in Pakistan Dr. Aneela Mushtaq , clinical psychologist at hospital Karwan-e-Hayaat, gives her account of the experience with the intervention so far: Since I have started using DIALOG+, I have found this exceptional intervention, convenient for both therapist and patient; reliable, time-saving and specific in targeting the main issue which is causing distress. It helps both therapist and patient to understand problems in more depth. Before, both sides had to do a lot of paperwork during psychotherapy sessions, however ever since I have started utilising DIALOG+ in my therapy sessions, my paperwork has noticeably decreased. If I talk about my patients’ views regarding DIALOG+ – according to them it is very easy to work with the instrument, and they can easily highlight the core issue which is the main source of problems. Previously both the therapist and the patient needed to take part in four to five sessions to come to the conclusion of the main problem, as normally either we are doing it verbally or performing some paperwork for clear understanding. Furthermore, another very effective part of the intervention is the action plan. This option helps to form smart goals for the rest of the week: patients have to achieve those goals while working on it. To understand more about DIALOG+ and how it’s used, please access the official website