Joint Crisis Planning Results in Clinically Reasonable Choices

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Analysis of 221 joint crisis plans for people with diagnoses of psychotic disorders and at least one psychiatric admission in the past two years, in England’s CRIMSON randomized controlled trial, finds that “Most service users requested full involvement in decisions about their care, clear and consistent treatment plans, access to familiar clinicians who knew them well, and to be treated with respect and compassion. Some service users requested hospitalisation, but the majority preferred alternatives. The most frequently preferred intervention was care by a home treatment team.” The researchers conclude that “Joint crisis planning (JCP) resulted in service users making choices that were clinically reasonable. The technique employed by JCPs appeared to empower service users by engaging them in a productive dialogue with their clinicians.”

Farrelly, S., Brown, G., Rose, D., Doherty, E., et al; What service users with psychotic disorders want in a mental health crisis or relapse: thematic analysis of joint crisis plans. Social Psychiatry and Psychiatric Epidemiology. Online April, 2014. DOI: 10.1007/s00127-014-0869-1

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].

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