Publications by authors named "Jukka Aaltonen"

6 Publications

  • Page 1 of 1

The family-oriented open dialogue approach in the treatment of first-episode psychosis: Nineteen-year outcomes.

Psychiatry Res 2018 12 18;270:168-175. Epub 2018 Sep 18.

Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.

Open Dialogue (OD) is a family-oriented early intervention approach which has demonstrated good outcomes in the treatment of first-episode psychosis (FEP). Nevertheless, more evidence is needed. In this register-based cohort study the long-term outcomes of OD were evaluated through a comparison with a control group over a period of approximately 19 years. We examined the mortality, the need for psychiatric treatment, and the granting of disability allowances. Data were obtained from Finnish national registers regarding all OD patients whose treatment for FEP commenced within the time of the original interventions (total N = 108). The control group consisted of all Finnish FEP patients who had a follow-up of 19-20 years and who were guided to other Finnish specialized mental healthcare facilities (N = 1763). No difference between the samples was found regarding the annual incidence of FEP, the diagnosis, and suicide rates. Over the entire follow-up, the figures for durations of hospital treatment, disability allowances, and the need for neuroleptics remained significantly lower with OD group. Findings indicated that many positive outcomes of OD are sustained over a long time period. Due to the observational nature of the study, randomized trials are still needed to provide more information on effectiveness of approach.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
December 2018

[Psychotherapy of a depressed patient--presentation of treatment modalities].

Duodecim 2009 ;125(16):1787-94

Jyväskylän yliopisto, psykologian laitos, PL 35, 40014 Jyväskylän yliopisto.

The article includes a brief introduction to five forms of psychotherapy that are in active use in Finland: psychodynamic, cognitive and group psychotherapy, family therapy of a depressed patient, and resource and solution-oriented working attitude. An advocate of each treatment modality provides a description of the suitability of the particular modality for a depressed patient. Different treatment modalities are not compared as such; the aim is rather to provide clinical thinking tools for the doctor, who considers the patient's suitability for and referral to psychotherapy.
View Article and Find Full Text PDF

Download full-text PDF

December 2009

Mental health care: trust and mistrust in different caring contexts.

J Clin Nurs 2008 Nov 4;17(21):2867-74. Epub 2008 Jul 4.

Department of Psychology, Jyväskylä University, Jyväskylä, Finland.

Aims And Objectives: To identify the factors that make trust within the context of public mental health possible. We also consider the question of patients' trust in the whole caring system. The study is based on individual interviews with 22 psychiatric patients, who were also users of social services.

Background: There are theoretical studies concerning trust between human beings in several disciplines within psychiatry and social services but few studies investigate how trust can be created and what makes it possible. The literature reveals that there is need for research concerning trust in psychiatry. In this study we examined two different caring contexts and investigated what makes trust possible in these contexts. The contexts are termed the Integrated Network and Family Model and the Traditional Model.

Design: A qualitative method based on the grounded theory approach was used.

Methods: The main focus in the analysis was on how the patients had experienced the contexts of the caring systems and how trust was created or not within them.

Results: Three categories creating trust were found in the Integrated Network and Family Model and two in the Traditional context. Acceptance of the patient's expertise concerning his/her life situation, openness and joint discussions concerning knowledge are important. Trust is closely connected to autonomy and power: patients feel that trust increases as their experience of autonomy increases and in such situations power is not owned by any one person.

Conclusions: Trust between psychiatric patients and personnel can be created in both the Integrated Network and Family Model and traditional context, but in different ways.

Relevance To Clinical Practice: Clinical workers and nursing personnel can use our findings in their practical work with psychiatric patients. Our findings support theoretical considerations concerning trust and can be used as guidelines for nursing personnel in their work.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
November 2008

Predicting medication-free treatment response in acute psychosis: cross-validation from the Finnish Need-Adapted Project.

J Nerv Ment Dis 2006 Oct;194(10):732-9

School of Social Work, University of Southern California, Los Angeles, California 90089-0411, USA.

This study tested predictors of 2-year antipsychotic-free response from the Soteria study (older, better social functioning, fewer cardinal symptoms) using data from the Finnish Acute Psychosis Integrated treatment study. The quasi-experimental study compared need-adapted family-oriented psychosocial intervention within a 3-week antipsychotic-free trial to psychosocial intervention plus antipsychotic medications. Forty-six percent of experimental completers (37% of intent-to-treat subjects) were successfully treated without antipsychotic medications for the entire 2-year study. The DSM-III-R diagnoses of schizophrenia and schizophreniform disorder and Soteria-suggested predictors were not related to antipsychotic-free response. Different variables within the same domains of good prognosis and fewer schizophrenia symptoms predicted antipsychotic-free response or nonresponse with 74% accuracy. The 6-month duration of symptom criterion distinguishing schizophrenia from schizophreniform disorder does not separate medication-free treatment responders from those requiring medications. Prognosis appears related to antipsychotic-free response and may be helpful in distinguishing schizophrenia from schizophreniform disorder in early episodes.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
October 2006

[Not Available].

Jukka Aaltonen

Duodecim 2006 ;122(6):724-31

Jyväskylän yliopiston psykologian laitos.

View Article and Find Full Text PDF

Download full-text PDF

April 2008

Mental health: integrated network and family-oriented model for co-operation between mental health patients, adult mental health services and social services.

J Clin Nurs 2004 Oct;13(7):876-85

Junior Lecturer, University of Mälardalen, Västerås, Sweden.

Background: Co-operation between mental health care units and the social services is important in the case of people with social problems who also suffer from mental health problems. However, participation of patients and their families in the treatment process, and co-operation between them and the professionals, are also important. Communication between the professionals, patients and their family members, and the professionals is a crucial factor for co-operation.

Aims And Objectives: The aim of this study was to elucidate the experiences and importance of co-operation for the patients. The data consisted of interviews with 22 mental health patients who were also clients of municipal social services.

Method: The grounded theory approach was used, focusing on the informants' experiences of the integrated network and family-oriented model for co-operation.

Results: The findings indicate the importance of the participation of patients and their social networks in psychiatric care or the treatment process. Meetings should be characterized by open and reflexive discussions with all participants' points of view being included, so that fruitful co-operation is possible. However, some negative experiences were also reported, all of which were connected with the professionals' behaviour.

Conclusions: Trust and honesty are essential elements in relations between professionals and psychiatric patients, but it cannot be assumed that they will develop naturally. It is the professionals' responsibility to adjust their behaviour so that these elements can be created in a mutual process between patients and professionals. Multidisciplinary teams are a necessity in family-oriented co-operation between psychiatry and social services, and in a satisfactory caring process.

Relevance To Clinical Practice: Nurses' work is often individually oriented and nurses are ruled by routines in their work. The mental health caring process should be seen as a shared process between the patient, his/her human environment and professionals for which nurses need skills to their interaction with patients and their social network.
View Article and Find Full Text PDF

Download full-text PDF

Source Listing
October 2004