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dc.contributor.authorPriebe, Sen_US
dc.contributor.authorConneely, Men_US
dc.contributor.authorMcCabe, Ren_US
dc.contributor.authorBird, Ven_US
dc.date.accessioned2019-10-29T08:42:43Z
dc.date.available2019-07-27en_US
dc.date.issued2019-08-15en_US
dc.identifier.urihttps://qmro.qmul.ac.uk/xmlui/handle/123456789/60784
dc.description.abstractAIMS: Psychiatric treatments have specific and non-specific components. The latter has been addressed in an extensive literature on the placebo-effect in pharmacology and on common factors in psychotherapy. In the practice of mental health care, pharmacological, psychotherapeutic and social treatments are combined in complex interventions. This paper aims to review non-specific components across diverse psychiatric treatments and consider implications for practice and research. METHODS: We conducted a non-systematic review of non-specific components across psychiatric treatments, their impact on treatment processes and outcomes, and interventions to improve them. RESULTS: The identified research is heterogeneous, both in design and quality. All non-specific components capture aspects of how clinicians communicate with patients. They are grouped into general verbal communication - focusing on initial contacts, empathy, clarity of communication, and detecting cues about unspoken concerns - non-verbal communication, the framing of treatments and decision-making. The evidence is stronger for the impact of these components on process measures - i.e. therapeutic relationship, treatment satisfaction and adherence than on clinical outcomes - i.e. symptoms and relapse. A small number of trials suggest that brief training courses and simple methods for structuring parts of clinical consultations can improve communication and subsequently clinical outcomes. CONCLUSIONS: Methodologically, rigorous research advancing current understandings of non-specific components may increase effectiveness across different treatments, potentially benefitting large numbers of patients. Brief training for clinicians and structuring clinical communication should be used more widely in practice.en_US
dc.format.extente48 - ?en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofEpidemiol Psychiatr Scien_US
dc.rightsCreative Commons Attribution licence
dc.rights.uri(http:// creativecommons.org/licenses/by/4.0/
dc.subjectCommon factorsen_US
dc.subjectcomplex interventionsen_US
dc.subjectnon-specific componentsen_US
dc.subjectplaceboen_US
dc.subjectpsychiatric treatmenten_US
dc.titleWhat can clinicians do to improve outcomes across psychiatric treatments: a conceptual review of non-specific components.en_US
dc.typeArticle
dc.rights.holder© The Author(s) 2019.
dc.identifier.doi10.1017/S2045796019000428en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/31412975en_US
pubs.notesNot knownen_US
pubs.publication-statusPublished onlineen_US
pubs.volume29en_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US


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