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The place for nidotherapy in psychiatric practice

  • Peter Tyrer (a1), Kofi Kramo (a2), Katerina Miloŝeska (a3) and Helen Seivewright (a2)
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Abstract
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Reid, D. H., Everson, J. M. & Green, C. W. (1999) Systematic evaluation of preferences identified through person-centered planning for people with profound multiple disabilities. Journal of Applied Behavior Analysis, 32, 467477.
Tyrer, P. (2000) A patient who changed my practice: the case for patient-based evidence versus trial-based evidence. International Journal of Clinical Practice, 4, 253255.
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Tyrer, P., Mitchard, S., Methuen, C. et al (2003b) Treatment-rejecting and treatment-seeking personality disorders: Type R and Type S. Journal of Personality Disorders, 17, 265270.
Tyrer, P. & Bajaj, P. (2005) Nidotherapy: making the environment do the therapeutic work. Advances in Psychiatric Treatment, 11, 232238.
Tyrer, P. & Kramo, K. (2007) Nidotherapy in practice. Journal of Mental Health, 15, in press.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The place for nidotherapy in psychiatric practice

  • Peter Tyrer (a1), Kofi Kramo (a2), Katerina Miloŝeska (a3) and Helen Seivewright (a2)
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eLetters

Comments on nidotherapy

Satnam S. Kunar, Specialist Registrar in Psychiatry
16 February 2007

I read with interest the article on the place for nidotherapy in psychiatric practice, Psychiatric Bulletin (2007),31,1-3.

In all branches of psychiatry, but perhaps especially so in AssertiveOutreach and Rehabilitation psychiatry, the impact of the environment on an individual's well being and its potential for precipitating a relapse iswell established. Anyone who has worked in these fields would welcome an approach that focuses on environmental factors in the management of difficult cases.

This concept may also have a role to play in situations of high expressed emotion where the home environment is contributing to an individual's illness but the individual may be unable or unwilling to challenge this.

Although the case vignette in the article described a "revolving door" patient, who engaged with the nidotherapist and eventually had a good outcome, there are of course individuals who will not want anything to do with professionals they think will feedback information to the mental health services and they will probably continue to have numerous protracted admissions with a poor outcome. Of course these patients will always be part of our work load and represent the most challenging of cases. As alluded to in a previous article (Tyrer & Bajaj, 2005), although environmental analysis and subsequent compromise sometimes involves patients moving to a new location that is better furnished and closer to their social network, this can be hindered by a lack of appropriate or affordable housing facilities.

Reference

TYRER R. & BAJAJ P. Nidotherapy: making the environment do the therapeutic work. Advances in Psychiatric Treatment. May 2005;11:232-238.

Declaration of interest: nil.

Satnam Singh Kunar,Specialist Registrar in General Adult psychiatry,Lyndon Clinic,Hobs Moat Road,Solihull. B92 8PW.Tel. 0121 678 4802Fax. 0121 678 4801
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Conflict of interest: None Declared

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