Client and key worker ratings of need in first-episode psychosis early intervention programmes

Jennifer M. Hensel, David J. Banayan, Chiachen Cheng, John Langley, Carolyn S Dewa

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Aim: The aim of this study was to fill a gap in the literature by examining agreement on need as rated by clients and their key workers from first-episode psychosis early intervention programmes. Compared with adult populations and more chronic courses of illness, these clients may have unique needs given the onset of their illness in adolescence or early adulthood. Methods: Needs agreement between clients and key workers was assessed using the Camberwell Assessment of Need in a sample of 188 client-key worker pairs recruited from six early intervention programmes in Ontario, Canada. Ratings were assessed with percentage agreement and prevalence-adjusted Cohen's kappa. Results: At the aggregate level, both clients and key workers rated a mean of 2.6 unmet needs. Compared with other diagnoses, key workers rated significantly more unmet need in clients with primary psychotic disorders. Agreement between individual client and key worker ratings was highest (adjusted κ>0.85) in the domains of telephone, risk to others, child care and accommodation. Lowest agreement (adjusted κ<0.4) was found in the domains of psychological distress, sexual expression, company, daytime activities and intimate relationships. Conclusions: While congruence is present in concrete domains, there is substantial variability in how clients and their key workers perceive need in more personal areas. The initial focus of care may necessarily be on needs such as shelter, food and treatment; however, subsequent care should incorporate a shared assessment of need to support strong relationships with providers and ongoing engagement in treatment.

Original languageEnglish (US)
Pages (from-to)246-251
Number of pages6
JournalEarly Intervention in Psychiatry
Volume10
Issue number3
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

Fingerprint

Needs Assessment
Psychotic Disorders
Ontario
Child Care
Telephone
Canada
Chronic Disease
Psychology
Food
Therapeutics
Population

Keywords

  • Adolescent
  • Early intervention
  • First-episode psychosis
  • Mental illness
  • Need

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Client and key worker ratings of need in first-episode psychosis early intervention programmes. / Hensel, Jennifer M.; Banayan, David J.; Cheng, Chiachen; Langley, John; Dewa, Carolyn S.

In: Early Intervention in Psychiatry, Vol. 10, No. 3, 01.06.2016, p. 246-251.

Research output: Contribution to journalArticle

Hensel, Jennifer M. ; Banayan, David J. ; Cheng, Chiachen ; Langley, John ; Dewa, Carolyn S. / Client and key worker ratings of need in first-episode psychosis early intervention programmes. In: Early Intervention in Psychiatry. 2016 ; Vol. 10, No. 3. pp. 246-251.
@article{8138f3506cae43c48cc6bfb78bc92cfa,
title = "Client and key worker ratings of need in first-episode psychosis early intervention programmes",
abstract = "Aim: The aim of this study was to fill a gap in the literature by examining agreement on need as rated by clients and their key workers from first-episode psychosis early intervention programmes. Compared with adult populations and more chronic courses of illness, these clients may have unique needs given the onset of their illness in adolescence or early adulthood. Methods: Needs agreement between clients and key workers was assessed using the Camberwell Assessment of Need in a sample of 188 client-key worker pairs recruited from six early intervention programmes in Ontario, Canada. Ratings were assessed with percentage agreement and prevalence-adjusted Cohen's kappa. Results: At the aggregate level, both clients and key workers rated a mean of 2.6 unmet needs. Compared with other diagnoses, key workers rated significantly more unmet need in clients with primary psychotic disorders. Agreement between individual client and key worker ratings was highest (adjusted κ>0.85) in the domains of telephone, risk to others, child care and accommodation. Lowest agreement (adjusted κ<0.4) was found in the domains of psychological distress, sexual expression, company, daytime activities and intimate relationships. Conclusions: While congruence is present in concrete domains, there is substantial variability in how clients and their key workers perceive need in more personal areas. The initial focus of care may necessarily be on needs such as shelter, food and treatment; however, subsequent care should incorporate a shared assessment of need to support strong relationships with providers and ongoing engagement in treatment.",
keywords = "Adolescent, Early intervention, First-episode psychosis, Mental illness, Need",
author = "Hensel, {Jennifer M.} and Banayan, {David J.} and Chiachen Cheng and John Langley and Dewa, {Carolyn S}",
year = "2016",
month = "6",
day = "1",
doi = "10.1111/eip.12171",
language = "English (US)",
volume = "10",
pages = "246--251",
journal = "Early Intervention in Psychiatry",
issn = "1751-7885",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Client and key worker ratings of need in first-episode psychosis early intervention programmes

AU - Hensel, Jennifer M.

AU - Banayan, David J.

AU - Cheng, Chiachen

AU - Langley, John

AU - Dewa, Carolyn S

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Aim: The aim of this study was to fill a gap in the literature by examining agreement on need as rated by clients and their key workers from first-episode psychosis early intervention programmes. Compared with adult populations and more chronic courses of illness, these clients may have unique needs given the onset of their illness in adolescence or early adulthood. Methods: Needs agreement between clients and key workers was assessed using the Camberwell Assessment of Need in a sample of 188 client-key worker pairs recruited from six early intervention programmes in Ontario, Canada. Ratings were assessed with percentage agreement and prevalence-adjusted Cohen's kappa. Results: At the aggregate level, both clients and key workers rated a mean of 2.6 unmet needs. Compared with other diagnoses, key workers rated significantly more unmet need in clients with primary psychotic disorders. Agreement between individual client and key worker ratings was highest (adjusted κ>0.85) in the domains of telephone, risk to others, child care and accommodation. Lowest agreement (adjusted κ<0.4) was found in the domains of psychological distress, sexual expression, company, daytime activities and intimate relationships. Conclusions: While congruence is present in concrete domains, there is substantial variability in how clients and their key workers perceive need in more personal areas. The initial focus of care may necessarily be on needs such as shelter, food and treatment; however, subsequent care should incorporate a shared assessment of need to support strong relationships with providers and ongoing engagement in treatment.

AB - Aim: The aim of this study was to fill a gap in the literature by examining agreement on need as rated by clients and their key workers from first-episode psychosis early intervention programmes. Compared with adult populations and more chronic courses of illness, these clients may have unique needs given the onset of their illness in adolescence or early adulthood. Methods: Needs agreement between clients and key workers was assessed using the Camberwell Assessment of Need in a sample of 188 client-key worker pairs recruited from six early intervention programmes in Ontario, Canada. Ratings were assessed with percentage agreement and prevalence-adjusted Cohen's kappa. Results: At the aggregate level, both clients and key workers rated a mean of 2.6 unmet needs. Compared with other diagnoses, key workers rated significantly more unmet need in clients with primary psychotic disorders. Agreement between individual client and key worker ratings was highest (adjusted κ>0.85) in the domains of telephone, risk to others, child care and accommodation. Lowest agreement (adjusted κ<0.4) was found in the domains of psychological distress, sexual expression, company, daytime activities and intimate relationships. Conclusions: While congruence is present in concrete domains, there is substantial variability in how clients and their key workers perceive need in more personal areas. The initial focus of care may necessarily be on needs such as shelter, food and treatment; however, subsequent care should incorporate a shared assessment of need to support strong relationships with providers and ongoing engagement in treatment.

KW - Adolescent

KW - Early intervention

KW - First-episode psychosis

KW - Mental illness

KW - Need

UR - http://www.scopus.com/inward/record.url?scp=84905634697&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905634697&partnerID=8YFLogxK

U2 - 10.1111/eip.12171

DO - 10.1111/eip.12171

M3 - Article

C2 - 25112944

AN - SCOPUS:84905634697

VL - 10

SP - 246

EP - 251

JO - Early Intervention in Psychiatry

JF - Early Intervention in Psychiatry

SN - 1751-7885

IS - 3

ER -