Nidotherapy

Nidotherapy, after nidus (Latin: nest) is the name of 'a collaborative treatment involving the systematic assessment and modification of the environment to minimise the impact of any form of mental disorder on the individual or on society'.1 It was introduced for patients with severe mental illness, mainly schizophrenia, and personality disorders2 who had failed to respond to conventional treatments and were usually antagonistic to services. The aim of nidotherapy is not to change the person but to create a better fit between the environment (in all its forms) and the patient. As a consequence the patient may improve but this is not a direct result of treatment but because a more harmonious relationship has been created with the environment.3 An essential part of nidotherapy is a full environmental analysis carried out from the patient's standpoint and with their full cooperation (provided they have the capacity) so that any changes recommended and implemented (the nidopathway) are understood and preferably owned by the patient instead of being imposed. Although nidotherapy has been classed as a psychotherapy it differs in not trying to alter the patient, only the environment.

Nidotherapy has been used mainly in the treatment of severe mental illness in assertive community treatment and community mental health services.4-6

There is no good evidence that nidotherapy is effective: it is still an experimental therapy.[1]

References

  1. ↑ Chamberlain IJ, Sampson S (2013). "Nidotherapy for people with schizophrenia". Cochrane Database Syst Rev (Systematic review). 3: CD009929. PMID 23543583. doi:10.1002/14651858.CD009929.pub2.

Notes

  1. Tyrer, P., Sensky, T., & Mitchard S (2003). The principles of nidotherapy in the treatment of persistent mental and personality disorders. Psychotherapy and Psychosomatics, 72, 350-356. PMID 14526138
  2. Tyrer, P. (2002). Nidotherapy: a new approach to the treatment of personality disorder. Acta Psychiatrica Scandinavica, 105, 469-471. PMID 12059852
  3. Tyrer, P. Nidotherapy: harmonising the environment with the patient. . London; RCPsych Press, 2009.
  4. Tyrer, P. & Bajaj, P. (2005). Nidotherapy: making the environment do the therapeutic work. Advances in Psychiatric Treatment, 11, 232-238.
  5. Byrne, P. (2007). Managing the acute psychotic episode. BMJ., 334, 686-92. PMID 17395949
  6. Tyrer, P. & Kramo, K. (2007). Nidotherapy in practice. Journal of Mental Health, 16, 117 – 129. doi:10.1080/09638230601182102
  7. Ranger M, Tyrer P, Milošeska K, Fourie H, Khaleel I, North B & Barrett B (2009). Cost-effectiveness of nidotherapy for comorbid personality disorder and severe mental illness: randomized controlled trial. Epidemiologia e Psichiatria Sociale, 18, 128-136.
  8. Tyrer, P. (2003). Nidotherapy in the treatment of stress. Stress and Health, 19,127-128.
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