Solution-focused assessment tools for improving the treatment of people with psychosis and schizophrenia within secondary mental health services

Health Technology Wales
Record ID 32018005464
Original Title: Solution-focused assessment tools for improving the treatment of people with severe mental illness within secondary mental health services
Authors' objectives: HTW assessed the clinical and cost effectiveness of a solution-focused assessment tool (DIALOG+) for people with psychosis and schizophrenia receiving care in the secondary mental health setting. Psychosis and schizophrenia are severe, long-term mental illnesses that affect a person’s perception, mood and behaviour, often leading to a major detrimental impact on their lives and relationships. A strong relationship with healthcare professionals is essential to ensure treatment is effective across all areas of life. DIALOG+ is a free to use, open-source assessment tool informed by the principles of solution-focused therapy (SFT). People receiving care are asked to rate their satisfaction with 11 domains of life in conjunction with their healthcare professionals to develop future treatment goals and judge their progress in a structured way.
Authors' results and conclusions: HTW identified three randomised controlled trials (RCTs) on the use of DIALOG and DIALOG+ for the treatment of psychosis and schizophrenia in secondary mental health services. Overall, patient experience of DIALOG+ was positive, with significant improvements in subjective quality of life when using either DIALOG or DIALOG+ in addition to standard care, compared to standard care alone. The evidence suggests that DIALOG+ improves subjective quality of life. Evidence was more mixed for treatment satisfaction, health and social needs, and psychological symptoms. Two cost-effectiveness studies suggest that the cost of DIALOG+ is likely to be offset by savings in other health and social care resources.
Authors' recommendations: The evidence supports the routine adoption of DIALOG+ for people receiving treatment for psychosis and schizophrenia in a secondary mental health setting. The use of DIALOG+ is shown to improve overall quality of life when compared with standard care but its impact on psychological symptoms, treatment satisfaction and addressing health and social needs remain uncertain. Economic evidence indicates that DIALOG+ is unlikely to increase overall health and social care costs compared to standard care.
Authors' methods: The Evidence Appraisal Report is based on a literature search (strategy available on request) for published clinical and economic evidence on the health technology of interest. It is not a full systematic review but aims to identify the best available evidence on the health technology of interest. Researchers critically evaluate and synthesise this evidence. We include the following clinical evidence in order of priority: systematic reviews; randomised trials; non-randomised trials. We only include evidence for “lower priority” evidence where outcomes are not reported by a “higher priority” source. We also search for economic evaluations or original research that can form the basis of an assessment of costs/cost comparison. We carry out various levels of economic evaluation, according to the evidence that is available to inform this.
Authors' identified further research: HTW recommends the collection of real-world data and any information on implementation challenges.
Project Status: Completed
Year Published: 2023
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: Wales, United Kingdom
MeSH Terms
  • Community Mental Health Services
  • Psychotic Disorders
  • Schizophrenia
  • Therapy, Computer-Assisted
  • Interview, Psychological
  • Feedback, Psychological
  • Goals
  • Communication
  • Quality of Life
  • Schizophrenia
  • Psychosis
  • Solution-focused therapy
  • Mental health
Organisation Name: Health Technology Wales
Contact Address: Life Sciences Hub Wales 3 Assembly Square Cardiff CF10 4PL
Contact Name: Susan Myles, PhD
Contact Email:
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.