Training in psychosocial intervention: the impact on the role of community psychiatric nurses.

A group of community psychiatric nurses (CPNs) received training via a short part-time course to deliver psychosocial intervention (PI) to families caring for a relative with schizophrenia living at home. The effects on CPNs of training in PI were examined by measuring, over time, a number of variables which reflected; CPNs' attitudes to schizophrenia, their skills, specific aspects of their role (such as visit length and frequency, caseload composition, etc.), and relationships with other disciplines. Analysis of the information showed that CPNs trained in PI changed their attitude to schizophrenia very little. However, evidence was obtained that CPNs' attitudes moved towards behaviour therapy as a preferred treatment approach. All CPNs who received training were competent in the component and global skills of PI at the end of training. These scores derived from blindly rated audiotaped recordings of CPN intervention. The CPNs estimated that caseload size and the proportion of people on caseloads with a diagnosis of schizophrenia did not alter. However, significant increases in the length of CPN sessions with people with schizophrenia and their families were observed. The CPN's liaison role with consumer groups, such as the National Schizophrenia Fellowship, significantly improved. Multi-disciplinary colleagues gave PI-trained CPNs a mixed reaction. Some CPN colleagues seemed pleased to transfer families to the PI-trained CPNs' caseloads, whilst others clearly regarded the PI-trained CPNs as a threat. Overall, the most encouraging reaction came from psychologists and psychiatrists.