Medicine:Nidotherapy

Short description: Experimental psychotherapy method

Nidotherapy, after nidus (Latin: nest), is an experimental form of psychotherapy, described as "a collaborative treatment involving the systematic assessment and modification of the environment to minimize the impact of any form of mental disorder on the individual or on society".

Etymology

The word nidotherapy is derived from the Latin nidus, or "nest".

History

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.

Medical and therapeutic use

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 any form of nidotherapy is effective, and no high-strength evidence exists to show that any type of treatment is effective for schizophrenia or mania.

Notes

• "The principles of nidotherapy in the treatment of persistent mental and personality disorders". Psychotherapy and Psychosomatics 72 (6): 350–356. 2003. doi:10.1159/000073032. PMID 14526138. 
• "Nidotherapy: a new approach to the treatment of personality disorder". Acta Psychiatrica Scandinavica 105 (6): 469–471. 2002. doi:10.1034/j.1600-0447.2002.01362.x. PMID 12059852. 
• Nidotherapy: harmonising the environment with the patient.. London: Royal College of Psychiatrists Press. 2009. 
• "Nidotherapy: making the environment do the therapeutic work". Advances in Psychiatric Treatment 11 (3): 232–238. 2005. doi:10.1192/apt.11.3.232. 
• "Managing the acute psychotic episode". BMJ 334 (7595): 686–92. 2007. doi:10.1136/bmj.39148.668160.80. PMID 17395949. 
• "Nidotherapy in practice". Journal of Mental Health 16: 117–129. 2007. doi:10.1080/09638230601182102. 
• "Cost-effectiveness of nidotherapy for comorbid personality disorder and severe mental illness: randomized controlled trial". Epidemiologia e Psichiatria Sociale 18 (2): 128–136. 2009. doi:10.1017/s1121189x00001019. PMID 19526744. 
• "Nidotherapy in the treatment of stress". Stress and Health 19: 127–128. 2003. doi:10.1002/smi.972.