The strengths based approach as a service delivery model for severe mental illness: a meta-analysis of clinical trials

Background: The strengths-based approach is considered a paradigm shift from the deficits-focused service delivery models. The aim of this review was to systematically review randomised controlled trials (RCTs) and quasi experimental studies examining the impact of the strengths-based approach on level of functioning and quality of life as primary outcomes and psychotic symptoms as secondary outcomes in people diagnosed with severe mental illness. Methods: This review was conducted in the School of Health Sciences, University of Nottingham, United Kingdom. Participants in the primary studies were adults diagnosed with psychotic disorders. The methodological quality of the included studies was assessed independently by two reviewers using "Consort 2010" checklist for the randomized controlled trials or "TREND" for the quasi-experimental studies. The EPOC checklist was used for data extraction while management of data and meta-analysis were performed using Review Manager software (RevMan version 5.2). Results: No significant difference was found between the strengths-based approach and other service delivery models in level of functioning and quality of life. However, a significant effect on symptoms favouring other service delivery models was reported. Conclusion: Based upon evidence of moderate quality, this review suggests there is no effect of the strengths-based model of service delivery in level of functioning and quality of life in adults diagnosed with severe mental illness. The number of trials is low; therefore further evidence is required to ascertain the impact of the strengths-based approach in community mental health care.