Nidotherapy


Nidotherapy, after nidus 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 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 so that any changes recommended and implemented 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.