Psychiatric Rehabilitation Journal最新文献

Objective: This study investigates individual and organizational factors influencing recovery-promoting competencies among mental health practitioners working with adults with serious mental illness, focusing on recovery knowledge, attitudes, organizational culture, and structure.

Methods: Using a cross-sectional design, an anonymous online survey was administered to 198 mental health practitioners across diverse U.S.

Settings: The survey measured practitioners' recovery-promoting competency, demographic characteristics, organizational culture, recovery-oriented structure, recovery knowledge, and recovery attitudes. Data were analyzed using hierarchical multiple regression guided by social ecological model.

Results: Recovery knowledge (β = 0.304, p < .001), recovery attitudes (β = 0.379, p < .001), supportive organizational culture (β = 0.123, p = .042), and recovery-oriented administrative structure (β = 0.200, p = .002) significantly predicted recovery-promoting competency. Male practitioners reported lower competencies than female (β = -0.131, p = .019), while those with doctoral degrees reported higher competencies than those with bachelor's degrees (β = 0.146, p = .034). The final model explained 69.9% of variance.

Conclusions and implications for practice: Study shows fostering recovery-promoting competency requires both individual development and organizational support. Enhancing recovery knowledge and attitudes through targeted education may be particularly effective. However, training must be supported by recovery-oriented organizational context that reinforces these values through culture, structures, and operations. A supportive environment can empower practitioners to implement recovery principles. Findings highlight the need for coordinated multilevel strategies to strengthen recovery-oriented practice across diverse service settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: This mixed-methods study evaluated a pilot peer specialist intervention designed to reduce suicide risk in high-risk veterans with severe psychiatric disabilities.

Method: Veterans with high-risk flags for suicide (n = 12) were recruited, and peer specialists (PSs, n = 5) were trained for a feasibility study of peers for valued living, a 3-month semistructured suicide prevention intervention delivered by PSs. The Reliable Change Index was used to calculate whether veterans achieved reliable changes on standardized baseline-to-posttest assessments of personal recovery, depression, suicide ideation, perceived burden and thwarted belongingness, suicide cognitions, and hopefulness. Qualitative interviews with veterans as well as PSs and their supervisors were analyzed using rapid qualitative analysis.

Results: Most veterans (n = 10, 83.3%) improved on at least one measure, and five veterans (41.7%) deteriorated in at least one area. Reliable improvements were most common in suicide cognitions (n = 5, 41.7%) and suicidal ideation (n = 4, 33.3%). Qualitative analyses indicated that veterans uniformly described positive experiences with peers for valued living. PSs and supervisors were initially uneasy about openly discussing suicide and struggled to adopt the semistructured discussion framework. But with time, they felt more confident and skilled in engaging with high-risk veterans.

Conclusions and implications for practice: This mixed-methods pilot study establishes the feasibility and preliminary effects of a peer-delivered suicide prevention intervention with veterans with high-risk flags for suicide. Reliable positive changes were observed in suicidal ideation and other suicide cognitions. Qualitative interviews identified a range of important factors that are critical to efforts to employ PSs more directly in suicide prevention roles. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: This article describes the historical, contemporary, and probable future roles of biosystemic whole-health perspectives in the evolution of psychiatric rehabilitation.

Methods: We identify and discuss three examples of failures to fully consider the interaction of biological, psychological, and social levels of functioning, which have led to significant barriers to recovery: failure to account for physical morbidity in psychiatric disorders, lack of integration with modern understanding of inflammatory processes in psychiatric symptoms, and disregard for social and interpersonal factors.

Results: Significant limitations in rehabilitation outcomes arise from failure to fully consider the molar (i.e., integrated) implications of molecular impairments and vulnerabilities, and vice versa. We articulate the consequences of molecular models of personal and social functioning as barriers to future research and clinical care and propose looking beyond the traditional scope of psychopathology and boundaries of mental health services to reach a whole-health understanding of psychiatric disorder and disability, rehabilitation, and recovery.

Conclusions and implications for practice: The integrative biopsychosocial model is a particularly promising direction in the evolution of psychiatric rehabilitation, with strong clinical and theoretic implications that may guide much-needed change in policy and practice. Key to progress in our understanding of psychiatric disorder, disability, rehabilitation, and recovery is a perspective on science and clinical practice that values integration of multiple domains of knowledge as much as analytic dissection of molecular (i.e., unitary) processes. Reforms must be expected at all levels of health care service systems, in practitioner training, administration, and social policy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Difficulties in social interactions are a core characteristic of schizophrenia spectrum disorders. They are often linked to impairments in social cognition, including emotion recognition, social perception, theory of mind, and attributional style. The RC2S program (cognitive remediation of social cognition) aims to address these deficits through individualized interventions. This study is the first controlled randomized trial to compare RC2S with RECOS (Remédiation Cognitive pour la Schizophrénie ou un trouble associé), a neurocognitive remediation program, to evaluate their respective impacts. Method: Fifty-one outpatients with schizophrenia were randomized into RC2S (n = 25) or RECOS (n = 26) groups. The primary outcome was a measure of attributional biases, with secondary outcomes including symptom severity, social functioning, and cognitive measures. Assessments were conducted at baseline (T1), posttreatment (T2), and 3 month follow-up (T3). Results: Both groups improved significantly in social cognition and neurocognition, with no overall between-group differences. Yet only the RC2S group showed a significant reduction in hostile attribution bias from T1 to T2, a domain where many social cognitive trainings falter. RC2S also produced faster gains in negative symptoms and one area of social functioning. RECOS showed stronger effects on positive symptoms and certain neurocognitive measures. Both programs enhanced functional outcomes, though the trajectories of change differed. Conclusions and Implications for Practice: While the results highlight RC2S's potential, the small sample size, high dropout rate, and low baseline levels of hostility bias limit the generalizability and interpretability of these findings. Future research should refine RC2S, use more sensitive assessments, and explore broader applications. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Peer support services are proliferating for young adults (YA) with serious mental health conditions. Psychiatric rehabilitation services continue to develop and launch these programs nationally and globally. This conceptual article builds upon principles from peer support and trauma-informed care and shares lessons from the field to advance a trauma-informed peer support framework for YA mental health.

Method: Informed by the literature, three YA mental health interventions, and a series of iterative team consensus-building meetings, we identified pillars of a trauma-informed peer support for young adults (TIPS-YA) framework to focus research and practice in psychiatric rehabilitation as peer support programs continue to emerge in many YA service contexts.

Results: TIPS-YA includes four pillars: (a) safety, (b) mutuality, (c) empowerment and voice, and (d) context. Each is a fundamental area for developing and providing peer support services. Yet, no previous training or conceptualization of peer support includes all aspects of these four critical areas.

Conclusions and implications for practice: Peer support for YAs needs distinct consideration in psychiatric rehabilitation. YA services must bridge the developmental period between youth and adulthood, and offer unique supports. TIPS-YA offers a starting point to develop and implement program models that embed peer supporters, and to advance the science of peer support. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Comments on an article by S. W. Schrader et al. (see record 2026-54463-001). Schrader et al. recently reported on VA programs for veterans in early stages of recovery from substance use disorder (SUD), finding that 78% of 78 veterans elected to receive therapeutic work activity, which has a primary goal of clinical recovery rather than employment, and only 22% selected programs focusing on competitive employment. Three possible interpretations may explain Schrader et al.'s anomalous finding and deserve further research. They are discussed in the current commentary. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Vocational research requires standardized measures of employment outcomes. Yet studies vary widely in how they define measures used to assess employment outcomes. This article makes recommendations for a core outcome package of objective measures of competitive employment suitable for vocational research.

Methods: We identified seven criteria for assessing the utility of an employment measure: widely used, reliable, simple to collect, easily understood, demonstrates criterion validity, sensitive to change, and relevant to multiple groups with vested interests. We then conducted a selective review of employment measures found in published studies, using these criteria to evaluate a range of objective employment measures within a conceptual framework consisting of six domains: job acquisition, amount of time employed, employment earnings, time commitment to employment, consistency of employment, and job stability. Results: Based on our review, we recommend three primary outcomes (competitive employment rate, total time worked, and total employment earnings) and eight descriptive outcomes for inclusion in a core outcome package. To ensure standardization, we provide explicit definitions for each measure.

Conclusions and implications for practice: Adoption of a core outcome package will (a) provide guidance to researchers planning new studies, (b) provide a common set of measures permitting direct comparisons between studies, and (c) facilitate meta-analytic reviews by using common metrics. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Psychiatric rehabilitation services (PRS) were developed to facilitate recovery and community integration by addressing psychosocial needs such as housing, employment, illness management, and social inclusion for individuals with serious mental illness. However, PRS are primarily designed for and available in community settings. The objective of this conceptual article is to explore the potential role of PRS during inpatient psychiatric hospitalization and offer a forward-looking vision, identifying trends to guide future efforts.

Method: This article presents a conceptual analysis of the potential benefits and impacts of PRS on the recovery process of individuals with serious mental illness if these services were also provided during hospitalization. This critical analysis was coauthored by various stakeholders, including individuals with lived experience, psychiatric, and other mental health providers, and psychiatric rehabilitation researchers.

Conclusions and implications for practice: Integrating PRS into routine care during psychiatric hospitalization supports recovery and facilitates postdischarge community connections and outcomes. While PRS were originally conceptualized and designed for community settings, efforts should be made to tailor and adapt them for use in inpatient settings. Shifting staff attitudes toward inpatient recovery-oriented care, developing interventions and training for PRS integration, and securing leadership and institutional buy-in are the next practical steps to make this vision a reality. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Initiatives developed by the Department of Veteran Affairs have reduced Veteran homelessness, but homeless-experienced veterans (HEVs) still face social integration challenges, such as reduced social interactions. Smartphone-based ecological momentary assessment provides a valuable way to remotely gather data on these challenges in HEVs' daily lives. Social interactions are part of a behavioral sequence, involving a social interaction, its appraisal (pleasant/successful vs. unpleasant/unsuccessful), and subsequent motivation for future social interaction. Motivation can be in the form of social approach (e.g., drive to initiative contact with others) or social avoidance (e.g., avoiding interaction due to fear of failure).

Methods: Ecological momentary assessment was used to sample positive and negative social appraisals, social motivation (approach and avoidance), and social interactions (frequency and time spent with others) multiple times daily over a week in 28 HEVs with serious mental illness or substance use disorder. Data were analyzed for concurrent (same day) and prospective (subsequent day) relationships.

Results: Positive social appraisals were linked to social approach motivation, while negative social appraisals were linked to social avoidance motivation on the same day. Social approach motivation was associated with more social interactions, more time with others, and less time at home on the same day. Additionally, social approach motivation predicted the number of social interactions the next day.

Conclusions and implications for practice: These findings suggest a pathway from social appraisals to motivation for social interactions, implicating potential targets for psychosocial interventions for social integration in HEVs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: This study aimed to explore the needs of families of individuals with serious mental illness (SMI) within the context of a public psychosocial rehabilitation service. The second aim was to identify and propose strategies to enhance family engagement and improve the effectiveness of family intervention programs.

Method: Qualitative study involving three focus groups: (a) service users (i.e., individuals with SMI), (b) family members, and (c) professionals (nursing/social work). A fourth group consisting of experts in the field of psychosocial rehabilitation (psychologists/psychiatrists) interpreted the results. A thematic analysis approach was used to evaluate the data.

Results: Family members expressed needs in the following areas: space for emotional expression, adjustment of expectations, communication, support, sexuality, management of family secrets, and acceptance of the mental health condition. Family members also reported a need for more information, assistance in dealing with stigma, and more support to foster autonomy. In many cases, the groups found it difficult to identify the needs of the other groups. Overall, the results reveal the important burden facing the family.

Conclusions and implications for practice: The findings of this exploratory study suggest that more tailored interventions are needed to better address the emotional and practical needs of families of individuals with SMI. We propose several changes to improve intervention programs, including therapeutic approaches specifically designed to address the needs identified in this study and new strategies to improve treatment engagement. If implemented, these proposed changes could improve treatment outcomes in this clinical population. In future studies, we recommend using larger, more diverse samples to test the current results. (PsycInfo Database Record (c) 2025 APA, all rights reserved).