Psychiatric Rehabilitation Journal最新文献

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) 2025 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) 2025 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) 2025 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) 2025 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: Clubhouses are nonclinical community-based recovery programs for adults with serious mental illness. This case study investigated the perceived impact and value of a Clubhouse startup from the perspectives of its inaugural members and staff, and potential referral sources.

Methods: Participatory mixed-methods research practices were used to engage Clubhouse members and staff as partners in all stages of the research process. A convergent parallel design integrated quantitative and qualitative data from three groups of participants: Clubhouse members, Clubhouse staff, and community referral sources. Redacted records for the first 43 members were used to gather demographic information and identify the functional needs of the startup's initial members. Three participatory exercises were conducted to gather and analyze qualitative data with Clubhouse members (n = 12) and staff (n = 2). Potential community referral sources completed anonymous online surveys (n = 41) or participated in an interview (n = 3).

Results: Quantitative and qualitative findings from members and staff support previous literature regarding the functional (housing and employment) and psychosocial needs (community, structure, growth, identity, and reactions to stigma) of Clubhouse members and are the first to report them in the context of a Clubhouse startup. Quantitative and qualitative findings from community referral sources suggest that the startup's initial outreach efforts with their local network of providers that serve adults with serious mental illness have yielded a positive and generally accurate impression of the startup's value.

Conclusions and implications for practice: Implications of findings for Clubhouse practice and research are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Person-centered care improves service engagement and retention among individuals with behavioral health challenges, but barriers to feasibility often prevent person-centered strategies from being effectively integrated into routine treatment. Collaborative documentation (CD), where providers complete visit notes jointly with clients during session, is designed to be a flexible and time-efficient person-centered practice that may address persistent challenges to adopting person-centered care. To date there is no work exploring the implementation of CD in behavioral health. This study utilized normalization process theory, a leading implementation framework, to understand the process of adopting CD in one outpatient behavioral health clinic.

Method: Focus groups with 22 providers evaluated barriers and facilitators to implementing CD following an organizational CD training. Rapid qualitative methods were used to analyze audio-recorded data.

Results: Whether providers viewed CD as a documentation strategy or as a person-centered practice shaped how it was implemented in routine care. Providers also highlighted the cognitive burden of real-time documentation as a barrier to CD implementation. The presence of organizational champions facilitated provider buy-in and increased adoption, though sustainability strategies were needed to support this in the long term.

Conclusions and implications for practice: Findings highlight the need to better articulate the core elements of CD and achieve a unified vision of practice principles and goals, including its connection to person-centered care. In addition, basic documentation training for providers is needed to increase the feasibility of CD. (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).

Objective: Cognitive deficits are common among defendants adjudicated incompetent to stand trial, although cognition-focused interventions for this population have not been researched extensively. This quasi-experimental study examined the effectiveness of a program that integrates cognitive training and competency restoration treatment for individuals with cognitive deficits.

Methods: Participants in a state hospital were enrolled in the program and assigned to naturally occurring full (n = 53) or limited (n = 29) access conditions. The program was delivered in a group format with semiweekly sessions over the course of 12 weeks. All participants had continuous access to standard competency restoration treatment.

Results: Participants in the full access condition demonstrated greater progress in most areas of competency, were more likely to be restored to competence, and had a shorter length of stay than participants in the limited access condition. Increases in all areas of competency progress were associated with restoration of competence. Improved ability to consult with counsel, free recall of information about the adjudicative process, and overall competency progress were associated with shorter length of stay. A reduction in positive, but not negative, symptoms of psychosis was observed across conditions. Although psychosis was negatively associated with restorability and positively associated with length of stay, no significant associations were found between changes in psychosis and these outcomes.

Conclusions and implications for practice: Findings of the present study provide supportive evidence for integrating cognitive interventions and competency restoration treatment. This approach has promise for improving outcomes for forensically committed individuals with cognitive deficits. (PsycInfo Database Record (c) 2025 APA, all rights reserved).