Psychiatric Rehabilitation Journal最新文献

Objective: Psychiatric rehabilitation approaches have evolved to offer individualized options for people with psychosis to direct their own recovery. Meaning making is a core component of self-directed recovery that allows individuals to make sense of psychosocial challenges and life experiences and then decide how to recover and move forward with their life. Individual psychotherapy that is personalized and collaborative can allow people with psychosis to explore the meaning of challenges and life experiences, especially for those with fragmented understanding of themselves and their life. Integrative psychotherapies may be uniquely positioned to target meaning making to promote self-directed recovery.

Method: We provide a narrative review of the literature and outline practical psychotherapy approaches and practice implications to describe how meaning making can be promoted with an integrative, metacognitive therapy approach.

Results: In this article we (a) discuss the metacognitive theoretical framework of psychosis as it relates to meaning making, (b) share specific methods from diverse psychotherapy approaches to promote meaning making, and (c) discuss how this meaning making further promotes self-directed recovery in practice.

Conclusions and implications for practice: We propose that meaning making can come from many different approaches and that integrating diverse methods can improve personalization to maximize benefit and enhance self-directed recovery. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: The present study assessed the relationship of college self-efficacy (beliefs in capacity to complete college tasks) and psychiatric rehabilitation attitudes (PRA; a measure of professional identity) and their relationship to educational barriers and several demographic variables among undergraduate students studying psychiatric rehabilitation.

Methods: A total of N = 92 undergraduate students completed an online survey for the current analysis. Data were collected on college self-efficacy, PRA (including beliefs, goals, practices), educational barriers, and student demographics.

Results: We found that students' college self-efficacy was positively associated with PRA (r = .326, p = .002). White students endorsed significantly stronger PRA (effect size 0.52, p = .03). College students' self-efficacy was inversely associated with living with mental health conditions (r = -.209, p = .028) and whether started clinical practicum (p = .015) where students who started clinical practicum had significantly higher self-efficacy, regardless of whether they lived with a mental health conditions or not.

Conclusions and implications for practice: Consistent with social cognitive career theory, students with higher college self-efficacy scored higher on the professional identity measure in the present study, PRA. We discuss the implications of this finding for rehabilitation education programs preparing students to work with individuals in the behavioral health care and rehabilitation fields. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: The open dialogue approach is a systemic, therapeutic intervention that aims to support individuals who experience severe and enduring mental health difficulties. Striving to encourage a rehabilitation-oriented approach, open dialogue (OD) has faced several adaptations according to different contexts and countries. This review sought to understand adherence and implementation practices of OD and specifically how they are reported within the OD intervention research literature.

Methods: A systematic strategy was used to search five electronic databases (CINAHL, APA PsycInfo, The Cochrane Library, PsycArticles, PubMed) using title/abstract and full text terms. Data were extracted using an extraction template developed for the purpose of this review that incorporated a recently developed OD adherence protocol (Lotmore et al., 2023). A methodological quality appraisal was employed. Narrative synthesis and content analysis were used to analyze the findings.

Results: Of the 1813 studies initially identified from the search string, 28 studies were included based on the inclusion and exclusion criteria. These composed of qualitative (n = 12), quantitative (n = 14), and mixed methods (n = 2) designs. The quality of the methods used in included studies overall was high. A descriptive analysis suggested generally good, though often implicit, adherence to principles of OD (64%). A narrative synthesis revealed five underpinning themes which affected adherence.

Conclusions and implications for practice: Adherence to principles of OD was only of good quality. Assessment and reporting of adherence to OD's principles in research is encouraged to align with rehabilitative practices in mental health services. To support greater adherence to OD, researchers are encouraged to use the OD adherence protocol in reporting their work. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Young adults (YAs) have high rates of serious mental health conditions and historically low rates of mental health treatment engagement. YAs have historically been understudied within psychiatric rehabilitation, but more recently, multidisciplinary team- and community-based approaches informed by assertive community treatment have become popular. Much can be learned from YAs enrolled in YA-specific teams to understand how YA-specific teams support YA recovery.

Methods: A research team with several YAs with lived/living mental health experience conducted and analyzed interviews with YAs (n = 22) enrolled in YA-specific team-based services. The research team used reflexive thematic analysis.

Results: Self-discovery was central in YA team-based service experiences. The YA team fostered discovery by (a) supporting YA self-reflection within mutually respectful YA client-team member relationships made possible through the YA team; (b) blending and balancing YA development, lived experience, and clinical expertise; and (c) providing flexible, tailored services and activities in the community and clinic.

Conclusions and implications for practice: Supporting YAs in building their sense of self is central in engaging YAs. YA mental health providers and policymakers in the field of psychiatric rehabilitation can use discovery practice concepts to describe how and why adult mental health care can successfully be different for YAs. (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: 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: 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).

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).