Psychiatric Rehabilitation Journal最新文献

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).

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: 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).

Objective: While leisure activities have been shown to enhance mental well-being and social participation, there is limited research on the specific effects of structured leisure-based occupational therapy interventions on individuals with schizophrenia. This study aims to evaluate the impact of leisure-based interventions on well-being and life satisfaction in individuals with schizophrenia.

Methods: This pre-post intervention mixed-methods study involved 18 individuals diagnosed with schizophrenia. The intervention consisted of 20 group sessions over 10 weeks. Participants were assessed using the Subjective Well-Being Scale, the Satisfaction With Life Scale, and the Canadian Occupational Performance Measure (COPM). Qualitative data were collected through semistructured interviews. Quantitative data were analyzed with within-subjects statistical tests, while qualitative data were examined through content analysis.

Results: The intervention was associated with substantial improvements in occupational performance and life satisfaction, as indicated by significant increases in COPM performance and satisfaction scores (COPM-P, COPM-S), the Satisfaction With Life Scale, and the Subjective Well-being Scale (all p < .001). Semistructured interviews revealed that participants valued leisure activities for improving their mood, social connections, and personal well-being. Barriers to engagement, such as lack of time and resources, were also highlighted.

Conclusions and implications for practice: Leisure-based occupational therapy interventions may enhance well-being, life satisfaction, and occupational performance in individuals with schizophrenia. The findings suggest that structured leisure activities can serve as a valuable therapeutic tool, promoting social interaction, personal fulfillment, and mental health recovery. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Cannabis use is common among young adults experiencing psychosis (YA-P) and is associated with negative consequences. Effective cannabis interventions for YA-P have not been identified. The Teen Marijuana Check-Up is a two-session intervention to reduce heavy cannabis use in YA-P who are not seeking cannabis treatment. We used data from interviews and focus groups to optimize the Teen Marijuana Check-Up for YA-P and conducted a demonstration project of this optimized intervention-the Cannabis Check-Up for Psychosis (CCU-P)-to evaluate its acceptability and feasibility.

Methods: Findings from qualitative interviews and focus groups were used to design optimizations that were reviewed by a Stakeholder Advisory Board for feedback. The final CCU-P was evaluated in a one-arm pilot study with 12 YA-P who were regular cannabis consumers and engaged in Coordinated Specialty Care. Feasibility (tracking participation) and acceptability (satisfaction ratings, qualitative input) were evaluated.

Results: Optimizations included (a) questions to elicit discussion of cannabis' impact on mental health, psychosis, and treatment; (b) data-based comparisons with infographics to inform about risks for rehospitalization and challenges to recovery associated with cannabis use; and (c) an infographic to detail harm reduction strategies. Overall, 92% completed both CCU-P sessions. Intervention satisfaction was high. All participants reported that they would recommend CCU-P to others in Coordinated Specialty Care.

Conclusions and implications for practice: CCU-P is a promising intervention, resonant with principles of psychiatric rehabilitation, that uses a nonjudgmental approach, provides science-based information about cannabis-psychosis interactions, and supports participants to make informed choices about use. A larger efficacy trial is warranted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: To examine and synthesize the available empirical evidence on the impact of transitional work (TW) on vocational (i.e., rates of competitive employment, time to competitive employment, tenure in competitive employment, income earned) and mental health outcomes.

Methods: APA PsycArticles, APA PsycInfo, Psychiatry Online, PubMed, and Social Sciences Citation Index were searched using the key terms: "transitional work," "compensated work therapy," "transitional employment," "noncompetitive employment," and "diversified placement approach." A gray literature search was conducted through Google Scholar.

Results: 28 studies met inclusion criteria for this review. There is some evidence indicating that TW improves vocational outcomes compared with general vocational support or no services at all, but that TW is less effective at improving vocational outcomes compared with job placement services (e.g., individual placement and support). With regard to mental health, there is some evidence that TW improves substance use outcomes when paired with other substance use-related services (e.g., transitional housing, drug screen protocols).

Conclusions and implications for practice: TW appears to be an effective approach for improving vocational outcomes compared with no treatment, incentive therapy, workshops, or other general vocational supports, and less effective than job placement services that are designed for individuals with immediate competitive employment goals (e.g., individual placement and support). Recommendations for practice and research are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: This study evaluated the feasibility and acceptability of Think and Cope Positively, a structured 15-session program designed to enhance well-being in adults diagnosed with severe mental health conditions such as schizophrenia and bipolar disorder.

Methods: Twenty-six participants were recruited through mental health services, and sociodemographic and clinical characteristics, protocol compliance, session attendance, and satisfaction were assessed. Intervention outcomes, including hedonic and eudaimonic well-being, optimism, therapeutic alliance, and psychological symptoms, were measured both before and after the intervention.

Results: Of the 26 participants, 20 completed the program (77%), attending an average of 14 out of 15 sessions. Both participants and facilitators reported high levels of satisfaction with the intervention. Statistically significant improvements in well-being, optimism, and therapeutic engagement were observed following the program.

Conclusions and implications for practice: These findings indicate that Think and Cope Positively is a feasible and acceptable intervention to enhance well-being in individuals with severe mental health conditions. It provides a promising addition to existing psychosocial rehabilitation strategies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Mental health services in the developed Western world have known a significant change in paradigm in favor of recovery. However, the transformation has not followed at the same pace in the developing Arab countries. Introducing recovery-oriented approaches in mental health care systems in Arab countries needs the provision of a valid, reliable, economic, and culturally tailored recovery measure that can be easily applied among people with mental illness. This study proposes to contribute to the field by translating and validating the Recovery Assessment scale (RAS-8) in the Arabic language.

Methods: The Arabic translated version of the RAS-8 was administered to 177 persons with schizophrenia receiving treatment, who were recruited from a long-stay hospital in Lebanon.

Results: Findings from the confirmatory factor analysis indicate that the bidimensional factor structure of the Arabic version of the RAS-8 revealed adequate goodness-of-fit values. A Cronbach's α coefficient of .68 was observed, indicating adequate internal consistency reliability. Concurrent validity was supported by showing that RAS-8 scores correlated significantly and negatively with symptom severity, and correlated positively with functioning levels. Finally, cross-sex invariance was established at the scalar, metric, and configural levels.

Conclusions and implications for practice: The present study makes available a simple, valid, and reliable translated version of the RAS-8 in the Arabic language to measure personal recovery as experienced and self-rated by patients with schizophrenia in an Arabic-speaking Lebanese population. Hopefully, the Arabic version of the RAS-8 will serve as a useful measure of recovery for both mental health professionals and researchers working in the Arabic language and context. (PsycInfo Database Record (c) 2026 APA, all rights reserved).