Psychiatric Rehabilitation Journal最新文献

Objective: Increasing service user involvement and collaboration with providers has become an important facet of the recovery movement. This study explored perspectives on the implementation and delivery of an intervention (Just Do You [JDY]) designed to improve treatment engagement among marginalized young adults diagnosed with serious mental illnesses.

Method: Informed by the Consolidated Framework for Implementation Research (CFIR), we conducted in-depth interviews (N = 11) with nine participants that included agency leaders, clinical providers, and researchers involved with the planning, delivery, and evaluation of JDY. We used grounded theory coding techniques and constant comparison to develop themes that capture the data on implementation and collaboration related to the delivery of JDY.

Results: Two broad themes emerged: (a) collaboration between the clinician and person with lived experience and (b) collaborative culture within and between organizations. Findings capture how collaboration occurred between providers within the clinical encounter (e.g., combined strengths of clinicians and peers) and within and between organizations, clustering around several CFIR domains (e.g., inner setting, process, characteristics of individuals, intervention characteristics). Findings speak to the importance of a "culture of collaboration" in which collaboration is occurring across multiple levels of an organization to support the delivery and implementation of JDY.

Conclusions and implications for practice: JDY can complement other collaborative approaches given its focus on improving initial engagement. Findings point to the perceived benefits of interventions that are facilitated by a clinician and a person with lived experience along with how their combined expertise can support recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Promoting leisure participation requires a collaborative approach that emphasizes personal interests, strengths, and motivations. The purpose of this article was to test the effectiveness of the Independence through Community Access and Navigation (ICAN) intervention on community participation, recreation participation, and positive emotions among individuals with schizophrenia spectrum disorders. Using motivational interviewing and an individualized placements and support framework, the ICAN intervention focuses on working with participants to identify and participate in personally meaningful leisure activities by connecting with personal motivations and mainstream community opportunities.

Method: This randomized controlled trial was conducted with 74 participants diagnosed with schizophrenia with assessments conducted at baseline and posttreatment. Intervention effects were examined with repeated-measures analysis of variance (ANOVA). Multiple regression analysis was also performed using a change score as an outcome variable and baseline negative symptoms score, condition, and interaction as predictors.

Results: There was no significant main effect of ICAN on positive emotions, recreation participation, or community participation; however, among those in the experimental group, those with impairments in motivation and pleasure experienced improvements in community participation.

Conclusions and implications for practice: For individuals experiencing greater negative symptoms, a supported leisure intervention may be an effective strategy to explore personal motivations and increase leisure participation. Future research should test the intervention effectiveness specifically targeting a larger sample of individuals with more severe negative symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: "Serious mental illness" (SMI) is a priority population within mental health treatment and policy. However, there is no standard operational definition across research, clinical, and policy contexts. The use of the label has also not been evaluated regarding its association with stigma among the general public. This mixed-method study compared community members' stigma toward "SMI" with other psychiatric labels and examined community understanding and perceptions of the SMI label.

Method: Two hundred forty-six participants recruited via Prolific read randomly manipulated vignettes describing an individual diagnosed with depression, schizophrenia, or "SMI" and completed measures of stigma and qualitative questions regarding familiarity, understanding, and perceived utility of SMI. Quantitative analyses evaluated stigma across vignettes, and qualitative analyses identified common themes across responses.

Results: Stigma was relatively high across vignettes, with more negative views reported toward SMI and schizophrenia compared with depression. Quantitative differences in stigma by vignette were not significant after controlling for participants' age and gender. Qualitative responses were split regarding the perceived utility of the SMI term, with noted concerns including its broadness and potential for stigma. Most participants described functional impairment or disability as characteristic of "SMI," and approximately 70% associated schizophrenia and psychotic disorders with "SMI" compared with 45% for depression.

Conclusions and implications for practice: Person-level factors were more strongly associated with stigma than psychiatric labels. However, our sample described concerns that the SMI term is vague and may exacerbate stigma. Community education and antistigma efforts should move beyond diagnostic labels in characterizing mental illness to facilitate change in attitudes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Community-based participatory research (CBPR) is based on power as fundamental to doing research. It evolved as a way of "knowing" from the broader idea of natural science. While previously viewed as objective, natural science is now understood as, at least, partially socially constructed.

Method: History of research and epistemology is reviewed in terms of science. More specifically, we delve into science as social construction and how this conceptually opens the door to considering power in its processes. We then unpack CBPR as one way to do mental health research that artfully weaves power into method.

Results: Natural science has evolved from believing scientism (i.e., the scientific method) is sufficient to describe physical and social phenomena to terms of social constructivism; namely, the social processes that impact investigators are necessary to understand science and its product. This highlights the role of power; namely, investigator choices about hypotheses, methods, analyses, and interpretations influence the products of individual studies. The recovery movement is the embodiment of power that significantly changed research and rehabilitation in mental health. CBPR has emerged to include people with lived experience in the research enterprise. CBPR is partnership among people with lived experience, health scientists, and service providers in all facets of doing research.

Conclusions and implications for practice: Integrating CBPR into rehabilitation science has led to findings and actions that better serve community objectives. Continuing to weave CBPR into research and development will further enhance recovery in practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This article conceptually examined the need for and utility of community-based participatory research (CBPR) approaches for increasing rates of engagement in psychological research among underserved minoritized ethnoracial groups.

Methods: This article examined the literature for relevant studies examining rates of research engagement by minoritized ethnoracial groups, significant factors precluding research engagement, and the consequences of this disparity for mental health outcomes. The theoretical literature outlining the development and utility of alternative, community-based participatory research methods was included. Key features of CBPR were examined along with limitations of current approaches. A case study example of CBPR is provided.

Results: The use of CBPR approaches has been documented to improve health outcomes, reduce stigma toward mental health research and treatment, and build the professional capacity of community partners, particularly among minoritized ethnoracial groups.

Conclusions and implications for practice: CBPR engagement practices are a means of reducing the mental health research gap for ethnic and racial minoritized groups. The use of such approaches in future research and practice will directly inform how existing psychological treatments may be modified per the needs of the patient, address long standing issues of cultural mistrust toward professional institutions, and reduce mental health stigma in underserved communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Many young adults who are unemployed and not in school need support achieving employment goals. Individual Placement and Support (IPS) is an evidence-based employment practice for adults with serious mental illness, but its applicability to young adults with mental health conditions has not been well-researched. The present study prospectively assessed IPS effectiveness in a national sample of young adults enrolled in routine practice settings in the U.S. public mental health system.

Method: Nine community agencies in five states participated in a 1-year follow-up study of young adults (aged 16-24) enrolled in IPS services. The study examined three outcomes: retention in services, employment, and education. State fidelity reviewers examined IPS fidelity using a new fidelity scale, the IPS-Y.

Results: In a sample of 111 participants, the mean age was 19.2, 72 (64.9%) had never worked, and 76 (68.5%) had a diagnosis of depressive and/or anxiety disorder. Participants averaged 8 months of enrollment before terminating from IPS services. During follow-up, 51 (45.9%) participants obtained a competitive job (N = 50) or paid internship (N = 1); 14 (12.6%) achieved a new education outcome.

Conclusions and implications for practice: IPS has promising outcomes for helping young adults with mental health conditions achieve positive employment outcomes, but its effectiveness in helping young adults achieve education goals has not been demonstrated. IPS should be offered to young adults with employment goals. Targeted funding for supported education and training for IPS specialists in delivering educational supports may be necessary to ensure optimal education outcomes in IPS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study aimed to assess the feasibility of implementing Individual Placement and Support (IPS) with a focus on educational and employment goals, within a clinical service for the early detection of individuals at clinical high risk (CHR) of psychosis.

Method: Between June 2019 and April 2021, participants were recruited and received up to 6 (± 2) months support. Primary outcome: Enrolled participants, attended sessions, and disengagement rates were analyzed to assess feasibility.

Secondary outcomes: Enrollment in mainstream education or/and employment, hours spent working or/and studying, salary, level of functioning, and self-efficacy at baseline and follow-up were compared.

Results: Thirty-one participants were recruited, 13 of whom were remotely recruited after the first COVID-19 lockdown. Dropout rates were relatively low (16.1%), and 26 participants (83.9%) completed the program. Each participant received on average nine sessions (M = 9.65; SD = 4.92). Secondary outcomes: At follow-up, 73.1% participants were employed, working on average more hours per week, t(25) = -2.725; p = .012, and were earning significantly more money, t(25) = -3.702; p = .001, compared to baseline. Gains in educational outcomes were less clear. Global Assessment of Functioning, t = 248.50; p = .001, and Social Occupational Functioning, t(25) = -3.273; p = .003, were significantly higher at 6-month follow-up compared to baseline. No differences were found in participants' self-efficacy.

Conclusions and implications for practice: Findings indicate that research procedures are appropriate and that IPS implementation within a CHR clinical team is feasible. Secondary outcomes also suggest that IPS may be a beneficial intervention for young people at CHR. A longer follow-up might be needed to assess its impact on educational outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This systematic review examined community-based participatory research (CBPR) studies in which people with mental illness (PWMI) directly contributed to research projects. The purpose was to describe study characteristics, team structure and logistics, and level of involvement of in the research process.

Method: We searched the PsycINFO database from January 2000 to July 2020, identifying 1,395 records and analyzing the 31 that met inclusion criteria. Articles were eligible if they were (a) published in English in a peer-reviewed journal; (b) explicitly stated that at least one adult with mental illness assisted with the study as a CBPR team member; and (c) included a research outcome.

Results: Most studies collected qualitative data. Project length, team composition, and frequency of meetings were not specified in about one third of the articles. Twenty-nine studies reported involvement of people with mental illness in research activities such as recruitment, data collection, transcription, and analysis. Nearly half did not specify if they received any training.

Conclusions and implications for practice: Individuals with mental illness were heavily involved in planning and conducting research, demonstrating the feasibility of meaningful involvement. Future research should consider how people with lived experience can assist with quantitative methods, and articles should clearly and explicitly describe characteristics of the partnership (e.g., team composition, frequency of meetings, compensation). The protocol is published in Open Science registry at https://osf.io/mshfb. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Including people most impacted by a challenge in designing and implementing solutions to that challenge has reemerged in social science research. In prison settings, academics' outside knowledge of "what works" combined with incarcerated people's inside knowledge of lived experience could lead to more comprehensive rehabilitative programs. This combined approach may make less sense as an intervention in prison, however, due to sensitive and complicated interpersonal dynamics. We determine if incarcerated women perceive prison programs as more efficacious when other incarcerated women are collaboratively involved in the design and implementation of those programs, as compared to other program delivery methods. Methods: We employ a participatory action research framework in administering a randomized vignette to 200 incarcerated women. We randomize who designs and teaches a prison program in a hypothetical scenario, with incarcerated women alongside university researchers the key combined condition of interest. We then ask a series of questions regarding incarcerated women's perception of the program's efficacy. Results: Women who received the combined condition were four times more likely to view the program as legitimate when compared to programs taught by correctional staff. The combined condition was not significantly different on legitimacy when compared to either researchers alone or incarcerated women alone. We did not observe other expected relationships between the combined condition and perceived program efficacy. Conclusions and Implications for Practice: Researcher and incarcerated person-led programming should be implemented carefully in institutional settings to leverage the value of lived experience while avoiding creating further harm for confined people. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Voices of people with lived experience led to a recovery-based revolution in rehabilitation practices and principles. Hence, these same voices must be included as partners in the research enterprise meant to evaluate ongoing developments in this area. Community-based participatory research (CBPR) is the one way to do this. CBPR is not really new to the rehabilitation arena; Rogers and Palmer-Erbs highlighted the paradigm shift in rehabilitation research calling for participatory action research (PAR). PAR is action-oriented and rooted in partnerships between people with lived experience, service providers, and intervention researchers. This special section briefly highlights important topics that highlight the continued need for CBPR in our research enterprise. (PsycInfo Database Record (c) 2024 APA, all rights reserved).