Psychiatric Rehabilitation Journal最新文献

Objective: Measuring the career development of individuals with psychiatric disabilities is essential for assessing their employment preparedness and the impact of educational and vocational supports and programs. The primary purpose of the two studies presented was to develop a shorter version of an established instrument, the Career Advancement Inventory (CAI), that assesses the psychological preparedness for careers and employment among individuals with psychiatric disabilities. The CAI was originally developed using a community-based participatory research approach and a combination of Classical Test Theory and Item Response Theory resulting in a 111-item scale.

Methods: We utilized exploratory factor analysis, reliability coefficients, correlations, and t tests to assess the factor structure, reduce the number of items, and establish the norms of the CAI. Two diverse samples were included, an online sample (n = 500) and an in-person sample (n = 100) of individuals with psychiatric disabilities.

Results: The resultant 52-item Career Advancement Inventory-Short Version has a five-factor structure and demonstrated excellent norms with high reliability and moderate to high concurrent, divergent, and known groups validity.

Conclusions and implications for practice: The Career Advancement Inventory-Short Version would be useful in assessing the career preparation of individuals with psychiatric disabilities and has implications for clinicians, rehabilitation providers, researchers, and educational and employment interventions for these populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice.

Method: Informed by community-based participatory research methods, a PhD-level qualitative researcher and a former peer support specialist conducted virtual interviews with 20 CSC peer support specialists. A multidisciplinary team including researchers with lived mental health experiences thematically coded interview transcripts.

Results: A spectrum of CSC peer support specialist SU responses emerged: (a) leverages lived SU experiences; (b) does not explore SU with clients; (c) shares client SU information with the CSC team; (d) educates, mentors, and advocates; (e) shares SU consequences and/or challenges substance use; (f) nonjudgmental, nondirective SU exploration; and (g) promotes harm reduction.

Conclusions and implications for practice: CSC peer specialist SU practice is influenced by several contextual tensions that must be better understood and addressed in future research to improve peer SU practice. Study findings speak to practice nuances that are helpful for CSC peer support training and supervision. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Peer recovery support specialists (PRSS) are essential members of the behavioral health workforce. While factors contributing to PRSS job satisfaction and burnout have been examined, less is understood about why PRSS consider leaving or remaining in their roles. This study sought to identify personal, professional, and organizational factors related to PRSS' intentions to leave their current position.

Method: A convenience sample of PRSS was recruited from a partnering organization's national listserv and digital newsletter. In collaboration with the same organization, we developed a survey using adaptations of validated instruments and electronically distributed it in June 2023. Bivariate analysis and hierarchical logistic regression were conducted to understand which factors may predict PRSS' intent to leave their current position.

Results: The total sample included 454 PRSS, with 42% considering leaving their current position, of which 44% reported intent to leave within the next year. The ability to meet financial needs (OR = 0.58, 95% CI [0.38, 0.90]), having to complete extra tasks outside of PRSS responsibilities (OR = 2.91, 95% CI [1.90, 4.44]), overall job satisfaction (OR = 0.46, 95% CI [0.25, 0.84]), and burnout (OR = 1.54, 95% CI [1.00, 2.36]) significantly predicted intent to leave.

Conclusions and implications for practice: PRSS reported high job satisfaction; however, burnout experiences, inability to meet financial needs, and extra work tasks beyond their role significantly impacted intent to leave. Findings underscore the need for organizational and policy-level changes to address burnout, low pay, and workload issues to better support PRSS' well-being and retain this essential behavioral health workforce. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Individuals with posttraumatic stress disorder (PTSD) and comorbid severe mental illness (SMI) are often underserved and undertreated. Empirical validation of commonly used measures of psychiatric symptoms in clinical practice, such as the Brief Psychiatric Rating Scale-Expanded (BPRS-E), is warranted in this vulnerable population. As such, this study sought to validate the factor structure and examine the psychometric properties of the BPRS-E among Veterans with comorbid PTSD and SMI.

Methods: The study sample included 126 Veterans with comorbid PTSD and SMI recruited for a larger randomized controlled trial. Confirmatory factor analysis was conducted to compare the fit of five potential factor structures. Construct validity was evaluated using Pearson correlation coefficients.

Results: Confirmatory factor analysis revealed that the four-factor model with 12 core items and the five-factor model with 15 items demonstrated a satisfactory fit. Construct validity evidence was provided for the BPRS-E total score via a moderate correlation with the Hamilton Depression Rating Scale, as well as weak but significant correlations with the Beck Depression Inventory and Clinician-Administered PTSD Scale.

Conclusions and implications for practice: This study is the first to examine the factor structure of the BPRS-E for individuals with PTSD and SMI. Our results support the BPRS-E as a reliable and valid assessment of psychiatric symptoms in this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The personalization in disability support emphasizes autonomy and tailored services. Individualized budget programs embody this approach, enabling participants to control resources and improve quality of life. This study, framed within self-determination theory, aimed to evaluate the contribution of Israel's individualized budget program. The analysis examined pre- and postprogram psychosocial outcomes-life satisfaction, subjective well-being, social participation, choices exercised, self-efficacy, self-esteem, and loneliness-with exploratory analyses conducted within two groups: individuals with mental health disabilities and those with physical or sensory disabilities.

Methods: This pilot study included 21 participants enrolled in the program, with mental health (n = 15) and physical/sensory disabilities (n = 6) subgroups. Data were collected at program entry and follow-up, and paired-sample t tests were used to assess pre-post changes in psychosocial outcomes.

Results: For the total sample, significant improvements were observed in life satisfaction and subjective well-being. No significant changes were found in social participation, choices exercised, self-efficacy, self-esteem, or loneliness. Exploratory analyses within disability subgroups revealed different patterns of change across these measures.

Conclusions and implications for practice: The findings highlight individualized budgeting's potential to enhance psychosocial outcomes, particularly life satisfaction and subjective well-being for the total sample. Exploratory analyses within disability subgroups suggest potential differences in program benefits that warrant investigation in larger studies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Individual placement and support (IPS) is an evidence-based model designed to help individuals with mental health conditions secure and maintain competitive employment. Young adults are a particularly vulnerable group in need of these services. The COVID-19 pandemic led many public institutions to curtail face-to-contacts, which affected IPS service delivery. This study was part of a broader mixed-methods evaluation examining employment and education outcomes of young adults in nine IPS programs across the United States. A secondary analysis of the qualitative component explored the experiences of IPS teams and state leaders delivering IPS to young adults with mental health conditions during the COVID-19 pandemic.

Method: Participants from the nine IPS programs across five states were interviewed twice during the project. For this secondary data analysis, we focused on COVID-19-related codes. Two coauthors independently reviewed and aggregated the open codes, and the coauthors collaborated to reach consensus. The analysis followed a qualitative descriptive approach.

Results: Two major themes were created from 29 interviews with 30 participants: adaptations and challenges. Adaptations centered on transitioning to virtual communication and remote IPS delivery. Challenges included reduced referral rates and difficulties in building rapport and maintaining engagement.

Conclusions: The COVID-19 pandemic significantly disrupted IPS services for young adults with mental health conditions. Despite these challenges, the need for adaptation spurred innovation, fostering positive changes, some of which may become permanent in the future, showcasing the resilience and creativity of IPS programs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The present study explored turnover reasons via exit surveys for organizational interventions.

Methods: The exit surveys were conducted at a community behavioral health organization for over a year, and the open-ended question responses on turnover reasons were analyzed.

Results: Thirty-five exit surveys were returned (58% response rate). Five major turnover themes were identified: struggles in current job roles, negative experiences with upper management and senior colleagues, quality of care concerns, no foreseeable future, and personal/family reasons.

Conclusions and implications for practice: Exit surveys are a useful approach to identify turnover reasons for organizational interventions. The findings provide insights into contextualized strategies for retaining the behavioral health workforce. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Stigma and self-stigma reduce self-esteem and increase hopelessness and suicidality. While psychotic disorders are widely recognized as the most stigmatizing of all mental health disorders, there is a dearth of research investigating how stigma and self-stigma are experienced by young people at ultra-high risk (UHR) for psychosis. These experiences warrant investigation given the unique position of this population, as while they do not have a psychotic disorder, they may be exposed to stigma by virtue of the UHR label and/or symptoms.

Methods: Twelve young people at UHR aged 14-25 years were recruited to participate in either an individual interview or focus group. Transcripts were analyzed using reflexive thematic analysis.

Results: Five themes were developed including: (1) being at UHR is an inherently difficult, uncertain experience; (2) stigma is pervasive; (3) stigma becomes internalized; (4) stigma and self-stigma are painful; and (5) defending against stigma (containing three subthemes of (a) hiding one's UHR status; (b) rebutting stigma; and (c) educating self and others). Results indicated that young people at UHR for psychosis experience pervasive stigma that leads them to seek ways to protect themselves and their loved ones from stigma.

Conclusions and implications for practice: Our findings affirm exposure to stigma and self-stigma in particular compound the distress experienced by young people at UHR for psychosis. The themes found in this research give further impetus to the need to develop effective interventions to reduce stigma within, and toward, young people at UHR for psychosis. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: We examined the feasibility and clinical outcomes of implementing a brief intervention for treating posttraumatic stress disorder (PTSD) in persons with serious mental illness receiving services at a large, urban community mental health agency. The Brief, Relaxation, Education and Trauma Healing (BREATHE) program is a standardized, three-session intervention that targets PTSD symptoms through teaching breathing retraining and personalized psychoeducation about trauma and PTSD.

Method: A total of 60 clinicians were trained in the BREATHE intervention throughout the agency, which was offered to 233 clients who screened positive for probable PTSD. Self-report assessments of PTSD and depressive symptom severity were obtained before the first session, after the third session, and at a 3-month follow-up. Participant satisfaction was assessed in a brief survey.

Results: Of the 233 clients offered the BREATHE program, 211 (91%) accepted and attended at least one session. Most participants attended all three BREATHE sessions (59%) or two sessions (32%), with completers reporting high levels of satisfaction with the program. Participants showed clinically significant improvements in PTSD and depression symptoms from pretreatment to posttreatment and the 3-month follow-up.

Conclusions and implications for practice: This brief intervention for PTSD was feasible to implement in a large agency serving a diverse population of persons with serious mental illness, showed high client acceptability in terms of participation and satisfaction, and was associated with significant reductions in PTSD and depressive symptoms. Further research is needed to evaluate the impact of the BREATHE program for treating PTSD in this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Substance use disorders are prevalent in Veterans and associated with a wide range of deleterious effects. Helping Veterans with substance use disorders identify and engage in meaningful and constructive goal-directed activities may be key to promoting recovery. Work, particularly, has been identified as beneficial. Despite the effects of therapeutic work activities, we still do not have a good understanding of who is enrolling in these services.

Methods: This study provides an in-depth descriptive look at psychiatric diagnoses, internal factors, disability level, and demographic characteristics of Veterans (N = 78) early in the course of recovery from substance use disorder who expressed an interest in engaging in work services as part of their recovery.

Results: Compared to normative scores, our sample exhibited deficits in multiple areas of functioning, including global disability, physical health, social relationships, physical safety, self-esteem, and substance use. Of the 78 Veterans, 17 (22%) chose competitive employment, and 61 (78%) chose therapeutic work activity. Compared to Veterans who chose competitive employment, Veterans in the therapeutic work activity branch reported higher rates of medical disabilities that impair the ability to work, were more likely to be retired from employment, had more previous treatment program participation, and had longer periods of abstinence from alcohol.

Conclusions and implications for practice: These findings, though descriptive and preliminary, help us better understand Veterans who are interested in engaging in work activities to promote their recovery, their preference for work therapy versus vocational rehabilitation services, and what additional services they may find most appealing based on their characteristics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).