Psychiatric Rehabilitation Journal最新文献

Objective: Supported education (SEd) provides individualized support to people with mental health problems to achieve their educational goals. Individual placement and support (IPS) has emerged as a model through which SEd may be efficiently delivered. However, the components and characteristics of educational support for these employment-focused services have not been fully explored. Building on earlier studies, we constructed a preliminary model of SEd components that integrated with the IPS model. The SEd model included the eight original principles of IPS, developed to reflect the SEd component, and two new principles were suggested. The aim of the study is to investigate these adapted principles by exploring the feasibility of applying them within established IPS programs providing both employment and educational services.

Methods: An organizational learning approach was taken, involving five IPS programs providing both employment and educational services to young adults with mental health problems. Data were collected through focus groups, interviews, and workshops with 19 IPS specialists.

Results: The results suggest that while the IPS principles provide a feasible and relevant structure for the development and provision of integrated services, adaptations that reflect the educational context were considered valuable when supporting young adults in pursuing their career-related goals.

Conclusions and implications for practice: The respondents confirmed that the SEd principles and the focus on support in educational contexts helped them to further develop their knowledge and strategies. While challenging, integrating SEd in IPS models shows good potential for supporting young adults as they struggle to reach longer term career-oriented goals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Different predictors of job tenure for people with a severe mental illness (SMI) have been documented. Conflicting results may be explained by the choice of indicators to measure job tenure. This study aimed to assess the contribution of employment specialist competencies working in supported employment programs, client variables, and work accommodations, in determining job tenure in the regular labor market.

Method: A longitudinal study was conducted over 6 months, including people with SMI (n = 209) registered in 24 Canadian supported employment programs. Multivariable modeling analyses were performed.

Results: Overall, 67% (n = 140) of the sample were employed at the 6-month follow-up. Multilevel analyses showed that shorter duration of unemployment (i.e., the number of weeks worked), employment specialist knowledge, and working alliance were the strongest predictors of job tenure for people with SMI. With respect to the number of hours worked per week, diagnosis, executive functions, social functioning, work accommodations, and employment specialist skills were the strongest predictors of job tenure for people with SMI, with 57% of variance explained.

Conclusions and implications for practice: Understanding the various predictors of job tenure can assist employment specialists in providing better interventions for the work integration of people with SMI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study involved the development, dissemination, and pre- and postassessment of a mental illness awareness webinar. The goal of the webinar is to educate the general public about serious mental illness (SMI) and reduce stigmatizing attitudes.

Method: The study included 203 participants (n = 101 treatment group; n = 102 control group). Each completed a pretest and posttest measure of a mental illness stigma scale and a transphobia scale in this randomized control trial research design, along with a demographic form and participant feedback questionnaire.

Results: Results revealed that stigma was significantly reduced from pretest to posttest depending on group condition. Participant feedback reflected generally positive responses to the benefits of participating in the webinar in terms of feeling more knowledgeable about SMI in particular (75.5%). Furthermore, while prior contact with people with-and prior education about-SMI alone did not appear to significantly impact stigma scores from pre- to posttest, these variables did appear to have a significant interaction in their combined impact on stigma scores.

Conclusions and implications for practice: Findings suggest that the mental illness awareness training holds promise as an effective tool or reducing stigma among members of the general public. The electronic nature of the webinar allows for widespread and cost-effective dissemination and can also be tailored to meet the needs of specific populations such as law enforcement, first responders, and veterans to destigmatize SMI and improve treatment seeking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Occupational function assessment is essential for rehabilitation of severe mental illness but lacks comprehensive tools.

Method: This study examines the psychometric properties of the Chinese versions of the Vocational Cognitive Rating Scale (VCRS) and the Work Behavior Inventory (WBI) in 60 chronic patients from a psychiatric daycare center and identifies clinical correlates of occupational function measured on the Positive and Negative Syndrome Scale (PANSS).

Results: The Chinese VCRS and WBI showed adequate internal consistency, interrater and test-retest reliability, and good convergent validity with the Comprehensive Occupational Therapy Evaluation Scale. Factor analysis favored a one-factor solution of the VCRS; and a four-factor structure in the WBI including Efficiency, Social Interaction, Appropriateness, and Regularity. The VCRS and Efficiency were predicted by fewer disorganization but greater affective symptoms. Social Interaction was negatively predicted by resistance symptoms. Appropriateness was associated with all but negative symptoms. Regularity was predicted by fewer negative symptoms. Considering work behavior altogether, WBI total scores were predicted by fewer negative, fewer disorganization, and greater affective symptoms.

Conclusions and implication for practice: Findings suggest that the Chinese VCRS and WBI have sound psychometric properties and are suitable for both clinical trials and for planning personalized rehabilitation programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Campus engagement, including participation in student organizations and groups, is important for both academic and health outcomes. Yet, college students with serious mental illnesses demonstrate lower levels of campus engagement compared to peers without mental illnesses. To inform psychiatric rehabilitation approaches that might enhance this outcome, the purpose of this study was to test an integrated model of self-determination and self-efficacy theories to predict campus engagement within this student population.

Methods: Sixty-seven college students with serious mental illnesses completed measures assessing self-determination constructs (autonomy, competence, and relatedness), college self-efficacy, and campus engagement. Correlational and path analytic models examined relationships among these variables.

Results: Bivariate and multivariate analyses supported the interrelationships among the variables. Specifically, the theory-driven path model demonstrated that autonomy (but not competence or relatedness) was a significant predictor of college self-efficacy, which in turn was associated with campus engagement.

Conclusions and implications for practice: Findings particularly highlight the importance of autonomy and self-efficacy for promoting campus engagement among college students with serious mental illnesses. As such, they may be relevant targets for psychiatric rehabilitation interventions, such as supported education, that are designed to enhance student success. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To illustrate the value of reading fiction as a group supervision practice focused on supporting recovery-oriented psychotherapy for individuals experiencing serious mental illness (SMI).

Method: Detailed practical description of the practice and conceptual analysis of the proposed value of using fiction as a group supervision method.

Findings: Authors suggest that the supervisory practice is a novel component of clinical supervision, and offers value in its ability to promote reflective practice, to establish intersubjectivity among peers and supervisory relationships, and may serve for some to counter risks of clinician burnout.

Conclusions and implications for practice: Participating in a book club that reads fiction as an adjunctive experience to supervision can promote recovery-oriented psychotherapy in four key ways: including its promotion of reflection on self, patients, and the experience of therapy for psychosis, its promotion of reflection on recovery and barriers to recovery, its ability to offer an experiential model of intersubjectivity, and its value in supporting peer consultation and helping offset clinician burnout. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Since the release of the Recovery After Initial Schizophrenia Episode-Early Treatment Program results in 2015, the United States Congress expanded funding for early intervention programs and these programs now exist in every state. The purpose of the present study was to understand the real-world experience of NAVIGATE Program Directors with respect to identifying and recruiting patients with early psychosis and engaging families in treatment.

Method: Utilizing a mixed-methods sequential explanatory design, researchers surveyed 32 program directors in 13 states and engaged in 22 follow-up interviews to explore how NAVIGATE is being translated to serve individuals experiencing early psychosis and their families.

Results: We found that program directors using the NAVIGATE model encountered difficulty identifying diagnosis at admission and that supporting families of individuals experiencing psychosis was an important aspect of the program with unique complexity.

Conclusions and implications for practice: These findings have important implications for future mental health research on early intervention programs and may serve to stimulate future research on how early intervention mental health programs can better serve individuals recovering from psychosis and support their families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Self-determination enhances well-being and quality of life. It is also considered a fundamental pillar in improving the efficacy of interventions used to treat people with severe mental disorders (SMD). Yet the assessment of self-determination in relation to mental health requires further research. The aim of this study was to analyze the adequacy and psychometric properties of the AUTODDIS scale in a Spanish population with SMD.

Method: The scale was originally developed and validated to assess self-determination in people with intellectual disability. The scale was administered to a sample of 333 adults with SMD (M = 47.6 years, SD = 11.68), most of whom were receiving treatment in an outpatient setting or at long-stay care facilities in six specialized centers in Spain.

Results: The quality of the items and the reliability of the scale and its subscales were analyzed. External validity was also explored, and confirmatory factor analysis was used to analyze the fit of the data to different models. The results indicate that the scale demonstrated sufficient evidence of reliability and validity, supporting the adequacy of its use in the field of mental health.

Conclusions and implications for practice: The use of this scale as a tool to assess self-determination and its domains in the mental health field is warranted. The article also discusses the need for more research and assessment tools to facilitate decision making by clinical and organizational stakeholders in promoting self-determination. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Individuals with serious mental illness (SMI) who re-enter the labor market after extended unemployment may benefit from exposure to job interview training. This study explored the processes and perceived benefits of preparing for interviews using Virtual Reality Job Interviewing Training (VR-JIT) among employment specialists (ESs) and clients within the individual placement and support (IPS) model of supported employment.

Method: This study analyzed secondary qualitative data from a randomized controlled trial (RCT) of VR-JIT including qualitative focus groups comprised of IPS employment specialists (n = 11) and IPS clients (n = 13), semistructured interviews with IPS employment specialists (n = 3), and semistructured interviews with IPS clients (n = 3). Additionally, semistructured interviews with IPS employment specialists (n = 8) who naturalistically implemented VR-JIT at four community mental health agencies independent of the RCT. All focus group and interview data were analyzed using grounded theory methodology.

Results: Three main processes were viewed by employment specialists (and their clients) as beneficial for individuals with SMI receiving IPS with VR-JIT: (a) exposure to a simulated interview in a safe environment; (b) practicing and receiving job interviewing feedback; and (c) improved confidence and motivation in job seeking.

Conclusions and implications for practice: VR-JIT improved IPS participants' confidence in job seeking through proposed mechanisms of exposure to a simulated job interview and repetition and practice of job interview skills. These critical elements indicate that VR-JIT has the potential to improve IPS client engagement particularly with those who have had prolonged periods of unemployment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).