Psychiatric Rehabilitation Journal最新文献

Objective: Having meaningful social roles and full community participation have been examined as a central tenet of the recovery paradigm. We undertook this study to test a new multimodal, peer-led intervention, which we have developed with the aim of fostering the self-efficacy of individuals with psychiatric disabilities to pursue involvement in community activities of their choice.

Method: We evaluated the effectiveness of the 6-month manualized peer-delivered "Bridging Community Gaps Photovoice (BCGP)" program with a multisite randomized trial (N = 185), with recipients of services at five community mental health programs. Mixed-effects regression models were used to examine the impact of the program on community participation, loneliness, personal stigma, psychosocial functioning, and personal growth and recovery when compared to services as usual. Individuals who were randomized to the BCGP intervention were also invited to participate in exit focus groups, exploring the program's perceived active ingredients of mechanisms of impact.

Results: Participation in the BCGP program facilitated ongoing involvement in community activities and contributed to a decreased sense of alienation from other members of the community due to internalized stigma of mental illness. In addition, greater attendance of group BCGP sessions had a significant impact on participants' sense of self-efficacy in pursuing desired community activities.

Conclusions and implications for practice: This study provided initial evidence about the promise of the BCGP program in enhancing community participation. Its implementation in community mental health agencies can further expand the recovery-oriented services provided to people with psychiatric disabilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Peer specialists are people with lived experience of a mental health or substance use disorder who are certified to deliver peer support services under state training programs. This qualitative study explored recently certified peer specialist (CPS) experiences navigating the job market to find postcertification employment, experiences with employment once in the workforce, and reflections on CPS training.

Method: Qualitative data were collected as part of a multistate, 3-year observational prospective cohort study of CPS graduate employment trajectories. We conducted 25 in-depth, semistructured interviews with a subsample of recent CPS graduates who indicated a range of employment experiences in a survey as part of the parent study. Interviews focused on their current employment and satisfaction with the position and experiences looking for work. Data were analyzed using constant comparative methods informed by grounded theory.

Results: Participants described factors that supported or undermined securing employment, which included a shortage of CPS positions, their professional networking skills, financial considerations, and a position's alignment with CPS values. Once employed, participants described how relationships with supervisors and coworkers, which ranged from supportive to confused about the value of the peer specialist role, impacted their work. In general, participants held their CPS training and certification in high regard.

Conclusions and implications for practice: Our findings highlight policy, employment, and practice opportunities to strengthen CPS training to improve their work readiness of graduates and expand their role, while preparing organizations and their staff to hire and work inclusively with CPSs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

William (Bill) A. Anthony was a pioneer in the field of psychosocial/psychiatric rehabilitation and recovery. He established the Center for Psychiatric Rehabilitation at Boston University and served as the editor/coeditor of the Psychosocial Rehabilitation Journal (later Psychiatric Rehabilitation Journal). He helped to clarify ideas, principles, policies, and practices that promoted the right and ability of people living with psychiatric disabilities and mental health challenges to aspire to and achieve their own vision of a meaningful life. This introductory article briefly overviews Bill's contributions to psychiatric rehabilitation and recovery of people with mental health challenges and his influence on recent work in this field, a sample of which is presented in the current special section dedicated to him. To conclude, the article overviews this special section, which reports on studies in the United States and elsewhere, addressing supported education, recovery colleges, photovoice to promote community integration, and policy developments in Israel. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Recovery Colleges support recovery for adults with mental health problems, through coproduction and education principles. This study aimed to determine whether students at three Recovery Colleges in England were representative of mental health service users.

Methods: Gender, age, ethnicity, diagnosis, involuntary detention, and inpatient admission were extracted from clinical records. Data for all service user students enrolled, and those who had attended 70% of a Recovery College course were compared to mental health services caseloads, using chi-square goodness-of-fit tests.

Results: Clinical records were identified for 1,788 students. Significant differences were identified for gender, age, and diagnosis (p < .001). In some Colleges, more students had recent inpatient admissions or involuntary detentions.

Conclusions and implications for practice: Service user students were largely representative of mental health service users, although some groups were underrepresented. Further research is needed to understand why, so that Recovery Colleges can continue to address inequalities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objectives: Mental health care has been identified as a major source of mental illness stigmatization. Detailed information about these stigmatization experiences is thus needed to reduce stigma in mental health practices. The study aimed to (a) identify the most relevant stigmatizing situations in mental health care encountered by users with schizophrenia and their families; (b) characterize the relative importance of these situations in terms of frequency, experienced stigmatization, and associated suffering; and (c) identify contextual and individual factors associated with these experiences.

Method: An online survey was conducted in France among users and family members to characterize situations of stigmatization in mental health care and identify associated factors. The survey content was first developed from a participative perspective, through a focus group including users.

Results: A total of 235 participants were included in the survey: 59 participants with schizophrenia diagnosis, 96 with other psychiatric diagnoses, and 80 family members. The results revealed 15 relevant situations with different levels of frequency, stigmatization, and suffering. Participants with a diagnosis of schizophrenia experienced more situations of stigmatization, with a higher frequency. Moreover, contextual factors were strongly associated with experienced stigmatization, including recovery-oriented practices (negatively associated) and measures without consent (positively associated).

Conclusions and implications for practice: These situations, as well as associated contextual factors, could be targeted to reduce stigmatization and related suffering in mental health practices. Results strongly underscore the potential of recovery-oriented practice as an instrument to fight stigma in mental health care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Social support is an important component of recovery-based interventions for individuals living with severe mental illness (IWSMI). Clubhouses are local community centers that facilitate the development of meaningful relationships among IWSMI through an empowering structure and engagement with the work-ordered day. This review synthesizes research on social networks in Clubhouses to provide insights on the role of supportive relationships in mental illness recovery, including the size and features of social networks of Clubhouse members, methodological trends and gaps, and the associations between social networks and demographic variables, recovery, health, and perceived social support.

Method: Research on social networks within Clubhouses were identified and analyzed following a systematic six-stage scoping review design.

Results: Twelve articles across six studies were included. Results revealed considerable variation in social network interview methods and network size and features. Overall findings suggest that network size is not consistently associated with reported loneliness, social support, recovery, or quality of life. A deep relationship with at least one supportive person, level of perceived affiliation with Clubhouses, or positive comments from network members may be more or equally valuable than a larger network. Some studies found that types of relationships were associated with unique benefits. Stronger peer networks were associated with relationship satisfaction, while increased connections with health care professionals and family were associated with reduced hospitalizations.

Conclusions and implications for practice: Future research should diversify research designs, expand the use of social network analysis and visualization, measure additional outcomes including recovery and health, and increase sample diversity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Despite increasing recognition of the difficulties faced by persons with psychosis with respect to intimacy and sexuality, there is a lack of valid and reliable instruments to measure these areas of functioning in this population. This study aimed to evaluate the psychometric properties (i.e., construct and convergent validity, internal consistency, test-retest reliability) of two measures, the Multidimensional Sexuality Questionnaire (MSQ) and the Romantic Relationship Functioning Scale (RRFS), in a sample of individuals with schizophrenia-spectrum disorders.

Method: Participants (N = 196) were administered a series of questionnaires online, with a subset of 40 respondents agreeing to complete the MSQ and the RRFS a second time at a 2-week follow-up. Confirmatory factor analyses were employed to examine the construct validity of both measures, while internal consistency estimates and correlation coefficients were computed to assess each instrument's reliability and convergent validity.

Results: The original factor structures of the MSQ and the RRFS were found to be acceptable, with αs ranging from 0.68 to 0.94 and 0.74 to 0.86, respectively. Test-retest reliability and convergent validity with other measures (First-Episode Social Functioning Scale [FESFS]-Intimacy subscale, Self-Esteem Rating Scale-Short Form [SERS-SF], Brief Symptom Inventory [BSI]-Anxiety and Depression subscales) were also demonstrated.

Conclusions and implications for practice: Future research should replicate these findings in larger samples and other languages, as well as evaluate additional aspects of the instruments' quality. Clinicians may benefit from using these tools to better understand the intimacy needs of service users with psychosis and offer corresponding services. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: The Community Rehabilitation of Persons with Mental Health Disability Law (2000a) is one of Israel's most important pieces of social legislation. It grants persons with psychiatric disabilities the right to receive rehabilitation in the community. This article is a case study of the development and implementation of a policy that led to the Rehabilitation Reform and that has become an important component in Israel's comprehensive mental health reform. The purpose of the study was to review and analyze the law and its elements, examine its implementation during its first two decades of operation, and to identify the issues it faces entering its third decade of application.

Method: The study examined the key components of the reform such as intended beneficiaries, financing, workforce, and services provided. It used Israel's official statistical data and drew upon a series of interviews with officials and experts on rehabilitation, mental health and social services.

Results: In 2020, 30,000 persons were receiving community psychiatric rehabilitation services, constituting about one fifth of the estimated eligible population. In addition to the reform's achievements, this article also identifies a number of issues. Toward the end of the second decade, problems between the psychiatric Rehabilitation Unit and the mental health services became apparent.

Conclusions and implications for practice: As the Rehabilitation Law enters its third decade, it is recommended to establish an independent committee of experts to examine needed modifications in light of the conclusions drawn about the first two decades of its implementation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: Peer support practice has seen exponential growth during the past several decades. While there exists a body of research on job satisfaction among this emerging workforce, many studies had limited sample sizes and demographic diversity and focused on few facets of job satisfaction. The present study examines multiple factors associated with job satisfaction and compensates for limitations of previous smaller studies.

Methods: A convenience/snowball sample of 645 peer support staff was recruited via National Association of Peer Supporters and Academy of Peer Services listservs. Eligible participants were at least 18 years of age, currently employed for a minimum of 6 months, and residing in one of the 50 states or one of U.S. territories. Global and multidimensional facets of job satisfaction were measured using the Indiana Job Satisfaction Survey.

Results: Data from an anonymous online survey were analyzed using hierarchical linear regression. The main hypothesis was supported; coworker support, perceived organizational support, supervisor support, and job empowerment explained 71% of the variance in overall job satisfaction, Adj R² = 0.71, F(9, 271) = 77.77, p < .01, with age and status as a certified peer specialist significant contributors. Perceived organizational support and job empowerment explained most variance in overall job satisfaction.

Conclusions and implications for practice: As this workforce continues to burgeon, it is crucial to promote peer support values, role clarity, certification, diversity, and optimal organizational and empowerment resources to sustain a satisfied and effective peer support workforce. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: People with mental illnesses may avoid or delay treatment due to a fear of labeling and discrimination, a phenomenon known as self-stigma. Self-stigma is a major barrier to care and creates obstacles to pursuing employment, independent living, and a fulfilling social life. We aimed to gather input from people with lived experience of mental illness to develop a social-contact-based, brief video-based intervention to reduce self-stigma.

Method: Two (n = 12) focus groups were conducted to inform video content and led to the creation of a script and brief video using a professional actor, who described a story of living with schizophrenia while focusing on symptoms, personal struggles, and recovery. Two (n = 9) additional focus groups were held after video development to gather feedback and suggested edits. Focus group transcripts were analyzed using thematic content analysis.

Results: Themes emerging in prevideo development included the negative effects of being diagnosed with severe mental illnesses, being stereotyped, the value of relatable recovery stories and seeing the person as a whole, and the utility of focusing on symptoms and experiences rather than diagnosis-specific language. Feedback in the postvideo focus groups was mainly favorable and resulted in edits related to language about "responsibility" and a disclaimer about using a professional actor.

Conclusions and implications for practice: While participants' experiences of stigma are consistent with extant literature, this is the first study to elicit the perspectives of people living with mental illnesses in developing a video intervention to reduce self-stigma. Studies are needed to examine the efficacy of these videos in reducing self/public stigma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).