Pub Date : 2014-04-03DOI: 10.1080/15487768.2014.904695
Russell C. Smith
Daniel Carlat remembers the initial session he had with a woman who witnessed her father’s death in an auto accident. Her symptoms included nightmares, insomnia, poor concentration, and flashbacks that were recurrent in the last month since the accident. She also described how she avoided all situations that might remind her of the incident such as driving, listening to newscasts, and reading newspapers. When she mentioned that the worst thing about it was the guilt she felt, he started to realize this was more complex than ‘‘a simple case of posttraumatic stress disorder.’’ When he inquired about her statement, she explained that her father had been drinking while driving and that she had confronted him while riding with him. His reaction was to scream at her and push the gas pedal to the floor. ‘‘That’s when it happened,’’ she said. In the brief time remaining in the session, he talked about PTSD, the standard treatments involved, and the prognosis for recovery. He also prescribed Klonopin and Zoloft and recommended a therapist for her to see, telling her that the medication would be more effective if combined with therapy. The woman looked confused, and Dr. Carlat knew that she thought he was her therapist. He shook his head and said,
{"title":"Unhinged: The Trouble With Psychiatry: A Doctor's Revelation About a Profession in Crisis","authors":"Russell C. Smith","doi":"10.1080/15487768.2014.904695","DOIUrl":"https://doi.org/10.1080/15487768.2014.904695","url":null,"abstract":"Daniel Carlat remembers the initial session he had with a woman who witnessed her father’s death in an auto accident. Her symptoms included nightmares, insomnia, poor concentration, and flashbacks that were recurrent in the last month since the accident. She also described how she avoided all situations that might remind her of the incident such as driving, listening to newscasts, and reading newspapers. When she mentioned that the worst thing about it was the guilt she felt, he started to realize this was more complex than ‘‘a simple case of posttraumatic stress disorder.’’ When he inquired about her statement, she explained that her father had been drinking while driving and that she had confronted him while riding with him. His reaction was to scream at her and push the gas pedal to the floor. ‘‘That’s when it happened,’’ she said. In the brief time remaining in the session, he talked about PTSD, the standard treatments involved, and the prognosis for recovery. He also prescribed Klonopin and Zoloft and recommended a therapist for her to see, telling her that the medication would be more effective if combined with therapy. The woman looked confused, and Dr. Carlat knew that she thought he was her therapist. He shook his head and said,","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"3 1","pages":"181 - 187"},"PeriodicalIF":0.0,"publicationDate":"2014-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85407130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-04-03DOI: 10.1080/15487768.2014.903874
Bill Burns-Lynch, A. Murphy, K. Gill, George H Brice
The current study was undertaken to identify stakeholder perceptions of their experiences with mental health crisis services throughout this northeastern state for administrators to use for program planning and development. A semistructured survey of opinions regarding current and proposed crisis management services of consumers, family members, and staff was conducted in the northeastern United States. They report that individuals in psychiatric crisis continue to be offered primarily medication changes and hospitalization. They also reported they would prefer the availability of additional services including professional support in person, on the phone, and in their homes. Implications for systems transformation and program development are discussed.
{"title":"Persons in Recovery, Family Members, and Staff Perspectives of Psychiatric Crisis Needs","authors":"Bill Burns-Lynch, A. Murphy, K. Gill, George H Brice","doi":"10.1080/15487768.2014.903874","DOIUrl":"https://doi.org/10.1080/15487768.2014.903874","url":null,"abstract":"The current study was undertaken to identify stakeholder perceptions of their experiences with mental health crisis services throughout this northeastern state for administrators to use for program planning and development. A semistructured survey of opinions regarding current and proposed crisis management services of consumers, family members, and staff was conducted in the northeastern United States. They report that individuals in psychiatric crisis continue to be offered primarily medication changes and hospitalization. They also reported they would prefer the availability of additional services including professional support in person, on the phone, and in their homes. Implications for systems transformation and program development are discussed.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"11 1","pages":"114 - 127"},"PeriodicalIF":0.0,"publicationDate":"2014-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88900790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-04-03DOI: 10.1080/15487768.2013.877409
Y. Lim, M. Millington, E. Mpofu
The authors have conducted a thematic review of the literature on the evidence of, and enquiry into, individualized placement and support (IPS) efficacy as an intervention for people with schizophrenia or schizoaffective disorders. Eight studies were identified that met all inclusion criteria. Explicit themes in the research included (a) investigation of the impact of schizophrenia sequelae on IPS efficacy and the differential impact of neurocognitive enhancement therapy in minimizing psychiatric symptoms and improving IPS outcomes and (b) IPS as an alternative to treatment-as-usual in different age demographics (older and younger clients). Implicit themes coalesced around a general theme of dealing with change, in practice and research, that implementing IPS implies. Each theme represents a challenge or confound to the research corpus and included (a) vaguely defined rationale for the issue of return on investment, (b) practical burden of overstressed and unprepared service structures, (c) diffuse outcome measures, (d) poor attention to IPS fidelity, and (e) lack of standard practice assigned to control groups identified as “treatment as usual.” Seeing confounds as directions for improvement, these early studies open an important dialogue on best practice research in IPS application with workers with schizophrenia.
{"title":"The Evidentiary Basis for Supported Employment Practice for Workers with Schizophrenia: A Thematic Analysis","authors":"Y. Lim, M. Millington, E. Mpofu","doi":"10.1080/15487768.2013.877409","DOIUrl":"https://doi.org/10.1080/15487768.2013.877409","url":null,"abstract":"The authors have conducted a thematic review of the literature on the evidence of, and enquiry into, individualized placement and support (IPS) efficacy as an intervention for people with schizophrenia or schizoaffective disorders. Eight studies were identified that met all inclusion criteria. Explicit themes in the research included (a) investigation of the impact of schizophrenia sequelae on IPS efficacy and the differential impact of neurocognitive enhancement therapy in minimizing psychiatric symptoms and improving IPS outcomes and (b) IPS as an alternative to treatment-as-usual in different age demographics (older and younger clients). Implicit themes coalesced around a general theme of dealing with change, in practice and research, that implementing IPS implies. Each theme represents a challenge or confound to the research corpus and included (a) vaguely defined rationale for the issue of return on investment, (b) practical burden of overstressed and unprepared service structures, (c) diffuse outcome measures, (d) poor attention to IPS fidelity, and (e) lack of standard practice assigned to control groups identified as “treatment as usual.” Seeing confounds as directions for improvement, these early studies open an important dialogue on best practice research in IPS application with workers with schizophrenia.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"70 1","pages":"113 - 93"},"PeriodicalIF":0.0,"publicationDate":"2014-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79725549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-04-03DOI: 10.1080/15487768.2014.916126
Susan R. Campbell, M. Holter, Trevor J. Manthey, C. Rapp
Located in a community mental health center, the first decision support center in psychiatry used peer support and an Internet-based software program, CommonGround, to assist consumers in decisional uncertainty about psychiatric medication use and to foster shared decision making between the consumer and prescriber. This study examined the impact of the decision support center on the consumer-doctor interaction in the medication consultation. A pretest/posttest design assigned consumers to either an experimental or control group for 4 months. The Measure of Patient-Centered Communication (MPCC) (Brown, Stewart, McCracken, McWhinney, & Levenstein, 1986) was used to evaluate the medication consultation. The Patient Perception of Patient-Centeredness Questionnaire (PPPC) (Stewart, Meredith, Ryan, & Brown, 2004) was used to evaluate the consumer's and prescriber's perceptions of the consultation. A one-way multivariate analysis of covariance was not significant for the combined dependent variable of the measures at Time 2, while controlling for the measures at Time 1. When the CommonGround report was referenced in the experimental group, post hoc analyses revealed significant differences (t[41] = 4.14, p = .001) in the PPCC-consumer score. This study provides provisional evidence of the effectiveness of a shared decision-making intervention. The clinical potential of a program that assists mental health consumers in communicating decisional uncertainty and developing shared decisions concerning medication use is worthy of further study.
{"title":"The Effect of CommonGround Software and Decision Support Center","authors":"Susan R. Campbell, M. Holter, Trevor J. Manthey, C. Rapp","doi":"10.1080/15487768.2014.916126","DOIUrl":"https://doi.org/10.1080/15487768.2014.916126","url":null,"abstract":"Located in a community mental health center, the first decision support center in psychiatry used peer support and an Internet-based software program, CommonGround, to assist consumers in decisional uncertainty about psychiatric medication use and to foster shared decision making between the consumer and prescriber. This study examined the impact of the decision support center on the consumer-doctor interaction in the medication consultation. A pretest/posttest design assigned consumers to either an experimental or control group for 4 months. The Measure of Patient-Centered Communication (MPCC) (Brown, Stewart, McCracken, McWhinney, & Levenstein, 1986) was used to evaluate the medication consultation. The Patient Perception of Patient-Centeredness Questionnaire (PPPC) (Stewart, Meredith, Ryan, & Brown, 2004) was used to evaluate the consumer's and prescriber's perceptions of the consultation. A one-way multivariate analysis of covariance was not significant for the combined dependent variable of the measures at Time 2, while controlling for the measures at Time 1. When the CommonGround report was referenced in the experimental group, post hoc analyses revealed significant differences (t[41] = 4.14, p = .001) in the PPCC-consumer score. This study provides provisional evidence of the effectiveness of a shared decision-making intervention. The clinical potential of a program that assists mental health consumers in communicating decisional uncertainty and developing shared decisions concerning medication use is worthy of further study.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"34 1","pages":"166 - 180"},"PeriodicalIF":0.0,"publicationDate":"2014-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77321957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-04-03DOI: 10.1080/15487768.2014.909683
Y. Iwasaki, C. Coyle, J. Shank, Emily S. Messina, Heather R. Porter, M. Salzer, D. Baron, Gretchen Kishbauch, Rocio Naveiras-Cabello, Lynda Mitchell, A. Ryan, Glenn Koons
Conceptually supported by recovery, positive psychology, and health promotion perspectives, this study explored the role of leisure in recovery and health among culturally diverse individuals with mental illness. One-on-one survey interviews were conducted with Black (n = 35), Hispanic/Latino (n = 28), White (n = 28), and Asian (n = 8) adults (aged between 23 and 78) with mental illness (N = 101). A variety of mental health diagnoses were represented in the sample (e.g., bipolar disorder, n = 32; major depression, n = 23; schizophrenia, n = 22). Regression analyses were performed to estimate the predictive effects of leisure variables on recovery, health, and psychiatric symptoms. The findings emphasize the importance of: (a) meanings that persons with mental illness gain from leisure (e.g., connection/belonging, identity, freedom/autonomy) (i.e., meaning making via leisure) and (b) leisure opportunities to fight against or reduce perceptions of boredom (i.e., boredom reduction in leisure) as both of these were significant predictors of recovery. Also, a greater perception of being actively engaged/involved (i.e., perceived active living) was a significant predictor of recovery and overall physical and mental health and less frequent psychiatric symptoms, whereby leisure potentially provides a key context for the pursuit of active living. Furthermore, the use of leisure both for coping with stress (i.e., stress coping via leisure) and reducing boredom significantly predicted fewer psychiatric symptoms. The findings highlight the need to consider the experiences, feelings/emotions, and meanings that people with mental illness gain from leisure beyond simply behavioral forms of leisure (i.e., leisure activities) per se by respectfully appreciating the cultural diversity of people with mental illness.
{"title":"Role of Leisure in Recovery From Mental Illness","authors":"Y. Iwasaki, C. Coyle, J. Shank, Emily S. Messina, Heather R. Porter, M. Salzer, D. Baron, Gretchen Kishbauch, Rocio Naveiras-Cabello, Lynda Mitchell, A. Ryan, Glenn Koons","doi":"10.1080/15487768.2014.909683","DOIUrl":"https://doi.org/10.1080/15487768.2014.909683","url":null,"abstract":"Conceptually supported by recovery, positive psychology, and health promotion perspectives, this study explored the role of leisure in recovery and health among culturally diverse individuals with mental illness. One-on-one survey interviews were conducted with Black (n = 35), Hispanic/Latino (n = 28), White (n = 28), and Asian (n = 8) adults (aged between 23 and 78) with mental illness (N = 101). A variety of mental health diagnoses were represented in the sample (e.g., bipolar disorder, n = 32; major depression, n = 23; schizophrenia, n = 22). Regression analyses were performed to estimate the predictive effects of leisure variables on recovery, health, and psychiatric symptoms. The findings emphasize the importance of: (a) meanings that persons with mental illness gain from leisure (e.g., connection/belonging, identity, freedom/autonomy) (i.e., meaning making via leisure) and (b) leisure opportunities to fight against or reduce perceptions of boredom (i.e., boredom reduction in leisure) as both of these were significant predictors of recovery. Also, a greater perception of being actively engaged/involved (i.e., perceived active living) was a significant predictor of recovery and overall physical and mental health and less frequent psychiatric symptoms, whereby leisure potentially provides a key context for the pursuit of active living. Furthermore, the use of leisure both for coping with stress (i.e., stress coping via leisure) and reducing boredom significantly predicted fewer psychiatric symptoms. The findings highlight the need to consider the experiences, feelings/emotions, and meanings that people with mental illness gain from leisure beyond simply behavioral forms of leisure (i.e., leisure activities) per se by respectfully appreciating the cultural diversity of people with mental illness.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"10 1","pages":"147 - 165"},"PeriodicalIF":0.0,"publicationDate":"2014-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79880932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1080/15487768.2014.935681
Steven M Silverstein, Matthew W Roché, Zaynab Khan, Sarah J Carson, Igor Malinovsky, William A Newbill, Anthony A Menditto, Sandra M Wilkniss
The attentional impairments associated with schizophrenia are well-documented and profound. Psychopharmacological and most psychosocial interventions have been shown to have limited effect in improving attentional capacity. That said, one form of psychosocial treatment, attention shaping procedures (ASP), has been repeatedly demonstrated to produce significant and meaningful change in various aspects of participant attentiveness behaviors. To date, studies of ASP have been limited in that they have been conducted primarily with inpatients, have not assessed the generalizability of ASP's effects, and have not explored whether reinforcement is required to be contingent on performance of attentive behaviors. To address these limitations we conducted the first randomized clinical trial of ASP with people diagnosed with schizophrenia who are being treated in a partial hospital program. Our results indicate that ASP is effective in improving attention in people with schizophrenia in these types of programs, the effects of ASP generalize outside of the immediate treatment context to both other treatment groups and real world functioning, and contingent reinforcement is a critical ingredient of ASP. This project provides further evidence for the benefits of use of ASP in the recovery-oriented treatment of people diagnosed with schizophrenia who have significant attentional impairments.
{"title":"Enhancing and Promoting Recovery In Attentionally Impaired People Diagnosed With Schizophrenia: Results From A Randomized Controlled Trial Of Attention Shaping In A Partial Hospital Program.","authors":"Steven M Silverstein, Matthew W Roché, Zaynab Khan, Sarah J Carson, Igor Malinovsky, William A Newbill, Anthony A Menditto, Sandra M Wilkniss","doi":"10.1080/15487768.2014.935681","DOIUrl":"https://doi.org/10.1080/15487768.2014.935681","url":null,"abstract":"<p><p>The attentional impairments associated with schizophrenia are well-documented and profound. Psychopharmacological and most psychosocial interventions have been shown to have limited effect in improving attentional capacity. That said, one form of psychosocial treatment, attention shaping procedures (ASP), has been repeatedly demonstrated to produce significant and meaningful change in various aspects of participant attentiveness behaviors. To date, studies of ASP have been limited in that they have been conducted primarily with inpatients, have not assessed the generalizability of ASP's effects, and have not explored whether reinforcement is required to be contingent on performance of attentive behaviors. To address these limitations we conducted the first randomized clinical trial of ASP with people diagnosed with schizophrenia who are being treated in a partial hospital program. Our results indicate that ASP is effective in improving attention in people with schizophrenia in these types of programs, the effects of ASP generalize outside of the immediate treatment context to both other treatment groups and real world functioning, and contingent reinforcement is a critical ingredient of ASP. This project provides further evidence for the benefits of use of ASP in the recovery-oriented treatment of people diagnosed with schizophrenia who have significant attentional impairments.</p>","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"17 3","pages":"272-305"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/15487768.2014.935681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32703468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1080/15487768.2013.876458
C. Dopke, C. Batscha
There is growing evidence that recovery in the presence of schizophrenia is achievable. Taken from the perspective of those experiencing this illness, recovery may or may not involve complete symptom relief and seems to occur in stages involving the restoration of stability, self-efficacy, self-esteem, and a sense of connectedness to the world. Cognitive-behavioral therapy (CBT) is now a well-established treatment for the positive symptoms of psychosis, and preliminary data suggest that it might be effective in aiding other aspects of recovery. In an effort to facilitate a more systematic approach to psychotherapy for individuals with schizophrenia, we present a framework that integrates specific recovery tasks and CBT techniques that are well suited for achieving them.
{"title":"Cognitive-Behavioral Therapy for Individuals with Schizophrenia: A Recovery Approach","authors":"C. Dopke, C. Batscha","doi":"10.1080/15487768.2013.876458","DOIUrl":"https://doi.org/10.1080/15487768.2013.876458","url":null,"abstract":"There is growing evidence that recovery in the presence of schizophrenia is achievable. Taken from the perspective of those experiencing this illness, recovery may or may not involve complete symptom relief and seems to occur in stages involving the restoration of stability, self-efficacy, self-esteem, and a sense of connectedness to the world. Cognitive-behavioral therapy (CBT) is now a well-established treatment for the positive symptoms of psychosis, and preliminary data suggest that it might be effective in aiding other aspects of recovery. In an effort to facilitate a more systematic approach to psychotherapy for individuals with schizophrenia, we present a framework that integrates specific recovery tasks and CBT techniques that are well suited for achieving them.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"88 1","pages":"44 - 71"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74963100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1080/15487768.2013.873371
S. Kidd, Gursharan Virdee, S. Quinn, K. McKenzie, Lisa Toole, T. Krupa
This qualitative study employed an arts-based methodology to explore the intersection of gender and ethnicity with the recovery experiences of six racialized women with severe mental illness in a large and highly diverse Canadian urban centre. The study was designed to address a gap in the recovery literature, which has minimally accounted for gender and ethnicity, and much less the intersection of the two. The arts-based approach revealed experiences centered on the three main themes of power, self-worth, and determining a coherent identity, all of which were described as being negotiated in contexts of supportive relationships and community participation. Although these themes are evident in the recovery experiences of most people with severe mental illness, the intersections of gender, ethnicity and racialized identities comprise additional layers of complexity and negotiation.
{"title":"Racialized Women with Severe Mental Illness: An Arts-Based Approach to Locating Recovery in Intersections of Power, Self-Worth, and Identity","authors":"S. Kidd, Gursharan Virdee, S. Quinn, K. McKenzie, Lisa Toole, T. Krupa","doi":"10.1080/15487768.2013.873371","DOIUrl":"https://doi.org/10.1080/15487768.2013.873371","url":null,"abstract":"This qualitative study employed an arts-based methodology to explore the intersection of gender and ethnicity with the recovery experiences of six racialized women with severe mental illness in a large and highly diverse Canadian urban centre. The study was designed to address a gap in the recovery literature, which has minimally accounted for gender and ethnicity, and much less the intersection of the two. The arts-based approach revealed experiences centered on the three main themes of power, self-worth, and determining a coherent identity, all of which were described as being negotiated in contexts of supportive relationships and community participation. Although these themes are evident in the recovery experiences of most people with severe mental illness, the intersections of gender, ethnicity and racialized identities comprise additional layers of complexity and negotiation.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"16 1","pages":"20 - 43"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82479253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1080/15487768.2013.877408
J. Jost, A. Levitt, A. Hannigan, A. Barbosa, Stacy Matuza
This paper presents findings from in-depth qualitative interviews conducted with 31 formerly homeless tenants and nine direct service staff at a supportive housing site, where a structured process for matching tenants with case managers (“Tenant Choice”) was piloted in which tenants were offered the option of choosing their respective case managers. Tenant Choice aims to increase the opportunity for tenants to make choices that will enable them to have more control over their treatment and recovery and obtain the optimal match between tenant and case manager. This study sought to understand how tenants and staff experienced Tenant Choice, determine whether Tenant Choice was meeting its goals, and identify areas for improvement. The major themes identified were: (1) pre-existing satisfaction drove tenant choices; (2) personal qualities of case managers were valued by tenants over professional qualifications and work experience; (3) the views of tenants and staff differed regarding whether minimal contact versus extended contact leads to better choices and working relationships; (4) the option of choice was valued by tenants regardless of whether it led to a change of case manager; and (5) staff concerns failed to materialize.
{"title":"Promoting Consumer Choice and Empowerment through Tenant Choice of Supportive Housing Case Manager","authors":"J. Jost, A. Levitt, A. Hannigan, A. Barbosa, Stacy Matuza","doi":"10.1080/15487768.2013.877408","DOIUrl":"https://doi.org/10.1080/15487768.2013.877408","url":null,"abstract":"This paper presents findings from in-depth qualitative interviews conducted with 31 formerly homeless tenants and nine direct service staff at a supportive housing site, where a structured process for matching tenants with case managers (“Tenant Choice”) was piloted in which tenants were offered the option of choosing their respective case managers. Tenant Choice aims to increase the opportunity for tenants to make choices that will enable them to have more control over their treatment and recovery and obtain the optimal match between tenant and case manager. This study sought to understand how tenants and staff experienced Tenant Choice, determine whether Tenant Choice was meeting its goals, and identify areas for improvement. The major themes identified were: (1) pre-existing satisfaction drove tenant choices; (2) personal qualities of case managers were valued by tenants over professional qualifications and work experience; (3) the views of tenants and staff differed regarding whether minimal contact versus extended contact leads to better choices and working relationships; (4) the option of choice was valued by tenants regardless of whether it led to a change of case manager; and (5) staff concerns failed to materialize.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"11 1","pages":"72 - 91"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81847026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.1080/15487768.2013.873370
D. Velligan, N. Maples, David L. Roberts, Elisa M. Medellin
Negative symptoms, including restricted affect, diminished emotional range, poverty of speech, decreased motivation and interests, diminished sense of purpose, and diminished social drive, contribute substantially to lost productivity, poor quality of life, social deficits, poor occupational and educational attainment, and generally poor outcomes observed for many individuals with schizophrenia. Although these symptoms may develop from neurobiological factors or as reactions to overstimulation in the acute psychotic phase, they are thought to be maintained by a confluence of biological, cognitive, behavioral, and environmental factors that are not adequately addressed by available treatments. We have developed a multicomponent set of intervention strategies to address persistent negative symptoms called the motivation and engagement (MOVE) program. MOVE builds on research on emotional processing as well as techniques from a variety of behavioral and skill-building approaches to specifically target a broad range of negative symptoms and their functional consequences in an integrated program delivered in the individual's home environment. In this manuscript, we describe an integrated theory for the development and maintenance of negative symptoms, available treatments that target aspects of the syndrome, and evidence supporting the components of MOVE for those with persistent negative symptoms.
{"title":"Integrated Psychosocial Treatment for Negative Symptoms","authors":"D. Velligan, N. Maples, David L. Roberts, Elisa M. Medellin","doi":"10.1080/15487768.2013.873370","DOIUrl":"https://doi.org/10.1080/15487768.2013.873370","url":null,"abstract":"Negative symptoms, including restricted affect, diminished emotional range, poverty of speech, decreased motivation and interests, diminished sense of purpose, and diminished social drive, contribute substantially to lost productivity, poor quality of life, social deficits, poor occupational and educational attainment, and generally poor outcomes observed for many individuals with schizophrenia. Although these symptoms may develop from neurobiological factors or as reactions to overstimulation in the acute psychotic phase, they are thought to be maintained by a confluence of biological, cognitive, behavioral, and environmental factors that are not adequately addressed by available treatments. We have developed a multicomponent set of intervention strategies to address persistent negative symptoms called the motivation and engagement (MOVE) program. MOVE builds on research on emotional processing as well as techniques from a variety of behavioral and skill-building approaches to specifically target a broad range of negative symptoms and their functional consequences in an integrated program delivered in the individual's home environment. In this manuscript, we describe an integrated theory for the development and maintenance of negative symptoms, available treatments that target aspects of the syndrome, and evidence supporting the components of MOVE for those with persistent negative symptoms.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"30 1","pages":"1 - 19"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88553491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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