Objective: This study aims to understand participant priorities in their personal recovery journey and their perspectives of recovery domains.
Methods: A card sort data gathering technique was employed to elicit priorities in recovery from consumers in supportive housing programs serving formerly homeless adults with severe mental illnesses in New York City. Participants (N=38) were asked to sort 12 cards printed with recovery domains in order of importance and describe the meaning attached to each domain.
Results: Mental health (95%), physical health (89%), and housing (92%) were the domains most frequently included and prioritized in the top three rankings. Family (76%) and partner (74%) were also frequently included and endorsed as most important second only to mental health. Housing was prioritized yet rated most important less often (58%). Work, school, hobbies, program, friends and neighborhood were less frequently endorsed. 'Card sort talk' revealed critical understanding of participants' priorities and their reasons for endorsing other domains less frequently.
Conclusions: Most important to participants was regaining functional independence through improved mental and physical health and access to housing. With underlying principles of efficiency and empowerment, card sort is a promising engagement technique for providers to elicit consumer priorities in their own recovery.
Cognitive deficits are a major determinant of functional outcome in schizophrenia. A promising treatment involves teaching individuals to use cognitive adaptation strategies to minimize the functional impact of cognitive difficulties. We developed Family Directed Cognitive Adaptation (FCA) to train caregivers to help their relatives with schizophrenia use cognitive adaptations to improve living skills. The goal of this open pilot trial was to examine the feasibility of FCA. Ten adults with schizophrenia, each with at least one relative, participated in FCA and were evaluated at baseline, post-treatment, and 6-month follow-up. Domains assessed included adaptive functioning, psychiatric symptoms, school/work involvement, hospitalizations, family burden, and treatment satisfaction. Participants reported high levels of satisfaction with FCA, and all families completed the 16-session intervention. Relatives reported reduced burden at termination and follow-up. No participants were hospitalized during the treatment or follow-up period, and rates of work/school involvement increased from 30% at baseline to 50% at the end of treatment and follow-up. Individuals improved in negative symptoms and adaptive functioning over the course of treatment, but these gains were not maintained. This pilot provides preliminary support for the acceptability and feasibility of FCA, and points to the need to address the maintenance of treatment gains after termination.
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