Pub Date : 2015-10-02DOI: 10.1080/15487768.2015.1089800
Alan B. McGuire, P. Lysaker, Sally Wasmuth
Goal setting is an essential part of psychiatric rehabilitation. Clinicians strive to maximize consumers’ participate in treatment decisions, including setting goals for treatment. Many psychiatric disabilities include alterations in a typical “open” dialogical self-experience that include cacophonous, monological, or barren self-experiences. Alterations to self-experience may affect the ability to formulate authentic and meaningful goals, and these perturbations may vary depending on the type of self-experience. The authors analyzed interviews regarding goals for treatment to explore themes emerging within self-experience types. Themes indicate people with differing self-experiences differ in how they form goals and the barriers they face in this process.
{"title":"Altered Self-Experience and Goal Setting in Severe Mental Illness","authors":"Alan B. McGuire, P. Lysaker, Sally Wasmuth","doi":"10.1080/15487768.2015.1089800","DOIUrl":"https://doi.org/10.1080/15487768.2015.1089800","url":null,"abstract":"Goal setting is an essential part of psychiatric rehabilitation. Clinicians strive to maximize consumers’ participate in treatment decisions, including setting goals for treatment. Many psychiatric disabilities include alterations in a typical “open” dialogical self-experience that include cacophonous, monological, or barren self-experiences. Alterations to self-experience may affect the ability to formulate authentic and meaningful goals, and these perturbations may vary depending on the type of self-experience. The authors analyzed interviews regarding goals for treatment to explore themes emerging within self-experience types. Themes indicate people with differing self-experiences differ in how they form goals and the barriers they face in this process.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"23 1","pages":"333 - 362"},"PeriodicalIF":0.0,"publicationDate":"2015-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84539953","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 : 2015-07-03DOI: 10.1080/15487768.2014.954163
Stacey L. Barrenger, V. Stanhope, K. Atterbury
A recovery orientation is imperative in mental health services. While structural aspects of programs can influence service providers’ orientation to recovery principles, team culture as exemplified by staff attitudes, values, and beliefs is central to the incorporation of recovery principles in everyday practice. Using Fine's (1979) idioculture framework, this study examined the discursive process in team meetings at a housing first program. Researchers observed team meetings and conducted in-depth, semistructured interviews with case managers from two assertive community treatment teams. Open coding identified categories indicating discursive processes grounded in the recovery language and higher-level coding derived intersubjective themes related to the use of recovery oriented culture during team meetings. Discursive processes included giving benefit of the doubt, withholding judgment, celebrating small things, and accentuating the positive and softening the negative. Using these discursive practices, the team navigated triggering events from landlords and providers by engaging in language that defused situations, normalized behaviors, and recognized residents’ successes, which served to facilitate positive discussions about residents rather than pathologizing their behaviors. Understanding the underlying processes contributing to team culture can inform and facilitate the implementation of recovery-oriented practice.
{"title":"Discursive Processes Creating Team Culture and Recovery Orientation Among Housing First Providers","authors":"Stacey L. Barrenger, V. Stanhope, K. Atterbury","doi":"10.1080/15487768.2014.954163","DOIUrl":"https://doi.org/10.1080/15487768.2014.954163","url":null,"abstract":"A recovery orientation is imperative in mental health services. While structural aspects of programs can influence service providers’ orientation to recovery principles, team culture as exemplified by staff attitudes, values, and beliefs is central to the incorporation of recovery principles in everyday practice. Using Fine's (1979) idioculture framework, this study examined the discursive process in team meetings at a housing first program. Researchers observed team meetings and conducted in-depth, semistructured interviews with case managers from two assertive community treatment teams. Open coding identified categories indicating discursive processes grounded in the recovery language and higher-level coding derived intersubjective themes related to the use of recovery oriented culture during team meetings. Discursive processes included giving benefit of the doubt, withholding judgment, celebrating small things, and accentuating the positive and softening the negative. Using these discursive practices, the team navigated triggering events from landlords and providers by engaging in language that defused situations, normalized behaviors, and recognized residents’ successes, which served to facilitate positive discussions about residents rather than pathologizing their behaviors. Understanding the underlying processes contributing to team culture can inform and facilitate the implementation of recovery-oriented practice.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"221 1","pages":"247 - 264"},"PeriodicalIF":0.0,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72686031","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 : 2015-07-03DOI: 10.1080/15487768.2014.954158
M. Hampson, R. Hicks, B. Watt
Motivational interviewing has been used effectively to promote positive change in a variety of clinical settings. Several authors have suggested that motivational interviewing also be used to improve vocational outcomes among people living with a serious mental health condition. This study investigated the effectiveness of motivational interviewing in improving employment-related outcomes among people living with a persisting mental health condition. Twenty-six volunteers diagnosed with long-term mental health conditions were assigned to two groups: The experimental group received a brief motivational interviewing intervention while control group members were mailed information to assist them to return to paid or unpaid work. Both groups were followed up after 6 and 12 months to compare occupational outcomes. The results of this study revealed significantly higher rates of paid employment at 12-month follow-up among participants in the motivational interviewing group compared with the control group. The findings demonstrate that motivational interviewing might be worth exploring as a user-friendly intervention that can assist in improving vocational outcomes among people recovering from a serious mental health condition. Further research using a larger sample size is needed to confirm these results.
{"title":"Exploring the Effectiveness of Motivational Interviewing in Re-engaging People Diagnosed with Severe Psychiatric Conditions in Work, Study, or Community Participation","authors":"M. Hampson, R. Hicks, B. Watt","doi":"10.1080/15487768.2014.954158","DOIUrl":"https://doi.org/10.1080/15487768.2014.954158","url":null,"abstract":"Motivational interviewing has been used effectively to promote positive change in a variety of clinical settings. Several authors have suggested that motivational interviewing also be used to improve vocational outcomes among people living with a serious mental health condition. This study investigated the effectiveness of motivational interviewing in improving employment-related outcomes among people living with a persisting mental health condition. Twenty-six volunteers diagnosed with long-term mental health conditions were assigned to two groups: The experimental group received a brief motivational interviewing intervention while control group members were mailed information to assist them to return to paid or unpaid work. Both groups were followed up after 6 and 12 months to compare occupational outcomes. The results of this study revealed significantly higher rates of paid employment at 12-month follow-up among participants in the motivational interviewing group compared with the control group. The findings demonstrate that motivational interviewing might be worth exploring as a user-friendly intervention that can assist in improving vocational outcomes among people recovering from a serious mental health condition. Further research using a larger sample size is needed to confirm these results.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"11 1","pages":"265 - 279"},"PeriodicalIF":0.0,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87818144","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 : 2015-07-03DOI: 10.1080/15487768.2014.954161
Marcelo Valencia, J. A. Moriana, A. Kopelowicz, S. López, R. Liberman
A review was conducted on the cross-cultural adaptation, effectiveness, and validation of social-skills training (SST), an evidence-based practice that originated in the English language, carried out in the Spanish language for persons with schizophrenia in Latin America, Spain, and the United States. This review of research delineates the methodology of the published literature that contained a wide variety of studies from empirically based evaluation of case reports to randomized, controlled trials. The weight of the evidence from all three regions revealed greater benefits to Spanish-speaking patients who received SST in symptoms, skill acquisition and community functioning than for patients who received customary treatment. To ensure the cross-cultural effectiveness of rehabilitation practices originating in English-speaking countries, it is essential that adaptations beyond language translations be made to meet the unique expectations, norms, values, and customs of Spanish-speaking patients and families in the three regions that are the focus of this report.
{"title":"Social-Skills Training for Spanish-Speaking Persons with Schizophrenia: Experiences From Latin America, Spain, and the United States","authors":"Marcelo Valencia, J. A. Moriana, A. Kopelowicz, S. López, R. Liberman","doi":"10.1080/15487768.2014.954161","DOIUrl":"https://doi.org/10.1080/15487768.2014.954161","url":null,"abstract":"A review was conducted on the cross-cultural adaptation, effectiveness, and validation of social-skills training (SST), an evidence-based practice that originated in the English language, carried out in the Spanish language for persons with schizophrenia in Latin America, Spain, and the United States. This review of research delineates the methodology of the published literature that contained a wide variety of studies from empirically based evaluation of case reports to randomized, controlled trials. The weight of the evidence from all three regions revealed greater benefits to Spanish-speaking patients who received SST in symptoms, skill acquisition and community functioning than for patients who received customary treatment. To ensure the cross-cultural effectiveness of rehabilitation practices originating in English-speaking countries, it is essential that adaptations beyond language translations be made to meet the unique expectations, norms, values, and customs of Spanish-speaking patients and families in the three regions that are the focus of this report.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"11 1","pages":"209 - 246"},"PeriodicalIF":0.0,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88335027","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 : 2015-07-03DOI: 10.1080/15487768.2015.1059383
M. Salyers, Ruth L. Firmin, Timothy Gearhart, Elizabeth Avery, R. Frankel
Appreciative Inquiry is an organizational change methodology that discovers what works well in an organization and then pursues strategies to enhance those factors. The initial discovery process itself provides data ripe for qualitative analysis. Narratives were collected from 27 community mental health staff about times when they were at their best. An emergent, consensus-based analysis was used to understand the stories and exemplary work—with competent, caring staff and elements needed to support them. Findings are discussed in light of self-determination theory that people are at their best with a sense of mastery, connection, and autonomy.
{"title":"What We Are Like When We Are at Our Best: Appreciative Stories of Staff in a Community Mental Health Center","authors":"M. Salyers, Ruth L. Firmin, Timothy Gearhart, Elizabeth Avery, R. Frankel","doi":"10.1080/15487768.2015.1059383","DOIUrl":"https://doi.org/10.1080/15487768.2015.1059383","url":null,"abstract":"Appreciative Inquiry is an organizational change methodology that discovers what works well in an organization and then pursues strategies to enhance those factors. The initial discovery process itself provides data ripe for qualitative analysis. Narratives were collected from 27 community mental health staff about times when they were at their best. An emergent, consensus-based analysis was used to understand the stories and exemplary work—with competent, caring staff and elements needed to support them. Findings are discussed in light of self-determination theory that people are at their best with a sense of mastery, connection, and autonomy.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"36 1","pages":"280 - 301"},"PeriodicalIF":0.0,"publicationDate":"2015-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84722006","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 : 2015-04-03DOI: 10.1080/15487768.2014.954162
C. Westcott, G. Waghorn, D. McLean, D. Statham, B. Mowry
There are divergent findings about the level of employment interest among community residents with schizophrenia. In addition, little is known about interest in other socially valued roles, such as formal education and training, self-development, living independently, and other forms of rehabilitation. Interest in employment is important as an indicator of demand for effective supported employment services. Data for this analysis were provided by a large and well-defined community sample of 255 persons with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Role functioning was investigated with the Socially-Valued Role Classification Scale. Interest in employment was high, with 85% of the participants being either employed or interested in employment as a future goal. In addition, 95% of participants were either performing, or interested in performing, two other socially valued roles (education and training or rehabilitation). This is more encouraging than some previous studies suggest and indicates that 95% of all community residents with schizophrenia and schizoaffective disorder are candidates for effective rehabilitation programs. Further research is needed to understand the importance of interest in socially valued roles and how appropriate assistance can develop both interest and lack of interest into motivation and action within each role domain.
{"title":"Interest in Employment Among People with Schizophrenia","authors":"C. Westcott, G. Waghorn, D. McLean, D. Statham, B. Mowry","doi":"10.1080/15487768.2014.954162","DOIUrl":"https://doi.org/10.1080/15487768.2014.954162","url":null,"abstract":"There are divergent findings about the level of employment interest among community residents with schizophrenia. In addition, little is known about interest in other socially valued roles, such as formal education and training, self-development, living independently, and other forms of rehabilitation. Interest in employment is important as an indicator of demand for effective supported employment services. Data for this analysis were provided by a large and well-defined community sample of 255 persons with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder. Role functioning was investigated with the Socially-Valued Role Classification Scale. Interest in employment was high, with 85% of the participants being either employed or interested in employment as a future goal. In addition, 95% of participants were either performing, or interested in performing, two other socially valued roles (education and training or rehabilitation). This is more encouraging than some previous studies suggest and indicates that 95% of all community residents with schizophrenia and schizoaffective disorder are candidates for effective rehabilitation programs. Further research is needed to understand the importance of interest in socially valued roles and how appropriate assistance can develop both interest and lack of interest into motivation and action within each role domain.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"6 1","pages":"187 - 207"},"PeriodicalIF":0.0,"publicationDate":"2015-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81069445","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 : 2015-04-03DOI: 10.1080/15487768.2014.954159
N. Tabak, Peter Link, Jason Holden, E. Granholm
Goal attainment scaling (GAS) is described as a method for standardizing achievement of personalized recovery goals. Collaborative goal setting enhances hope and motivation and promotes recovery for consumers with serious mental illness (SMI). Many available outcome measures survey broad functioning domains (e.g., work, school) and not personalized recovery goals that match consumers' self-determined needs and preferences. GAS was utilized to measure goal progress in consumers with schizophrenia and schizoaffective disorder (N = 55) in a clinical trial of group psychosocial interventions. Goals included 10 steps with objective anchors, which were measured at three time points (baseline, midtreatment, and end of treatment). Hierarchical linear modeling evaluated change over time. The most common goal chosen by consumers was establishing or reestablishing relationships, followed by self-care, employment, leisure activities, housing, school, independent transportation, recovery from addictions, and money management. Results indicated a significant increase in mean goal attainment with scores increasing from 2.38 (SD = 1.69)—corresponding to “talks to support person about goal”—at baseline to 5.64 (SD = 2.31)—corresponding to “actively engages in goal activity/behavior at least once”—at end of treatment. This preliminary evidence suggests the GAS measure is sensitive to change in a clinical trial. GAS is a promising recovery-oriented therapeutic tool and functional outcome measure for consumers with SMI.
{"title":"Goal Attainment Scaling: Tracking Goal Achievement in Consumers with Serious Mental Illness","authors":"N. Tabak, Peter Link, Jason Holden, E. Granholm","doi":"10.1080/15487768.2014.954159","DOIUrl":"https://doi.org/10.1080/15487768.2014.954159","url":null,"abstract":"Goal attainment scaling (GAS) is described as a method for standardizing achievement of personalized recovery goals. Collaborative goal setting enhances hope and motivation and promotes recovery for consumers with serious mental illness (SMI). Many available outcome measures survey broad functioning domains (e.g., work, school) and not personalized recovery goals that match consumers' self-determined needs and preferences. GAS was utilized to measure goal progress in consumers with schizophrenia and schizoaffective disorder (N = 55) in a clinical trial of group psychosocial interventions. Goals included 10 steps with objective anchors, which were measured at three time points (baseline, midtreatment, and end of treatment). Hierarchical linear modeling evaluated change over time. The most common goal chosen by consumers was establishing or reestablishing relationships, followed by self-care, employment, leisure activities, housing, school, independent transportation, recovery from addictions, and money management. Results indicated a significant increase in mean goal attainment with scores increasing from 2.38 (SD = 1.69)—corresponding to “talks to support person about goal”—at baseline to 5.64 (SD = 2.31)—corresponding to “actively engages in goal activity/behavior at least once”—at end of treatment. This preliminary evidence suggests the GAS measure is sensitive to change in a clinical trial. GAS is a promising recovery-oriented therapeutic tool and functional outcome measure for consumers with SMI.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"191 1","pages":"173 - 186"},"PeriodicalIF":0.0,"publicationDate":"2015-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74181024","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 : 2015-04-03DOI: 10.1080/15487768.2014.954160
J. Shank, Y. Iwasaki, C. Coyle, Emily S. Messina
This paper presents the findings from Phase II of our multiphase, community-based research project that examined in-depth insights into the meanings of leisure and active living in the recovery experiences of culturally diverse, community-dwelling adults with mental illness. A series of three face-to-face, semistructured interviews were conducted once each week for 3 weeks with each individual who was purposefully selected from a pool of Phase I study participants. This case-study subsample (n = 23; 14 women and 9 men) included seven White, six Black, six Hispanic American, and four Asian American participants, aged between 23 and 78 years. The findings suggested that actively engaged leisure would act as a mechanism (i.e., “leisure space”) for “movement from” stress and tension and “movement to” something enjoyable and meaningful (e.g., a source of fulfillment, social connections, the reaffirmation of self-worth, hope for the future, altruism).
{"title":"Experiences and Meanings of Leisure, Active Living, and Recovery Among Culturally Diverse Community-Dwelling Adults with Mental Illness","authors":"J. Shank, Y. Iwasaki, C. Coyle, Emily S. Messina","doi":"10.1080/15487768.2014.954160","DOIUrl":"https://doi.org/10.1080/15487768.2014.954160","url":null,"abstract":"This paper presents the findings from Phase II of our multiphase, community-based research project that examined in-depth insights into the meanings of leisure and active living in the recovery experiences of culturally diverse, community-dwelling adults with mental illness. A series of three face-to-face, semistructured interviews were conducted once each week for 3 weeks with each individual who was purposefully selected from a pool of Phase I study participants. This case-study subsample (n = 23; 14 women and 9 men) included seven White, six Black, six Hispanic American, and four Asian American participants, aged between 23 and 78 years. The findings suggested that actively engaged leisure would act as a mechanism (i.e., “leisure space”) for “movement from” stress and tension and “movement to” something enjoyable and meaningful (e.g., a source of fulfillment, social connections, the reaffirmation of self-worth, hope for the future, altruism).","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"16 1","pages":"129 - 151"},"PeriodicalIF":0.0,"publicationDate":"2015-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81104311","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 : 2015-04-03DOI: 10.1080/15487768.2014.954157
Hayden C. Bottoms, E. Treichler, C. Davidson, W. Spaulding
Despite advances in psychiatric rehabilitation (PR), a substantial number of individuals with serious mental illness (SMI) are institutionalized for extended periods. The cognitive characteristics of these individuals play a role in their institutionalized status. Consideration of individual cognitive characteristics, including “attribution biases” and insight into one's illness, has benefited PR in improving case conceptualization and treatment planning. Insight, or understanding one's illness, involves attributions about the causes of one's own behavior and experience, including psychiatric symptoms. Further, attribution biases may have a negative impact on such understanding, and consequently on engagement in rehabilitation. This exploratory study analyzed quantitative individual differences in attribution bias, understanding of illness, and psychiatric symptoms, to determine how these functional domains interact in people with SMI who are “difficult to discharge.” The results reveal an interaction between active positive symptoms, exaggerated externalizing attribution bias (attributing the cause of positive events to others), and understanding of illness. Among individuals with more impaired understanding of illness, attribution biases are associated with high levels of suspiciousness. However, among individuals with better understanding of illness, attribution biases and suspiciousness are not related. The dynamic relationship between attribution bias, positive symptoms, and understanding of illness sheds light on the variable nature of insight in SMI and supports utilizing these cognitive characteristics in case conceptualization, individualized treatment plans, and developing cognitively focused PR treatment modalities.
{"title":"Cognitive Characteristics in “Difficult-to-Discharge” Inpatients with Serious Mental Illness: Attribution Biases are Associated with Suspiciousness Only for Those with Lower Levels of Insight","authors":"Hayden C. Bottoms, E. Treichler, C. Davidson, W. Spaulding","doi":"10.1080/15487768.2014.954157","DOIUrl":"https://doi.org/10.1080/15487768.2014.954157","url":null,"abstract":"Despite advances in psychiatric rehabilitation (PR), a substantial number of individuals with serious mental illness (SMI) are institutionalized for extended periods. The cognitive characteristics of these individuals play a role in their institutionalized status. Consideration of individual cognitive characteristics, including “attribution biases” and insight into one's illness, has benefited PR in improving case conceptualization and treatment planning. Insight, or understanding one's illness, involves attributions about the causes of one's own behavior and experience, including psychiatric symptoms. Further, attribution biases may have a negative impact on such understanding, and consequently on engagement in rehabilitation. This exploratory study analyzed quantitative individual differences in attribution bias, understanding of illness, and psychiatric symptoms, to determine how these functional domains interact in people with SMI who are “difficult to discharge.” The results reveal an interaction between active positive symptoms, exaggerated externalizing attribution bias (attributing the cause of positive events to others), and understanding of illness. Among individuals with more impaired understanding of illness, attribution biases are associated with high levels of suspiciousness. However, among individuals with better understanding of illness, attribution biases and suspiciousness are not related. The dynamic relationship between attribution bias, positive symptoms, and understanding of illness sheds light on the variable nature of insight in SMI and supports utilizing these cognitive characteristics in case conceptualization, individualized treatment plans, and developing cognitively focused PR treatment modalities.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"1 1","pages":"152 - 172"},"PeriodicalIF":0.0,"publicationDate":"2015-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89836402","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 : 2015-01-02DOI: 10.1080/15487768.2015.1001700
L. Razzano, Marie M. Hamilton, C. Yost, Nicole Pashka, J. K. Perloff
With the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvement in their health, making many of their ongoing employment and career goals more realistic. However, these individuals continue to report experiencing employment barriers, including factors related to symptoms and illness progression, medication adherence and HIV treatment, and beliefs about health and wellness. The present evaluation focuses on factors predicting employment status among individuals with HIV/AIDS, as well as the effects of other indicators on work, including chronic mental health comorbidities such as depression, medication adherence to antiretroviral regimens, and perceived adjustment to chronic illness. Results of multivariate logistic regression identify significant predictors of work participation among this population, including gender and education. Study strengths, weaknesses, and recommendations for innovative services are discussed.
{"title":"Employment Outcomes for Individuals With HIV/AIDS and Co-Occurring Mental Health Factors","authors":"L. Razzano, Marie M. Hamilton, C. Yost, Nicole Pashka, J. K. Perloff","doi":"10.1080/15487768.2015.1001700","DOIUrl":"https://doi.org/10.1080/15487768.2015.1001700","url":null,"abstract":"With the advent of more advanced treatments and therapies, people with HIV/AIDS are experiencing significant improvement in their health, making many of their ongoing employment and career goals more realistic. However, these individuals continue to report experiencing employment barriers, including factors related to symptoms and illness progression, medication adherence and HIV treatment, and beliefs about health and wellness. The present evaluation focuses on factors predicting employment status among individuals with HIV/AIDS, as well as the effects of other indicators on work, including chronic mental health comorbidities such as depression, medication adherence to antiretroviral regimens, and perceived adjustment to chronic illness. Results of multivariate logistic regression identify significant predictors of work participation among this population, including gender and education. Study strengths, weaknesses, and recommendations for innovative services are discussed.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":"89 1","pages":"19 - 41"},"PeriodicalIF":0.0,"publicationDate":"2015-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72972594","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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