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":null,"pages":null},"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":null,"pages":null},"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}
Pub Date : 2013-10-01DOI: 10.1080/15487768.2013.847741
A. Stefancic, S. Tsemberis, P. Messeri, R. Drake, P. Goering
Pathways Housing First (PHF) is an innovative, evidence-based model of providing permanent housing and services to adults with severe mental illness. This approach has been widely and rapidly disseminated across the U.S. and internationally, but sometimes with considerable variability from the original PHF model. This study developed and validated a PHF fidelity scale. The PHF model's guiding principles and prospective ingredients were identified through reviews of PHF literature and relevant fidelity scales, interviews with PHF administrators, and a survey administered to HF providers. An expert panel developed the items into a fidelity scale, which was field-tested as part of two large-scale research initiatives in California and Canada. General guiding principles for PHF included (a) eliminating barriers to housing access and retention, (b) fostering a sense of home, (c) facilitating community integration and minimizing stigma, (d) utilizing a harm-reduction approach, and (e) adhering to consumer choice and providing individualized consumer-driven services that promote recovery. The provider survey demonstrated that 32 key ingredients, derived from these principles, had good face and content validity. An expert panel refined the wording of these ingredients, added new items when there was consensus, and developed operational criteria to measure them. The resulting 38-item fidelity scale generally had good internal consistency; it captured variability in program implementation; it demonstrated discriminant validity; and it was useful in guiding program implementation and technical assistance. In conjunction with other program materials, the fidelity scale can be used as a guide for program development and technical assistance and as a research tool. Examining how these key ingredients relate to the model's success will contribute to a broader understanding of how to end homelessness and facilitate recovery.
{"title":"The Pathways Housing First Fidelity Scale for Individuals With Psychiatric Disabilities","authors":"A. Stefancic, S. Tsemberis, P. Messeri, R. Drake, P. Goering","doi":"10.1080/15487768.2013.847741","DOIUrl":"https://doi.org/10.1080/15487768.2013.847741","url":null,"abstract":"Pathways Housing First (PHF) is an innovative, evidence-based model of providing permanent housing and services to adults with severe mental illness. This approach has been widely and rapidly disseminated across the U.S. and internationally, but sometimes with considerable variability from the original PHF model. This study developed and validated a PHF fidelity scale. The PHF model's guiding principles and prospective ingredients were identified through reviews of PHF literature and relevant fidelity scales, interviews with PHF administrators, and a survey administered to HF providers. An expert panel developed the items into a fidelity scale, which was field-tested as part of two large-scale research initiatives in California and Canada. General guiding principles for PHF included (a) eliminating barriers to housing access and retention, (b) fostering a sense of home, (c) facilitating community integration and minimizing stigma, (d) utilizing a harm-reduction approach, and (e) adhering to consumer choice and providing individualized consumer-driven services that promote recovery. The provider survey demonstrated that 32 key ingredients, derived from these principles, had good face and content validity. An expert panel refined the wording of these ingredients, added new items when there was consensus, and developed operational criteria to measure them. The resulting 38-item fidelity scale generally had good internal consistency; it captured variability in program implementation; it demonstrated discriminant validity; and it was useful in guiding program implementation and technical assistance. In conjunction with other program materials, the fidelity scale can be used as a guide for program development and technical assistance and as a research tool. Examining how these key ingredients relate to the model's success will contribute to a broader understanding of how to end homelessness and facilitate recovery.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86142053","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 : 2013-10-01DOI: 10.1080/15487768.2013.847764
R. Greenwood, A. Stefancic, S. Tsemberis, Volker Busch-Geertsema
To describe and evaluate the fidelity of Housing First (HF) initiatives in six European countries to the Pathways HF (PHF) model and examine the larger social, historical, and political factors that may foster or impede model fidelity. Key stakeholders representing six European HF initiatives completed semi-structured phone interviews. Interviews were thematically analyzed according to five key fidelity domains and updated with interim results of a recent European research project (Housing First Europe). Dissatisfaction with the status quo was often cited as the catalyst driving searches for system change. PHF's evidence base, consumer-driven philosophy, recovery-oriented services, and view of housing as a basic right swayed local decisions to implement HF programs. Interviews yielded stronger evidence of fidelity on no housing readiness requirements, separation of housing and services, a harm reduction approach, consumer choice in services, and weaker evidence of fidelity on scatter-site housing, choice in housing, and breadth and intensity of services provided. Implementation challenges included resistance from existing programs, availability of affordable housing, and moral judgments of worthiness for housing. Both new and established programs evidenced high commitment to PHF principles and philosophy, but older programs demonstrated greater fidelity on a wider range of indicators. Early evidence indicates that HF can be successfully replicated within the European context, though local historical, social, and political factors may impact fidelity. Many programs committed to fidelity in principle faced external or financial barriers to implementation. Strategic planning and training to ensure that the programs unfold and mature in ways that realize HF principles in practice is recommended.
{"title":"Implementations of Housing First in Europe: Successes and Challenges in Maintaining Model Fidelity","authors":"R. Greenwood, A. Stefancic, S. Tsemberis, Volker Busch-Geertsema","doi":"10.1080/15487768.2013.847764","DOIUrl":"https://doi.org/10.1080/15487768.2013.847764","url":null,"abstract":"To describe and evaluate the fidelity of Housing First (HF) initiatives in six European countries to the Pathways HF (PHF) model and examine the larger social, historical, and political factors that may foster or impede model fidelity. Key stakeholders representing six European HF initiatives completed semi-structured phone interviews. Interviews were thematically analyzed according to five key fidelity domains and updated with interim results of a recent European research project (Housing First Europe). Dissatisfaction with the status quo was often cited as the catalyst driving searches for system change. PHF's evidence base, consumer-driven philosophy, recovery-oriented services, and view of housing as a basic right swayed local decisions to implement HF programs. Interviews yielded stronger evidence of fidelity on no housing readiness requirements, separation of housing and services, a harm reduction approach, consumer choice in services, and weaker evidence of fidelity on scatter-site housing, choice in housing, and breadth and intensity of services provided. Implementation challenges included resistance from existing programs, availability of affordable housing, and moral judgments of worthiness for housing. Both new and established programs evidenced high commitment to PHF principles and philosophy, but older programs demonstrated greater fidelity on a wider range of indicators. Early evidence indicates that HF can be successfully replicated within the European context, though local historical, social, and political factors may impact fidelity. Many programs committed to fidelity in principle faced external or financial barriers to implementation. Strategic planning and training to ensure that the programs unfold and mature in ways that realize HF principles in practice is recommended.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87613858","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 : 2013-10-01DOI: 10.1080/15487768.2013.847769
T. Gilmer, V. D. Ojeda, Sarah P. Hiller, A. Stefancic, S. Tsemberis, L. Palinkas
In California, the Mental Health Services Act allocated substantial funding to Full Service Partnerships (FSPs): programs that do whatever it takes to improve residential stability and mental health outcomes. The state-guided, but stakeholder-driven, approach to FSPs resulted in a set of programs that share core similarities but vary in their specific approaches. This qualitative study examines FSP variations within the framework of fidelity to the Housing First model. Semistructured interviews with 21 FSP program managers identified through purposeful sampling were coded and analyzed to identify variations across programs in their approaches to housing and services. Through the process of constant comparison, FSP characteristics were condensed into a set of broad themes related to fidelity to the Housing First model. We identified three broad themes: (a) FSPs varied in the degree to which key elements of Housing First were present; (b) program recovery orientation and staff experience were associated with fidelity; and (c) FSPs for older adults, adults exiting the justice system, and transitional age youth made specific adaptations to tailor their programs for the needs of their specific populations. FSPs bring a considerable level of community-based housing and treatment resources to homeless persons with serious mental illness. However, when examined individually, there exists enough variation in approaches to housing and treatment to raise the question whether some programs may be more or less effective than others. An opportunity exists to employ the variation in FSPs implemented under this initiative to analyze the importance of fidelity to HF for client outcomes, program costs, and recovery-oriented care.
在加州，《精神健康服务法》(Mental Health Services Act)为全面服务伙伴关系(FSPs)分配了大量资金:这些项目尽一切努力改善居住稳定性和精神健康结果。国家引导但利益相关者驱动的fsp方法产生了一系列项目，这些项目具有核心相似性，但在具体方法上有所不同。本定性研究在忠实于住房第一模型的框架内检验了FSP的变化。通过有目的的抽样，对21名FSP项目经理进行了半结构化访谈，并对其进行了编码和分析，以确定不同项目在住房和服务方面的差异。通过不断比较的过程，FSP的特征被浓缩成一系列与住房优先模型相关的广泛主题。我们确定了三个主要主题:(a)住宅优先的主要要素在不同程度上存在;(b)计划恢复导向和员工经验与保真度相关;(c)针对老年人、退出司法系统的成年人和过渡年龄青年的fsp进行了具体调整，使其方案适合其特定人群的需求。家庭服务计划为患有严重精神疾病的无家可归者提供相当数量的社区住房和治疗资源。然而，当单独检查时，在住房和治疗方法上存在足够的差异，从而提出一些方案是否比其他方案更有效的问题。有机会利用在该计划下实施的fsp的变化来分析心衰保真度对客户结果、项目成本和康复导向护理的重要性。
{"title":"Variations in Full Service Partnerships and Fidelity to the Housing First Model","authors":"T. Gilmer, V. D. Ojeda, Sarah P. Hiller, A. Stefancic, S. Tsemberis, L. Palinkas","doi":"10.1080/15487768.2013.847769","DOIUrl":"https://doi.org/10.1080/15487768.2013.847769","url":null,"abstract":"In California, the Mental Health Services Act allocated substantial funding to Full Service Partnerships (FSPs): programs that do whatever it takes to improve residential stability and mental health outcomes. The state-guided, but stakeholder-driven, approach to FSPs resulted in a set of programs that share core similarities but vary in their specific approaches. This qualitative study examines FSP variations within the framework of fidelity to the Housing First model. Semistructured interviews with 21 FSP program managers identified through purposeful sampling were coded and analyzed to identify variations across programs in their approaches to housing and services. Through the process of constant comparison, FSP characteristics were condensed into a set of broad themes related to fidelity to the Housing First model. We identified three broad themes: (a) FSPs varied in the degree to which key elements of Housing First were present; (b) program recovery orientation and staff experience were associated with fidelity; and (c) FSPs for older adults, adults exiting the justice system, and transitional age youth made specific adaptations to tailor their programs for the needs of their specific populations. FSPs bring a considerable level of community-based housing and treatment resources to homeless persons with serious mental illness. However, when examined individually, there exists enough variation in approaches to housing and treatment to raise the question whether some programs may be more or less effective than others. An opportunity exists to employ the variation in FSPs implemented under this initiative to analyze the importance of fidelity to HF for client outcomes, program costs, and recovery-oriented care.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72698404","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 : 2013-10-01DOI: 10.1080/15487768.2013.847732
S. Tsemberis
The theme of this special issue is implementation, dissemination, and program fidelity of the Pathways’ Housing First (PHF) program. I cannot imagine a more fitting platform than The American Journal of Psychiatric Rehabilitation for the first collection of articles on Housing First (HF). It is a sometimes overlooked but important fact that the (PHF) program was founded on the principles of psychiatric rehabilitation, which were infused into the program’s clinical practice from its inception. PHF began as an NIMH research-demonstration project called Taking Psych Rehab to the Streets, which sought to engage people who were homeless and who had co-occurring severe mental health and addiction problems (Tsemberis, Moran, Shinn, Shern, & Asmussen, 2003). Respecting consumers’ preferences was one of the core practices of that early outreach intervention, and it continues to be the foundation of the PHF program. In that initial study, we found that consumers who had remained homeless and previously shunned help for years were quick to engage if the offer of assistance was consistent with their priorities. What these consumers wanted above all was fundamental to their
{"title":"Housing First: Implementation, Dissemination, and Program Fidelity","authors":"S. Tsemberis","doi":"10.1080/15487768.2013.847732","DOIUrl":"https://doi.org/10.1080/15487768.2013.847732","url":null,"abstract":"The theme of this special issue is implementation, dissemination, and program fidelity of the Pathways’ Housing First (PHF) program. I cannot imagine a more fitting platform than The American Journal of Psychiatric Rehabilitation for the first collection of articles on Housing First (HF). It is a sometimes overlooked but important fact that the (PHF) program was founded on the principles of psychiatric rehabilitation, which were infused into the program’s clinical practice from its inception. PHF began as an NIMH research-demonstration project called Taking Psych Rehab to the Streets, which sought to engage people who were homeless and who had co-occurring severe mental health and addiction problems (Tsemberis, Moran, Shinn, Shern, & Asmussen, 2003). Respecting consumers’ preferences was one of the core practices of that early outreach intervention, and it continues to be the foundation of the PHF program. In that initial study, we found that consumers who had remained homeless and previously shunned help for years were quick to engage if the offer of assistance was consistent with their priorities. What these consumers wanted above all was fundamental to their","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79617882","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 : 2013-10-01DOI: 10.1080/15487768.2013.847761
Cameron Keller, P. Goering, C. Hume, E. Macnaughton, P. O’Campo, Aseefa Sarang, M. Thomson, C. Vallée, Aimee Watson, S. Tsemberis
At Home/Chez Soi, a large, $110-million, randomized trial evaluating the effectiveness of Housing First services for 2,235 individuals who are homeless and experiencing mental illness, was implemented in five Canadian cities, beginning in fall 2009. This paper describes initial implementation of the Housing First model, focusing on specific strategies, including centrally coordinated training/technical assistance and local site coordinators as change agents in each city. Implementation of this complex intervention varied across sites but was remarkably consistent regarding the essential ingredients of the program model. A strategy that balanced a strong centrally coordinated approach to technical assistance with customization and adaptation on the local level was essential for achieving a high fidelity implementation.
At Home/Chez Soi是一项耗资1.1亿美元的大型随机试验，评估了住房优先服务对2,235名无家可归者和患有精神疾病的人的有效性，该试验于2009年秋季在加拿大五个城市实施。本文描述了住房优先模式的初步实施，重点是具体策略，包括中央协调培训/技术援助和作为每个城市变革推动者的地方现场协调员。这种复杂的干预措施的实施在不同的地点有所不同，但在项目模型的基本成分方面是非常一致的。一项平衡强有力的中央协调的技术援助方法与地方一级的定制和调整的战略对于实现高度忠实的执行是必不可少的。
{"title":"Initial Implementation of Housing First in Five Canadian Cities: How Do You Make the Shoe Fit, When One Size Does Not Fit All?","authors":"Cameron Keller, P. Goering, C. Hume, E. Macnaughton, P. O’Campo, Aseefa Sarang, M. Thomson, C. Vallée, Aimee Watson, S. Tsemberis","doi":"10.1080/15487768.2013.847761","DOIUrl":"https://doi.org/10.1080/15487768.2013.847761","url":null,"abstract":"At Home/Chez Soi, a large, $110-million, randomized trial evaluating the effectiveness of Housing First services for 2,235 individuals who are homeless and experiencing mental illness, was implemented in five Canadian cities, beginning in fall 2009. This paper describes initial implementation of the Housing First model, focusing on specific strategies, including centrally coordinated training/technical assistance and local site coordinators as change agents in each city. Implementation of this complex intervention varied across sites but was remarkably consistent regarding the essential ingredients of the program model. A strategy that balanced a strong centrally coordinated approach to technical assistance with customization and adaptation on the local level was essential for achieving a high fidelity implementation.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75343987","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 : 2013-07-01DOI: 10.1080/15487768.2013.813873
C. J. Stewart, P. Lysaker, L. Davis
Committed sexual relationships are a key part of healthy psychological functioning yet are often missing in the lives of adults with schizophrenia. Although the current focus on policy and initiatives regarding schizophrenia has shifted to understanding what facilitates recovery, little is known about what helps and hinders the establishment and maintenance of these intimate relationships. In this study, we therefore sought to examine whether two psychological phenomena were concurrently and prospectively related to socio-sexual functioning: internalized stigma and narrative quality. Participants were 103 adults with schizophrenia or schizoaffective disorder. Assessments of internalized stigma, narrative quality, and socio-sexual functioning were obtained at baseline, and socio-sexual functioning was assessed again 5 and 12 months later. Internalized stigma was assessed using the Internalized Stigma of Mental Illness scale, narrative quality was evaluated using the scale to Assess Narrative Development, and socio-sexual functioning was assessed using the Quality of Life scale. Correlations and multiple regressions revealed that social withdrawal in the face of stigma and limited social worth (as contained within personal narratives) were related to decreased socio-sexual functioning concurrently and prospectively.
{"title":"Relationships of Social-Sexual Function with Stigma and Narrative Quality Among Persons with Schizophrenia Spectrum Disorders Over One Year","authors":"C. J. Stewart, P. Lysaker, L. Davis","doi":"10.1080/15487768.2013.813873","DOIUrl":"https://doi.org/10.1080/15487768.2013.813873","url":null,"abstract":"Committed sexual relationships are a key part of healthy psychological functioning yet are often missing in the lives of adults with schizophrenia. Although the current focus on policy and initiatives regarding schizophrenia has shifted to understanding what facilitates recovery, little is known about what helps and hinders the establishment and maintenance of these intimate relationships. In this study, we therefore sought to examine whether two psychological phenomena were concurrently and prospectively related to socio-sexual functioning: internalized stigma and narrative quality. Participants were 103 adults with schizophrenia or schizoaffective disorder. Assessments of internalized stigma, narrative quality, and socio-sexual functioning were obtained at baseline, and socio-sexual functioning was assessed again 5 and 12 months later. Internalized stigma was assessed using the Internalized Stigma of Mental Illness scale, narrative quality was evaluated using the scale to Assess Narrative Development, and socio-sexual functioning was assessed using the Quality of Life scale. Correlations and multiple regressions revealed that social withdrawal in the face of stigma and limited social worth (as contained within personal narratives) were related to decreased socio-sexual functioning concurrently and prospectively.","PeriodicalId":72174,"journal":{"name":"American journal of psychiatric rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88304747","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 : 2013-07-01DOI: 10.1080/15487768.2013.818883
D. Kranke, S. E. Jackson, J. Floersch, L. Townsend, E. Anderson-Fye
Psychiatric treatment is critical for people living with mental illness as it enables resumption of normal roles and engagement in meaningful opportunities, and it increases the chance of positive long-term outcomes. There is an urgent need to assess college student experience of psychiatric treatment because as many as 45% of college students may meet the criteria for a mental illness diagnosis. All college students are at some risk for negative mental health outcomes because of home-to-college stressors, but these are often intensified for those students living with a mental illness. The aim of this article is to qualitatively explore the psychiatric treatment and recovery experiences of college students diagnosed with mental health disorders, with a particular focus on the impact of treatment on the academic and social aspects of college. Seventeen undergraduate college students who had a psychiatric illness and were taking prescribed psychiatric medication were enrolled in this study. A semistructured interview queried college students about their perceptions of having psychiatric diagnoses and taking psychiatric medications. Authors conducted thematic analysis by using the constant comparative method for coding data and sorting in vivo codes by a shared theme. Respondents reported positive attitudes toward medication and services, endorsing themes of positive family influence, improved functioning, acceptance toward medication and service usage, willingness to disclose, and independent management of treatment. College students were empowered by their treatment because of its positive effects on success and integration into the college setting. Environmental factors that influence college students' feeling of empowerment are discussed.
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