American journal of psychiatric rehabilitation最新文献

英文中文

Veterans' Views of a Shared Decision-Making Process: A Qualitative Substudy of REORDER 退伍军人对共同决策过程的看法:REORDER的定性子研究

American journal of psychiatric rehabilitation

Pub Date : 2014-10-02 DOI: 10.1080/15487768.2014.903877

Deborah Gioia, S. Autrey, Amy L. Drapalski, S. Glynn, Amy N. Cohen, L. Dixon

The Recovery-Oriented Decisions for Relatives' Support (REORDER) intervention is an innovative, manualized protocol utilizing shared decision-making principles with military veterans who have serious mental illnesses to promote recovery and encourage consideration of family involvement in care. This treatment study by Dixon et al. (2014) compared REORDER to enhanced treatment as usual in a randomized design. This qualitative sub-study sought to understand the nuances of the decision-making process of including family members through in-depth interviews with veterans who were randomized to REORDER. The qualitative themes support the willingness of the interviewed veterans who have previously not included family members to situate themselves at the center of their care and deliberate through facilitated conversation, the pros and cons of involving family. REORDER brings a fresh perspective to adapting recovery principles into family-based interventions.

以康复为导向的亲属支持决策(REORDER)干预是一种创新的、手动的协议，利用与患有严重精神疾病的退伍军人共享的决策原则来促进康复并鼓励考虑家庭参与护理。Dixon等人(2014)在随机设计中将REORDER与常规强化治疗进行了比较。本定性子研究通过对随机分配到REORDER的退伍军人进行深入访谈，试图了解包括家庭成员在内的决策过程的细微差别。定性主题支持了接受采访的退伍军人的意愿他们以前没有包括家庭成员他们将自己置于照顾的中心，并通过促进对话，考虑让家庭成员参与的利弊。REORDER为将恢复原则纳入以家庭为基础的干预措施带来了新的视角。

引用次数: 3

Editorial Board EOV 编辑委员会EOV

American journal of psychiatric rehabilitation

Pub Date : 2014-10-02 DOI: 10.1080/15487768.2014.980201

引用次数: 0

Evolution of Errorless Learning in Psychiatric Rehabilitation 精神病学康复中无误学习的演变

American journal of psychiatric rehabilitation

Pub Date : 2014-07-03 DOI: 10.1080/15487768.2014.935677

R. Kern, L. Reddy

We focus on Robert P. Liberman's influence on the development and adaptation of a behavioral learning approach used in the rehabilitation of individuals with schizophrenia called errorless learning. In this article we present: the origins of errorless learning; first proof-of-concept study of errorless learning in a sample of individuals with psychotic disorders; follow-up laboratory-based studies of errorless learning; and a community-based study of errorless learning.

我们专注于罗伯特P.利伯曼对精神分裂症患者康复中使用的行为学习方法的发展和适应的影响，这种方法被称为无误学习。在这篇文章中，我们提出:无差错学习的起源;第一个在精神病患者样本中进行的无差错学习的概念验证研究;基于实验室的无差错学习后续研究;以及基于社区的无差错学习研究。

引用次数: 1

Bridging Psychiatric Rehabilitation and Recovery in Schizophrenia: A Life's Work 弥合精神分裂症的精神康复和恢复:一生的工作

American journal of psychiatric rehabilitation

Pub Date : 2014-07-03 DOI: 10.1080/15487768.2014.935668

S. Glynn

For many years, schizophrenia was thought of as a lifelong deteriorating illness with little hope of improvement. However, recent naturalistic studies demonstrate that the course of the disorder is more positive than had been previously thought. With the advent of more effective pharmacological and psychosocial interventions for those with the disorder who continue to experience impairment and disabilities, the potential of recovery in schizophrenia has become increasingly acknowledged. This paper presents a brief history of the development of psychosocial interventions for schizophrenia and the role Robert Paul Liberman played in advancing psychiatric rehabilitation as an effective strategy for helping individuals with serious psychiatric illnesses live richer lives in the community. The core tenets of Liberman's work—community-based care, designing interventions to bolster (re)hablitation of life skills critical to successful functional adjustment, promoting widespread availability of effective interventions, emphasizing personalized goals as legitimate treatment targets, and recognizing the importance of cultivating enduring respectful relationships among professionals and consumers and those who care about them—are identified and their relevance to the evolving recovery movement is discussed.

多年来，精神分裂症被认为是一种终身恶化的疾病，几乎没有好转的希望。然而，最近的自然主义研究表明，这种疾病的病程比以前认为的更为积极。随着更有效的药理学和社会心理干预措施的出现，精神分裂症患者继续经历损伤和残疾，其康复的潜力已日益得到承认。本文简要介绍了精神分裂症的社会心理干预的发展历史，以及罗伯特·保罗·利伯曼在促进精神康复方面所发挥的作用，作为一种有效的策略，帮助患有严重精神疾病的个体在社区中过上更丰富的生活。Liberman工作的核心原则是基于社区的护理，设计干预措施来支持(重新)适应对成功的功能调整至关重要的生活技能，促进有效干预措施的广泛可用性，强调个性化目标作为合法的治疗目标，认识到在专业人士、消费者和关心他们的人之间培养持久尊重关系的重要性，并讨论了它们与不断发展的复苏运动的相关性。

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引用次数: 2

Introduction to Series 系列简介

American journal of psychiatric rehabilitation

Pub Date : 2014-07-03 DOI: 10.1080/15487768.2014.935661

P. Corrigan

There are many who have impacted the practice of psychiatric rehabilitation importantly. There are some who have done so monumentally. The former added incrementally to the body of knowledge, turning the ship of service ever so slightly in the process. There are others who defined the ship and current in which it sails. It is difficult to appreciate changes of this magnitude when they occur over a career and when they are recalled some 50 years later. Bob Liberman is one of these people; to understand how he earns these accolades, we need to appreciate how services for people with the most severe of mental illnesses have evolved over this time. When Liberman started his work in the ‘60s, illnesses like schizophrenia were understood wholly as diseases; not just diseases in the biological view (which Liberman and most modern practitioners acknowledge as essential), but also in the psychodynamic and psychoanalytic sense. Psychodynamic models at times represented people with mental illness as broken personalities, suffering deep psychic conflicts that could be healed only through intensive and esoteric interventions. Prognoses were typically gloomy and interventions custodial. Liberman’s insight was to borrow from the recently forming behavioral movement to better frame the vagaries of broken personality into more approachable, almost discrete targets for change. Liberman is one of the true granddads of behavior therapy, translating the mechanical ideas of B. F. Skinner into clinically meaningful and humane approaches. He did not do this just once. Very early in his career, Bob Liberman used behavioral analysis to decipher the challenges of mental illness into treatable disorders. He was early in work on reinforcement and token economies. He did the first and most important research on

有许多人对精神康复的实践产生了重要的影响。有些人的成就是不朽的。前者逐渐增加了知识体系，在这个过程中稍微改变了服务的方向。还有一些人定义了这艘船和它所航行的洋流。当这些变化发生在一个人的职业生涯中，或者在大约50年后被回忆起来时，我们很难理解如此巨大的变化。鲍勃·利伯曼就是其中之一;为了理解他是如何获得这些荣誉的，我们需要了解在这段时间里，为最严重的精神疾病患者提供的服务是如何发展的。当利伯曼在60年代开始他的研究时，像精神分裂症这样的疾病被完全理解为疾病;不仅仅是生物学观点的疾病(Liberman和大多数现代实践者都认为这是必不可少的)，还有精神动力学和精神分析意义上的疾病。心理动力学模型有时会将患有精神疾病的人描述为人格破碎的人，他们遭受着深刻的精神冲突，只有通过密集和深奥的干预才能治愈。预后通常是悲观的，干预措施是监护的。利伯曼的见解是从最近形成的行为运动中借鉴，以更好地将破碎人格的变幻莫测塑造成更容易接近、几乎是离散的改变目标。利伯曼是行为疗法真正的鼻祖之一，他将斯金纳的机械性思想转化为临床意义和人性化的方法。他不止一次这样做。在他职业生涯的早期，鲍勃·利伯曼(Bob Liberman)使用行为分析将精神疾病的挑战解读为可治疗的障碍。他很早就开始研究强化和代币经济。他做了第一个也是最重要的研究

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引用次数: 0

Change in AJPR Editors AJPR编辑器的变化

American journal of psychiatric rehabilitation

Pub Date : 2014-07-03 DOI: 10.1080/15487768.2014.935687

引用次数: 0

The Role of Robert Liberman in the Development of Family Psychoeducation 罗伯特·利伯曼在家庭心理教育发展中的作用

American journal of psychiatric rehabilitation

Pub Date : 2014-07-03 DOI: 10.1080/15487768.2014.935666

A. Kopelowicz, R. Zárate

Over the past 50 years, mental health professionals have come to recognize the enormous benefits that can be derived from involving the families of people with serious mental illness in the treatment enterprise. One of the earliest advocates for this perspective, Robert Liberman, has played a pivotal role in the development of evidence-based practices targeted to improving the outcomes for this population. From his early work starting in the 1970 s with Ian Falloon on behavioral family therapy for schizophrenia, through his influence as director of the UCLA Clinical Research Center in the 1980 s and ‘90 s on colleagues who applied family psychoeducation principles to the treatment of other mental disorders, to his most recent efforts designed to adapt these approaches to people of diverse cultural backgrounds, Liberman has steadfastly championed the value of teaching families the skills required to meet their needs and to enhance the social adjustment and quality of life of individuals with serious mental disorders.

在过去的50年里，精神卫生专业人员已经认识到，让患有严重精神疾病的人的家庭参与治疗事业，可以带来巨大的好处。罗伯特·利伯曼(Robert Liberman)是这一观点的最早倡导者之一，他在以证据为基础的实践的发展中发挥了关键作用，这些实践旨在改善这一人群的结果。从他1970年代开始与Ian Falloon一起研究精神分裂症的行为家庭疗法，到他在1980年代和90年代担任加州大学洛杉矶分校临床研究中心主任期间对将家庭心理教育原则应用于其他精神障碍治疗的同事的影响，再到他最近致力于将这些方法应用于不同文化背景的人，李伯曼坚定地支持教育家庭所需技能的价值，以满足他们的需求，并加强社会适应和严重精神障碍患者的生活质量。

引用次数: 0

Robert Liberman's Influence on Supported Employment 罗伯特·利伯曼对支持就业的影响

American journal of psychiatric rehabilitation

Pub Date : 2014-07-03 DOI: 10.1080/15487768.2014.935663

R. Drake, D. Becker

The authors have developed individual placement and support using many of the principles of psychiatric rehabilitation of Robert P. Liberman. These included respect for the individual, working in collaboration with the family, integrating skills and supports, using simple behavioral techniques to teach skills in a particular context, combining clinical and rehabilitative approaches, and insisting on rigorous research. As individual placement and support has become an evidence-based practice and has spread around the globe, Bob continues to be a tireless mentor, supporter, colleague, and friend.

作者利用罗伯特·p·利伯曼的许多精神康复原则发展了个体安置和支持。这些措施包括尊重个人，与家庭合作，整合技能和支持，在特定情况下使用简单的行为技术来教授技能，结合临床和康复方法，以及坚持严格的研究。随着个人安置和支持已经成为一种基于证据的实践，并在全球范围内传播，鲍勃仍然是一位不知疲倦的导师、支持者、同事和朋友。

引用次数: 0

Developing a Cognitive Training Strategy for First-Episode Schizophrenia: Integrating Bottom-Up and Top-Down Approaches. 开发针对首发精神分裂症的认知训练策略：整合自下而上和自上而下的方法。

American journal of psychiatric rehabilitation

Pub Date : 2014-07-01 DOI: 10.1080/15487768.2014.935674

Keith H Nuechterlein, Joseph Ventura, Kenneth L Subotnik, Jacqueline N Hayata, Alice Medalia, Morris D Bell

It is clear that people with schizophrenia typically have cognitive problems in multiple domains as part of their illness. The cognitive deficits are among the main contributors to limitations in their everyday functioning, including their work recovery. Cognitive remediation has been applied successfully to help people with long-term, persistent schizophrenia to improve their cognitive functioning, but it is only beginning to be applied with individuals who have recently had a first episode of psychosis. Several different approaches to cognitive training have been developed. Some approaches emphasize extensive systematic practice with lower-level cognitive processes and building toward higher-level processes ("bottom-up"), while others emphasize greater focus on high-level cognitive processes that normally integrate and organize lower-level processes ("top-down"). Each approach has advantages and disadvantages for a disorder like schizophrenia, with its multiple levels of cognitive dysfunction. In addition, approaches to cognitive remediation differ in the extent to which they systematically facilitate transfer of learning to everyday functioning. We describe in this article the cognitive training approach that was developed for a UCLA study of people with a recent first episode of schizophrenia, a group that may benefit greatly from early intervention that focuses on cognition and recovery of work functioning. This approach integrated bottom-up and top-down computerized cognitive training and incorporated an additional weekly group session to bridge between computerized training and application to everyday work and school functioning.

很明显，精神分裂症患者通常会在多个领域出现认知问题，这是疾病的一部分。认知障碍是导致其日常功能（包括工作恢复）受限的主要原因之一。认知矫正已成功应用于帮助长期、持续性精神分裂症患者改善认知功能，但对于近期首次发作的精神病患者，认知矫正才刚刚开始应用。目前已开发出几种不同的认知训练方法。有些方法强调对低级认知过程进行广泛的系统练习，然后再向高级认知过程发展（"自下而上"），而另一些方法则强调更多关注高级认知过程，这些过程通常会整合和组织低级认知过程（"自上而下"）。对于精神分裂症这种具有多层次认知功能障碍的疾病来说，每种方法都各有利弊。此外，认知矫正的方法在系统地促进学习向日常功能转移的程度上也各不相同。我们在这篇文章中介绍了加州大学洛杉矶分校针对近期首次发作的精神分裂症患者所开展的一项研究中开发的认知训练方法，这类患者可能会从侧重于认知和工作功能恢复的早期干预中受益匪浅。这种方法整合了自下而上和自上而下的计算机化认知训练，并每周增加一次小组课程，在计算机化训练与日常工作和学习功能的应用之间架起一座桥梁。

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引用次数: 0

Impact of Stigma on Veteran Treatment Seeking for Depression 耻辱对退伍军人寻求抑郁症治疗的影响

American journal of psychiatric rehabilitation

Pub Date : 2014-04-03 DOI: 10.1080/15487768.2014.903875

Stephanie Rodrigues, B. Bokhour, Nora M Mueller, Natalie S. Dell, P. E. Osei-Bonsu, Shibei Zhao, M. Glickman, S. Eisen, A. Elwy

The Veterans Health Administration (VHA) mandates annual depression screening in primary care; however, veterans often delay seeking treatment after screening positive, which can increase the severity and impact of depression. This mixed-methods study examined the association between stigma and treatment utilization among veterans (N = 271) in primary care with a positive depression screen. A subsample of veterans (n = 23) participated in a semistructured interview to qualitatively explore the social and cultural contexts of treatment utilization for depression. Treatment utilization data based on Healthcare Effectiveness Data and Information Set (HEDIS) guidelines were obtained by chart review 3 months following the positive screen date. Logistic regression indicated a lack of evidence that stigma was associated with treatment utilization. However, grounded thematic analysis suggested that stigma negatively influenced perceptions of depression and treatment utilization for some veterans. Four themes emerged: (1) depression is weakness; (2) depression is an unwanted label; (3) depression is normal; and (4) overcoming stigma. Evidence from interviews suggests that stigma may play a larger role in decisions about treatment seeking, which was not quantitatively evident. Addressing the psychosocial ramifications of stigma for depression may help minimize treatment lapses and maximize treatment seeking among veterans who screen positive for depression in primary care.

退伍军人健康管理局(VHA)要求在初级保健中每年进行抑郁症筛查;然而，退伍军人在筛查呈阳性后往往会推迟寻求治疗，这可能会增加抑郁症的严重程度和影响。本混合方法研究了在初级保健中抑郁筛查呈阳性的退伍军人(N = 271)中耻辱与治疗利用之间的关系。对23名退伍军人进行半结构化访谈，以定性地探讨抑郁症治疗利用的社会和文化背景。根据医疗保健有效性数据和信息集(HEDIS)指南，在阳性筛查日期后3个月通过图表回顾获得治疗利用数据。逻辑回归表明缺乏证据表明病耻感与治疗利用相关。然而，有根据的专题分析表明，耻辱感对一些退伍军人的抑郁认知和治疗利用产生了负面影响。出现了四个主题:(1)抑郁是软弱;(2)抑郁是一个不想要的标签;(3)抑郁正常;(4)克服耻辱。来自访谈的证据表明，耻辱感可能在寻求治疗的决定中发挥更大的作用，这在数量上并不明显。解决抑郁症耻辱感的社会心理后果可能有助于减少治疗失误，并最大限度地提高在初级保健中抑郁症筛查呈阳性的退伍军人的治疗寻求。

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