Illness Management and Recovery: A Review of the Research

Department of Psychiatry, Dartmouth Medical School and the New Hampshire-Dartmouth Psychiatric Research Center, Concord, New Hampshire 03301, USA.
Psychiatric Services (Impact Factor: 1.99). 11/2002; 53(10):1272-84. DOI: 10.1176/
Source: PubMed

ABSTRACT Illness management is a broad set of strategies designed to help individuals with serious mental illness collaborate with professionals, reduce their susceptibility to the illness, and cope effectively with their symptoms. Recovery occurs when people with mental illness discover, or rediscover, their strengths and abilities for pursuing personal goals and develop a sense of identity that allows them to grow beyond their mental illness. The authors discuss the concept of recovery from psychiatric disorders and then review research on professional-based programs for helping people manage their mental illness. Research on illness management for persons with severe mental illness, including 40 randomized controlled studies, indicates that psychoeducation improves people's knowledge of mental illness; that behavioral tailoring helps people take medication as prescribed; that relapse prevention programs reduce symptom relapses and rehospitalizations; and that coping skills training using cognitive-behavioral techniques reduces the severity and distress of persistent symptoms. The authors discuss the implementation and dissemination of illness management programs from the perspectives of mental health administrators, program directors, people with a psychiatric illness, and family members.

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    ABSTRACT: Psychotic experiences (PE) have been found to be much more common in the general population than psychotic disorders, yet research is currently ambivalent about whether or not PE warrant clinical treatment, and what treatment should entail. In light of this dilemma,wereviewthe definitions of PEandhowthey differ fromtworelated sub-threshold phenomena, which are ‘clinical high risk’ and ‘voice hearing’. Thenwe discuss the clinical significance of PE with respect to three areas: (i) the risk of transitioning from PE to threshold psychotic disorder, (ii) the distress and impairment associated with PE irrespective of transition and (iii) the treatment-seeking behaviours and need for care of people with PE. Finally, we consider the implications for social work practice and underscore the importance of a person-centred treatment system to detect and respond to PE while working with social support systems.
    British Journal of Social Work 01/2014; DOI:10.1093/bjsw/bct199 · 1.19 Impact Factor
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    ABSTRACT: Objective: Illness management and recovery strategies are considered evidence-based practices. The article describes how a web-based application, CommonGround, has been used to support implementation of such strategies in outpatient mental health services and assess its impact. The specific focus of this article is Personal Medicine, self-management strategies that are a salient component of the CommonGround intervention. Method: With support from counties and a not-for-profit managed care organization, CommonGround has been introduced in 10 medication clinics, one Assertive Community Treatment (ACT) team, and one peer support center across Pennsylvania. Methods include analysis of data from the application's database and evaluation of health functioning, symptoms, and progress toward recovery. Results: Health functioning improved over time and use of self-management strategies was associated with fewer concerns about medication side effects, fewer concerns about the impact of mental health medicine on physical health, more reports that mental health medicines were helping, and greater progress in individuals' recovery. Conclusions and Implications for Practice: Using Personal Medicine empowers individuals to work with their prescribers to find a "right balance" between what they do to be well and what they take to be well. This program helps individuals and their service team focus on individual strengths and resilient self-care strategies. More research is needed to assess factors that may predict changes in outcomes and how a web-based tool focused on self-management strategies may moderate those factors. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychiatric Rehabilitation Journal 12/2013; 36(4):258-63. DOI:10.1037/prj0000027 · 0.75 Impact Factor
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    ABSTRACT: Objective: Most research on the Illness Management and Recovery (IMR) program for people with severe mental illnesses has focused on individuals with stable symptoms living in the community, with less attention to persons being treated in an inpatient setting. We evaluated the feasibility and effects of an IMR program adapted for individuals with schizophrenia who were awaiting discharge into the community. Method: A randomized controlled trial was conducted at 2 hospitals in Taiwan to compare the adapted IMR program with treatment as usual (TAU). Ninety-seven individuals with schizophrenia were randomized to the adapted IMR program or TAU. Four outcome indicators including illness-management knowledge, attitudes toward medication, insight, and symptoms were assessed at baseline, posttreatment, and at a 1-month follow-up following discharge from the hospital. Results: Participants in the adapted IMR group showed significantly greater improvements at posttreatment and 1-month follow-up in illness-management knowledge, attitudes toward medication, insight, and negative symptoms on the Brief Psychiatric Rating Scale (BPRS) than individuals in the TAU group. There were no significant differences between the 2 groups on other subscales of the BPRS. Conclusions and Implications for Practice: This is the first controlled evaluation of a version of the IMR program in an East Asian culture, and the first to evaluate it in an acute care inpatient setting. Our findings support the feasibility and potential benefits of implementing an adapted IMR program, focused on the prevention of relapses and rehospitalizations, during the discharge period of an inpatient treatment stay to prepare individuals to reenter the community. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
    Psychiatric Rehabilitation Journal 12/2013; 36(4):243-9. DOI:10.1037/prj0000013 · 0.75 Impact Factor

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