The treatment relationship in peer-based and regular case management for clients with severe mental illness
ABSTRACT This study compared the quality of treatment relationships and engagement in peer-based and regular case management. It also assessed the value of positive relationship qualities in predicting motivation for and use of community-based services for persons with severe mental illness.
One hundred thirty-seven adults with severe mental illness participated in a 2x2 prospective longitudinal randomized clinical trial with two levels of case management intervention (peer and regular) and two interviews (six and 12 months). Self-report questionnaires assessed treatment relationships, motivation, and service use, and providers rated participants' initial engagement and monthly attendance in treatment.
Participants perceived higher positive regard, understanding, and acceptance from peer providers rather than from regular providers at six months only, with initially unengaged clients showing more contacts with case managers in the peer condition and decreasing contacts in the regular condition. Six-month positive regard and understanding positively predicted 12-month treatment motivation for psychiatric, alcohol, and drug use problems and attendance at Alcoholics and Narcotics Anonymous meetings.
Early in treatment, peer providers may possess distinctive skills in communicating positive regard, understanding, and acceptance to clients and a facility for increasing treatment participation among the most disengaged, leading to greater motivation for further treatment and use of peer-based community services. Findings strongly suggest that peer providers serve a valued role in quickly forging therapeutic connections with persons typically considered to be among the most alienated from the health care service system.
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ABSTRACT: Objective: The purpose of the study was to characterize and compare participants' experiences of peer-facilitated versus clinician-facilitated recovery groups for veterans with mental illness. Method: We analyzed qualitative data from 24 interviews with veterans who participated in mental health recovery groups led by peer or clinician facilitators. Results: Subtle differences in group structure, participation/communication and utility/relevance between peer- and clinician-facilitated groups were identified. Participants experienced both peer and clinician facilitators as helpful in promoting recovery, though they appeared to do this in different ways. Conclusions and Implications for Practice: Peer and clinician facilitators offer different strengths in the promotion of mental health recovery. (PsycINFO Database Record (c) 2014 APA, all rights reserved).Psychiatric Rehabilitation Journal 03/2014; 37(1):43-50. DOI:10.1037/prj0000048 · 0.75 Impact Factor
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ABSTRACT: Humanistic approaches to counseling are particularly concerned with process, emphasizing the person of the client, the person of the counselor, and the therapeutic relationship. Process and outcomes in humanistic interventions are highly related and complementary aspects of counseling. Counseling outcomes may include client outcomes as well as research outcomes. Whereas client outcomes are focused on the specific needs of clients, research outcomes tend to focus on generalizable results. When considering process, outcomes, or research, the humanistic counselor seeks to integrate the principles of humanism into all aspects of practice.10/2014; 53(3). DOI:10.1002/j.2161-1939.2014.00058.x