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Research in psychiatric rehabilitation: A review of experimental and quasi-experimental studies

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Abstract

Reviews the literature on the outcome of psychiatric rehabilitation. The material reviewed reflects the mission, client demographics, types of interventions, and outcomes that characterize the field of psychiatric rehabilitation. All studies were analyzed with respect to certain key dimensions (source, setting, focus, outcome type, intervention, research design, and findings). Studies were categorized as to the predominant environment on which the intervention is focused (i.e., the client functioning in living, learning, or working environments). Indications of prevailing philosophies within psychiatric rehabilitation are provided. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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... As many researchers and evaluators have noted, the psychiatrically disabled are ancng the most difficult clients to rehabilitate (Anthony & Blanch, 1987;Dion & Anthony, 1987;Rubin & Roessler, 1978). Among the Psychiatrically disabled Population, those persons with the most severe diagnoses and inçaizments (e.g., schizophrenics) obtain the lowest success rates no matter how such rates are defined (Anthony & Blanch, 1987;Dion & Anthony, 1987). ...
... As many researchers and evaluators have noted, the psychiatrically disabled are ancng the most difficult clients to rehabilitate (Anthony & Blanch, 1987;Dion & Anthony, 1987;Rubin & Roessler, 1978). Among the Psychiatrically disabled Population, those persons with the most severe diagnoses and inçaizments (e.g., schizophrenics) obtain the lowest success rates no matter how such rates are defined (Anthony & Blanch, 1987;Dion & Anthony, 1987). It has been estimated that the oczretitive employment rate of psychiatrically disabled persons is 20% to 25% and the rate for the severely psychiatrically disabled is 15% or less (Dion & Anthony, 1987;Anthony & Blanch, 1987). ...
... Among the Psychiatrically disabled Population, those persons with the most severe diagnoses and inçaizments (e.g., schizophrenics) obtain the lowest success rates no matter how such rates are defined (Anthony & Blanch, 1987;Dion & Anthony, 1987). It has been estimated that the oczretitive employment rate of psychiatrically disabled persons is 20% to 25% and the rate for the severely psychiatrically disabled is 15% or less (Dion & Anthony, 1987;Anthony & Blanch, 1987). Though job success rates have been found to be low among the severely psychiatrically disabled, successful adaptation to work does appear to facilitate ongoing recovery (Rubin & Roessler, 1978). ...
Technical Report
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Executive Summary In response to AB 2541 and Governor Deukmejian's initiative to provide coordinated services for the mentally ill, the Department of Rehabilitation (1) set aside 2.5millioninFY19861987fortheMentalHealthInitiative,aprogramtodevelopcountyvocationalrehabilitationservicesfortheseverelymentallydisabled.Fourteenprojects(MHIprojects)werefundedthroughaprocessinwhichcountydepartmentsofmentalhealth(MH)andDRDistrictadministratorsjointlysubmittedproposals.Anotherfiveprojects(MOUprojects)wereprovidedcaseservicefundsfollowingthedevelopmentofmemorandaofunderstandingbetweencountyMHDirectorsandDRDistrictAdministrators.ThisreportisanevaluationoftheiiiplementationphaseoftheInitiative,fromOctober1986throughAugust1987FourteenMHIand4MOUprojectsprovidedvocationalservicesfortheseverelymentallydisabledduringthefirst11monthsoftheInitiative.Inall,18.5FTEcounselorsandsupportingstaffwerefunded(13.5MHIand5.0MOU).Thisrepresents88positionsinFY19861987.Atotalof585clientsbecameERApplicantsthroughAugust1987(522MHIclientsand63MOUclients).Projectsstartedslowlyandmostcaseloadsarenotyetfull:Morethan70werestillinvolvedintherehabilitationprocessinAugust(440MHIand51MOUclients);andmorethan50awaitingthedevelopmentofanindividualizedRehabilitationPlan.Theprojectcaseloadsincludealargeproportionoftheseverelymentallydisabled.About50551,and65Most(60ThroughAugust1987,acanbinedtotalof2.5 million in FY 1986-1987 for the Mental Health Initiative, a program to develop county vocational rehabilitation services for the severely mentally disabled. Fourteen projects (MHI projects) were funded through a process in which county departments of mental health (MH) and DR District administrators jointly submitted proposals. Another five projects (MOU projects) were provided case service funds following the development of memoranda of understanding between county MH Directors and DR District Administrators. This report is an evaluation of the iiiplementation phase of the Initiative, from October 1986 through August 1987 • Fourteen MHI and 4 MOU projects provided vocational services for the severely mentally disabled during the first 11 months of the Initiative. • In all, 18.5 FTE counselors and supporting staff were funded (13.5 MHI and 5.0 MOU). This represents 88% of the funds allocated for staff positions in FY 1986-1987. • A total of 585 clients became ER Applicants through August 1987 (522 MHI clients and 63 MOU clients). • Projects started slowly and most caseloads are not yet full: More than 70% of the Initiative clients became DR Applicants after February 1987; 84% were still involved in the rehabilitation process in August (440 MHI and 51 MOU clients); and more than 50% of these remained in Applicant status awaiting the development of an individualized Rehabilitation Plan. • The project caseloads include a large proportion of the severely mentally disabled. About 50% are psychotic, 70% are severely disabled, 40% are on 551, and 65% are on sate form of public assistance. • Most (60%) clients received some purchased case services. • Through August 1987, a canbined total of 68,515 was expended on case services by the MHI and MOU projects (63,262intheMHIprojectsand63,262 in the MHI projects and 5,253 in MOU projects). • A small proportion of case service funds were expended because most clients are not yet at the stage of the rehabilitation process at which costly services are purchased and because counselors were purchasing low cost services for those in the process of being rehabilitated. • In FY 1986-1987, approximately 11% of the allocated case service funds were expended or cannitted to clients (encumbered). • Counselor morale remained high despite concern about the small number of Rehabilitation Plans and Successful Rehabilitations in the Initiative as compared with customary DR standards. • The DR and county departments of mental health are developing comfortable working relationships in most projects. In MHI projects, 26 individuals were successfully rehabilitated, but they were not representative of most Initiative clients. They were generally functioning at a relatively high level at referral: less likely to be Psychotic, severely disabled, on SSI, and on public assistance. From referral to closure, they took an average of only 8 months to be rehabilitated. • During the implementation period of the Initiative, it is premature to evaluate the success of providing vocational rehabilitation to the severely mentally disabled, or to assess cost-effectiveness. There were 8 recommendations to the State of California.
... Habilitation-rehabilitation , as we use the term here, is a philosophical approach to mental health service delivery that can be incorporated into case management programs. The focus of rehabilitation-based services is on individuals in their environments with interventions broadly classified into two types: those aimed at helping clients develop the skills they need to function in their particular community environment and those aimed at modi-fying the environment (e.g., helping clients acquire supportive community resources to compensate for skill deficits; Anthony & Nemec, 1984; Dion & Anthony, 1987; Modrcin, Rapp, & Chamberlain, 1985; ). These approaches are quite different from traditional mental health interventions , which have tended to rely on reducing and controlling symptoms and promoting therapeutic insight into psychodynamic phenomena as the primary means for achieving successful adaptation to community living. ...
... These approaches are quite different from traditional mental health interventions , which have tended to rely on reducing and controlling symptoms and promoting therapeutic insight into psychodynamic phenomena as the primary means for achieving successful adaptation to community living. Studies concerning psychiatric rehabilitation generally indicate that such approaches can be effective in promoting community adjustment for many people afflicted with serious and persistent mental illness (Bond, Dincin, Setze, & Witheridge, 1984; Dion & Anthony, 1987; Rosenfield, 1992; Stein & Test, 1980). However, although an important conceptual distinction has been made between community support and habilitationrehabilitation services, differences in the effectiveness of these services have not been examined (Dion & Anthony, 1987 ). ...
... Studies concerning psychiatric rehabilitation generally indicate that such approaches can be effective in promoting community adjustment for many people afflicted with serious and persistent mental illness (Bond, Dincin, Setze, & Witheridge, 1984; Dion & Anthony, 1987; Rosenfield, 1992; Stein & Test, 1980). However, although an important conceptual distinction has been made between community support and habilitationrehabilitation services, differences in the effectiveness of these services have not been examined (Dion & Anthony, 1987 ). Furthermore , it is not clear whether rehabilitation-based approaches make a significant contribution to improving community functioning beyond traditional psychiatric treatments that focus on medication and reducing mental pathology. ...
Article
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Three methods of accounting for case manager effects in tests of the efficacy of mental health services are explored. These methods include (1) treating the case manager as a fixed factor, (2) treating the case manager as a random factor, and (3) examining service effects within the case manager. They are demonstrated with data from a nationally known case management program serving individuals with serious and persistent mental illness. Specifically, 3 conceptually distinct types of services provided or brokered by case managers are identified: habilitation-rehabilitation, community support, and traditional psychiatric services. The effectiveness of each in improving clients' adjustment is then examined with multiple regression adjustment strategies and each of the 3 methods to account for case manager effects. The results provide strong support for effects attributable to case managers and some support for the efficacy of habilitation-rehabilitation and community support services beyond the effects of traditional psychiatric services. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Results of these CSP surveys may not be representative of all persons with severe psychiatric disability. Other researchers examining different samples have found, for example, that between 52% and 92% of individuals with severe psychiatric disability are high school graduates, and that between 15% and 60% have attended college (Dion & Anthony, 1987). Simi-larly, other studies suggest different proportions of clients living in different types of residential settings. ...
... Studies suggest that no more than 20 to 30% of individuals with psychiatric disability are competitively employed (Anthony, 1979;Dion & Anthony, 1987;Walker & McCourt, 1965). According to Dion and Anthony (1987), if only individuals with severe psychiatric disability are considered, the full-time competitive employment rate drops to below 15%. ...
... Studies suggest that no more than 20 to 30% of individuals with psychiatric disability are competitively employed (Anthony, 1979;Dion & Anthony, 1987;Walker & McCourt, 1965). According to Dion and Anthony (1987), if only individuals with severe psychiatric disability are considered, the full-time competitive employment rate drops to below 15%. These conclusions are consistent with other authors (Farkas, Rogers, & Thurer, 1987;Spivack, Siegel, Sklaver, Deuschle, & Garrett, 1982;Zipple & Spaniol, 1984), who report rates of 0 to 15% for competitive employment among individuals with severe psychiatric disability. ...
Article
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Defines severe psychiatric disability (SPD) and discusses the demographic characteristics of persons with SPD. Two groups with SPD have become sources of public policy debate: the homeless and young adults (aged 18–35 yrs). Attempts to impact client rehabilitation outcome are noted. It is suggested that interventions based on a rehabilitation model show promise as a way to reduce psychiatric disability. These interventions are based on strategies aimed at increasing a person's skills and supports. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Reviews assessing the effects of psychi atric rehabilitation programs (Dion & Anthony, 1987) and community support services (Anthony & Blanch, 1989) have noted that much of the outcome re search in this area consists of small scale quasi experimental studies. While the contributions of this research have been acknowledged, investigators have noted that more systematic, long term assess ments of intervention programs need to be undertaken. ...
... While the contributions of this research have been acknowledged, investigators have noted that more systematic, long term assess ments of intervention programs need to be undertaken. For instance, Dion and Anthony (1987) noted that in the psychi atric rehabilitation literature there is a lack of studies from which causality can be implied because most studies used single group, post test only methodolo gies. More recendy, there has also been a call for greater attention to the need for research that "amplifies the voice of the consumer" as a partner in the re search process (Rapp, Shera, & Kisthardt, 1993, p. 727), as well as the measurement of treatment outcomes in the context of the emerging recovery paradigm (Ralph & Kidder, 1998). ...
Article
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The concept of recovery for individuals with psychiatric disabilities is an emerging paradigm that has important implications for understanding and treating persons with psychiatric disability. The current study evaluated the effects of a 16-wk psychoeducational program, the Leadership Education Program, designed to promote the recovery process within the context of preparing persons with psychiatric disabilities for participation on community agency boards. There were 68 program participants (aged 20–61 yrs) divided into 4 training groups. Outcome measures included self-reported severity of psychiatric symptoms, quality of life, self-efficacy, recovery attitudes, empowerment, and community living skills. The program was evaluated by employing both experimental and wait-list control groups, and by conducting pre-, post-, and 6-mo followup outcome assessments. Results indicated that participation in the program was associated with significant improvement across a variety of psychometric measures assessing recovery processes. Results also suggest that changes in feelings of self-efficacy, empowerment, and self-esteem are more stable indicators of recovery than psychiatric symptomatology. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
... Over the next five years, much work was done in an attempt to improve the service and outpatient community-based treatment jettisoned in prevalence. In 1986, mental health services focusing on the chronically mentally ill within the community was recognized as experiencing the greatest growth relative to other services (Dion & Anthony, 1987). With this evolution came new programs, models, and research. ...
... With this evolution came new programs, models, and research. Dion and Anthony (1987) reviewed over 30 experimental and quasi-experimental studies examining the outcomes of psychiatric rehabilitation. ...
Article
Psychiatric rehabilitation is a service designed to improve functioning that is impaired by the symptoms of severe mental illness. A review of the literature identified several functional domains impaired by mental illness and established the need and effectiveness of the service. Adult Rehabilitative Mental Health Services (ARMHS) is a psychiatric rehabilitation model that seeks to improve functioning in each impaired domain. ARMHS requires a complex array of documentation to demonstrate the existence of such impairments, the need for the service, and progress made toward improving functioning. The complexities of this documentation dissuade recipient and practitioner satisfaction, initial expeditious provision of services, compliance with state regulations, and fluid programmatic functioning. A training manual demarcating and edifying all components of required ARMHS documents was developed to assuage such dissuasions.
... In various studies social skills training has found moderately to strongly effective on increasing skills acquisition and reducing psychiatric symptoms (Dilk, and Bond, 1996). Skills training are effective for virtually every area of role functioning for person with severe psychiatric disabilities (Dion, and Anthony, 1987). However, there is scarcity of research that validates the efficacy of social skills tainting to maintain personal, social and occupational life of persons with schizophrenia. ...
Article
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Social skill training is a collection of behavioral techniques that helps a person to restart her/his life in her/his community. Schizophrenia is a psychotic disorder with almost life long course causing a suffer withdrawal from his community and social life. The study aimed at assessing socio-occupational functioning of persons with chronic schizophrenia and assessing efficacy of social skills training module on socio-occupational functioning. Findings of the study shows significant improvement in self-care, communication and instrumental skills. Individuals improved coping and communication skills, evaluated anomalous experiences more objectively and improved socio-occupational functioning.
... The third group of factors considers the social environment. In their analysis of 35 studies, Dion and Anthony (1987) found that psychiatric rehabilitation reduces re-hospitalizations, positively affect employment, skills development, customer satisfaction and the amount of time spent in the community. Reducing the use of hospital treatment after the inclusion of the subject in psychiatric rehabilitation programs and / or case management is well documented and is a sustainable finding in many studies (Dincin & Witheridge, 1982). ...
Article
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At the current level of development in psychiatry, in the conditions of deinstitutionalization of mental health services and increased opportunities for control of the symptoms of mental disorders, the problem related to the socialization of patients is becoming more and more relevant. More than 50% of patients with schizophrenia are in a socially active age, which gives rise to the social significance of their rehabilitation. International practice shows that all specialists dealing with the rehabilitation of patients with mental disorders need to undergo training, which includes the adoption of special methods and techniques. Their work is complex, long and creative. In Bulgaria there are many national strategies that present different programs for long-term care or only analyze the current situation and care needs. There is no clear vision of how exactly in the future and with what means and specialists this process will take place. The development of psychiatric care lags far behind the needs of the population. There is a serious risk that the lack of trained specialists can ruin the good intentions for deinstitutionalization. The goal of the present study is to examine the readiness of specialists working in specialized medical institutions and social services to work with patients and users suffering from mental illness. A survey method was used among specialists from medical institutions and social services for patients with mental and behavioral disorders. Most of the specialists in psychiatric hospitals in Bulgaria feel prepared to work with the mentally ill - 88.9%; Almost everyone believes that they need additional training.
... Initially the idea of establishing the employment status of mental health consumers serviced by the team was promoted in the weekly multi-disciplinary team meetings. Consistent with the methodology adopted in similar studies (e.g., Crowther & Marshall, 2001;Anthony, Cohen, & Vitals 1978;Anthony & Dion, 1984) all clinicians in the HUH team were asked to complete a questionnaire designed by the author, to record the numbers of clients who were employed for more than 20 hours per week, employed part-time for less than 20 hours per week, doing a course or undergoing some training, not attending a course and not employed and number of clients on the invalids benefit. Clinicians would only fill in for clients for whom they were the key worker. ...
Article
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For adults using mental health services it is envisaged that the single largest outcome would be employment status. This paper describes a pilot survey on the employment status of mental health consumers serviced by the Hamilton-Huntly team in the Waikato region of New Zealand and suggests a way forward. The author concludes by recommending that adult mental health service providers should employ occupational therapists as employment specialists within multi-disciplinary treatment teams to achieve better employment outcomes.
... There is widespread documentation in the literature describing rehabilitation programs for clients with long-term mental illness. The results of these studies provide clinical support for a relationship between intervention techniques and treatment outcomes (Dion & Anthony, 1987). However, vocational issues which must be addressed with inpatients in an extended hospital setting have not been sufficiently addressed in the literature. ...
Article
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Presents a vocational rehabilitation approach in an inpatient forensic psychiatric institute. In-house work, voluntary community work, and competitive community employment were part of the treatment approach. Patient goals were to improve basic work habits and to obtain competitive employment prior to release. Four case histories illustrate that the program was more effective for people with personality disorders than for people with schizophrenia. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
... In the initial review of this body of research, Anthony and Margules (1974) concluded that persons with long-term psychiatric disabilities can learn a variety of skills regardless of their symptoms and that these skills, when properly integrated into a comprehensive rehabilitation program that provides support for the use of these skills in the community, can have a significant impact on client rehabilitation outcome. Since that 1974 literature review, several other reviews and studies have also concluded that rehabilitation outcome is a function of clients' skills and the supportive resources in their communities (Anthony, 1979b;Anthony, 1994;Anthony, Cohen, & Vitalo, 1978;Anthony & Jansen, 1984;Anthony & Liberman, 1986;Arns & Linney, 1995;Dion & Anthony, 1987). ...
Article
Psychiatric rehabilitation assessment is the first phase of the psychiatric rehabilitation process. The psychiatric rehabilitation process itself varies greatly in terms of its formality, specificity, and documentation. At its most generic level, the practice of psychiatric rehabilitation involves consumers figuring out the residential, vocational, educational, and/or social goals they want to achieve and developing the skills and supports they need to reach their goals. In some psychiatric rehabilitation programs, this process is helped to unfold in an indirect, less formal, and less documented manner (for example, clubhouses). In other psychiatric rehabilitation programs, this process is directly facilitated and documented by a practitioner (for example, programs using the psychiatric rehabilitation approach developed at Boston University). Even with differences in how the entire psychiatric rehabilitation process is structured in various rehabilitation settings, the psychiatric rehabilitation assessment process at a minimum should include information on consumers' goals and the skills and supports needed to reach those goals. Psychiatric rehabilitation assessment is not to be confused with traditional psychiatric diagnosis. A rehabilitation assessment and a traditional psychiatric diagnosis are very different. The goal is different; the process is different; the tools are different. Yet, each provides useful and meaningful information, each requires training to implement, and each has a role in a comprehensive treatment and rehabilitation intervention. The focus of this chapter is on psychiatric rehabilitation assessment. A psychiatric rehabilitation assessment and a psychiatric diagnosis focus on completely different aspects of the person. In contrast to the traditional diagnostic focus on pathological conditions and symptom development over time, the rehabilitation assessment focuses on the skills and the resources the person needs to achieve an overall rehabilitation goal.
... These data provide significant empirical support for the following seven points. 15 (1) People with long-term mental illness can be maintained in the community with minimal use of inpatient services. (2) People with long-term mental illness can be helped to function more successfully in the commu-nity with interventions to enhance skills and supports. ...
... It became clear that some mechanism was needed to help people negotiate complex, fragmented, and sometimes inaccessible community-based services. It also became clear that many people needed help learning or re-learning a variety of daily living skills (Dion & Anthony, 1987), and that such skills were best taught in consumers' natural environments (Stein & Test, 1980). Intensive case management was hailed as a mechanism that could fulfill these needs. ...
Article
Recent work suggests that some people who have severe and persistent mental illnesses can be transferred to less intensive services without suffering ill effects. However, the factors that affect the success of such transitions remain unknown. This longitudinal study examines consumer characteristics and types of intensive case management services that predict decompensation. We examined the trajectories of 86 individuals in an intensive case management program after they attained the highest level of functioning, identifying three patterns: stability, immediate decline followed by improvement, and gradual decline. Number of hospitalizations prior to program entry, being judged suicidal at program entry, and greater use of psychiatric services during program participation consistently predicted decompensation. Substance abuse and psychiatric symptomatology at program entry also predicted decompensation, but did so less consistently. Predictors of differences in specific patterns of decompensation are explored.
... Without a better understanding of the hassles experienced and the role that they play in generating stress, it is difficult to design and test intervention strategies which improve the coping capacity of persons with psychiatric disabilities. With a growing Volume 14, Number 4: April, 1991 emphasis on rehabilitation and self-help, it is clear that many people previously written off, warehoused, or left in the streets can function effectively and achieve satisfaction and success in their communities (Dion & Anthony, 1987;Harding, Zubin & Strauss, 1987;Leete, 1989). ...
Article
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Identified the daily hassles experienced by 35 individuals from the mainstream population (mean age 37 yrs) and 69 severely psychiatrically disabled persons (mean age 35.9 yrs) living in the community. Questionnaire results indicate that almost half of the hassles were endorsed by the Ss with disabilities as having happened in the past month. Although the disabled Ss checked fewer items as regular occurrences in their lives, they rated the items they did check as more bothersome. Findings have implications for the development of hassles measures and the measurement of changes in hassles as community integration is achieved. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Previous studies have found that aggressive outreach and interagency collaboration reduce the dropout of persons with severe mental disabilities from rehabilitation and treatment programs (Barker, 1988, Dellario, 1985Dion and Anthony, 1987;Jones, 1986;Rogers, Anthony, and Jansen, 1988). Rogers et al., (1988) reported that improved linkages between VR and MH systems resulted in a 5% to 36% increase in rehabilitations of severely men tally disabled persons. ...
Article
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Tested an intervention involving personalized outreach and interagency collaboration at the initial stage in the rehabilitation process to reduce dropout. The experimental group consisted of 25 severely psychiatrically disabled clients of a single mental health clinic; controls included 26 clients served by other mental health clinics in the area. At 4 mo after case opening, 15 consumers in the experimental group had reached the point of rehabilitation service delivery and 10 had dropped out, compared to 24 and 2, respectively, in the control group. The outreach in the experimental group may have eliminated the delay between referral and intake which may in itself contribute to consumer dropout. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... The practice of psychiatric rehabilitation has been developed over the past three decades in response to the needs of persons being discharged from state mental hospitals. Anthony, Buell, Sharratt, and Althoff (1972); Dion and Anthony (1987); Anthony (1989) describe psychiatric rehabilita tion as a technology for helping mentally ill persons develop the skills and environmental supports to become more successful and satisfied in their liv ing, learning and working environment. The emphasis is on improving the quality of a psychiatric client's relationship to his or her socio-cultural envi ronment, not on treating the individual's psychopathology. ...
Article
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Describes the author's experience facilitating the empowerment process with various groups of persons with mental illness. Some possible roles for professionals are proposed as a means for facilitating the development of interdependent consumer groups. A 3-phase developmental process is put forth as a reference point for professional staff members to use in establishing their role(s) in a particular phase of group development. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... People with severe mental illness (SMI) are significantly underrepresented in the American workforce. Early reviews of the rehabilitation literature consistently reported a competitive employment rate of 15% or lower for this population [2,3,14]. More recently, studies of supported employment have suggested that * Address for correspondence: Michael McQuilken, Director of the Office of Consumer and Family Affairs, Mental Health Corporation of Denver, 4141 E. Dickenson Place, Denver, CO 80222, USA. ...
Article
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Objective: Mental health consumers at an urban mental health center were surveyed about their motivations for working and perceived barriers to employment. Design: A survey was developed and administered by a consumer-led research team to 389 persons receiving case management and outpatient services. Results: Most consumers were either working (16%; n=59) or reported a desire to work (46%; n=170). The latter group constituted 55% of the 310 respondents who were not working at the time of the study. The most common perceived barrier was the fear of losing Social Security benefits. Consumers also reported concerns about receiving low pay and being ashamed of their job histories. Among the 38% of the total sample who expressed a reluctance or unwillingness to work, two-thirds (n=58) indicated that, if they did not have to worry about losing their Social Security benefits while working, they would try to obtain employment. A total of 179 (49%) respondents expressed a preference for receiving vocational services at their clinical sites, versus at a clubhouse location. Conclusions: Most consumers in this study were working or wanted to work. Consumers' motivations for work can be increased, especially if key barriers to work are described as removable. Preferences for types and locations of vocational services need to be considered in planning services.
... While outcome research in psychosocial rehabilitation is a relatively new initiative in mental health research, there is growing evidence that it has a positive impact on the lives of people with serious and persistent mental illness. After reviewing 35 studies Dion and Anthony[1] reported that psychosocial rehabilitation interventions have a positive impact on skill development, employment, and the amount of time spent in the community. Participation in psychosocial rehabilitation has been found to increase the level of independent living.[2] ...
Article
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People with severe and persistent mental illness need help in most aspects of their lives, as the disability associated with these diseases can be debilitating. Psychosocial rehabilitation interventions aim to help them relearn skills that would reduce disabilities so that they can be reintegrated into society. To study the efficacy of the rehabilitation program at the Richmond Fellowship Society (RFS) 'ASHA' half-way home. Fifty-four clients diagnosed with either schizophrenia or affective disorder who stayed at the half-way home for more than 6 months. A retrospective evaluative approach was followed. An evaluation checklist was developed for the purpose and this was used to assess the level of functioning of the clients. A paired sample t-test was used to score changes in client progress between admission and discharge. Significant improvement ( P≤.05 level) was noticed on all the parameters from baseline to discharge. CONCLUSSION: The psychosocial rehabilitation program at the RFS half-way home has a beneficial effect.
... The 2-year follow-up study by 10hnstone and colleagues (1990) showed that poorer vocational outcomes were associated with poorer social skills in a sample of people with SMI. Literature indicated that 75% to 90% of adults with SMI are unemployed (Bond, Becker, Drake et aI., 2001; Dion & Anthony, 1987; Mueser, Saylers & Mueser, 2001; Trupin, Sebesta, Yelin et aI., 1997; Unger & Anthony, 1984). In Hong Kong, available statistics showed that the competitive employment rate was around 30% in a sample of 325 people with psychiatric disabilities (Equal Opportunities Commission, 1997) .. Another problem revealed by literature was that people with SMI had interpersonal difficulty in their workplace that might have led to their pre-maturejob termination (Becker, Drake, Bond et aI., 1998; Cook & Razzano, 2000; Tsang, Lam, Ng & Leung, 2000). ...
Article
165, [299] leaves : ill. ; 30 cm. PolyU Library Call No.: [THS] LG51 .H577M RS 2005 Cheung Background: Literature has shown that people with severe mental illness (SMI) experience deficits in social skills and social competencies which affect their performance in getting and keeping a job. However, there was a scarcity of studies on social skill needed in the workplace. This study aimed at developing a Job-specific Social Skills Training (JSST) based on the conceptual framework of Work-related Social Skills and Work-related Social Skills Training (WSST) programme in psychiatric rehabilitation (Tsang, 2001b; Tsang & Pearson, 1996) in order to further improve employment outcomes of individuals with SMI in Hong Kong. A control study was carried out to assess its efficacy. Method: In Phase One of the study, factor structure of relevant Job-specific SoCial Skills Components (JSSC) required by salespersons which may contribute to successful employment of consumers was identified by exploratory factor analysis of results of a questionnaire survey. The respondents consisted of 106 salespersons from the retail market. In Phase Two. the JSST module for consumers who have a vocational goal working as salespersons was developed. The content of the module follows the factor structure results in Phase One. Five skill areas are covered in the module. In Phase Three, a control study was conducted to test the efficacy of the module. An Integrated Social Skills Training group (WSST with JSST) (n=37) was compared with two historical comparison groups conducted by Tsang and Pearson (2001), a training group with WSST only (n=30), and a control group (n=41). Results: Comparisons of the pre-treatment and post-treatment assessment results among the three groups, using a series of work-related social skills assessments and vocational follow-up questionnaire, showed that the Integrated Social Skills Training group (WSST with JSST) was effective in improving work-related social skills of participants in a larger progress. Vocational follow-up assessment after three-month completion of the training showed that the integrated training group had the most participants (70.3%) who were employed when compared with the previous results (WSST group = 46.7%; control group = 2.4%) done by Tsang and Pearson (2001). Conclusion: This study substantiated that the training module of JSST used as an Integrated Social Skills Training with WSST is efficacious in improving the work-related social skills and the chance of open employment of people with SMI in Hong Kong. M.Phil., Dept. of Rehabilitation Sciences, The Hong Kong Polytechnic University, 2005
... De acuerdo a varios reportes de estudios llevados a cabo en países desarrollados, apenas 20 a 30% de los pacientes con trastornos psiquiátricos tiene un empleo competitivo de tiempo completo (3, 12, 17, 33 ), y sólo 15% de aquellos con esquizofrenia (7). Este porcentaje puede ser aún más bajo en países en vías de desarrollo , pues las dificultades de los pacientes para encontrar trabajo no se deben sólo a la falta de tratamiento y/o entrenamiento, o a barreras culturales como el estigma (32), sino a los problemas socioeconómicos de una nación en particular. ...
... De acuerdo a varios reportes de estudios llevados a cabo en países desarrollados, apenas 20 a 30% de los pacientes con trastornos psiquiátricos tiene un empleo competitivo de tiempo completo (3, 12, 17, 33 ), y sólo 15% de aquellos con esquizofrenia (7). Este porcentaje puede ser aún más bajo en países en vías de desarrollo , pues las dificultades de los pacientes para encontrar trabajo no se deben sólo a la falta de tratamiento y/o entrenamiento, o a barreras culturales como el estigma (32), sino a los problemas socioeconómicos de una nación en particular. ...
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