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Articles1997Below is a list of articles, abstracts, book chapters, or handbooks authored by Center for Psychiatric Rehabilitation staff. Due to copyright laws some articles are not available for full-text download. In most cases, these articles are available for purchase after searching the publisher's web site. "Empowerment" has become a popular term in mental health programs, yet it has lacked a clear definition. In a research project designed to measure empowerment in programs run by and for mental health service users, we first undertook to come up with a working definition. Key elements of empowerment were identified, including access to information, ability to make choices, assertiveness, and self-esteem. Empowerment has both an individual and a group dimension. Details of the definition are provided, along with a discussion of the implications of empowerment for psychiatric rehabilitation programs.
INTRODUCTION Clinicians face a difficult dilemma when they are asked to evaluate an individual's disability status. On one side they face the Scylla of the Social Security Administration and its demand that those with serious mental illness be "permanently disabled" to be eligible for benefits. These benefits may make the difference between consumers living independently in the community, living marginally on general relief, or being institutionalized. On the other side lurks the Charybdis of stigmatization and disincentives for rehabilitation. Once individuals receive SSI or SSDI benefits, they may identify themselves as "sick" and may become unwilling or unable to proceed to financial independence.
Nurses working in traditional psychiatric inpatient settings are becoming more aware of rehabilitation as it applies to people who experience long-term mental illness. With the advent of managed care models, a large percentage of nursing staff will shift from traditional inpatient care to work with consumer-survivors in rehabilitation-oriented, community-based settings. As nurses increase involvement in assessing and providing psychiatric rehabilitation interventions, they will need information sources focused on psychiatric rehabilitation for persons with serious mental illness.
Booklet Description
The Americans with Disabilities Act (ADA) prohibits discrimination on the basis of disability in employment, public services, public accommodations, transportation, and telecommunications. As employers, it is important to understand the critical issues involved in providing reasonable accommodations for people with psychiatric disabilities. Many employers have serious questions about people with psychiatric disabilities in the workplace since the Americans with Disabilities Act was passed in 1990. This booklet is an attempt to answer some of those questions and direct employers to relevant resources. Learn what researchers, service providers, and educators at the Center for Psychiatric Rehabilitation at Boston University have learned about providing reasonable accommodations for people with psychiatric disabilities in work settings.
In this era of cost containment and managed care, the benefits and costs of vocational interventions for persons with psychiatric disability are receiving increased scrutiny. In response to this scrutiny, evaluators, providers, and agencies are turning to cost-benefit studies. The purpose of this article is, first, to examine the basic steps involved in cost-benefit studies in a way that will be understandable to program administrators, policy makers, and practitioners. Second, a review of cost-benefit studies on vocational programs for persons with psychiatric disability will be undertaken and the results summarized.
Examined the clinical and demographic correlates of work skills and vocational outcome for persons with psychiatric disabilities. The same clinical, demographic, work skills, and vocational outcome instruments including the Griffiths Work Behavior Scale, were administered to 275 persons (mean age 35.7 yrs) working toward their vocational goals at 3 psychosocial rehabilitation centers in 3 distinct geographic areas. Data regarding vocational outcomes were collected quarterly over a period of 3.25 yrs. Using multivariate statistical techniques, clinical and demographic variables that predict work skills and future vocational outcomes were identified. The implications of the findings for program administrators, system planners, and researchers are discussed. Key Words : clinical and demographic characteristics, vocational outcome, adults in psychosocial rehabilitation
Developed and tested the validity and reliability of a scale to measure the personal construct of empowerment as defined by consumers of mental health services. The 28-item scale was tested on 271 members of 6 self-help programs in 6 states. Factor analyses were used to identify 5 underlying dimensions of empowerment (i.e.,self-efficacy-self-esteem, power-powerlessness, community activism, righteous anger, and optimism-control over the future). Results showed that empowerment was related to quality of life and income but not to the demographic variables of age, gender, ethnicity, marital status, education level, or employment status. Empowerment was inversely related to use of traditional mental health services and positively related to community activism. The scale demonstrated adequate internal consistency and some evidence for validity. Further testing is needed to establish whether the scale has discriminant validity and is sensitive to change. Key Words: development and reliability, empowerment, test reliability, test validity
Meeting the vocational needs of adults with mental illness is one of the most critical issues currently facing mental health planners and policy makers. An extensive technology has been developed for one such service: supported employment (SE). This article reports on a process analysis of an innovative 3-yr research and demonstration project which was designed to evaluate a SE program designed specifically for persons with psychiatric disability. A process and method were implemented and an instrument developed to monitor the intervention. 19 participants were enrolled in the study; enrollment was staggered and occurred over a period of 12 mo. Results revealed that SE staff had frequent, brief contact with participants in the program at varied times of day and via varied modes of contact. A large proportion of time was spent providing emotional support to help participants keep their jobs. Implications of this process analysis for program design are discussed. Key words: process analysis, supported employment program, persons with serious psychiatric disabilities
EXCERPT
Acceptance is one of the harder tasks in the recovery process. Acceptance means seeing and acknowledging all the various aspects of oneself without devaluing oneself (Spaniol, Koehier & Hutchinson, 1995). Negative judgments are barriers to acceptance. They lead to disbelief or even denial because it is hard to accept what one devalues. Yet acceptance does not mean approval, or even disapproval. Acceptance means seeing and acknowledging what is.
Professionals are frequently unaware of the traumatic impact of mental illness, its treatment, and stigma on the person with mental illness. They are also frequently unaware of the process of recovery for the person who experiences this trauma, and how they can assist that person in his or her recovery. An understanding of the four questions raised in this article and our responses to them have been very helpful to us in working more effectively with people with serious mental illness. These four questions are: 1. What is recovery?
2. What are people recovering from? 3. What is the impact of what people are recovering from? 4. How can people be assisted by professionals in their recovery?
Booklet Description The Rehabilitation Act of 1973 was the first “civil rights” legislation to prohibit discrimination against people with disabilities. Section 504 in particular requires that qualified individuals with disabilities shall not be excluded from, denied access to, or be subjected to discrimination under any program or activity that receives federal financial assistance. The passage of the Americans with Disabilities Act (ADA) in 1990 extended these rights, prohibiting discrimination on the basis of disability in employment, public services, public accommodations, transportation, and telecommunications. As educators, it is important to understand the critical issues involved in providing academic adjustments for students with psychiatric disabilities.Many educators and administrators have serious questions about serving students with psychiatric disabilities on campus, as more and more of these students resume their pursuit of their educational goals. This booklet is an attempt to answer some of those questions and direct educators to relevant resources. Learn what researchers, service providers, and educators at the Center for Psychiatric Rehabilitation at Boston University have learned about providing academic adjustments for people with psychiatric disabilities in school settings.
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| Contact Us | © Center for Psychiatric Rehabilitation, Trustees of Boston University| Updated September 24, 2007 |