 |
|
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
Articles2003Below 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. Anthony, W. A. (2003). Expanding the Evidence Base in an Era of Recovery. Psychiatric Rehabilitation Journal, 27(1), 1-2. INTRODUCTION
Prior to this decade’s focus on evidence based practices, the last decade of the twentieth century witnessed the acceptance of the notion that people with severe mental illnesses could be integrated into and function within the natural community, rather than just the mental health community. Further-more, recovery from severe mental illnesses was seen as a legitimate vision to guide mental health practice and policy. The vision of recovery from severe mental illnesses was brought to the field by the writings of current and former service recipients, and solidified by the long term research conducted and synthesized by Courtenay Harding and her colleagues. While many definitions of recovery have been suggested, the various definitions are somewhat similar in that they imply the development of new meaning and purpose in life as people grow beyond the catastrophe of severe mental illnesses.
Anthony, W. A. (2003). Studying Evidence-Based Processes, Not Practices. Psychiatric Services, 54(1), 7. INTRODUCTION
Anthony, W. A. (2003). The Decade of the Person and the Walls that Divide Us. Behavioral Healthcare Tomorrow, April, 23-30. INTRODUCTION About one decade ago, I suggested in an editorial in the Psychiatric Rehabilitation Journal that the 1990s should be called "the decade of recovery," rather than its heretofore declaration as "the decade of the brain." I made this suggestion based on the increasing attention paid to the recovery-focuses writings of people with psychiatric disabilities, and the long-term outcome studies conducted and synthesized by Courtenay Harding and her colleagues. At the beginning of this century I was asked, based I guess on the fact that I did it before, to give a name to his new decade, the first decade of the 21st century. I suggested, once again in an editorial in the Psychiatric Rehabilitation Journal, that it be called "the decade of the person." I chose this term because I believed that late in the 20th century we as a field had "forgotten" that this is a person we are trying to help. Somewhat like traditional medicine, the mental health field seemed to be treating people diagnosed with severe mental illnesses as if they were impaired body parts - in this case dysfunctional brains. To me, this partitioning of the person into body parts was part of a legacy in our field of separating people into categories, or said another way, putting up walls that divide us from one another, and from our whole person.
Copyright permission granted from Manisses Communications Group, Inc. Anthony, W. A., Rogers, E. S., & Farkas, M. (2003). Research on evidence-based practices: Future directions in an era of recovery. Community Mental Health Journal, 39(2), 101-114. Many mental health systems are trying to promote the adoption of what has come to be known as evidence-based practices while incorporating a recovery vision into the services they provide. Unfortunately, much of the existing, published, research on evidence-based practices was conceived without an understanding of the recovery vision and/or implemented prior to the emergence of the recovery vision. As result, evidence-based practice research that has been published to date is deficient in speaking to a system being built on a recovery philosophy and mission; these deficiencies are detailed, and suggestions are advanced for new directions in evidence-based practice research. Keywords: evidence-based practice, recovery, mental health practice, mental health system
Corrigan, P.,McCorkle, B., Schell, B., & Kidder, K. (2003). Religion and spirituality on the lives of people with serious mental illness. Community Mental Health Journal, 39(6), 487-489.
Ellison, M. L., Russinova, Z., MacDonald-Wilson, K. L., & Lyass, A. (2003). Patterns and correlates of workplace disclosure among professionals and managers with psychiatric conditions. Journal of Vocational Rehabilitation, 18(1), 3-13. Objective: This study identifies patterns and correlates of disclosure among professionals and managers with serious psychiatric conditions. Design: A national mail survey of such respondents was conducted. Results: A large proportion (87%) of study participants reported having disclosed their mental illness. About half of the disclosures reported unfavorable circumstances leading to disclosure while one third disclosed when they felt comfortable. Most frequently, respondents disclosed to supervisors; one third made their disability known when applying for the job. About half of the respondents had no regrets about disclosing. Multivariate analysis showed that correlates with the occurrence, timing, and choice of disclosure converge around constructs related to job confidence, empowerment, and recovery. We also describe those who chose not to disclose. Conclusion: Higher rates than previously reported and better experiences with disclosure were evident and may be related to this population's greater recovery as well as to occupational factors. Keywords: psychiatric disability, mental illness, disclosure, occupations, Americans with disabilities act, professionals, managers, competitive employment
Copyright permission granted from IOS Press. Essock, S. M., Goldman, H. H., Van Tosh, L., Anthony, W. A., et al. (2003). Evidence-based practices: setting the context and responding to concerns. Psychiatric Clinics of North America, 26(4), 919-938. After nearly 20 years of progress in general medicine, the evidence-based practice movement is becoming the central theme for mental health care reform in the first decade of 2000. Several leaders in the movement met to discuss concerns raised by six stakeholder groups: consumers, family members, practitioners, administrators, policy makers, and researchers. Recurrent themes relate to concerns regarding the limits of science, diversion of funding from valued practices, increased costs, feasibility, prior investments in other practices, and shifts in power and control. The authors recommend that all stakeholder groups be involved in further dialog and planning to ensure that practices emerge that represent the integration of the best research evidence with clinical expertise and consumer values.
Farkas, M., Jette, A. M., Tennstedt, S., Haley, S. M., Quinn, V. (2003). Knowledge Dissemination and Utilization in Gerontology: An Organizing Framework. The Gerontologist, 43(1), 47-56. Purpose: Enabling valuable research findings to be used by the field requires a strategic approach to dissemination and utilization rather than simply making constituencies aware of the information. This article describes a conceptual framework for the dissemination and utilization of information, along with examples of its use by the Boston University Roybal Center for Enhancement of Late Life Function. Design and Methods: The framework identifies dissemination/utilization goals of exposure, experience, expertise, and embedding ("4 E") and relates each goal to strategies targeted for specific users. Results and Implications: The Boston University center exposed the field to information through presentations, print- and Web-based information, provided consumers and family members with new findings through motivational videotapes, developed expertise-level training programs, and embedded the new findings within organizations and systems. The 4 E framework can translate critical research outcomes into useful information to assist the field to better care and support available for individuals in late life. Key words: Information dissemination, Information utilization, Conceptual framework, Roybal Center, Fear of falling, Muscle strengthening, Late Life Function and Disability Instrument
Harding, C. M. (2003). Changes in Schizophrenia Over Time. In: Carl I. Cohen, Schizophrenia into Later Life: Treatment, Research, and Policy. American Psychiatric Publishing. There exist two polar, yet accurate, views about the outcome of schizophrenia. Huber et al. (1979), after studying the outcome of schizophrenia in 502 patients for more than two decades, wrote: “Schizophrenia does not seem to be a disease of slow progressive deterioration. Even in the second and third decades of illness, there is still a potential for full or partial recovery” (p. 595). Nine other such studies agree. Yet today, we have dayrooms, shelters, and public mental health caseloads consistently overcrowded with persons chronically languishing with the diagnosis of schizophrenia. Furthermore, DSM-IV (American Psychiatric Association 1994) indicates that complete remission is likely uncommon, and they go on to describe a variable course of exacerbations and remission for some patents and a chronic one for most persons. Although this is an improvement from earlier, more dire, predictions of a deteriorating course for all patients (e.g., American Psychiatric Association 1980, 1987; Kraepelin 1902), a significant discrepancy remains between the prognostic expectations of official psychiatry and the findings of 10 long-term studies completed during the last three decades of twentieth century. Arguments against this paradox have often centered around the use of other diagnostic systems in these studies, although most are similar to the DSM-IV. This chapter shows that regardless how wide or narrow such systems are, patients still persist in improving across time and thus have much to teach us.
Kramer, P., Anthony, W. A., Rogers, E. S., & Kennard, W. A. (2003). Another Way of Avoiding the "Single Model Trap.” Psychiatric Rehabilitation Journal, 26(4), 413-415. Another way to end the "model wars" (Hughes & Clement, 1999; IAPSRS, 1998) is to take what works best from different models and blend them. At two different sites, practitioners being trained to deliver ACT received additional training in the psychiatric rehabilitation and case management technology that had been previously developed at Boston University. Feedback from the practitioners indicated that the blending of these two "models" was helpful and additive. A 4-year period of data collection at one site using a simple pre-post test design showed inpatient days were reduced by about 90% for 80 individuals who were considered to be high utilizers of inpatient services. It appears that the integration of separately developed model approaches bears further study.
MacDonald-Wilson, Kim L.; Rogers, E. Sally; Ellison, Marsha Langer; Lyass, Asya. (2003). A Study of the Social Security Work Incentives and Their Relation to Perceived Barriers to Work Among Persons With Psychiatric Disability. Rehabilitation Psychology. 48(4), 301-309. Objective: To study use and awareness of the Social Security Work Incentives (SSWIs) and to obtain empirical data on barriers to returning to work. Study Design: Using parallel surveys and multiple sampling and recruitment strategies, the authors administered a brief survey about the SSWIs. Participants: Persons with a psychiatric disability (n=539), service providers (n=120), and family members (n=174). Results: All groups registered the greatest concern about the loss of health insurance; this and other concerns were perceived as serious barriers to returning to work. There were differences in the perceptions of the 3 groups about the importance of disincentives to work and differences among consumers by demographic characteristics. Conclusions: Consumers, family members, and providers of services need more information about the work incentives, particularly if the goals of the new Ticket to Work legislation are to be realized. MacDonald-Wilson, K. L., Rogers, E. S., & Lyass, A. (2003). Identifying functional limitations in work for people with psychiatric disabilities. Journal of Vocational Rehabilitation, 18(1),15-24. Objective: Years after the passage of the Americans with Disabilities Act, little empirical information exists about the relationship between the functional limitations experienced by individuals with psychiatric disabilities, and related reasonable accommodations provided on the job. Design: A multi-site, longitudinal study was conducted with 191 employees in 22 supported employment programs across 3 states during a 1-year study period. Data were gathered prospectively in a structured, narrative form designed to describe both the functional limitations and accommodations of participants. Results: The most frequent functional limitations among this group of employed persons with psychiatric disabilities were cognitive in nature, followed by social, physical, and emotional/other. There was a significant relationship between the type of functional limitation and the number and type of accommodations received. There was a marginally significant relationship between type of functional limitation and a diagnosis of schizophrenia. There were no significant relationships between any other clinical or demographic factors, functional limitations or reasonable accommodations. Conclusion: Functional limitations and their associated accommodations can be defined and categorized. Cognitive limitations were the most prevalent in this sample and the best predictor of the number of accommodations provided. Implications of these findings for accommodations under the ADA, eligibility for Social Security Disability benefits, and vocational assessment and planning are discussed. Keywords: functional limitations, psychiatric disability, reasonable accommodations, work Copyright permission granted from IOS Press. INTRODUCTION It is with pleasure that I introduce this special issue devoted to vocational rehabilitation for persons with psychiatric disabilities. Vocational services have evolved significantly over the past several years. Supported employment has taken firm root as a viable approach to providing vocational services, the Americans with Disabilities act mandating reasonable accommodations for persons with disabilities who are qualified for work has been in effect now well over 10 years, and our understanding of the value of situational and functional assessment has matured. Building on this evolution, the seven articles contained in this issue will broaden and expand our understanding of what vocational services work for whom and under what circumstances. In addition, the studies contained in this issue use a variety of research strategies, including a randomized clinical trial, a population based survey, a consumer driven survey and qualitative research methods. This diversity of research paradigms suggests that there are many viable ways to add to our body of knowledge about vocational rehabilitation and that our approach to vocational research has gained in sophistication. Copyright permission granted from IOS Press. |
|
 |
 |
 |
 |
| Contact Us | © Center for Psychiatric Rehabilitation, Trustees of Boston University| Updated April 27, 2009 |