Below 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. (2007). Giving psychiatric rehabilitation its due. Psychiatric Rehabilitation Journal, 31(2), 95.
I can definitely say that the field of psychiatric rehabilitation has arrived when ideas that formed the basis of psychiatric rehabilitation in the last half century now form this century’s “new” initiatives in the entire field of mental health. Examples would be the recent emphasis in the mental health literature on “shared decision-making” and “person centered planning”; the vision statement of the President’s New Freedom Commission on Mental Health which points to essential outcomes, such as “living, working, learning and participating fully in the community”; and The Institute of Medicine’s “Crossing the Quality Chasm” report related to behavioral health care which stresses “healing relationships” and “patient centered care.”
Ashcraft, L., & Anthony, W. A. (2007). Adding peers to the workforce: What to keep in mind when you train peer employees and your existing staff. Behavioral Healthcare, 27(11), 8-12.
The 2003 report of the President's New Freedom Commission on Mental Health gave us a wonderful vision of recovery, and urged the strategic and systematic inclusion of peers and family members in the behavioral healthcare workforce. Since then training programs have cropped up across the country to prepare peers and family members, such as “parent partners” (see our June 2007 column), to work alongside professional staff members, adding their hard-won expertise to promoting recovery for those who use our services…
Ashcraft, L., & Anthony, W. A. (2007). Data collection with recovery in mind: Involve service users as much as possible. Behavioral Healthcare, 27(9), 12-13.
Are you looking for another way to move your programs and services further into a recovery framework? Take a look at your data-collection system. It can help focus your organizational energy on data compatible with, instead of inconsistent with, the vision of recovery. Since a data-collection system touches nearly every service user and employee, each data-collection form and process could guide the organization toward a recovery orientation. Some of the information funding sources and licensing and accrediting bodies require isn't compatible with the recovery approach, but there is a lot you can do to transform the overall data-collection system…
Ashcraft, L., Anthony, W. A., & St. George, L. (2007). Let's talk about solutions: Organizational leaders can be role models for promoting recovery-based conversations. Behavioral Healthcare, 27(1), 12-13.
Have you ever noticed how most conversations begin between behavioral health professionals and people receiving services? From our experience, the conversation usually begins by identifying the presenting problem and goes downhill from there, becoming more and more immersed in layers of the problem. By the time the conversation is over, both the person and the professional are exhausted, sometimes overwhelmed, and have little energy left to find a creative solution. If you think about it, people don't come to our programs to wallow in their problems. They come for help in finding solutions. Yet we seem to spend most of our time talking about the problems…
Ashcraft, L., & Anthony, W. A. (2007). Our workforce's biggest secret: Here's a hint: It affects one in four of your professional staff members. Behavioral Healthcare, 27(10), 10-11.
After reading the headline, you're probably wondering, “So what is the biggest secret about the behavioral health workforce?” Well, we're not sure this is the biggest secret in behavioral healthcare and, in fact, it may not even be a secret at all. However, it's certainly a topic that we pretend doesn't exist, so we rarely talk about it…
Ashcraft, L., Anthony, W. A., & Dayan, E. (2007). Parent partners' possibilities: If you can overcome several hurdles, these "peer" employees can be valuable resources for people you serve. Behavioral Healthcare, 27(6), 10-12.
In our previous column, we discussed the benefits of adding peer employees to the behavioral health workforce. For the most part, our focus has been on adult systems, but in this column we share an example of “parent partners” who work with families in a system of care for children. We are thrilled that in many systems for both adults and children, parents finally are being given the opportunity to share their experiences and hard-learned expertise with families in the process of recovering from mental illnesses. This is consistent with one of the fundamental goals in the final report of the President's New Freedom Commission on Mental Health: to involve people receiving services and their families in the planning and delivery of services in order to promote recovery…
Ashcraft, L., Anthony, W. A., & Martin, C. (2007). Recovery blows in on the winds of change: Recovery reinforcement training promotes a healthier environment for people receiving services and staff. Behavioral Healthcare, 27(8), 8-13.
Since we can appreciate a pleasant climate more by knowing what an unfavorable one feels like, let's start there. Have you ever walked into a behavioral health environment where not even global warming could melt the surface freeze? It's the kind of place with a wind chill, instead of the warm and open hospitality needed for a recovery environment...
Ashcraft, L., & Anthony, W. A. (2007). Reinventing performance evaluations: If conducted correctly, they can help an organization adopt a recovery focus. Behavioral Healthcare, 27(3), 12-13.
Would you rather have a poor performance evaluation or a root canal? Lori would rather have a root canal, and for Bill it's a toss-up! Over the course of our lifetimes we both have received evaluations singing our praises, as well as others that said we needed to straighten up! None of them changed our performance much, especially the negative ones...
Ashcraft, L., & Anthony, W. A. (2007). Turn evaluations into mentoring sessions: Performance evaluations don't have to be dreadful-try the Get-Give-Merge-Go approach. Behavioral Healthcare, 27(4), 8-11.
In last month's column, we introduced the concept of using the employee performance evaluation process as a tool to reinforce recovery principles and shift an organization's culture toward recovery practices. You may be thinking, “Oh no! Do we have to talk about this again? I dread doing performance evaluations, and I hate getting them.” If this is your response, stay with us. We'll try to show you how to be creative and make this a rewarding experience…
Ashcraft, L., & Anthony, W. A. (2007). The value of peer employees: Professional staff shouldn't fear peers' greater involvement in the behavioral health workforce. Behavioral Healthcare, 27(5), 8-9.
We both spend a lot of time traveling across the country training staff in various programs and systems about recovery. When we get to the part about how to actually transform a program into one that regularly uses recovery principles and practices, we suggest adding well-trained peers and family members to the workforce. We find this to be one of the single most effective ways to develop and sustain a culture that stays focused on recovery practices. This is not to say that a program without peers can't do the same thing. It's just more difficult…
Ashcraft, L., & Anthony, W. A. (2007). A weekly dose of recovery information: Weekly refresher courses can help sustain recovery principles and practices. Behavioral Healthcare, 27(2), 13.
We all probably have had the experience of attending a training event and getting very excited about implementing new recovery-oriented ideas once we return to work. But when Monday morning rolls around, and we’re faced with all the work that wasn’t addressed while we were away at training, plus all the immediate demands waiting for us, our enthusiasm takes a backseat. We say to ourselves, “I’ll just handle all this stuff first, and then I’ll start doing the new things I learned in the training.”
Ashcraft, L., Anthony, W. A., & Martin, C. (2007). Training veterans in recovery: Two female veterans share how peer employment training is making a difference in their recovery from PTSD. Behavioral Healthcare, 27(7), 10-13.
Chris recently introduced us to two female veterans, Lisa and Jo, who had completed the Peer Employment Training (PET) class he teaches at Recovery Innovations (formerly META Services). They taught us much about what it means to fight for our country, as well as what it's like to come home feeling empty and disconnected. We want to share their stories and advice with you so we all can make strides toward helping our returning troops rejoin our communities...
Farkas, M. (2007). The vision of recovery today: What it is and what it means for services. World Psychiatry, 6(2), 1-7.
In the past, practice in mental health was guided by the belief that individuals with serious mental illnesses do not recover. The course of their illness was either seen pessimistically, as deteriorative, or optimistically, as a maintenance course. Research over the past thirty to forty years has indicted that belief and shown that a vision of recovery can be achieved for many individuals. People with serious mental illnesses have themselves published accounts of their own recovery as well as advocated for the development of recovery promoting services. In North America and other regions, policies have been developed to make recovery the guiding vision of services. Today, particularly in the United States, much effort is going into the transformation of services and systems to achieve recovery outcomes. Despite these trends, the idea of recovery remains controversial and, some say, even illusory. This article clarifies the meaning of the term "recovery", reviews the research and first person accounts providing a rationale for recovery, and sets out implications for developing recovery oriented services.
Farkas, M., & Anthony, W. A. (2007). Bridging science to service: Using Rehabilitation Research and Training Center program to ensure that research-based knowledge makes a difference. Journal of Rehabilitation Research and Development, 44(6), 879-892.
The challenge of bridging science to service is increasingly visible in the healthcare field, with emphasis on the influence of evidence-based knowledge on both policy and practice. Since its inception more than 40 years ago, the Rehabilitation Research and Training Center (RRTC) program has provided grants for both research and training activities designed to ensure that research knowledge is translated into practice. The RRTC program is unique in that its mission and funding have always required that both time and money be invested in the translation and dissemination of research-generated knowledge to users in the field, i.e., decision makers and practitioners. Boston University's Center for Psychiatric Rehabilitation has been an RRTC for more than 25 years and provides an example of the effect of the RRTC program in bridging science to service. The Center's mission as an RRTC has been to develop and transfer research knowledge to decision makers and practitioners who can then inform change and promote progress in mental health disability policy and practice. This article reviews five basic dissemination and utilization principles for overcoming the most common barriers to effective dissemination of evidence-based knowledge and provides examples of the Center's activities related to each principle. In addition, a knowledge-transfer framework developed by the Center to organize dissemination and utilization efforts is described.
Farkas, M., Jansen, M., & Penk, W. (2007). Psychosocial rehabilitation: Approach of choice for those with serious mental illnesses. Journal of Rehabilitation Research and Development, 44(6), 801-812.
We begin by thanking the Editor of the Journal of Rehabilitation Research and Development (JRRD) for commissioning a special issue onpsychosocial rehabilitation (PSR) for persons with serious mental illnesses. For many years, the conventional wisdom in the field of mental health has been that serious mental illnesses result in inevitable deterioration. Professional practice has therefore focused on managing psychopathology and its symptoms. A wider variety of outcomes has been identified as critical over the past 30 years, however, particularly for individuals with schizophrenia. These outcomes include regaining functioning over the long term, developing friendships, and living satisfying lives. Thirty years of empirical evidence, as well as first-person accounts, support the notion that recovery from serious mental illnesses is possible…
Gagne, C. A., White, W., & Anthony, W. A. (2007). Recovery: A Common Vision for the Fields of Mental Health and Addictions. Psychiatric Rehabilitation Journal, 31, 32-37.
The vision of recovery is reshaping the fields of mental health and addiction services. This paper reviews how this broad vision is shaping common goals, principles, values and strategies across the two fields. We further examine how a common vision of recovery can positively impact the treatment of co-occurring disorders and speculate on how this vision can bridge the seeming differences between these two fields and reshape a mutual understanding of the essentials of recovery from severe mental illness and addiction.
Hutchinson, D., Anthony, W. A., Massaro, J. M., & Rogers, E. S. (2007). Evaluation of a Combined Supported Computer Education and Employment Training Program for Persons with Psychiatric Disabilities. Psychiatric Services, 30(3).
Meaningful work is described as one of the functional indicators of healing and growth beyond the disability and is seen as critical in recovering a personal sense of worth and value. We describe a supported education-supported employment program which focused on teaching computer, recovery and work skills. A program evaluation was implemented on four consecutive classes of this program. Four classes with a convenience sample of sixty-one students were involved in the evaluation over 5 years. The program utilized a one group pretest, posttest design, with repeated measures over time. Following the 10-month classroom training phase, students entered a 2-month internship to give them computer office work experience. Students were interviewed quarterly using standardized assessments involving work and other subjective outcomes. Results suggest that overall the students experienced a positive change in work status and income and a decrease in mental health services utilization. In addition, non-vocational outcomes, specifically self-esteem and empowerment improved. The program represents a successful integration of supported education and supported employment program models.
Nemec, P. B., & Gagne, C. A. (2007). Recovery from Psychiatric Disabilities. In A. dell Orto & P. Powers (Eds.), The Psychological and Social Impact of Illness and Disability. New York: Springer Publishing Co.
The newest edition of The Psychological and Social Impact of Illness and Disability continues the tradition of presenting a realistic perspective on life with disabilities and then improves upon its predecessors with the inclusion of illness as a major influence on client care needs. Articles included represent the best of developing concepts, theory, research, and intervention approaches. Classic articles kept from previous editions round out a diversity of viewpoints that will enrich student understanding of what is important in beginning rehabilitation practice. Further broadening the scope of this edition is the inclusion of personal perspectives and stories from those living with illness or disabilities. These stories offer a glimpse into what it is like to cope day to day with these issues and direct examples of how effective current care models and rehabilitation theories can be.
Restrepo-Toro, M. E. (2007). Training Program Aims to Recruit Latino Providers, Peer Specialists. Mental Health Weekly, 17(17).
Training Latinos to become providers, peer specialists and leaders in the mental health field in delivering recovery and recovery oriented psychiatric rehabilitation is the aim of an up and running pilot project based at Boston University.
Restrepo-Toro, M. E., & Delman, D. (2007). Peer Run Program Learn Skills to Conduct Program Evaluation. The Capacity Builder: Newsletter of the Center for Capacity Building on Minorities with Disabilities Research. UIC, 3(1).
During the last 12 months Center staff has been working with the Transformation Center in Massachusetts. The Transformation Center is a technical assistance center run by people in mental health and/or addictions recovery. It trains peers to work in the mental health system and service providers to understand the recovery process. In addition, it provides consultation to peer-run and provider-run organizations, as well as researchers and policy makers, to increase their effectiveness in supporting mental health recovery…
Rogers, E., & Furlong-Norman, K. (2007). From the editor: 30th Anniversary of the Psychiatric Rehabilitation Journal. Psychiatric Rehabilitation Journal, 30(3), 167-168.
This year marks the 30th anniversary of the Psychiatric Rehabilitation Journal (PRJ). Since the publication of its first issue in 1977, the PRJ has maintained an important mission to promote the development of new knowledge for the field of psychiatric rehabilitation. Initiated in response to the trend of deinstitutionalization of people with psychiatric disabilities from state hospitals and the concomitant need to provide information about community-based models of rehabilitation, the Psychosocial Rehabilitation Journal (as the PRJ was first named), continues to evolve and to be recognized as a valued publication in the social and behavioral science literature.
Rogers, E. S., Teague, Lichtenstein, C., Campbell, J., Lyass, A., Chen, R., et al. (2007). Effects of participation in adjunctive consumer-operated programs on both personal and organizationally mediated empowerment: Results of a multi-site study. Journal of Rehabilitation Research and Development, 44(6), 785-800.
The number of empowerment-oriented consumer-operated service programs (COSPs) in mental health has increased dramatically over the past decade; however, little empirical evidence exists about the effects of such programs on their intended outcomes. This study examined the effects of COSPs on various aspects of empowerment within the context of a multisite, federally funded, randomized clinical trial of COSPs. Results suggest that the individuals who received the consumer-operated services perceived higher levels of personal empowerment than those in the control intervention; overall, effect sizes were very modest when all sites were examined together in intent-to-treat analyses. However, we noted variations in outcomes by intensity of COSP use and also by study site, which suggest that specific programs had significant effects, while others did not. The implications of these results for the mental health field and for service providers and policy makers are discussed.
Russinova, Z., & Blanch, A. (2007). Supported spirituality: A new frontier in recovery-oriented mental health system. Psychiatric Rehabilitation Journal, 30(4), 247-249.
This special issue of the Psychiatric Rehabilitation Journal marks a new milestone in documenting the growing efforts of mental health practitioners, researchers, advocates and clergy in recognizing the healing power of religion and spirituality in recovery. It comes to fruition almost 10 years after Fallot’s landmark edited volume (1998) on this topic. Papers included in this special issue present an amalgam of literature reviews, research findings, training programs and personal perspectives about the role spirituality can play in the lives of people in recovery. Although these papers vary in the way they have approached religion and spirituality, they all examine these two concepts as different manifestations of the transcendent in experiencing and recovering from psychiatric disability.
Russinova, Z., Bloch, P. P., & Lyass, A. (2007). Patterns of employment among individuals with mental illness in vocational recovery. Journal of Psychosocial Nursing and Mental Health Services, 45(12), 48-54.
This article provides empirical evidence about the patterns of competitive employment among individuals with serious mental illness who are in vocational recovery. The findings are based on a 5-year longitudinal study on sustained employment, conducted with a national sample of 529 individuals with serious mental illness who were in vocational recovery at the time of study enrollment. Data analysis from the 328 participants who completed the study—from baseline through all five annual follow-up assessments—revealed three different post recovery employment patterns: continuous, stable, and fluctuating. Although many participants demonstrated the capacity to sustain competitive employment during prolonged periods of time, others experienced employment interruptions. Work interruptions were most frequently attributed to exacerbation of psychiatric symptoms. Schizophrenia spectrum disorder, difficulties with daily functioning, and current receipt of disability benefits predicted the psychiatric-based work interruptions in this sample. Implications for clinical practice are also discussed.
Russinova, Z., & Cash, D. (2007). Personal perspectives about the meaning of religion and spirituality among persons with serious mental illnesses. Psychiatric Rehabilitation Journal, 30(4), 271-285.
This paper examines the various meanings persons with serious mental illnesses attribute to the concepts of religion and spirituality. In-depth semi-structured interviews were conducted with forty individuals with serious mental illnesses who have incorporated alternative healing practices into their recovery process. The qualitative data analysis revealed that study participants differentially defined religion and spirituality using two sets of descriptors: a) core characteristics describing the nature of each concept, and b) functional characteristics describing the impact of religion and spirituality on the individual, Implications for clinical practice and future research on the role of religion and spirituality in recovery are discussed.
Salkever, D. S., Karakus, M. C., Slade, E. P., Harding, C. M., Hough, R. L., Rosenheck, R. A., et al. (2007). Measures and Predictors of Community-Based Employment and Earnings of Persons With Schizophrenia in a Multisite Study. Psychiatric Services, 58(3).
OBJECTIVE: Data from a national study of persons with schizophrenia-related disorders were examined to determine clinical factors and labor-market conditions related to employment outcomes. METHODS: Data were obtained from the U.S. Schizophrenia Care and Assessment Program, a naturalistic study of more than 2,300 persons from organized care systems in six U.S. regions. Data were collected via surveys and from medical records and clinical assessments at baseline and for three years. Outcome measures included any community-based (nonsheltered) employment, 40 or more hours of work in the past month, employment at or above the federal minimum wage, days and hours of work, and earnings. Bivariate and multiple regression analyses of data from more than 7,000 assessments tested relationships between outcomes and sociodemographic, clinical, and local labor market characteristics. RESULTS: The employment rate was 17.2%; only 57.1% of participants who worked reported 40 or more hours of past-month employment. The mean hourly wage was $7.05, and mean monthly earnings were $494.20. Employment rates and number of hours worked were substantially below those found in household surveys or in baseline data from trials of employment programs but substantially higher than those found in a recent large clinical trial. Strong positive relationships were found between clinical factors and work outcomes, but evidence of a relationship between local unemployment rates and outcomes was weak. CONCLUSIONS: Work attachment and earnings were substantially lower than in previous survey data, not very sensitive to labor market conditions, and strongly related to clinical status.
