Psychiatric Rehabilitation Journal

The author reflects on a decade of antipsychotic treatment, providing an intimate glimpse into living with schizophrenia. Their narrative unravels the balance of vulnerability and strength, coercion, and dialogue inherent in the acceptance of medication. Their journey from defiance to adherence showcases the profound complexities patients face and the ethical dilemmas confronting caregivers. Interactions with loved ones and mentors underscore the importance of a shared decision-making approach. The author emphasizes not just the significance of medication but the broader, holistic perspective of aligning treatment with one's life goals and values...

OBJECTIVE: Explore a lived experience perspective on using antipsychotic medicine and call to action for psychiatric rehabilitation practitioners to get involved in preparing people diagnosed with serious mental illness (SMI) to have a voice and choice in antipsychotic medication treatment. METHODS: A first-person account of awakening on an antipsychotic medication for the first time is used to understand the lived experience and challenges of using it. Lessons learned are amplified through de-identified queries of the CommonGround database capturing concerns about antipsychotic medication of people diagnosed with SMI in public sector mental health clinics in the United States...

OBJECTIVE: The support of the personal recovery of people with lived experience of mental illness is a major issue in clinical practice. Thus, a valid instrument to assess personal recovery is needed. The present study aimed to validate the French translation of the 22-item Questionnaire about the Process of Recovery (QPR-Fr). METHOD: A convenience sample of 222 participants reporting a severe mental illness diagnosis was recruited online. Psychometric properties of the QPR-Fr were evaluated...

Deprescribing is a long-overdue concept for psychiatrists and therapists, presenting potentially more sophisticated approaches to psychiatric care. This approach is fueled by both scientific pursuits and contemporary social ideologies that underscore the pivotal role of a patient's values and their freedom of choice. Indeed, deprescribing is well woven with modern liberal and progressive values. Yet, amidst the emphasis on these aspects, it is crucial not to lose sight of the "conservative" perspective within this discourse-one that emphasizes the potential consequences of failure...

OBJECTIVE: Compared to Western cultures, self-determination needs are expressed and pursued differently in Asian cultures, where interdependence and achieving greater good for the group are prioritized. To accommodate these needs, we propose the use of family-centered decision making (FCDM) to complement the shared decision-making (SDM) practice, fostering collaborative psychiatric care for Asian individuals residing in the United States. METHOD: This article synthesizes various literature to outline the similarities and differences between SDM and FCDM, discuss implementation steps, challenges associated with implementation, potential solutions, and future research considerations...

OBJECTIVE: Campus engagement, including participation in student organizations and groups, is important for both academic and health outcomes. Yet, college students with serious mental illnesses demonstrate lower levels of campus engagement compared to peers without mental illnesses. To inform psychiatric rehabilitation approaches that might enhance this outcome, the purpose of this study was to test an integrated model of self-determination and self-efficacy theories to predict campus engagement within this student population...

OBJECTIVE: People with serious mental illness (PWSMI) experience dramatic disparities in health, quality of life, and longevity. Mental health Clubhouses are a community-based treatment model that can positively affect health and quality of life among PWSMI. However, few studies investigate the processes within Clubhouses and what factors are related to the improvement of health and quality of life among members. To address this gap, this research offers a conceptual model of how Clubhouses contribute to health and quality of life...

OBJECTIVE: Promoting leisure participation requires a collaborative approach that emphasizes personal interests, strengths, and motivations. The purpose of this article was to test the effectiveness of the Independence through Community Access and Navigation (ICAN) intervention on community participation, recreation participation, and positive emotions among individuals with schizophrenia spectrum disorders. Using motivational interviewing and an individualized placements and support framework, the ICAN intervention focuses on working with participants to identify and participate in personally meaningful leisure activities by connecting with personal motivations and mainstream community opportunities...

OBJECTIVE: Traumatic experiences are prevalent among people with serious mental illness and can significantly worsen outcomes. This study aimed to identify an urban cluster of trauma types, compare continuous distress ratings versus categorical experience of trauma for predicting outcomes such as depression and quality of life, and investigate the mediating role of recovery orientation in the impact of trauma exposure on outcomes. METHOD: Data came from an intervention study on African Americans with serious mental illness living in a large urban area; 212 participants completed baseline self-report measures of past trauma experiences, related distress levels, recovery, depression, and quality of life...

OBJECTIVE: "Serious mental illness" (SMI) is a priority population within mental health treatment and policy. However, there is no standard operational definition across research, clinical, and policy contexts. The use of the label has also not been evaluated regarding its association with stigma among the general public. This mixed-method study compared community members' stigma toward "SMI" with other psychiatric labels and examined community understanding and perceptions of the SMI label...

OBJECTIVE: Supported education (SEd) provides individualized support to people with mental health problems to achieve their educational goals. Individual placement and support (IPS) has emerged as a model through which SEd may be efficiently delivered. However, the components and characteristics of educational support for these employment-focused services have not been fully explored. Building on earlier studies, we constructed a preliminary model of SEd components that integrated with the IPS model...

OBJECTIVE: Though the efficacy of the Clubhouse model's interventions and practices in supporting recovery from serious mental illness (SMI) have been demonstrated by prior research, the causal mechanisms and theory driving these outcomes have yet to be comprehensively defined. This theory article aims to synthesize existing knowledge of these methods to define a unified theory of social practice, outline its role in SMI recovery, and discuss future implications. METHOD: Historical, theoretical, and practical foundations of social practice were synthesized to define a current theory of social practice and expand the term to apply to the methods and interventions that define the Clubhouse model...

OBJECTIVE: This study involved the development, dissemination, and pre- and postassessment of a mental illness awareness webinar. The goal of the webinar is to educate the general public about serious mental illness (SMI) and reduce stigmatizing attitudes. METHOD: The study included 203 participants ( n = 101 treatment group; n = 102 control group). Each completed a pretest and posttest measure of a mental illness stigma scale and a transphobia scale in this randomized control trial research design, along with a demographic form and participant feedback questionnaire...

OBJECTIVE: This study aimed to examine the psychometric properties of the English version of the Self-Stigma Scale-Short (SSS-S), a nine-item self-report self-stigma measurement, among U.S. adults with psychiatric disabilities. METHOD: We obtained reliability and validity evidence from a sample of 275 adults with psychiatric disabilities. RESULTS: Exploratory factor analysis (EFA; n = 139) yielded a two-factor solution that accounts for 64...

OBJECTIVE: The Clubhouse model (CM) for serious mental illness is a recovery-oriented and member-driven program that aims to facilitate functional recovery. Efficacy evaluation of the CM is limited by lack of uniform functional disability assessment. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) is a widely accepted measure of functional disability, but its psychometric properties have yet to be examined within the CM. METHOD: This research sought to confirm the generic six-factor structure of the 12-item WHODAS-2...

OBJECTIVE: To illustrate the value of reading fiction as a group supervision practice focused on supporting recovery-oriented psychotherapy for individuals experiencing serious mental illness (SMI). METHOD: Detailed practical description of the practice and conceptual analysis of the proposed value of using fiction as a group supervision method. FINDINGS: Authors suggest that the supervisory practice is a novel component of clinical supervision, and offers value in its ability to promote reflective practice, to establish intersubjectivity among peers and supervisory relationships, and may serve for some to counter risks of clinician burnout...

This article presents an introduction to the special issue of Psychiatric Rehabilitation Journal. This special issue explores what exposure to various forms of art can add to the understanding of human nature, including mental health, and in particular, efforts and ways to advance psychiatric rehabilitation and recovery. While psychiatric rehabilitation is increasingly positioned as a scientific enterprise, we ask whether this field can benefit from lessons learned from the arts. More specifically, the authors explore how the arts can enhance the field of psychiatric rehabilitation by helping those in this field to understand, through new perspectives, the experiences of people with mental health issues...

OBJECTIVE: In Canada and elsewhere, making treatment decisions for a person with serious mental illness (SMI) who was found incapable for treatment decisions via a substitute decision maker (SDM) is the norm. This practice is often called into question from a rights-based perspective. The literature on the views of affected individuals is limited. We explore the experiences of adults with SMI who have had SDMs to gain more in-depth understanding. METHOD: We conducted semistructured interviews with 11 consumers of psychiatric services who have had experiences with SDM (range 1-12 years) at an urban hospital in Toronto, Canada...

OBJECTIVE: Severe loneliness infrequently occurs in the general population but has very significant impacts on health and quality of life. This study examined the extent to which severe loneliness is experienced by adults with serious mental illnesses (SMIs) relative to adults in the general population and its possible implications for psychiatric rehabilitation services. METHOD: Data were gathered from samples of individuals with SMI ( N = 231) and a general community sample of adults ( N = 300) using the University of California, Los Angeles Loneliness Scale...

OBJECTIVE: Occupational function assessment is essential for rehabilitation of severe mental illness but lacks comprehensive tools. METHOD: This study examines the psychometric properties of the Chinese versions of the Vocational Cognitive Rating Scale (VCRS) and the Work Behavior Inventory (WBI) in 60 chronic patients from a psychiatric daycare center and identifies clinical correlates of occupational function measured on the Positive and Negative Syndrome Scale (PANSS)...