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Chapter 22. Psychiatric Rehabilitation

Alex Kopelowicz, M.D.; Charles J. Wallace, Ph.D.; Robert Paul Liberman, M.D.
DOI: 10.1176/appi.books.9781585622986.255189

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Excerpt

The growing recognition that long-term disability is experienced by a large proportion of persons with serious and persistent mental disorders has spurred the development of the field of psychiatric rehabilitation. Even with the best evidence-based treatment, individuals with psychotic disorders have suboptimal outcomes, with symptoms persisting despite appropriate treatment (Lieberman et al. 2005). Beyond persisting symptoms, social maladjustment in family and vocational roles interferes with the quality of life of an exceedingly high number of those with psychotic disorders (Marshall et al. 2005).

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Figure 22–1. The spectrum of interventions for mental disorders.

Figure 22–2. Seven learning activities.

Figure 22–3. The competencies required of effective case managers in psychiatric rehabilitation encompass relationship skills, clinical skills, and liaison and advocacy skills.

Figure 22–4. Areas encompassed by the Client's Assessment of Strengths, Interests, and Goals (CASIG).

References

Adair CE, McDougall GM, Mitton CR, et al: Continuity of care and health outcomes among persons with severe mental illness. Psychiatr Serv 56:1061–1069, 2005
[PubMed]
 
Barrowclough C, Haddock G, Tarrier N, et al: Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. Am J Psychiatry 158:1706–1713, 2001
[PubMed]
 
Bellack AS, Mueser KT, Gingerich S, et al: Social Skills Training for Schizophrenia, 2nd Edition: A Step by Step Guide. New York, Guilford, 2004
 
Bond GR, Drake RE, Mueser KT, et al: Assertive community treatment for people with severe mental illness: critical ingredients and impact on clients. Disease Management and Health Outcomes 9:141–159, 2001a
 
Bond GR, Becker DR, Drake RE, et al: Implementing supported employment as an evidence-based practice. Psychiatr Serv 52:313–322, 2001b
 
Carey KB, Carey MP, Maisto SA, et al: The feasibility of enhancing psychiatric outpatients' readiness to change their substance abuse. Psychiatr Serv 53:602–608, 2002
[PubMed]
 
Chandler D, Meisel J, McGovern M, et al: Client outcomes in two model capitated integrated service agencies. Psychiatr Serv 47:175–180, 1996
[PubMed]
 
Chanut F, Brown TG, Dongier M: Motivational interviewing and clinical psychiatry. Can J Psychiatry 50:548–554, 2005
[PubMed]
 
Clark RE, Ricketts SK, McHugo GJ: Legal system involvement and costs for persons in treatment for severe mental illness and substance abuse disorders. Psychiatr Serv 50:641–647, 1999
[PubMed]
 
Cook JA, Leff HS, Blyler CR, et al: Results of a multisite randomized trial of supported employment interventions for individuals with severe mental illness. Arch Gen Psychiatry 62:505–512, 2005
[PubMed]
 
Corrigan PW, Steiner L, McCracken SG, et al: Strategies for disseminating evidence-based practices to staff who treat people with serious mental illness. Psychiatr Serv 52:1598–1606, 2001
[PubMed]
 
Dickerson F: Cognitive behavioral psychotherapy for schizophrenia: a review of recent empirical studies. Schizophr Res 43:71–90, 2000
[PubMed]
 
Dixon L, Adams C, Luckstead A: Update on family psychoeducation for schizophrenia. Schizophr Bull 26:5–20, 2000
[PubMed]
 
Drake RE, Wallach MA: Dual diagnosis: 15 years of progress. Psychiatr Serv 51:1126–1129, 2000
[PubMed]
 
Drake RE, Essock SM, Shaner A, et al: Implementing dual diagnosis services for clients with severe mental illness. Psychiatr Serv 52:469–476, 2001a
 
Drake RE, Goldman HE, Leff HS, et al: Implementing evidence-based practices in routine mental health service settings. Psychiatr Serv 52:179–182, 2001b
 
Eckman TA, Liberman RP, Phipps C, et al: Teaching medication management skills to schizophrenic patients. J Clin Psychopharmacol 10:33–38, 1990
[PubMed]
 
Eckman TA, Wirshing WC, Marder SR, et al: Techniques for training patients in illness self-management: a controlled trial. Am J Psychiatry 149:1549–1555, 1992
[PubMed]
 
Falloon IRH, Fadden G: Integrated Mental Health Care: A Comprehensive Community-Based Approach. Cambridge, MA, Cambridge University Press, 1993
 
Falloon IRH, Montero I, Sungur M, et al: Implementation of evidence-based treatment for schizophrenic disorders: two year outcome of an international field trial of optimal treatment. World Psychiatry 3:104–109, 2004
[PubMed]
 
Fixsen D, Naoom S, Blase K, et al: Implementation Research: A Synthesis of the Literature (FMHI Publ No 231). Tampa, FL, The National Implementation Research Network, 2005
 
Glynn SM, Marder SR, Liberman RP, et al: Supplementing clinic-based skills training for schizophrenia with manual-based community support: effects on social adjustment of patients with schizophrenia. Am J Psychiatry 159:829–837, 2002
[PubMed]
 
Heinssen RK, Liberman RP, Kopelowicz A: Psychosocial skills training for schizophrenia: lessons from the laboratory. Schizophr Bull 26:21–46, 2000
[PubMed]
 
Herz MI, Lamberti JS, Mintz J, et al: A program for relapse prevention in schizophrenia: a controlled study. Arch Gen Psychiatry 57:277–283, 2000
[PubMed]
 
Hogarty GE, Anderson CM, Reiss DJ: Family education, social skills training and maintenance therapy in aftercare treatment of schizophrenia. Arch Gen Psychiatry 43:633–642, 1986
[PubMed]
 
Jones C, Cormac I, da Mota Neto S, et al: Cognitive behaviour therapy for schizophrenia. Cochrane Database Syst Rev (4):CD000524, 2004
 
Kavanaugh DJ, McGrath J, Saunders JB, et al: Substance misuse in patients with schizophrenia: epidemiology and management. Drugs 62:743–755, 2002
 
Kopelowicz A, Zarate R, Gonzalez Smith V, et al: Disease management in Latinos with schizophrenia: a family-assisted skills training approach. Schizophr Bull 29:211–228, 2003
[PubMed]
 
Kopelowicz A, Ventura J, Zarate R, et al: Neurocognitive correlates of recovery from schizophrenia. Psychol Med 35:1165–1173, 2005
[PubMed]
 
LeComte T, Wallace CJ, Caron J, et al: Further validation of the Client Assessment of Strengths Interests and Goals. Schizophr Res 66:59–70, 2004
[PubMed]
 
Lehman AF, Lieberman JA, Dixon LB, et al: Practice guideline for the treatment of patients with schizophrenia, 2nd edition. Am J Psychiatry 161 (suppl 2):1–56, 2004a
 
Lehman AF, Kreyenbuhl J, Buchanan RW, et al: The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2003. Schizophr Bull 30:193–217, 2004b
 
Levin S: Project Return: the next step—transition from a self-help to a consumer-controlled agency, in Consumers as Providers in Psychiatric Rehabilitation. Edited by Mowbray CT, Moxley DP, Jasper CA, et al. Columbia, MD, International Association of Psychosocial Rehabilitation Services, 1997, pp 419–455
 
Liberman RP, Kopelowicz A: Recovery from schizophrenia: a challenge for the 21st century. Int Rev Psychiatry 14:245–255, 2002
 
Liberman RP, Wallace CJ, Blackwell GA, et al: Innovations in skills training for the seriously mentally ill: the UCLA Social and Independent Living Skills Modules. Innovations and Research 2:43–60, 1993
 
Liberman RP, Van Putten T, Marshall BD, et al: Optimal drug and behavior therapy for treatment-refractory schizophrenic patients. Am J Psychiatry 151:756–759, 1994
[PubMed]
 
Liberman RP, Glynn S, Blair KE, et al: In vivo amplified skills training: promoting generalization of independent living skills for clients with schizophrenia. Psychiatry 65:137–155, 2002
[PubMed]
 
Lieberman JA, Stroup TS, McEvoy JP, et al: Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 353:1209–1223, 2005
[PubMed]
 
Marshall M, Lewis S, Lockwood A, et al: Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review. Arch Gen Psychiatry 62:975–983, 2005
[PubMed]
 
McFarlane WR: Multifamily Groups in the Treatment of Psychiatric Disorders. New York, Guilford, 2002
 
McHugo GJ, Drake RE, Becker D: The durability of supported employment effects. Psychiatr Rehabil J 22:55–61, 1998
 
Miller W, Rollnick S: Motivational Interviewing: Preparing People to Change Addictive Behavior, 2nd Edition. New York, Guilford, 2002
 
Morrison DP: Use caution with evidence-based treatments in systems of behavioral healthcare. Behav Healthc Tomorrow 12:37–41, 2003
[PubMed]
 
Morrison DP: Real-world use of evidence-based treatments in community behavioral health care. Psychiatr Serv 55:485–487, 2004
[PubMed]
 
Mueser KT, Drake RE, Noordsy DL: Integrated mental health and substance abuse treatment for severe psychiatric disorders. Journal of Practical Psychiatry and Behavioral Health 4:129–139, 1998
 
Mueser KT, Yarnold PR, Rosenberg SD, et al: Substance use disorder in hospitalized severely mentally ill psychiatric patients: prevalence, correlates and subgroups. Schizophr Bull 26:179–192, 2000
[PubMed]
 
Mueser KT, Torrey WC, Lynde D, et al: Implementing evidence-based practices for people with severe mental illness. Behav Modif 27:387–411, 2003
[PubMed]
 
Pilling S, Bebbington P, Kuipers E, et al: Psychological treatments in schizophrenia, I: meta-analyses of family intervention and cognitive behaviour therapy. Psychol Med 32:763–782, 2002a
 
Pilling S, Bebbington P, Kuipers E, et al: Psychological treatments in schizophrenia, II: meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychol Med 32:783–791, 2002b
 
Pitschel-Walz G, Leucht S, Bauml J, et al: The effect of family interventions on relapse and rehospitalization in schizophrenia: a meta-analysis. Schizophr Bull 27:73–92, 2001
[PubMed]
 
Prouteau A, Verdoux H, Briand C, et al: Cognitive predictors of psychosocial functioning outcome in schizophrenia: a follow-up study of subjects participating in a rehabilitation program. Schizophr Res 77:343–353, 2005
[PubMed]
 
Rector NA, Beck AT: Cognitive behavioral therapy for schizophrenia: an empirical review. J Nerv Ment Dis 189:278–287, 2001
[PubMed]
 
Regier DA, Farmer ME, Rae DS, et al: Comorbidity of mental disorders with alcohol and other drug abuse. JAMA 264:2511–2518, 1990
[PubMed]
 
Ries RK, Dyck DG: Representative payee practices of community mental health centers in Washington State. Psychiatr Serv 48:811–814, 1997
[PubMed]
 
Roberts LJ, Shaner A, Eckman T: Overcoming Addiction: Skills Training for People with Schizophrenia. New York, WW Norton, 1999
 
Schaub A, Behrendt B, Mueser KT, et al: Training schizophrenic patients to manage their symptoms. Schizophr Res 31:121–130, 1998
[PubMed]
 
Shaner A, Eckman TA, Roberts LJ, et al: Disability income, cocaine use, and repeated hospitalization among schizophrenic cocaine abusers: a government-sponsored revolving door? N Engl J Med 333:777–783, 1995
[PubMed]
 
Shaner A, Roberts LJ, Eckman TA, et al: Monetary reinforcement of abstinence from cocaine among mentally ill patients with cocaine dependence. Psychiatr Serv 48:807–810, 1997
[PubMed]
 
Shaner A, Eckman T, Roberts LJ, Fuller T: Feasibility of a skills training approach to reduce substance dependence among individuals with schizophrenia. Psychiatr Serv 54:1287–1289, 2003
[PubMed]
 
Tauber R, Wallace CJ, LeComte T: Enlisting indigenous community supporters in skills training programs for persons with severe mental illness. Psychiatr Serv 51:1428–1432, 2000
[PubMed]
 
Velligan DI, Bow-Thomas C, Huntzinger C, et al: Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatients with schizophrenia. Am J Psychiatry 157:1317–1323, 2000
[PubMed]
 
Velligan DI, Prihoda TJ, Maples N, et al: A randomized single-blind pilot study of compensatory strategies in schizophrenic outpatients. Schizophr Bull 28:283–292, 2002
[PubMed]
 
Wallace CJ, LeComte T, Wilde J, et al: CASIG: A consumer-centered assessment for planning individualized treatment and evaluating program outcomes. Schizophr Res 50:105–119, 2001
[PubMed]
 
Winter JP, Calsyn RJ: The Dartmouth Assertive Community Treatment Scale: a generalizability study. Eval Rev 24:319–338, 2000
[PubMed]
 
World Health Organization World Mental Health Survey Consortium: Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291:2581–2590, 2004
 
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