Ann A. Murphy

Wellness coaching: a new role for peers.

TOPIC This brief report presents the conceptual framework for the development of the peer wellness coach role including the definition of a new job role for peer providers and an overview of the knowledge and skills required for this role. PURPOSE People with serious mental illnesses are at greater risk of living with untreated chronic medical conditions that severely impact their quality of life and result in premature mortality. Wellness coaching represents an intervention that can help individuals persist in the pursuit of individually chosen health and wellness goals. SOURCES USED Literature and our personal and professional experiences developing this role and training are presented. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Wellness coaching seems an ideal role for peers in recovery that has potential to address health and wellness issues facing persons living with mental illnesses who are at high risk of comorbid medical conditions.

A study of the impact of social support development on job acquisition and retention among people with psychiatric disabilities

The current study examined the relationship between specific techniques for developing social support (i.e., Person Centered Planning) and job related outcomes among 110 individuals with psychiatric disabilities receiving Supported Employment (SE) services in a northeastern state. Seven SE programs participated. All individuals receiving SE services from any of the seven SE programs were eligible to enroll in the study. Participant data were collected on demographics, psychiatric history, work history, and social support over a period of two years. Data on the use of Person Center Planning practices were collected from SE staff every three months for the first 12 months of the study. This information was recorded in the Quality Indicators Survey, an instrument developed for this study. A positive relationship was found between total days employed and the number of non- paid supporters an individual reported having; a negative relationship existed between total days employed and number of paid supporters; and there was a positive correlation between total days employed and Person Centered Planning techniques used at nine and 12 months.

Persons in Recovery, Family Members, and Staff Perspectives of Psychiatric Crisis Needs

The current study was undertaken to identify stakeholder perceptions of their experiences with mental health crisis services throughout this northeastern state for administrators to use for program planning and development. A semistructured survey of opinions regarding current and proposed crisis management services of consumers, family members, and staff was conducted in the northeastern United States. They report that individuals in psychiatric crisis continue to be offered primarily medication changes and hospitalization. They also reported they would prefer the availability of additional services including professional support in person, on the phone, and in their homes. Implications for systems transformation and program development are discussed.

Selective Provision of Illness Management and Recovery Modules

This project assessed the effectiveness of group provision of four modules of illness management and recovery (IMR): recovery strategies, building social support, coping with problems and symptoms, and reducing relapse. Sixty-six adults (ages 20–68) diagnosed with severe mental illness recruited from consumer-run self-help centers in New Jersey participated in four IMR modules over 16 weekly sessions. The data from 36 of those individuals who attended five or more IMR sessions were used in this analysis. Presenters (six mental health professionals and three peer providers) who were closely matched in age, education, and experience were trained to cofacilitate weekly groups using the selected IMR modules. Assessment included self-reports and interviews (IMR Rating Scale, symptoms, two measures of social support, and two measures of coping skills). IMR participants showed improvement compared with a wait list control on the IMR Rating Scale, while the wait list control group showed improvement compared with IMR participants on the Norbeck Social Support Questionnaire. Overall, participants showed improvement on the IMR Rating Scale, the Perceived Social Support scale, and the Brief Symptom Inventory. Selected IMR modules provided in a group setting can foster positive change for participants.

Developing Attitudes: The Role of Psychiatric Rehabilitation Education

ABSTRACT This article examines the development of Psychiatric Rehabilitation (PsyR) beliefs, goals, and practices among students from different academic programs within the same university. Undergraduate and graduate students were studied. Students educated and working at psychiatric hospitals were compared to those on college campuses and in the community. The relationship of these attitudes to both affective and career commitment was examined. A cross-sectional design examining student attitudes at different intervals in their academic career was employed. Among undergraduate students, the number of PsyR credits earned was positively correlated with the development of the PsyR attitudes (r = .51). This was true for both hospital and community based students. The largest growth in PsyR beliefs and practices was apparent after completion of clinical field placements. PsyR attitudes were also positively correlated with affective or emotional commitment to the field. A similar relationship between PsyR attitudes and affective and career commitment was found for graduate students. The number of graduate credits earned, however, was not associated with the development of PsyR attitudes, perhaps due to a ceiling effect.

A study of the perceived barriers to the implementation of circles of support.

OBJECTIVE The purpose of this study was to identity barriers to implementing the social support intervention, Circle of Support, in supported employment (SE) services for people with psychiatric disabilities. METHOD Semi-structured interviews were administered to SE staff at three month intervals up to one year. Two focus groups were held with service recipients who did not participate in a circle of support. Interviews were conducted with two individuals receiving SE services who participated in a pilot project in which study researchers implemented circles of support. RESULTS Common themes regarding the barriers to implementing a circle of support developed from the data. Service recipients who did not participate in a circle of support and those who did expressed the perceived and actual barriers to this approach as being: time, too much focus on the participant, and lack of control/facilitation of circle activities. Service recipients who participated in a pilot who had circles of support reported that this intervention was beneficial to them. Staff and service recipients identified time, running of the actual circle of support meetings, and supporter issues as barriers to implementing this technique. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Although certain barriers to this technique were identified, there were features of this approach that both staff and service recipients, who had a circle of support, found beneficial. Since ongoing support is a critical component of successful employment, individuals may benefit from the use of these Circles of Support techniques.

Evaluation of a cognitive remediation intervention for college students with psychiatric conditions

Objective: Given the poor educational outcomes associated with psychiatric conditions, we developed Focused Academic Strength Training (FAST), a 12-week strategy-focused cognitive remediation intervention designed to improve academic functioning among college students with psychiatric conditions. Here we report initial results from a randomized controlled trial of FAST. Method: Seventy-two college students with mood, anxiety, and/or psychotic disorders were randomized to receive FAST or services as usual and were assessed at baseline and 4 months (posttreatment). Results: Repeated-measures analyses of variance indicated FAST-associated improvements in self-reported cognitive strategy use (p < .001), self-efficacy (p = .001), and academic difficulties (p = .025). There were no significant treatment-related improvements in neuropsychological performance. Conclusions and Implications for Practice: FAST may lead to an increase in self-efficacy and cognitive strategy use, as well as a reduction in academic difficulties among students with psychiatric conditions. Future analyses with follow-up data through 12 months will address the potential of FAST to improve academic functioning among this population.

Jail Diversion for Persons with Serious Mental Illness Coordinated by a Prosecutor’s Office

Persons with serious mental illnesses (SMI) are involved in the criminal justice system at a disproportionately higher rate than the general population. While the exact causes remain unclear, it is accepted that a comprehensive strategy including mental health treatment is needed to reduce recidivism. This paper describes a unique jail diversion program coordinated by a county prosecutors office in which individuals were diverted towards mental health services including case management, community-based services, and housing supports. Outcomes were studied over a five-year period, beyond the typical 12- to 24-month follow-up in other studies. Individuals who completed the program, compared to those who did not complete it, were at lower risk for being rearrested, arrested fewer times, and incarcerated fewer days. Gains were moderated by previous criminal justice involvement and substance use but, nevertheless, were maintained despite severity of history. The strongest gains were seen while the individual was still actively enrolled in the diversion services and these outcomes were maintained for up to four years. These findings suggest that completion of a jail diversion program facilitated by a prosecutors office can lower recidivism and days incarcerated. Further research is needed to assess the unique contribution of prosecutor office facilitation.