Psychiatric Rehabilitation (eBook)

Front cover 1
Title page 4
Copyright page 5
Table of contents 8
Foreword 14
Acknowledgments 18
Part I Understanding the Nature of Severe and Persistent Mental Illness 20
Chapter 1: The Experience of Mental Illness: An Introduction to Psychiatric Rehabilitation 22
Introduction 23
The Story of Paul 23
The Serious Mental Illnesses 28
Psychiatric Disability 29
The Stigma of Severe Mental Illness 32
Psychiatric Rehabilitation 33
Summary 45
Class Exercise 46
References 46
Chapter 2: Symptoms and Etiology of Severe and Persistent Mental Illness 50
Introduction 51
Symptoms 51
The Symptoms of Schizophrenia 52
Mood Disorders 61
Relevance to Psychiatric Rehabilitation 65
Dual Diagnosis 66
Etiology 69
The Story of Dara 72
Obsolete Etiological Theories 81
Summary 83
Class Exercise 83
References 84
Chapter 3: Course, Treatment, and Outcome of Severe and Persistent Mental Illnesses 88
Introduction 89
Course 91
Do Rehabilitation Services Matter? 97
Treatment 98
Biological (Somatic) Treatments 98
Psychosocial Treatments 112
Maria’s Story 115
Understanding Course, Treatment, and Outcome: What the Staff and Consumers Don’t Know Can Hurt Them! 116
Summary 120
Class Exercise 121
References 121
Part II Psychiatric Rehabilitation Principles and Methodology 126
Chapter 4: Goals, Values, and Guiding Principles of Psychiatric Rehabilitation 128
Introduction 129
The Concept of Recovery 130
Goals, Values, and Guiding Principles 131
Guiding Principles of Psychiatric Rehabilitation 138
Psychiatric Rehabilitation Ethics 145
The Future of Psychiatric Rehabilitation Thought and Practice 152
Summary 153
Class Exercise 153
References 154
Chapter 5: Psychiatric Rehabilitation Methods 158
Introduction 159
Consumer Choice 160
Psychiatric Rehabilitation Readiness 161
Rehabilitation Diagnosis 163
Rehabilitation Plan 166
Rehabilitation Interventions 166
The Story of Paul (Continued from Chapter 1) 166
Skill Acquisition and Development 168
Resource Development 174
Evaluating Rehabilitation Progress 175
Summary 177
Class Exercise 178
References 179
Part III Applications of Psychiatric Rehabilitation Principles and Methodology 182
Chapter 6: Psychiatric Rehabilitation Day Programming 184
Introduction 185
The Origins of Day Programming in the United States 186
The Story of Jill, Affi nity House Member 190
Partial Hospitalization 192
Milieu Therapy 194
Components of a Psychiatric Rehabilitation Day Program 195
Evaluating Psychiatric Rehabilitation Day Programs 199
State-of-the-Art Psychiatric Rehabilitation Day Programming 202
Summary 205
Class Exercise 206
References 207
Chapter 7: Assertive Community Treatment and Case Management 210
Introduction 211
The Need for Continuity of Care 212
Awareness of the Need for Care Coordination at the National Level 215
Case Management 215
Models of Case Management 218
The Story of Micky 220
Evaluating Case Management 222
The Development of Assertive Community Treatment 223
Assertive Community Treatment: An Evidence-Based Practice 228
The Future of ACT and Case Management Approaches 233
Summary 234
Class Exercise 235
References 235
Chapter 8: Dual Diagnosis: Substance Abuse and Mental Illness 238
Introduction 239
History of Dual Diagnosis Treatment 240
Fundamental Treatment Strategies in Providing Integrated Dual Disorders: Stages of Treatment 244
Stages of Change: A Case Study Applying Motivational Interviewing 246
Principles of Treatment for People with Dual Diagnoses 247
Integrated Services: An Evidence-Based Practice 249
Roger’s Story 253
Summary 257
Class Exercise 257
References 259
Chapter 9: Vocational Rehabilitation 262
Introduction 263
Barriers to Employment 264
Developing Vocational Services 269
Vocational Service Modalities 274
Supported Employment 277
Carl’s Story 279
Models of Supported Employment 283
Other Vocational Preparation Services 286
Supported Employment: An Evidence-Based Practice 287
Summary 288
Class Exercise 289
References 290
Chapter 10: Supported Education 294
Introduction 295
Benefi ts of Supported Education 295
Barriers to Education 296
History of the Supported Employment Model 299
Defi nition and Models of Supported Education 302
Jose’s Story 306
Applying Psychiatric Rehabilitation Principles to Supported Education 308
Research in Supported Education 310
Dissemination of Supported Education 314
Future Directions in Supported Education 314
Summary 317
Class Exercise 317
References 318
Chapter 11: Residential Services and Independent Living 322
Introduction 323
Barriers to Housing 323
History of Residential Services 326
Rehabilitation Treatment Facilities as Residential Providers 331
Stigma and Residential Treatment Programs 331
Emergence of the Linear Continuum Paradigm 332
The Story of Joanna: An Experience of the Linear Continuum Approach 334
Supported Housing: A New Approach to Residential Services 337
The Independent Living Movement 342
Housing First 345
Summary 349
Class Exercise 349
References 350
Chapter 12: Self-Help and Peer-Delivered Services 354
Introduction 355
Defi ning Self-Help and Peer Support 355
History of the Self-Help Movement 357
Self-Advocacy and the Ex-Patient/Consumer/Survivor Movement 358
Collaboration between Consumers and Provides 361
Self-Help for Persons with Dual Diagnoses 364
Access to Self-Help 365
The Story of David 366
Beyond Self-Help: Categories of Peer-Provided Services 368
Research on the Effectiveness of Self-Help and Peer-Provided Services 371
Challenges for Peer Providers 377
Supports and Professional Development 381
Other Infl uential Roles for Consumers 383
Summary 385
Class Exercises 386
References 386
Chapter 13: The Role of the Family in Psychiatric Rehabilitation 392
Introduction 393
Working with Families and Psychiatric Rehabilitation Principles 394
Kevin’s Story: A Confi dentiality Issue 400
The Burdens of Family Living for the Person with Mental Illness 405
Family Interventions 406
Family Psychoeducation: An Evidence-Based Practice 411
Other Family Psychoeducation Approaches 413
The Concept of Family Recovery 414
The Story of NAMI 415
Familial Strengths and Resilience 418
Summary 418
Class Exercise 419
References 420
Chapter 14: Psychiatric Rehabilitation in Hospital Settings 424
Introduction 425
Functions of State Psychiatric Hospitals 429
Stan’s Story 431
Julie’s Story 433
Challenges in the Hospital Environment 435
Psychiatric Rehabilitation Models within Hospitals 439
Case Study of a Hospital Implementing Individualized Psychiatric Rehabilitation 441
Is Hospitalization Always Necessary? 442
Summary 444
Class Exercise 445
References 445
Glossary 448
Index 456