Psychiatric Rehabilitation Journal最新文献

{"title":"Prevalence of chronic physical conditions and physical multimorbidity among young adults with serious mental health conditions.","authors":"Jessica A Jonikas, Frances Aranda, Jane K Burke-Miller, Kathryn Sabella, Michelle G Mullen, Maryann Davis, Judith A Cook","doi":"10.1037/prj0000637","DOIUrl":"https://doi.org/10.1037/prj0000637","url":null,"abstract":"<p><strong>Objective: </strong>There is minimal research on the prevalence of chronic medical conditions among young adults with mental health conditions. This exploratory study assessed the prevalence and number of chronic medical conditions and their association with mental health status.</p><p><strong>Methods: </strong>A cross-sectional, online survey was completed in March-June 2021, by 967 U.S. young adults (age 18-25 years) with self-identified serious mental health conditions, recruited nationally via social media, email, and websites. Medical conditions were assessed using items from the National Health Interview Survey and National Health and Nutrition Examination Survey; mental health was assessed with the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scales. Multivariable regression analysis examined associations between mental health and the six most prevalent medical conditions, as well as the number of conditions, controlling for background characteristics.</p><p><strong>Results: </strong>We found notable prevalence of obesity (18.5%), migraines (18.2%), allergies (14.8%), asthma (9.2%), and gastrointestinal disorders (9.2%). Controlling for all other factors, high levels of anxiety were associated with greater likelihood of obesity and gastrointestinal disorders, while high levels of depression were associated with lower likelihood of obesity. While 23.2% reported two or more medical conditions, anxiety but not depressive symptoms was associated with a greater number of co-occurring medical conditions.</p><p><strong>Conclusions and implications for practice: </strong>A notable prevalence of chronic conditions puts young adults with mental health conditions at significant risk of adverse physical health outcomes from a young age. Results can inform the design of tailored health promotion and self-management programs to improve outcomes among this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using exit surveys to elicit turnover reasons among behavioral health employees for organizational interventions.","authors":"Sadaaki Fukui, Jennifer Garabrant, Jaime Greenfield, Michelle P Salyers, Gary Morse, Emily Bass","doi":"10.1037/prj0000638","DOIUrl":"https://doi.org/10.1037/prj0000638","url":null,"abstract":"<p><strong>Objective: </strong>The present study explored turnover reasons via exit surveys for organizational interventions.</p><p><strong>Methods: </strong>The exit surveys were conducted at a community behavioral health organization for over a year, and the open-ended question responses on turnover reasons were analyzed.</p><p><strong>Results: </strong>Thirty-five exit surveys were returned (58% response rate). Five major turnover themes were identified: struggles in current job roles, negative experiences with upper management and senior colleagues, quality of care concerns, no foreseeable future, and personal/family reasons.</p><p><strong>Conclusions and implications for practice: </strong>Exit surveys are a useful approach to identify turnover reasons for organizational interventions. The findings provide insights into contextualized strategies for retaining the behavioral health workforce. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retaining peers in the behavioral health workforce: Factors associated with peer recovery support specialists intent to remain or leave current position.","authors":"Brianna Lombardi, Danya K Krueger, Maria G Gaiser, Nelson Spence","doi":"10.1037/prj0000633","DOIUrl":"https://doi.org/10.1037/prj0000633","url":null,"abstract":"<p><strong>Objective: </strong>Peer recovery support specialists (PRSS) are essential members of the behavioral health workforce. While factors contributing to PRSS job satisfaction and burnout have been examined, less is understood about why PRSS consider leaving or remaining in their roles. This study sought to identify personal, professional, and organizational factors related to PRSS' intentions to leave their current position.</p><p><strong>Method: </strong>A convenience sample of PRSS was recruited from a partnering organization's national listserv and digital newsletter. In collaboration with the same organization, we developed a survey using adaptations of validated instruments and electronically distributed it in June 2023. Bivariate analysis and hierarchical logistic regression were conducted to understand which factors may predict PRSS' intent to leave their current position.</p><p><strong>Results: </strong>The total sample included 454 PRSS, with 42% considering leaving their current position, of which 44% reported intent to leave within the next year. The ability to meet financial needs (<i>OR</i> = 0.58, 95% CI [0.38, 0.90]), having to complete extra tasks outside of PRSS responsibilities (<i>OR</i> = 2.91, 95% CI [1.90, 4.44]), overall job satisfaction (<i>OR</i> = 0.46, 95% CI [0.25, 0.84]), and burnout (<i>OR</i> = 1.54, 95% CI [1.00, 2.36]) significantly predicted intent to leave.</p><p><strong>Conclusions and implications for practice: </strong>PRSS reported high job satisfaction; however, burnout experiences, inability to meet financial needs, and extra work tasks beyond their role significantly impacted intent to leave. Findings underscore the need for organizational and policy-level changes to address burnout, low pay, and workload issues to better support PRSS' well-being and retain this essential behavioral health workforce. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation in individual placement support: Ethnoracial differences in the supported employment demonstration.","authors":"Justin D Metcalfe, Gary R Bond, Robert E Drake","doi":"10.1037/prj0000631","DOIUrl":"https://doi.org/10.1037/prj0000631","url":null,"abstract":"<p><strong>Objective: </strong>The Supported Employment Demonstration (SED), a large, multisite randomized controlled trial, provided evidence-based supported employment to help individuals recently denied Social Security disability benefits for reason of mental illness to gain competitive employment and avoid disability. Monthly, client-level measurement of participation in individual placement and support permitted the first detailed exploration of potential ethnoracial disparities in the IPS participation process, from enrollment to end of follow-along job supports, in a vulnerable population with ready access to the intervention.</p><p><strong>Method: </strong>Monthly participation data in a subsample of enrollees randomized to receive supported employment enabled decomposition of IPS service participation into take-up, effectiveness, and follow-along support phases, yielding times to participation duration milestones, job start, and end of follow-along supports for 614 non-Hispanic White, non-Hispanic Black, and Hispanic SED enrollees. Cox proportional hazards models provided differences in the monthly hazard of each event by race and ethnicity.</p><p><strong>Results: </strong>Black non-Hispanics (hazard ratio [HR] = 1.50) and Hispanics (HR = 1.52) were both more likely than White non-Hispanics to complete consecutive 3-month periods of supported employment participation. However, ethnoracial group was not significantly associated with either increased effectiveness, measured as the monthly likelihood of finding a job during IPS participation, or likelihood of ending follow-along job supports.</p><p><strong>Conclusions and implications for practice: </strong>Potential clients' race and ethnicity are associated with a differential willingness to engage IPS services. For this reason, ethnoracial differences in IPS penetration may persist even when structural barriers to IPS access are removed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-scale implementation of a brief treatment program for PTSD in persons with serious mental illness in a mental health agency: The Brief, Relaxation, Education and Trauma Healing (BREATHE) program.","authors":"Kim T Mueser, Kristin E Davis, Jane K Burke-Miller, Stephanie Marcello, Jennifer D Gottlieb, Virginia Fraser, Lisa A Razzano","doi":"10.1037/prj0000632","DOIUrl":"https://doi.org/10.1037/prj0000632","url":null,"abstract":"<p><strong>Objective: </strong>We examined the feasibility and clinical outcomes of implementing a brief intervention for treating posttraumatic stress disorder (PTSD) in persons with serious mental illness receiving services at a large, urban community mental health agency. The Brief, Relaxation, Education and Trauma Healing (BREATHE) program is a standardized, three-session intervention that targets PTSD symptoms through teaching breathing retraining and personalized psychoeducation about trauma and PTSD.</p><p><strong>Method: </strong>A total of 60 clinicians were trained in the BREATHE intervention throughout the agency, which was offered to 233 clients who screened positive for probable PTSD. Self-report assessments of PTSD and depressive symptom severity were obtained before the first session, after the third session, and at a 3-month follow-up. Participant satisfaction was assessed in a brief survey.</p><p><strong>Results: </strong>Of the 233 clients offered the BREATHE program, 211 (91%) accepted and attended at least one session. Most participants attended all three BREATHE sessions (59%) or two sessions (32%), with completers reporting high levels of satisfaction with the program. Participants showed clinically significant improvements in PTSD and depression symptoms from pretreatment to posttreatment and the 3-month follow-up.</p><p><strong>Conclusions and implications for practice: </strong>This brief intervention for PTSD was feasible to implement in a large agency serving a diverse population of persons with serious mental illness, showed high client acceptability in terms of participation and satisfaction, and was associated with significant reductions in PTSD and depressive symptoms. Further research is needed to evaluate the impact of the BREATHE program for treating PTSD in this population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"My child's medication journey: A parent's view.","authors":"Orly Yaniv-Harari","doi":"10.1037/prj0000618","DOIUrl":"10.1037/prj0000618","url":null,"abstract":"<p><p>This article discusses the personal experiences of the parents regarding their child's medication journey. Parents can play a vital role in their child's overall mental well-being, ensuring they receive the care and support they need. To navigate these difficult circumstances, it is crucial for parents to maintain open lines of communication with their child as well as with the health care professionals involved in their care. Professionals should be aware that parents' perspectives toward mental health medication can evolve over time, influenced by the experiences and challenges faced by both child and family. Excluding parents from their child's treatment limits the potential for a comprehensive and holistic treatment approach. By recognizing the value of parental input, health care professionals can create a collaborative environment that maximizes the chances of finding the most suitable treatment strategy. It is important for health care professionals to engage families in a respectful and empathetic manner, recognizing the challenges they face. Providing them with the necessary support and guidance can help reduce feelings of helplessness and ensure their active involvement in their child's mental health journey (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"342-344"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"All paths do not lead to Rome or adherence: Innovative antipsychotic prescribing in partnership with people in recovery as they define.","authors":"Dale Sebastian, Erika R Carr","doi":"10.1037/prj0000623","DOIUrl":"10.1037/prj0000623","url":null,"abstract":"<p><strong>Objective: </strong>Though the psychiatric field has primarily focused on medication and symptom amelioration via medication \"adherence,\" contemporary approaches that incorporate recovery-oriented care and shared decision-making (SDM) could provide a more holistic and effective approach to serving individuals experiencing psychosis. This article explores the implementation of such innovative and collaborative practices while highlighting their benefits and challenges. Furthermore, it aims to offer practical implementations of SDM in prescribing practices.</p><p><strong>Method: </strong>This article presents innovative strategies for prescribing antipsychotics utilizing SDM and recovery-oriented care approaches for those who experience psychosis. The study explores the clinical applications of these approaches within an inpatient psychiatric setting.</p><p><strong>Results: </strong>The article emphasizes the numerous challenges for those who experience psychosis in adhering to antipsychotic medication and proposes a recovery-oriented approach facilitated by SDM. It emphasizes the importance of therapeutic alliance and collaboration while providing practical clinical applications of this approach.</p><p><strong>Conclusions and implications for practice: </strong>The article advocates for collaborative approaches in antipsychotic prescribing, such as SDM and recovery-oriented care, to support those experiencing psychosis in constructing a life of meaning as they define it, including in how they choose to take medications. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"303-312"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stories that trap us and stories that save us.","authors":"Helene Speyer","doi":"10.1037/prj0000609","DOIUrl":"10.1037/prj0000609","url":null,"abstract":"<p><p>The prevalence of the medical model in the field of mental health care has undoubtedly contributed to significant scientific progress. However, it is important to recognize that it may not represent the sole perspective for comprehending mental distress. Rather than endorsing particular paradigms, I advocate for a pluralistic approach that empowers individuals to discover their unique narratives, the stories that may save them. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"345-347"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring momentary subjective well-being and psychotic experiences during antipsychotic dose reduction: Two single-case time series experience sampling method pilot study.","authors":"Priscilla P Oomen, Claudia J P Simons, Kim Broekmans-Madikrama, Machteld Marcelis","doi":"10.1037/prj0000621","DOIUrl":"10.1037/prj0000621","url":null,"abstract":"<p><strong>Objective: </strong>Personalized dose optimization is desirable to improve subjective well-being and support rehabilitation. Therefore, <i>N</i> = 1 trials investigating tools to self-manage functional outcomes during dose optimization are necessary. The aim of this pilot study was to determine in two <i>N</i> = 1 trials whether an experience sampling method (ESM) smartphone app could be used to monitor and detect changes in subjective well-being and psychotic experiences during and after dose reduction.</p><p><strong>Method: </strong>Two participants with a psychotic disorder in remission underwent gradual dose reduction under a longitudinal self-monitoring paradigm, accompanied by regular clinical monitoring by the attending physician. Subjective well-being was monitored with an (ESM) app through momentary affective experience (positive and negative affect) and physical well-being (tiredness, feeling unwell, and pain). Momentary psychotic experiences were assessed with four items. Time-series linear regression models were used to detect changes in reduction phases compared to baseline.</p><p><strong>Results: </strong>Whereas significant improvements in subjective well-being and psychotic experiences during dose reduction were detected in one participant, the opposite was demonstrated for the other participant, showing worsened subjective well-being and increased psychotic experiences in the reduction phase compared to baseline.</p><p><strong>Conclusions and implications for practice: </strong>Self-monitoring with an ESM smartphone app offers a tool for detecting changes in subjective well-being and psychotic experiences during antipsychotic dose reduction. In this way, ESM may increase an individual's sense of control and empowerment. It may further facilitate dose optimization and shared decision-making at an individual level, which is required considering the high heterogeneity in psychotic disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"329-338"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An ethics analysis of antipsychotic dose reduction and discontinuation: Principles for supporting recovery from psychosis.","authors":"Kelly Allott, Allie Pert, Audrey Rattray, Ruth E Cooper, Josefine Winther Davy, Lisa Grünwald, Mark Horowitz, Joanna Moncrieff, Bram-Sieben Rosema, Magenta Simmons, Alexandra Stainton, Anne Emilie Stürup, Eóin Killackey","doi":"10.1037/prj0000599","DOIUrl":"10.1037/prj0000599","url":null,"abstract":"<p><strong>Objective: </strong>To examine the evidence and practice of antipsychotic dose reduction from the lens of biomedical ethics (specifically principlism) to support evidence-based practice and patient choice and self-determination.</p><p><strong>Methods: </strong>An overview of the evidence from randomized controlled trials of antipsychotic dose reduction versus maintenance is presented. This is followed by a theoretical examination of the four key biomedical ethical principles of autonomy, nonmaleficence, beneficence, and justice and how they apply in the case of antipsychotic dose reduction.</p><p><strong>Results: </strong>Existing clinical trial research is dominated by relapse as the primary outcome, with dose reduction associated with a higher risk of relapse than maintenance. Few studies have measured other patient-centered outcomes but have shown preliminary evidence for superior cognitive functioning, lower negative symptoms, and better functioning following dose reduction. Respect for autonomy is a cornerstone of psychiatric rehabilitation, and this includes the right of people to choose to reduce or discontinue antipsychotic medication. Reduced capacity for treatment decision making can be supported. Autonomy and appraisal of nonmaleficence and beneficence associated with dose reduction can be facilitated through shared or supported decision making. Clinicians should continue to strive for justice through the fair allocation of resources to support all people who request antipsychotic dose reduction.</p><p><strong>Conclusions and implications for practice: </strong>Clinicians have a responsibility to balance the four core ethical principles to the best of their ability when supporting a person in their recovery journey. Exploring, trialing, and supporting antipsychotic dose reduction may be part of this process if that is the patient's choice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"291-302"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}