Wilson J Brown, Jessica A Wojtalik, Zachary A Babb, Alyssa M Zampogna, Deyu Pan, Anouk L Grubaugh
{"title":"Confirmatory factor analysis of the Brief Psychiatric Rating Scale-Expanded in veterans with comorbid posttraumatic stress disorder and severe mental illness.","authors":"Wilson J Brown, Jessica A Wojtalik, Zachary A Babb, Alyssa M Zampogna, Deyu Pan, Anouk L Grubaugh","doi":"10.1037/prj0000648","DOIUrl":"https://doi.org/10.1037/prj0000648","url":null,"abstract":"<p><strong>Objective: </strong>Individuals with posttraumatic stress disorder (PTSD) and comorbid severe mental illness (SMI) are often underserved and undertreated. Empirical validation of commonly used measures of psychiatric symptoms in clinical practice, such as the Brief Psychiatric Rating Scale-Expanded (BPRS-E), is warranted in this vulnerable population. As such, this study sought to validate the factor structure and examine the psychometric properties of the BPRS-E among Veterans with comorbid PTSD and SMI.</p><p><strong>Methods: </strong>The study sample included 126 Veterans with comorbid PTSD and SMI recruited for a larger randomized controlled trial. Confirmatory factor analysis was conducted to compare the fit of five potential factor structures. Construct validity was evaluated using Pearson correlation coefficients.</p><p><strong>Results: </strong>Confirmatory factor analysis revealed that the four-factor model with 12 core items and the five-factor model with 15 items demonstrated a satisfactory fit. Construct validity evidence was provided for the BPRS-E total score via a moderate correlation with the Hamilton Depression Rating Scale, as well as weak but significant correlations with the Beck Depression Inventory and Clinician-Administered PTSD Scale.</p><p><strong>Conclusions and implications for practice: </strong>This study is the first to examine the factor structure of the BPRS-E for individuals with PTSD and SMI. Our results support the BPRS-E as a reliable and valid assessment of psychiatric symptoms in 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":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041101","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}
Logane Dupont, Delphine Raucher-Chéné, Novembre Mercier, Gabriel Demers, Michelle Wang, Philippe Beauchamp, Martin Lepage, Elisabeth Thibaudeau
{"title":"Digital travel using virtual reality in inpatient psychiatric care: Focus group exploration of perspectives from individuals with lived experience.","authors":"Logane Dupont, Delphine Raucher-Chéné, Novembre Mercier, Gabriel Demers, Michelle Wang, Philippe Beauchamp, Martin Lepage, Elisabeth Thibaudeau","doi":"10.1037/prj0000646","DOIUrl":"https://doi.org/10.1037/prj0000646","url":null,"abstract":"<p><strong>Objective: </strong>Hospitalization in psychiatry is a challenging experience associated with increased levels of distress, anxiety, and loneliness. Novel technologies are being developed to help alleviate these symptoms and support the treatment and rehabilitation of these individuals. This study aims to explore the perspectives of individuals with lived experience of a complex mood disorder on the proposal of an immersive virtual reality (VR) travel-in-nature application with a social feature being an available service in a psychiatric inpatient unit.</p><p><strong>Methods: </strong>A thematic analysis was performed with data acquired from two focus group semistructured interviews conducted by a patient partner with individuals currently hospitalized in a short-term inpatient unit dedicated to complex mood disorders.</p><p><strong>Results: </strong>Three themes were generated from the thematic analysis: (a) factors enhancing acceptability, (b) barriers, and (c) envisioning the future of the application and VR in inpatient mental health.</p><p><strong>Conclusions: </strong>Participants were largely positive regarding the potential of the application and VR in psychiatric inpatient care. They viewed it as a promising rehabilitation tool for relaxation and positive escapism. Concerns regarding suitability, potential risks associated with the technology, and technical barriers were raised and warrant further investigation.</p><p><strong>Implications for practice: </strong>This study's preliminary findings offer relevant information for designing the implementation process of VR in psychiatric inpatient units, with the intent of tailoring services to the needs and realities of their intended users. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024972","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}
Mary Stone, Liam McGlynn, Kiana Pathirana, Noah Brown, Amy Baric, Anna Sifneos, Rachel Mondora, Anna Dolidze
{"title":"Three perspectives on a clubhouse startup: Members, staff, and community partners.","authors":"Mary Stone, Liam McGlynn, Kiana Pathirana, Noah Brown, Amy Baric, Anna Sifneos, Rachel Mondora, Anna Dolidze","doi":"10.1037/prj0000643","DOIUrl":"https://doi.org/10.1037/prj0000643","url":null,"abstract":"<p><strong>Objective: </strong>Clubhouses are nonclinical community-based recovery programs for adults with serious mental illness. This case study investigated the perceived impact and value of a Clubhouse startup from the perspectives of its inaugural members and staff, and potential referral sources.</p><p><strong>Methods: </strong>Participatory mixed-methods research practices were used to engage Clubhouse members and staff as partners in all stages of the research process. A convergent parallel design integrated quantitative and qualitative data from three groups of participants: Clubhouse members, Clubhouse staff, and community referral sources. Redacted records for the first 43 members were used to gather demographic information and identify the functional needs of the startup's initial members. Three participatory exercises were conducted to gather and analyze qualitative data with Clubhouse members (<i>n</i> = 12) and staff (<i>n</i> = 2). Potential community referral sources completed anonymous online surveys (<i>n</i> = 41) or participated in an interview (<i>n</i> = 3).</p><p><strong>Results: </strong>Quantitative and qualitative findings from members and staff support previous literature regarding the functional (housing and employment) and psychosocial needs (community, structure, growth, identity, and reactions to stigma) of Clubhouse members and are the first to report them in the context of a Clubhouse startup. Quantitative and qualitative findings from community referral sources suggest that the startup's initial outreach efforts with their local network of providers that serve adults with serious mental illness have yielded a positive and generally accurate impression of the startup's value.</p><p><strong>Conclusions and implications for practice: </strong>Implications of findings for Clubhouse practice and research are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016046","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":"A shared commitment to recovery for persons with psychiatric disabilities.","authors":"Kristen M Abraham","doi":"10.1037/prj0000641","DOIUrl":"10.1037/prj0000641","url":null,"abstract":"<p><p>Although a number of established practices are known to promote good outcomes for persons with psychiatric disabilities, significant challenges remain. As scholars and practitioners, we must work to ensure that psychiatric rehabilitative services are culturally relevant, accessible to the people who need them, and reflective of the needs and lived experiences of persons with psychiatric disabilities in today's context. Facilitating access to culturally relevant services involves conducting foundational research on the effectiveness and efficacy of established practices in diverse samples; tailoring existing services and developing new services to better meet the needs of diverse populations; and delivering such services in a manner that reduces health care disparities. Promoting service accessibility entails putting research findings into practice; ensuring that a trained workforce is available to provide services; and aligning policies and funding. Enhancing the relevance and impact of psychiatric rehabilitation services requires incorporating the perspectives of persons with lived experience across all phases of research and program delivery. The author's goal is for the research published in <i>Psychiatric Rehabilitation Journal</i> (<i>PRJ)</i> to address these critical issues. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":"48 1","pages":"1-2"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671470","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}
Matthew Turissini, Angela L Rollins, Allan Kimaina, Florence Jaguga, Julius Barasa, Lily Okeyo, Mercy Kimaiyo, Richard Matundura, Gilliane Kosgei, Naomi Kipkorir, Neal Patel, Edith Kamaru Kwobah
{"title":"Evaluating changes in recovery in people living with severe and persistent mental illness after psychiatric rehabilitation services at Moi Teaching and Referral Hospital, Eldoret, Kenya.","authors":"Matthew Turissini, Angela L Rollins, Allan Kimaina, Florence Jaguga, Julius Barasa, Lily Okeyo, Mercy Kimaiyo, Richard Matundura, Gilliane Kosgei, Naomi Kipkorir, Neal Patel, Edith Kamaru Kwobah","doi":"10.1037/prj0000634","DOIUrl":"10.1037/prj0000634","url":null,"abstract":"<p><strong>Objective: </strong>People living with severe and persistent mental illness (SPMI) in Kenya lack access to recovery-based services. In this study, we assessed changes in recovery in people living with SPMI in Kenya 6 months after receiving services at the Moi Teaching and Referral Hospital Nawiri Recovery and Skills Centre (Nawiri).</p><p><strong>Methods: </strong>A retrospective evaluation was conducted using a pretest/posttest design analyzing Nawiri care program data collected on admission and 6 months after discharge for recovery metrics.</p><p><strong>Results: </strong>Thirty patients, with an average age of 33 years and of whom 57% are female, met criteria for the study, with the most common mental diagnoses being schizophrenia (60%) and bipolar mood disorder (30%); 76% of participants met the definition of extreme poverty and had a median of two psychiatric admissions in the 12 months before admission. Patients improved significantly on recovery outcomes 6 months after receiving care at Nawiri, including decreased psychiatric hospitalizations (from 1.33 to 0.07), improved rates of independence in life skills (75.9%-96.7%), improved engagement in income generating activities (23.3%-63.3%), improved food security (69.0%-96.7%), decreased days of functional impairment from symptoms (3.7 to 1.7 days in past week), decreased substance use (53.3%-13.8%), and improved engagement in outpatient mental health care (50.0%-93.3%).</p><p><strong>Conclusions and implications for practice: </strong>People living with SPMI had improved recovery 6 months after receiving residential psychiatric rehabilitation services in western Kenya. A more robust evaluation of program effectiveness and implementation is recommended to help explore generalizability and scalability to other resource limited settings. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"32-41"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819741","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}
Regina Skar-Fröding, Hanne Clausen, Torleif Ruud, Jurate Šaltyte Benth, Mina Veland, Kristin S Heiervang
{"title":"The relationship between personal recovery, clinical symptoms, and psychosocial functioning over time among service users with psychosis.","authors":"Regina Skar-Fröding, Hanne Clausen, Torleif Ruud, Jurate Šaltyte Benth, Mina Veland, Kristin S Heiervang","doi":"10.1037/prj0000635","DOIUrl":"10.1037/prj0000635","url":null,"abstract":"<p><strong>Objective: </strong>Longitudinal investigation of associations between personal and clinical recovery is important to understand how the relationship unfolds over time. This prospective study investigated associations between personal recovery and clinical symptoms, and personal recovery and psychosocial functioning, at baseline and 18-month follow-up, among service users with psychosis.</p><p><strong>Method: </strong>Data were collected from 318 service users with psychosis and their clinicians from 32 clinical sites across Norway at baseline and after 18 months. Personal recovery was measured using the Questionnaire About the Process of Recovery. Linear mixed models with random intercepts for units were estimated to test the association between personal recovery and clinical symptoms, and personal recovery and psychosocial functioning.</p><p><strong>Results: </strong>Greater severity of symptoms and lower level of functioning were associated with lower personal recovery assessed at both baseline and follow-up. Greater severity of symptoms and lower level of functioning measured at baseline predicted lower personal recovery at follow-up. In addition, personal recovery decreased over time for those with a greater severity of symptoms but increased over time for those with a high level of functioning.</p><p><strong>Conclusions and implications for practice: </strong>Overall, this study confirms the relationship between clinical recovery and personal recovery. Both clinical symptoms and level of functioning were associated with personal recovery, indicating that both aspects are important for personal recovery. These findings suggest that it might be beneficial to support both clinical and personal recovery in the treatment of people with psychosis. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"23-31"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392308","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}
Sophia Shuster, Yunlai Gui, Alessia McGowan, Matthew Cotter, Isaac J Wert, Alexandria Selloni, Shreya Vaidya, Olivia Neu, Cansu Sarac, Melanie Formica, Kate Gwyther, Marija Krcmar, Jessica Spark, Patrick McGorry, Barnaby Nelson, Shaynna N Herrera, Cheryl M Corcoran
{"title":"Psychosis and the self: How spontaneous discussions of subjective experiences compare in the clinical high-risk and first-episode psychosis populations.","authors":"Sophia Shuster, Yunlai Gui, Alessia McGowan, Matthew Cotter, Isaac J Wert, Alexandria Selloni, Shreya Vaidya, Olivia Neu, Cansu Sarac, Melanie Formica, Kate Gwyther, Marija Krcmar, Jessica Spark, Patrick McGorry, Barnaby Nelson, Shaynna N Herrera, Cheryl M Corcoran","doi":"10.1037/prj0000629","DOIUrl":"10.1037/prj0000629","url":null,"abstract":"<p><strong>Objective: </strong>Prior qualitative studies show that individuals with psychoticlike experiences express difficulties concerning their identity. However, previous work has studied individuals at clinical high risk for psychosis (CHR) and individuals with first-episode psychosis (FEP) separately. Here, we compare the experiences of individuals at CHR, individuals with FEP, and healthy individuals.</p><p><strong>Methods: </strong>Participants included 70 individuals at CHR (57% female, <i>M</i><sub>age</sub> = 19.2 ± 3.0), 50 individuals with FEP (56% female, <i>M</i><sub>age</sub> = 20.4 ± 2.9), and 70 healthy individuals (67% female, <i>M</i><sub>age</sub> = 21.1 ± 2.8). Participants completed 30-45-min open-ended interviews. Trained research staff reviewed interview transcripts and conducted an iterative thematic analysis to identify major themes.</p><p><strong>Results: </strong>Themes related to distress, social difficulties, trauma, gratitude, and communication were spontaneously described by both individuals at CHR and individuals with FEP, with individuals at CHR describing suspiciousness more than individuals with FEP (42% vs. 22%), <i>χ</i>²(1, 120) = 4.95, <i>p</i> = .03, and individuals with FEP discussing adaptive integration of mental health struggles into their identity more than individuals at CHR (56% vs. 36%), <i>χ</i>²(1, 120) = 4.87, <i>p</i> = .03. Healthy individuals endorsed future orientation more than individuals at CHR (69% vs. 49%), <i>χ</i>²(1, 140) = 5.77, <i>p</i> = .02, and individuals with FEP (69% vs. 48%) <i>χ</i>²(1, 120) = 5.14, <i>p</i> = .02. All groups endorsed essentialist beliefs: CHR (31%), FEP (43%), and healthy controls (44%).</p><p><strong>Conclusions and implications for practice: </strong>Individuals at CHR and with FEP spontaneously discuss issues related to their identities in ways that are informed and shaped by the social milieu. The bidirectional nature of these struggles reinforces a need for integrated care through psychiatric rehabilitation, with a specific focus on identity development. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"42-53"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773731","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":"The impact of life story work during peer worker training: Identity reconstruction, social connection, and recovery.","authors":"Rikke Amalie Agergaard Jensen, Signe Lehn Brand, Tine Holm, Mike Slade, Dorthe Kirkegaard Thomsen","doi":"10.1037/prj0000639","DOIUrl":"10.1037/prj0000639","url":null,"abstract":"<p><strong>Objective: </strong>Personal recovery has become a guiding vision in mental health care, and peer workers play a key role in assisting individuals on their recovery journey. As a component of training to prepare for this role, peer workers need to engage with their own life story, in order to support recovery in both them and in the service users they will assist. The purpose of the present study was to explore the impact of life story work on peer workers.</p><p><strong>Method: </strong>Fifteen individuals training to be peer workers were interviewed to explore the impact of telling and listening to life stories. Reflexive thematic analysis involving two analysts was conducted.</p><p><strong>Results: </strong>Three main themes were identified: (a) life story work as identity reconstruction, (b) social connection through life story sharing, and (c) negative impacts of engaging with life stories in peer worker training. Each theme was connected to a number of subthemes.</p><p><strong>Conclusions and implications for practice: </strong>Life story work can both facilitate personal recovery in peer workers during their training and aid them in utilizing their stories in their future peer worker roles. Training needs to prepare peer workers to deal with the future role-related challenges of life story work. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"13-22"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415837","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}
Jill R Laquidara, Katelyn Furgason, Lindsay M Banks, Sophia Saavedra, Sarah Hope Lincoln
{"title":"Perceived impacts of internalized stigma in individuals with schizophrenia and schizoaffective disorder.","authors":"Jill R Laquidara, Katelyn Furgason, Lindsay M Banks, Sophia Saavedra, Sarah Hope Lincoln","doi":"10.1037/prj0000640","DOIUrl":"10.1037/prj0000640","url":null,"abstract":"<p><strong>Objective: </strong>Internalized stigma, a stigmatized view of oneself, is a prevalent issue in individuals with schizophrenia spectrum disorders (SSDs). Past evidence has suggested that internalized stigma may contribute to lower levels of functional recovery and lower engagement with mental health treatment in this population. The present study first involved a quantitative portion to check whether the current sample aligned with the literature regarding internalized stigma's links with functional recovery and treatment engagement. Then, a qualitative analysis examined participants' perceptions of whether and how their experiences with internalized stigma are related to their functional recovery and treatment engagement.</p><p><strong>Methods: </strong>Adult participants in the United States (<i>N</i> = 29) with diagnoses of schizophrenia or schizoaffective disorder completed self-report quantitative measures of internalized stigma, treatment engagement, and functional recovery, and then, they answered open-ended written questions on their perspectives. Data were collected in the Years 2022-2023.</p><p><strong>Results: </strong>Quantitative results indicate that internalized stigma was associated with lower functional recovery and lower treatment engagement, aligning with prior findings in the literature. Qualitative analysis of written responses revealed that many but not all participants perceive internalized stigma as impacting their functioning and treatment engagement. Themes are described in detail and involve relationship issues, difficulty leaving the house, self-doubt, and decreased engagement with treatment providers.</p><p><strong>Conclusions and implications for practice: </strong>Internalized stigma is a prevalent issue with varying impacts on individuals with SSDs. This study highlights the importance of addressing internalized stigma and its consequences as a part of mental health treatment for individuals with SSDs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"3-12"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415835","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":"\"It's like a kind of chronic pain that goes with you\": Understanding the phenomenon of family burden as experienced by primary caregivers of persons with serious mental illness who refuse treatment.","authors":"Carmit-Noa Shpigelman, Netta Galimidi, Matat Kal","doi":"10.1037/prj0000613","DOIUrl":"10.1037/prj0000613","url":null,"abstract":"<p><strong>Objective: </strong>Persons who cope with serious mental illness (SMI) without immediate physical risk to themselves or others have the right to refuse to be treated. Treatment refusal has implications not only for the individual but also for the family, especially the primary caregivers. Still, less is known about the phenomenon of family burden while coping with a situation where the family member with SMI refuses treatment and lives in the community. The present study aimed to understand and describe the caregivers' lived experience of family burden in the context of treatment refusal among their relatives.</p><p><strong>Methods: </strong>Using a descriptive phenomenological qualitative approach and a semi-structured interview guide, 15 family caregivers of persons with SMI refusing to receive medicinal treatment and rehabilitation services were interviewed. Inductive thematic analysis was conducted on the interview transcripts.</p><p><strong>Results: </strong>The caregivers described a complex experience of ongoing and intense burden that had a negative impact on the family cohesion and the caregivers' well-being. Four themes related to the perceived reasons for treatment refusal, the caregivers' experience of the family burden and cohesion, and coping with this situation were identified.</p><p><strong>Conclusions and implications for practice: </strong>The findings demonstrate the unique family burden experienced by the caregivers, mainly as they are the only ones supporting the individual with SMI who refuses treatment. Practitioners should support these families throughout their coping process-from understanding the reasons for the refusal of treatment to continuous support in their daily coping by locating the control of the situation on the family level. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":47875,"journal":{"name":"Psychiatric Rehabilitation Journal","volume":" ","pages":"80-88"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634997","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}