PSYCHIATRIC REHABILITATION JOURNAL

Harms of a single story: A researcher's personal narrative and plea for change
Anonymous
A brief autoethnographic commentary that describes the harms of a pervasive emphasis on medications and medication adherence in the treatment of schizophrenia, including within "best practice" early psychosis programs. The narrative emphasizes the extent to which, in spite of endless rhetoric of person-centered, recovery-oriented care, the reality remains that medication-centric treatment tends to dominate clinical services and programs, fueling the objectification and alienation of service users, and ultimately, in all too many cases, disengagement. The author's personal experiences are provided as an illustration of the potentially devastating impacts that a narrow and rigid focus on medications (and medicalized clinical relationships) can have. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
The growth and diversity of the evidence base for the clubhouse model
McKay CE
The Clubhouse Model is a long-standing form of psychosocial rehabilitation that has been in existence for over 75 years. Today, over 350 Clubhouse programs in 33 countries affiliate with Clubhouse International and operate as nonclinical community-based recovery centers for adults and young adults living with mental illness. Clubhouses provide a strengths-based approach to recovery and offer participants, referred to as members, a variety of supports and services including assistance with obtaining and maintaining community-based employment, education, housing, social integration, outreach and advocacy, wellness and health promotion activities, and linkages to medical and psychiatric services. There is evidence and support for the Clubhouse Model in improving quality of life and social functioning, reducing hospitalization(s) and/or psychiatric symptoms, and promoting employment. This special issue has nine articles that highlight ongoing research collaborations from across the globe that examine the impact of the Clubhouse Model on a variety of novel outcomes. While more research is needed, the articles in this special issue reflect the growth and diversity of the evidence base for the Clubhouse Model. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Expanding community-based participatory action research practices to clubhouses through sustainable research activities
Rice K, Hand R, Diop B, Mejia A, Mahoney O and Seidman J
There is growing utilization and acknowledgement of the benefits of community-based participatory action research (CBPAR) in advancing health practices and equity. However, the sustainability and full impact of CBPAR in health care settings faces many obstacles and limitations. The present article examines the synergies between CBPAR and Clubhouse programs, presents the demonstration and ongoing implementation of sustainable CBPAR practices at Fountain House in New York City, and offers lessons learned for other Clubhouses and similar programs seeking to integrate CBPAR.
Consent to voluntary antipsychotic drug treatment-Is it free and informed?
Yonatan-Leus R and Karako-Eyal N
The present research investigates the dynamics of consent in the context of antipsychotic drug therapy, with a particular emphasis on the essential attributes that constitute free and informed consent within medical treatment scenarios.
The method and application of social practice in the clubhouse
Pernice F, Hinchey LM, Rice K, Michon A, Drews J, Jenuwine M, Doyle A, Madison E, Kessler L, Bayer C, Napolitano C, Jedrzejczak K and Delman J
The theory of describes a therapeutic community process for people living with serious mental illness, while the methods involve engaging people to become collaborators and contributors to a social environment. Confusion in the mental health field surrounding the applied methods of social practice-as occurring within the clubhouse model-has not been sufficiently addressed. This article aims to outline the methodology of social practice, as well as provide guidance on its practical application.
Clubhouse virtual programming: A trend analysis of member engagement patterns before, during, and after pandemic lockdown
Rice K, Simaitis G and Pernice F
The COVID-19 pandemic had a profound impact on the mental health of individuals with serious mental illness, with restricting social gatherings and limiting access to essential community and psychosocial support services. For programs like clubhouses, adapting typically in-person programming to online settings led to the creation of virtual clubhouse programming that persists at many sites even after reopening. Although it has been documented how clubhouses adapted their programming online, it has not been investigated at the individual level how those programs were utilized over time, by different member cohorts, and how they persist in comparison to one another.
Ideals of joint decision making in clubhouse communities
Mäntysaari K, Stevanovic M, Weiste E, Paananen J and Lindholm C
This article explores the ideological dilemmas of decision making identified in members' and staff's talk in Clubhouse communities.
Creative virtual engagement: Successes and challenges supporting people with serious mental illness in hybrid Clubhouse environments
Agner J, Nakamura L, Kaukau TM, Liu M, Botero A, Churchill H, Teranishi D, Patton F, Cogo K and Cha T
This study examines adaptations, successes, and persistent challenges engaging members in virtual or hybrid community-based psychosocial rehabilitation centers called Clubhouses.
All paths do not lead to Rome or adherence: Innovative antipsychotic prescribing in partnership with people in recovery as they define
Sebastian D and Carr ER
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.
My child's medication journey: A parent's view
Yaniv-Harari O
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).
Exploring interests: A pathway to ikigai and eudaimonic well-being among people with serious mental illness
Nagata S, Kono S, Tanaka K, Ota K, Hirasawa E and Kato D
Ikigai is a Japanese concept of a life worth living and related to eudaimonic well-being. Supporting the pursuit of is of central importance to recovery-oriented psychiatric rehabilitation for people with serious mental illnesses (SMI). While research suggests that work, leisure, and social relationships are potential sources of , people with SMI have restricted access to these as they encounter systemic barriers to participating in such activities. This study investigated how people with SMI in Japan pursued sources of in the face of barriers.
Predictors of length of time in service: Characteristics of people in intensive case management for longer than 5 years
Roebuck M, Bridger T, Magny A, Tiderington E and Aubry T
The purpose of this study was to examine the characteristics of people who stay in intensive case management (ICM) for longer than 5 years.
The liminal space of first-episode psychosis and its treatment: A qualitative study exploring the experience of young people participating in an antipsychotic dose reduction randomized controlled trial
Gates J, Ellinghaus C, Valentine L, Kamitsis I, Stainton A, Harrigan S, Thompson A, Alvarez-Jimenez M, Wood S, Polari A, Gleeson JF, Bartholomeusz C, Allott K, Killackey E and Bendall S
The current guidelines recommend continuation of antipsychotic medication for a minimum of at least 1 year following a first episode of psychosis (FEP). There have been several trials investigating whether early dose reduction or cessation leads to improved functional outcomes. The aim of this study was to explore the experience of consenting to and participating in a randomized controlled trial (RCT) of antipsychotic medication cessation.
An ethics analysis of antipsychotic dose reduction and discontinuation: Principles for supporting recovery from psychosis
Allott K, Pert A, Rattray A, Cooper RE, Winther Davy J, Grünwald L, Horowitz M, Moncrieff J, Rosema BS, Simmons M, Stainton A, Stürup AE, Killackey E and
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.
Substance use approaches among peer support specialists in community mental health early psychosis programs
Klodnick VV, LaPelusa B, Reznik SJ, Johnson RP, Myers NL, Lucksted A, Cohen DA and Lopez M
Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice.
Stories that trap us and stories that save us
Speyer H
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).
Monitoring momentary subjective well-being and psychotic experiences during antipsychotic dose reduction: Two single-case time series experience sampling method pilot study
Oomen PP, Simons CJP, Broekmans-Madikrama K and Marcelis M
Personalized dose optimization is desirable to improve subjective well-being and support rehabilitation. Therefore, = 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 = 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.
"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
Shpigelman CN, Galimidi N and Kal M
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.
"Sheltered and secure": Facilitators and barriers toward recovery for Haredi Jewish women with mental illness
Rohr E, Antebi L, Jarvis GE and Whitley R
The overall aim of this study was to elicit and document the recovery-related perspectives and experiences of Haredi Jews with lived experience of mental illness living in Canada. A more focused objective was to specifically explore self-identified facilitators and barriers toward recovery from mental illness in this group.
"I was able to share more details": The experiences of using a smartphone application to support shared decision making in young people with psychosis
Meyer A, Austin SF, Vitger T and Korsbek L
This study explores the experiences of young adults with psychosis using a smartphone application to promote patient activation and support shared decision making in their outpatient treatment.
Family-centered decision making: A culturally responsive collaborative approach among Asians living in the United States
Qin S, Corrigan P and Lee EJ
Compared to Western cultures, self-determination needs are expressed and pursued differently in Asian cultures, where interdependence and achieving greater good for the group are prioritized. To accommodate these needs, we propose the use of family-centered decision making (FCDM) to complement the shared decision-making (SDM) practice, fostering collaborative psychiatric care for Asian individuals residing in the United States.
Characterizing personal recovery in severe mental illness: French psychometric validation of the Questionnaire about the Process of Recovery (QPR-Fr)
Munuera C, Felix S, Prouteau A, Caiada M, Guionnet S, Valéry KM, Fombouchet Y, Gard S, Chevrier F, Minois I and M'bailara K
The support of the personal recovery of people with lived experience of mental illness is a major issue in clinical practice. Thus, a valid instrument to assess personal recovery is needed. The present study aimed to validate the French translation of the 22-item Questionnaire about the Process of Recovery (QPR-Fr).
Recovery-oriented care in long-term mental health settings: Relationship between the active recovery triad (ART) model, recovery-oriented care, and recovery of service users
Zomer L, Voskes Y, van Weeghel J, Widdershoven G, Twisk J and van der Meer L
The active recovery triad (ART) model provides guidelines for recovery-oriented care in long-term mental health care. The aim of this study is to evaluate whether compliance to the principles of the ART model is related to recovery-oriented care, service user recovery and satisfaction.
Collaborative approaches in psychiatric rehabilitation: Innovations in practice
Thomas EC
This special section is dedicated to collaborative approaches in psychiatric rehabilitation, which are rooted in foundational values such as service user involvement and self-determination.
Navigating the straits of deprescribing: Psychiatrist's personal account of fears and hopes
Segev A
Deprescribing is a long-overdue concept for psychiatrists and therapists, presenting potentially more sophisticated approaches to psychiatric care. This approach is fueled by both scientific pursuits and contemporary social ideologies that underscore the pivotal role of a patient's values and their freedom of choice. Indeed, deprescribing is well woven with modern liberal and progressive values. Yet, amidst the emphasis on these aspects, it is crucial not to lose sight of the "conservative" perspective within this discourse-one that emphasizes the potential consequences of failure. While constantly addressing relapse as a looming cloud may not yield benefits for patients, overlooking these potential pitfalls could tip the balance too far, resulting in unintended harm rather than good. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Awakening on antipsychotic medication: A call to action
Deegan PE, Stiles A, Rufo M and Zisman-Ilani Y
Explore a lived experience perspective on using antipsychotic medicine and call to action for psychiatric rehabilitation practitioners to get involved in preparing people diagnosed with serious mental illness (SMI) to have a voice and choice in antipsychotic medication treatment.
Finding meaning in medication
Larrauri CA
The author reflects on a decade of antipsychotic treatment, providing an intimate glimpse into living with schizophrenia. Their narrative unravels the balance of vulnerability and strength, coercion, and dialogue inherent in the acceptance of medication. Their journey from defiance to adherence showcases the profound complexities patients face and the ethical dilemmas confronting caregivers. Interactions with loved ones and mentors underscore the importance of a shared decision-making approach. The author emphasizes not just the significance of medication but the broader, holistic perspective of aligning treatment with one's life goals and values. Their story champions the power of lived experiences, aiming to inspire a more empathetic and collaborative approach to antipsychotic treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Changing vistas of psychosis and antipsychotic drug dosing toward personalized management of antipsychotics in clinical practice
Wunderink L
To discuss current evidence on tapering antipsychotic drugs in view of changing vistas of psychosis, suggesting a provisional framework for safely tapering antipsychotic drugs to an optimal low dose, in collaboration with patients and their relatives, to promote functional recovery while preventing relapse.
Supporting education with ips: Advancing a career-oriented model for integrating work and study support for young adults in sweden
Hillborg H, Lövgren V, Bejerholm U and Rosenberg D
Supported education (SEd) provides individualized support to people with mental health problems to achieve their educational goals. Individual placement and support (IPS) has emerged as a model through which SEd may be efficiently delivered. However, the components and characteristics of educational support for these employment-focused services have not been fully explored. Building on earlier studies, we constructed a preliminary model of SEd components that integrated with the IPS model. The SEd model included the eight original principles of IPS, developed to reflect the SEd component, and two new principles were suggested. The aim of the study is to investigate these adapted principles by exploring the feasibility of applying them within established IPS programs providing both employment and educational services.
Self-determination and self-efficacy as predictors of campus engagement among college students with serious mental illnesses
Thomas EC, Brusilovskiy E, O'Shea A and Salzer MS
Campus engagement, including participation in student organizations and groups, is important for both academic and health outcomes. Yet, college students with serious mental illnesses demonstrate lower levels of campus engagement compared to peers without mental illnesses. To inform psychiatric rehabilitation approaches that might enhance this outcome, the purpose of this study was to test an integrated model of self-determination and self-efficacy theories to predict campus engagement within this student population.