ABSTRACT
This longitudinal study examined differences in intervention outcomes based on readiness-to-change cluster profiles among 73 adults with a mental illness at risk for homelessness participating in a manualized life skills intervention. Intervention topics included money management, food management, safe community participation, and room- and self-care. Life skill knowledge and readiness-to-change, measured using the University of Rhode Island Change Assessment, was examined at baseline, post-intervention, and 3-6 months later. Two scoring patterns emerged for readiness-to-change at each time point: Pre-Engaged and Engaged. Participants who were Engaged at the time of assessment scored significantly better than Pre-Engaged on post-intervention life skill testing, however group identification changed over time. Baseline readiness-to-change did not predict future performance or attrition, and therefore may not provide accurate indication of client investment for future learning or participation. Further investigation is needed to determine what factors contribute to Engaged membership.
Subject(s)
Ill-Housed Persons , Mental Disorders/rehabilitation , Motivation , Patient Acceptance of Health Care , Social Adjustment , Activities of Daily Living , Adaptation, Psychological , Adult , Cluster Analysis , Female , Humans , Longitudinal Studies , Male , Middle Aged , Midwestern United States , Motivational Interviewing , Outcome Assessment, Health Care , Risk Factors , Self Care , Self Efficacy , Young AdultABSTRACT
OBJECTIVE: We investigated the effectiveness of a life skills intervention for people with mental illness who have been homeless. METHOD: In this longitudinal outcomes study, we used Situated Learning Theory (Lave & Wenger, 1991) to provide group and individual sessions to 38 participants from two housing programs after completing baseline Allen Cognitive Level Screen-2000 (ACLS-2000; Allen Conferences, 2000) and Practical Skills Tests (PSTs). Data were analyzed using linear mixed-effects regression models. RESULTS: The PST scores of participants with higher ACLS-2000 scores significantly increased over time (food management, p = .021; money management, p = .039; safe community participation, p = .02). Participants with lower ACLS-2000 scores demonstrated an even greater change over time. CONCLUSION: Most participants, including those with lower ACLS-2000 scores, improved and retained life skills knowledge over time, challenging the premise that people with mental illness should be excluded from mixed-level group interventions.
Subject(s)
Activities of Daily Living , Community Mental Health Services/methods , Ill-Housed Persons/psychology , Mental Disorders/rehabilitation , Occupational Therapy/methods , Adaptation, Psychological , Cognition , Educational Status , Humans , Interview, Psychological , Life Style , Linear Models , Longitudinal Studies , Midwestern United States , Public Housing , Risk Factors , Treatment OutcomeABSTRACT
SUMMARY This paper presents three exploratory studies of life skills interventions (employment, money management or food/nutrition) with 73 homeless individuals from four shelters and supportive housing programs located in the urban Midwest for youth, victims of domestic violence and adults with mental illness. The Ansell Casey Life Skills Assessment was administered prior to the eight group and individual sessions. Quizzes and posttests indicated clinical change in all groups, with statistical significance in the domestic violence group. The intervention implementation, challenges encountered, and strategies developed for implementing shelter-based interventions are discussed. Recommendations for successfully providing collaborative university-shelter clinical interventions are provided.
