ABSTRACT
This article examines the adoption in Québec of the evidence-based practice, Integrated Psychological Treatment (IPT) of people with schizophrenia and the longevity of this practice within nine clinical milieus in a context of transformation of services. A team of researchers of the Centre de recherche Fernand Seguin has closely followed the implementation and the maintenance of the IPT in nine clinical milieus. More specifically, this article presents the factors that have contributed, on a five year period, to the maintenance (or not) of the IPT in these settings. It raises the important question of longevity of an approach that is specialized and specific to a clientele in contexts of transformation of services.
Subject(s)
Mental Health Services/organization & administration , Schizophrenia/therapy , Humans , Program Evaluation , QuebecABSTRACT
To assess the clinical outcomes associated with the inclusion of Integrated Psychological Treatment (IPT) standard medical therapy in nine regular clinical settings, nine clinical teams integrated the complete IPT program (six hierarchically arranged subprograms) with their respective standard medical therapies for outpatients with schizophrenia. A total of 90 patients, young adults to long-term mentally ill patients, participated in the program. Patients were evaluated using standardized instruments at four time points: (1) prior to including the IPT program, (2) after the first three IPT subprograms, (3) at the end of IPT, and (4) 3 to 4 months post-IPT. The IPT program was associated with positive results. Patients improved in terms of overall symptoms, subjective experiences, cognitive and social functioning, and quality of life. IPT is one of the most up-to-date programs to address the rehabilitation needs of persons suffering from schizophrenia. Our experience in nine clinical settings suggests that IPT can successfully be included as part of standard medical therapy in the rehabilitation of patients with schizophrenia.
Subject(s)
Cognitive Behavioral Therapy/methods , Psychotherapy, Group/methods , Schizophrenia/therapy , Adaptation, Psychological , Adolescent , Adult , Aged , Ambulatory Care , Cognitive Behavioral Therapy/organization & administration , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Ontario , Patient Care Team/organization & administration , Program Evaluation , Psychotherapy, Group/organization & administration , Quality of Life , Schizophrenia/rehabilitation , Schizophrenic Psychology , Social Adjustment , Treatment OutcomeABSTRACT
Work integration for people with mental illness is complex and difficult. For those who obtain employment, job tenure is typically brief. The purpose of this article is to identify the personal determinants of job tenure of people with severe mental illness registered in prevocational programs. Out of 105 people with mental illness who are employed during the nine month follow-up after their registration in a prevocational program, close to 50 % kept their first job. According to the job tenure indicators (first or last job obtained), the results from survival analyses show that the significant variables are related to background characteristics (financial aid), work-related characteristics (length of absence from the workplace, type of job), cognitive (executive functions), and clinical aspects (paranoid symptoms). In conclusion, the authors propose not only to assess personal variables to better understand the work integration process for people with mental illness, but also to conduct a systematic evaluation of the job site.
Subject(s)
Mental Disorders , Work , Humans , Prospective Studies , Psychological Tests , Surveys and Questionnaires , Work Capacity EvaluationABSTRACT
A prospective study of individuals with a mental illness aimed to identify significant determinants of their integration in the work force. Regression and mean comparison analysis allowed exploring an individual's most typical characteristics that could explain his or her socio-professional integration, while considering several professional integration indicators. First, results suggest that linked to work (e.g. commitment to work) and socio-demographic variables (e.g. financial support received) can predict performing a work activity and obtaining competitive employment. Second, 2 additional variables can predict autonomy in employment, which are a feeling of efficiency in looking for work and a capacity to overcome obstacles to work integration. Third, cognitive and clinical variables are associated with a delay to start work. Fourth, the number of hours worked per week is explained by the feeling of efficiency in overcoming health problems and others motivational and psychosocial variables. Finally, it is important to clearly identify the professional integration indicators in order to determine the significant predictors.
