WORK IN FAMILY AIDED ASSERTIVE COMMUNITY TREATMENT

这里提出的项目是一个试验田示范和 最近开发的一种心理健康服务模式的评估 严重精神病患者的康复，特别是那些 参与或有资格参加社区支持计划。这种方法 结合了两个最有效的心理社会的核心要素 最新发展的治疗：社区生活训练(TCL)模式 以及心理教育多家庭小组(PEMFG)方法。我们打电话给 由此产生的家庭辅助自信社区治疗的组合 (FAACT)。这些家庭群体是一种独特而强大的资源， TCL团队在职业发展和解决求职问题中的作用 留存。即将完成的试验的初步结果包括 FAACT对职业成就的主效应较大。 这个应用程序提出了一个实验设计，它将比较 FAACT的职业结果与传统职业的结果 康复(CVR)。144名失业但病情稳定的精神病患者 符合纽约州社区支持服务标准的将是 招募，匹配，随机分配到康复条件， 进行了纵向修复和评估。该项目将被实施。 在两个有密切联系的典型社区精神卫生中心 提供优质的职业康复服务。它的结果将服务于 作为纽约州重新配置其整个 成人精神健康系统，强调精神康复和 消费者和家庭的参与。 拟议项目的目标是：1.比较职业 适应，精神症状，社会功能，生活质量， 两种方法的社区保有权和服务成本；2.比较 超过18个月的累积效应；3.确定患者和家属 可能与更好的职业适应相关的特征 每种方法；以及4.通过有意义的公众进行研究- 学术联络。 研究设计包括：工作经历的分层与匹配 和诊断，随机分配，保真度导向的临床监督， 独立评分者和多变量的纵向评估 检验主效应和相互作用的统计分析技术 康复方法与职业、精神和人口统计学的关系 变量。

The project proposed here is an experimental field demonstration and evaluation of a recently developed mental health service model for the rehabilitation of severely mentally ill (SMI) patients, especially those involved in, or eligible, for Community Support Programs. This approach combines core elements of two of the most effective psychosocial treatments developed to date: the Training in Community Living (TCL) model and the psychoeducational multi-family group (PEMFG) approach. We call the resulting combination Family-Aided Assertive Community Treatment (FAACT). These family groups are a unique and powerful resource for the TCL team in job development and in solving problems of job finding and retention. Preliminary results in a nearly completed trial include a large main effect for FAACT on vocational achievement. This application proposes an experimental design which will compare vocational outcome in FAACT with that in conventional vocational rehabilitation (CVR). 144 unemployed but stabilized psychiatric patients meeting New York State Community Support Services criteria will be recruited, matched, randomly assigned to rehabilitation condition, rehabilitated and evaluated longitudinally. The project will be carried out in two typical community mental health centers which have close ties to excellent vocational rehabilitation services. Its results will serve as a guide to policy-making as New York State reconfigures its entire adult mental health system to emphasize psychiatric rehabilitation and consumer and family participation. The goals of the proposed project are to: 1. compare vocational adjustment, psychiatric symptoms, social functioning, quality of life, community tenure and costs of services in the two approaches; 2. compare cumulative effects over eighteen months; 3. identify patient and family characteristics that may be associated with better vocational adjustment in each approach; and 4. conduct the research through a meaningful Public- Academic Liaison. The research design includes: stratification and matching for work history and diagnosis, random assignment, fidelity-oriented clinical supervision, longitudinal assessments by independent raters and multivariate statistical analysis techniques to examine main effects and interactions of rehabilitation method with vocational, psychiatric and demographic variables.