WORK IN FAMILY AIDED ASSERTIVE COMMUNITY TREATMENT

这里提出的项目是一个试验性的实地示范， 对最近开发的精神卫生服务模式的评价 严重精神病患者（SMI）的康复，特别是那些 参与或有资格参与社区支持计划。 这种方法 结合了两个最有效的社会心理学的核心要素， 社区生活培训（TCL）模式 心理教育多家庭小组（PEMFG）。 我们称 由此产生的家庭辅助自信社区治疗 （FAACT）。 这些家庭团体是一个独特的和强大的资源， TCL团队在职业发展和解决就业问题， 潴留 在一项接近完成的试验中，初步结果包括： FAACT对职业成就有较大的主效应。 本申请提出了一种实验设计， FAACT与传统职业教育的职业教育效果比较 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 招募，匹配，随机分配到康复条件， 恢复和纵向评估。 该项目将进行 在两个有密切联系的典型社区心理健康中心 优秀的职业康复服务。 其结果将有助于 作为政策制定的指南，因为纽约州重新配置其整个 成人精神卫生系统强调精神康复， 消费者和家庭参与。 该项目的目标是：1。比较职业 适应，精神症状，社会功能，生活质量， 两种方法中的社区保有权和服务成本; 2.比较 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 在每一种方法;和4.通过有意义的公共研究进行研究- 学术联络。 研究设计包括：工作经历分层与匹配 和诊断，随机分配，以能力为导向的临床监督， 独立评定者和多变量的纵向评估 统计分析技术，以检查主要影响和相互作用 康复方法与职业，精神和人口 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.