WORK IN FAMILY AIDED ASSERTIVE COMMUNITY TREATMENT

从事家庭辅助自信社区治疗工作

• 批准号: 3567448
• 负责人: WILLIAM R MCFARLANE
• 金额: $ 45.39万
• 依托单位: NEW YORK STATE OFFICE OF MENTAL HEALTH
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-09-28 至 1993-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3567448
• 关键词: community mental health services; health care cost /financing; health care service evaluation; health service demonstration project; human subject; human therapy evaluation; longitudinal human study; mental disorders; occupational therapy; psychosocial rehabilitation; vocational guidance; vocational rehabilitation

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.

这里提出的项目是一个实验性的演示， 评估最近开发的心理健康服务模型 严重精神病患者的康复，尤其是那些患者 参与或符合资格的社区支持计划。 这种方法 结合了两个最有效的社会心理的核心要素 迄今为止开发的治疗方法：社区生活的培训（TCL）模型 以及心理教育多族群（PEMFG）方法。 我们打电话 由此产生的家庭辅助社区治疗 （FAACT）。 这些家庭团体是一个独特而强大的资源 TCL团队在工作发展和解决工作发现问题和 保留。 几乎完成的试验中的初步结果包括 FAACT对职业成就的主要主要影响。 该应用程序提出了一种实验设计，该设计将比较 传统职业中的职业结果 康复（CVR）。 144名失业但稳定的精神病患者 满足纽约州社区支持服务标准将是 招募，匹配，随机分配到康复条件， 修复和纵向评估。 该项目将被携带 在两个典型的社区精神卫生中心中，有紧密的联系 向优秀的职业康复服务。 它的结果将服务 作为制定政策的指南，纽约州重新配置了整个 成人心理卫生系统，以强调精神病康复和 消费者和家庭参与。 拟议项目的目标是：1。比较职业 调整，精神病症状，社会功能，生活质量， 两种方法中的社区任期和服务成本； 2。比较 18个月的累积影响； 3。确定患者和家人 可能与更好的职业调整有关的特征 在每种方法中；和4。通过有意义的公众进行研究 学术联络。 研究设计包括：分层和匹配工作历史 和诊断，随机分配，面向保真度的临床监督， 独立评估者和多元评估的纵向评估 统计分析技术以检查主要影响和相互作用 与职业，精神病和人群的康复方法 变量。