Religion and Spirituality (R/S) are recognized components of recovery-oriented mental health serv... more Religion and Spirituality (R/S) are recognized components of recovery-oriented mental health services, but a clinically focused R/S needs assessment tool for Veterans with Serious Mental Illness (SMI) has not been developed. A questionnaire including 39 items was developed by experienced chaplains and mental health clinicians and administered to 110 participants in a recovery-oriented VA program. Altogether 40 (37%) said they would like R/S issues to be a greater part of their treatment (i.e. very or extremely). A screening tool to identify Veterans for referral to R/S focused interventions was developed based on the selection of the five items most strongly loading on the strongest factor in a factor analysis. This R/S survey of SMI adults suggests that over one-third of participants in a recovery-oriented program would like more R/S emphasis in their treatment. Factor analysis showed desire for uplifting religious/spiritual communityto be the predominant factor.
Training and Education in Professional Psychology, May 1, 2018
As professions evolve, they become increasingly specialized. Psychology is one such profession th... more As professions evolve, they become increasingly specialized. Psychology is one such profession that recognizes the need for unique knowledge and abilities for clinical practice with particular populations. There is a demonstrated need for such advanced skill in the assessment and treatment of serious mental illness (SMI) and the provision of evidence-based interventions that comprise psychosocial rehabilitation (PSR) for SMI. Postdoctoral residency is an opportunity to receive specific training in the provision of PSR services for those with SMI. However, there are few opportunities for such education and training, and there is little research on the impact of such training. This article summarizes the outcomes of a PSR/SMI psychology residency at a large, Northeastern Veterans Affairs Medical Center. Program data of residents’ self-ratings at the beginning and end of the training year suggest that the postdoctoral training program contributes to increased self-confidence both as an entry-level psychologist (7 out of 7 domains increased, p < .05), and also as a PSR practitioner (6 out of 7 domains increased, p < .05). A majority of residents from the program went on to SMI/PSR-related jobs immediately postresidency. Results demonstrate that postdoctoral psychology training can provide trainees with the confidence to work as a psychologist and PSR practitioner working with individuals with SMI.
This article presents a case series of three formerly homeless clients who were in the Housing an... more This article presents a case series of three formerly homeless clients who were in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program 20 years ago and describes their progress since. Clients were identified from a 1992 client roster at one of the original HUD-VASH sites. Clients were interviewed and their medical records were reviewed. The case studies were characterized as “sustained involvement in subsidized housing,” “successful discharge followed by re-engagement,” and “case management more important than the voucher.” These cases illustrate that, first, long-term success in supported housing has not been defined, but perhaps social integration and self-sufficiency should be a focus. Second, mental health and substance abuse treatment appear to be important in long-term client success, but when and how they should be promoted remains unclear. Last, case management services may represent a crucial and necessary form of support for clients in supported housing programs.
psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with... more psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness. the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation. a 3-month rotation in psychiatric rehabilitation significantly improved residents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents. a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.
Computer technology is used in various ways to deliver and enhance health care. It is therefore i... more Computer technology is used in various ways to deliver and enhance health care. It is therefore important to understand technology use patterns among underserved populations such as persons with serious mental illnesses who often experience inequitable care. A survey was administered to 210 veterans with serious mental illnesses attending programs at a Department of Veterans Affairs community care center, with data collected on demographics, psychiatric diagnoses, access, use, and willingness to use cell phones, smart phones, Internet-based online social networking, and computerized therapies. Descriptive and multivariable analyses were conducted to determine utilization and interest in different technologies. Although 80.4% of the respondents reported owning a cellphone, only 30.3% reported they had a computer and 13.1% reported owning a smartphone. Although 56.7% reported using the Internet and 47.6% indicated they used e-mail, 68.6% of respondents reported that they were interested in using computer programs for mental health-related problems. Older, less educated veterans, and those with alcohol use disorders were less likely to use the Internet. Veterans who were White or had PTSD diagnoses were less willing to use any computerized therapy. Lower rates of computer use, Internet, and cell phone technologies were observed among veterans with serious mental illnesses compared to general population surveys. Sociodemographic barriers likely impede access to technology among veterans with serious mental illnesses. Providing financial resources and associated education and training to veterans with serious mental illnesses could increase access to helpful technology-based interventions in a population that traditionally experiences service gaps. (PsycINFO Database Record
Religion and Spirituality (R/S) are recognized components of recovery-oriented mental health serv... more Religion and Spirituality (R/S) are recognized components of recovery-oriented mental health services, but a clinically focused R/S needs assessment tool for Veterans with Serious Mental Illness (SMI) has not been developed. A questionnaire including 39 items was developed by experienced chaplains and mental health clinicians and administered to 110 participants in a recovery-oriented VA program. Altogether 40 (37%) said they would like R/S issues to be a greater part of their treatment (i.e. very or extremely). A screening tool to identify Veterans for referral to R/S focused interventions was developed based on the selection of the five items most strongly loading on the strongest factor in a factor analysis. This R/S survey of SMI adults suggests that over one-third of participants in a recovery-oriented program would like more R/S emphasis in their treatment. Factor analysis showed desire for uplifting religious/spiritual communityto be the predominant factor.
Training and Education in Professional Psychology, May 1, 2018
As professions evolve, they become increasingly specialized. Psychology is one such profession th... more As professions evolve, they become increasingly specialized. Psychology is one such profession that recognizes the need for unique knowledge and abilities for clinical practice with particular populations. There is a demonstrated need for such advanced skill in the assessment and treatment of serious mental illness (SMI) and the provision of evidence-based interventions that comprise psychosocial rehabilitation (PSR) for SMI. Postdoctoral residency is an opportunity to receive specific training in the provision of PSR services for those with SMI. However, there are few opportunities for such education and training, and there is little research on the impact of such training. This article summarizes the outcomes of a PSR/SMI psychology residency at a large, Northeastern Veterans Affairs Medical Center. Program data of residents’ self-ratings at the beginning and end of the training year suggest that the postdoctoral training program contributes to increased self-confidence both as an entry-level psychologist (7 out of 7 domains increased, p < .05), and also as a PSR practitioner (6 out of 7 domains increased, p < .05). A majority of residents from the program went on to SMI/PSR-related jobs immediately postresidency. Results demonstrate that postdoctoral psychology training can provide trainees with the confidence to work as a psychologist and PSR practitioner working with individuals with SMI.
This article presents a case series of three formerly homeless clients who were in the Housing an... more This article presents a case series of three formerly homeless clients who were in the Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program 20 years ago and describes their progress since. Clients were identified from a 1992 client roster at one of the original HUD-VASH sites. Clients were interviewed and their medical records were reviewed. The case studies were characterized as “sustained involvement in subsidized housing,” “successful discharge followed by re-engagement,” and “case management more important than the voucher.” These cases illustrate that, first, long-term success in supported housing has not been defined, but perhaps social integration and self-sufficiency should be a focus. Second, mental health and substance abuse treatment appear to be important in long-term client success, but when and how they should be promoted remains unclear. Last, case management services may represent a crucial and necessary form of support for clients in supported housing programs.
psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with... more psychiatric rehabilitation is an evidence-based service with the goal of recovery for people with severe mental illness. Psychiatric residents should understand the services and learn the principles of psychiatric rehabilitation. This study assessed whether a 3-month rotation in a psychiatric rehabilitation center changes the competency level of second-year psychiatric residents in evidence-based treatment of severe mental illness. the study is a prospective, case-control comparison using the validated Competency Assessment Instrument (CAI), which measures 15 provider competencies critical to recovery, rehabilitation, and empowerment for people with severe mental illness, providing a score for each competency. Participants were second-year psychiatric residents attending a 3-month rotation at the Community Reintegration Program, a psychiatric rehabilitation day program. The authors administered the CAI at the beginning and the end of the residents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; 3-month rotation in order to assess change in their competency in psychiatric rehabilitation. The authors also administered the CAI to a comparison group of second-year psychiatric residents who did not rotate through the Community Reintegration Program, and therefore had no formal training in psychiatric rehabilitation. a 3-month rotation in psychiatric rehabilitation significantly improved residents&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; competency in the domains of goal functioning, client preferences, holistic approach, skills, and team value relative to nonrotating residents. a brief community psychiatry rotation in the second year of residency likely improves some skills in the treatment of people with severe mental illness. Future research should evaluate year-long electives and public psychiatry fellowships.
Computer technology is used in various ways to deliver and enhance health care. It is therefore i... more Computer technology is used in various ways to deliver and enhance health care. It is therefore important to understand technology use patterns among underserved populations such as persons with serious mental illnesses who often experience inequitable care. A survey was administered to 210 veterans with serious mental illnesses attending programs at a Department of Veterans Affairs community care center, with data collected on demographics, psychiatric diagnoses, access, use, and willingness to use cell phones, smart phones, Internet-based online social networking, and computerized therapies. Descriptive and multivariable analyses were conducted to determine utilization and interest in different technologies. Although 80.4% of the respondents reported owning a cellphone, only 30.3% reported they had a computer and 13.1% reported owning a smartphone. Although 56.7% reported using the Internet and 47.6% indicated they used e-mail, 68.6% of respondents reported that they were interested in using computer programs for mental health-related problems. Older, less educated veterans, and those with alcohol use disorders were less likely to use the Internet. Veterans who were White or had PTSD diagnoses were less willing to use any computerized therapy. Lower rates of computer use, Internet, and cell phone technologies were observed among veterans with serious mental illnesses compared to general population surveys. Sociodemographic barriers likely impede access to technology among veterans with serious mental illnesses. Providing financial resources and associated education and training to veterans with serious mental illnesses could increase access to helpful technology-based interventions in a population that traditionally experiences service gaps. (PsycINFO Database Record
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