The Boston Psychiatric rehabilitation approach – evaluation of an implementation project in Sweden

• Background: Despite the potential impact of psychiatric rehabilitation on wellbeing and health, there is a lack of research regarding the model called Psychiatric Rehabilitation Approach from Boston University. To our knowledge no empirical studies have been made regarding the model in Sweden.Aim: The aims of the present study were to investigate outcome of the intervention regarding changes in life situation, use of health care services, quality of life, health, psychosocial functioning and empowerment. Further aims were to investigate to what extent the personal rehabilitation goals were attained and clients’ experiences of the intervention.The intervention: Seven mental health services who worked according to the Boston Psychiatric Rehabilitation Approach in the county of Halland in Sweden were included. The purpose of the intervention was to support and guide the patient to formulate and achieve his/her own goals for various life areas such as work/occupation, housing, education and leisure time. All staff working in the chosen services had completed education in the methodology and supervised training in providing the different phases of the rehabilitation process.Methods: The study had a prospective longitudinal design and the data collection at baseline started in August 2007 and a 2-year follow-up data collection ended in December 2010. In total 71 patients completed the assessment at baseline and of these 49 completed the 2-year follow-up data collection. Of these 49 clients, a sample of 10 clients was participated in interviews. Statistical analysis and qualitative content analysis were used.Results: The result showed a clear indication that Boston Psychiatric Rehabilitation Approach lead to a better life situation with respect to quality of life, health, empowerment and psychosocial functioning as well decreased utilization of psychiatric care. Thirty-two of the clients (65%) considered that they largely or almost completely had achieved their goals. Clients’ experiences of the intervention was summarized in the theme “Recovery ingredients” consisting of three interweaved categories: “Relationship”, “Structure” and “Participation”.Conclusion: The clients’ subjective experience of quality of the relationship to the staff do not seem to relate to goal attainment regarding exterior life situation concerning housing situation, work situation, education, leisure time and social relationships but rather between the clients’ goal attainment and other positive results of the rehabilitation as clients’ perceived.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Keyword

Psychiatric rehabilitation

Severe mental illness

Choose–Get–Keep Model

Publication and Content Type

ref (subject category)

kon (subject category)