| 1. |
- Bellamy, Chyrell D., et al.
(författare)
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An analysis of groups in consumer-centered programs
- 2006
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Ingår i: American Journal of Psychiatric Rehabilitation. - : University of Nebraska Press. - 1548-7768 .- 1548-7776. ; 9:3, s. 219-240
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Tidskriftsartikel (refereegranskat)abstract
- This study used a mixed methods approach to describe and analyze data from groups observed in two types of mental health consumer-centered programs, namely consumer-run drop-in centers and clubhouses. An overview of consumer-centered programs is presented, followed by a report of the study which includes a description of the groups in the sample and data on the effects of group process and group leader characteristics on group functioning. Results indicate that, for the most part, the groups were task oriented (e.g., planning events or discussing issues about the center). Psychoeducation and recovery were also frequent topics in the group meetings. In terms of group participation, consumers took on various assignments, served as facilitators, assumed tasks and roles, shared experiences, and provided support to other group participants. A major finding is that group leaders displayed both good and poor leadership behaviors. The good leadership behaviors were often efforts to respond to problematic responses of members and poor leadership behaviors often elicited such responses. The qualitative analysis provided examples of how these behaviors affected the group sessions. This pilot study, by identifying some of the group conditions present in such groups, should lead to new studies that are based on specific hypotheses concerning the relationships that exist among group conditions, interventions to improve such conditions, and outcomes for participants.
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| 2. |
- Bellamy, Chyrell D., et al.
(författare)
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Relevance of spirituality for people with mental illness attending consumer-centered services
- 2007
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Ingår i: Psychiatric rehabilitation journal. - : American Psychological Association (APA). - 1095-158X .- 1559-3126. ; 30:4, s. 287-294
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Tidskriftsartikel (refereegranskat)abstract
- Spirituality has been cited in the literature as having a positive effect on mental health outcomes. This paper explores the relationship of spirituality to demographic, psychiatric illness history and psychological constructs for people with mental illness (N=1835) involved in consumer-centered services (CCS-Clubhouses and Consumer run drop-in centers). Descriptive statistics indicate that spirituality is important for at least two thirds of the members in the study. Members primarily indicated participation in public spiritual activities (i.e., church, bible study groups), followed by private activities (prayer, reading the bible, and meditation) (both of which were centered on belief in the transcendent). A logistic regression analysis was done to explore variables related to spirituality (i.e., demographics, psychiatric illness history, and psychological constructs). Results suggest that age, gender, having psychotic symptoms, having depressive symptoms, and having a higher global quality of life, hope and sense of community were all significant correlates of spirituality.
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| 3. |
- Mowbray, Carol T, et al.
(författare)
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Characteristics of users of consumer-run drop-in centers versus clubhouses
- 2009
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Ingår i: Journal of Behavioral Health Services & Research. - : Springer Science and Business Media LLC. - 1094-3412 .- 1556-3308. ; 36:3, s. 361-371
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Tidskriftsartikel (refereegranskat)abstract
- Clubhouses and consumer-run drop-in centers (CRDIs) are two of the most widely implemented models of consumer-centered services for persons with serious mental illness. Differences in structure and goals suggest that they may be useful to different types of consumers. Information on what types of consumers use which programs would be useful in service planning. This study analyzes data from the authors' NIMH-funded research on 31 geographically matched pairs of clubhouses and CRDIs involving more than 1,800 consumers to address the following question: are there significant differences in the characteristics and outcomes of members of clubhouses versus CRDIs? Results from multilevel analyses indicated that clubhouse members were more likely to be female, to receive SSI/SSDI, to report having a diagnosis of schizophrenia, and to live in dependent care; and they reported both a greater number of lifetime hospitalizations and current receipt of higher intensity traditional MH services. Controlling for differences in demographic characteristics, psychiatric history, and mental health service receipt, clubhouse members also reported higher quality of life and were more likely to report being in recovery. CRDI consumers were more likely to have substance abuse histories. Possible reasons for the differences are discussed. The results suggest that CRDIs are a viable alternative to more traditional mental health services for individuals who might not otherwise receive mental health services.
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| 4. |
- Mowbray, Carol T, et al.
(författare)
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Consumer-run drop-in centers and clubhouses : Comparisons of services and resources in a statewide sample
- 2005
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Ingår i: Psychological Services. - : American Psychological Association (APA). - 1541-1559 .- 1939-148X. ; 2:1, s. 54-64
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Tidskriftsartikel (refereegranskat)abstract
- Consumer-run programs and clubhouses are 2 important models in the emerging field of psychosocial rehabilitation according to the 1999 Surgeon General's report (U.S. Department of Health and Human Services, 1999). However, no published studies have compared the operations and services of these 2 models. The research reported here involves a statewide study of a matched sample of 29 clubhouses and 29 consumer-run drop-in centers (CDIs), with data gathered by obtaining documents from and conducting on-site interviews with agency directors. As expected, the authors found greater member control and involvement at CDIs and more instrumental services and activities at clubhouses. The authors also found that clubhouses had substantially more resources than CDIs and that CDIs showed significantly greater variance across programs on most measures. Implications for planning and further research are presented. © 2005 Educational Publishing Foundation.
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| 5. |
- Grazier, Kyle L, et al.
(författare)
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Rationing psychosocial treatments in the United States
- 2005
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Ingår i: International Journal of Law and Psychiatry. - : Elsevier. - 0160-2527 .- 1873-6386. ; 28:5, s. 545-560
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Tidskriftsartikel (refereegranskat)abstract
- This paper briefly reviews the recent history of psychosocial treatment for adults with severe mental illnesses in the United States. It examines the current sources and financing of such care, revealing the planned and unplanned reclassification of entitled beneficiaries and eligible patients, appropriate treatment, acceptable outcomes, and levels and sources of payment. One illustration of this phenomenon is seen in current efforts to identify and deliver only those public services that are covered by Medicaid, so as to allocate state resources only when they can be matched by federal monies. Another is the reliance on private health insurance, tied in the U.S. almost exclusively to employment, for medical care delivered under an acute, rather than a chronic care model. These analyses conclude with a discussion of the implicit and explicit mechanisms used to ration access to psychosocial treatment in the United States. The implications for individuals with serious mental illnesses, their families, and the general public are placed in historical and current policy contexts, recognizing the economic, social, and clinical variables that can moderate outcomes.
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| 6. |
- Holter, Mark, et al.
(författare)
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Consumer-run drop-in centers : Program operations and costs
- 2005
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Ingår i: Psychiatric rehabilitation journal. - : American Psychological Association (APA). - 1095-158X .- 1559-3126. ; 28:4, s. 323-331
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Tidskriftsartikel (refereegranskat)abstract
- In-depth phone surveys were conducted with 32 consumer-run drop-in centers in Michigan. Results indicate that centers serve a diverse array of consumers at an average cost of about $8 daily per person. Funding levels, salaries, and services are quite heterogeneous among centers. Those with higher funding levels, greater involvement with other human service agencies, and higher overall CMH county budgets differed significantly in total services and activities provided than those centers with less of each of these resources. Daily attendance was predicted by other-agency involvement, participation of volunteer personnel, and negative neighborhood context.
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| 7. |
- Holter, Mark, et al.
(författare)
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Critical ingredients of consumer run services : Results of a national survey
- 2004
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Ingår i: Community mental health journal. - 0010-3853 .- 1573-2789. ; 40:1, s. 47-63
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Tidskriftsartikel (refereegranskat)abstract
- Fidelity criteria are increasingly used in program monitoring and evaluation, but are difficult to derive for emerging models (i.e., those not based on theory or a research demonstration project). We describe steps used to develop and operationalize fidelity criteria for consumer-run (CR) mental health services: articulating and operationalizing criteria based on published literature, then revising and validating the criteria through expert judgments using a modified Delphi method. Respondents rated highest those structural and process components emphasizing the value of consumerism: consumer control, consumer choices and opportunities for decision-making, voluntary participation (and the absence of coercion), and respect for members by staff.
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| 8. |
- Mowbray, Carol T, et al.
(författare)
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A Fidelity Rating Instrument for Consumer-Run Drop-in Centers (FRI-CRDI)
- 2005
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Ingår i: Research on social work practice. - : SAGE Publications. - 1049-7315 .- 1552-7581. ; 15:4, s. 278-290
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Given the present emphasis on accountability and maintaining quality, the objective of this study was to develop, apply, and assess the reliability of a fidelity rating instrument for consumer-operated services - a promising model, but one for which fidelity criteria are not yet established. Method: Based on observations, documents, and director interviews from 31 consumer-run drop-in centers, we developed a scale measuring fidelity to pre-established criteria and rated each center on scale items. A second study examined the interrater reliability of the measure. Results: Scale scores on the 31 centers showed substantial heterogeneity on the majority of the criteria. The fidelity rating scale demonstrated satisfactory interrater reliability on most items. Conclusions: The fidelity rating instrument is ready to be used by social work researchers evaluating consumer-operated services. Furthermore, social work researchers can use similar methods with other innovative services that should be evaluated but currently lack standards and fidelity criteria.
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| 9. |
- Mowbray, Carol T, et al.
(författare)
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Consumer Drop-in Centers : Operations, Services, and Consumer Involvement
- 2002
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Ingår i: Health & Social Work. - : National Association of Social Workers. - 0360-7283 .- 1545-6854. ; 27:4, s. 248-261
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Tidskriftsartikel (refereegranskat)abstract
- Interest in involvement of consumers in mental health and psychiatric rehabilitation services delivery has expanded in recent years, encompassing self-help approaches, consumers employed as providers in formal agencies, and consumers operating their own services. This study reports results from in-depth phone surveys conducted with 32 consumer drop-in centers in Michigan. Results indicate that centers operate in many ways like other human services businesses, albeit with much smaller budgets. Funding levels, salaries, and services showed great heterogeneity among the centers and in comparison with reports in the literature. Centers autonomously run by consumers and centers with consumer involvement (operated by a non-consumer agency) were found to differ significantly on several variables, including consumer control, funding and service levels, and challenges. Implications for the growth and increased use of consumer drop-in centers are discussed.
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| 10. |
- Mowbray, Carol T, et al.
(författare)
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Fidelity Criteria: Development, Measurement, and Validation
- 2003
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Ingår i: American Journal of Evaluation. - : Elsevier. - 1098-2140 .- 1557-0878. ; 24:3, s. 315-340
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Tidskriftsartikel (refereegranskat)abstract
- Fidelity may be defined as the extent to which delivery of an intervention adheres to the protocol or program model originally developed. Fidelity measurement has increasing significance for evaluation, treatment effectiveness research, and service administration. Yet few published studies using fidelity criteria provide details on the construction of a valid fidelity index. The purpose of this review article is to outline steps in the development, measurement, and validation of fidelity criteria, providing examples from health and education literatures. We further identify important issues in conducting each step. Finally, we raise questions about the dynamic nature of fidelity criteria, appropriate validation and statistical analysis methods, the inclusion of structure and process criteria in fidelity assessment, and the role of program theory in deciding on the balance between adaptation versus exact replication of model programs. Further attention to the use and refinement of fidelity criteria is important to evaluation practice.
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