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Biomedical subjects

J Draine

Publications and source records attributed to J Draine.

At least 19 recordsLinked to original sources
PubMed1998

Increased contact with community mental health resources as a potential benefit of family education.

OBJECTIVE: This study examined the hypothesis that families of adults with severe mental illness who participate in either a group family education workshop or individual family consultation will try to seek more assistance from community services than those in a control group assigned to a waiting list. METHODS: A total of 225 family members who agreed to participate in the study were randomly assigned to one of three conditions: a ten-week group workshop, individual family consultation, or a waiting list (control group). Family members were interviewed about the extent of their contact with mental health professionals, providers, and community resources at baseline, termination of the interventions, and at six months after termination. RESULTS: No differences were found between conditions in the extent of family members' contact with three types of services: conventional, psychosocial, and ancillary mental health services. CONCLUSIONS: Neither of the educational interventions produced any change in behaviors of families seeking advice and assistance on behalf of their ill relative from the three types of services examined. Modifications in the interventions may be worthwhile. Increasing family members' contacts with community resources on behalf of their ill relative may increase the benefits of the intervention to the family as well as to the ill relative.

Adult↗
PubMed1997

Conceptualizing services research on outpatient commitment.

Issues affecting the research of outcomes of involuntary outpatient commitment (OC) of persons with serious mental illness are explored. These issues include the reliance on hospital recidivism as a primary measure of outcome, the role of family members and coercion in the process of outpatient commitment, and the conceptualization and design of studies. A conceptual framework that attempts to incorporate responses to these issues is proposed. Continued research on OC should build on conceptual models that include family role and burden, services delivered, an accounting for varied coercive mechanisms, and client-level outcomes. Rehospitalization should be conceptualized as an intermediate variable between OC and client-level outcomes rather than as an ultimate outcome.

Ambulatory Care↗
PubMed1997

Applying research on family education about mental illness to development of a relatives' group consultation model.

Results from a random field trial of family education interventions were applied to create a new model of family education programs. This paper reviews the family education literature, the random field trial results, and the pre-piloting of an adapted service model called group consultation. The new model emphasizes a more interactive approach to the conventional group workshop model as opposed to adherence to a pre-planned curriculum. Pre-pilot group participants were all past members of group workshops. In a process evaluation these group members were questioned about their reactions to the new group format and its usefulness.

Family Health↗
PubMed1997

Effectiveness of two models of brief family education: retention of gains by family members of adults with serious mental illness.

The retention of benefits from two models of family education was compared with maturational effects in an untreated control group. The three-month interventions showed an initial effect for self-efficacy regarding a mentally ill relative that did not significantly diminish during the following six months. However, no significant differences on this measure were found between the treated groups and the untreated controls. Ways of refining the interventions and measures so as to improve gains and retain them over time are discussed.

Adaptation, Psychological↗
PubMed1996

Examination of grief among family members of individuals with serious and persistent mental illness.

Many family members experience a profound sense of loss when a relative becomes mentally ill. The adjustment to this loss is similar to grief as a response to death. The extent of this grief may be explained by personal characteristics of family members, the severity of the illness, and the extent of social support available. A family member's emotional response to a relative's mental illness may be exacerbated by increases in both objective and subjective burden. While grief among families with a seriously mentally ill relative is the emotional response to reflecting on the loss of an emotionally healthy relative, burden reflects the present state of responsibility for the ill relative, expressed in both subjective and objective terms. In this study, family member characteristics, social support, objective burden and subjective burden contributed to explaining expressed grief among 225 family members of seriously mentally ill individuals. Mental health and family support professionals are encouraged to recognize the grief response in family members with a mentally ill relative.

Caregivers↗
PubMed1996

Perspectives concerning consumers as case managers.

Consumer and non-consumer case managers participating in a randomized trial of consumer case management were interviewed regarding their perceptions of consumer and non-consumer case managers, their work and their clients. Consumer case managers were concerned about how they were accepted by other mental health professionals. The consumer team maintained less collateral contact with other professionals and more interpersonal contact with clients than the non-consumer team. Consumer case managers did not show any greater signs of stress, diminished self esteem, or burnout than non-consumer case managers.

Burnout, Professional↗
PubMed1996

Case manager alliance with clients in an older cohort.

It was hypothesized that members of an older cohort of seriously mentally ill community mental health clients would develop stronger alliances with intensive case managers. Eighty-six clients participating in a study of case management services completed a measure of working alliance and structured interviews. It was found that older cohort clients, those age 45 or older, showed much stronger alliances with their case managers than younger clients.

Adult↗
PubMed1996

Impact of brief family psychoeducation on self-efficacy.

One hundred eighty-three relatives of people with serious mental illnesses were randomly assigned to receive individualized consultation or group psychoeducation or were placed on a 9-month wait list. Analysis of variance and multiple regression revealed that the individualized consultation increased the family members' sense of self-efficacy regarding mentally ill relatives. Group psychoeducation was helpful in increasing self-efficacy of family members who had never participated in a support or advocacy group for relatives of psychiatrically disabled individuals.

Adult↗
PubMed1995

Consumer case management and attitudes concerning family relations among persons with mental illness.

Data from 91 clients participating in a clinical trial of consumer case management services were analyzed to determine if there is a relationship between client satisfaction with family relations and the amount of community treatment services, including case management. It was found that clients' greater face to face contact with case managers was related to less satisfaction with family relations after one year of service. The analysis provides some support for the hypothesis that case managers may be serving some of the functions that have traditionally been served by the families of mentally ill clients. Another conclusion that could be supported by this analysis is that the degree of intensity of case management services has an impact on family relations.

Adult↗
PubMed1995

Subjective burden among family members of mentally ill adults: relation to stress, coping, and adaptation.

Among 225 family members participating in a study of psychoeducational interventions, 39% of the variance in subjective burden was explained by the severity of stressors related to the relative's illness and by mediators related to social support and coping capabilities. Interventions directed toward improving self-efficacy and coping strategies may be important mediators of subjective burden.

Adaptation, Psychological↗
PubMed1995

Jail recidivism in a forensic case management program.

This article explores the factors related to jail recidivism among clients receiving case management services who were seriously mentally ill, homeless, and former inmates in a large urban jail. The authors interviewed six case managers about 51 clients and examined the use of treatment stipulations as a condition of probation, clients' major diagnostic and behavioral problems, and case management strategies. Clients whose case managers actively sought legal stipulations to case management as a condition of probation and parole were more likely to return to jail. Implications for service planning and future research are discussed.

Case Management↗
PubMed1995

Adaptive coping among family members of persons with serious mental illness.

OBJECTIVE: This study sought to describe factors associated with adaptive coping by family members with a psychiatrically disabled relative. METHODS: A total of 225 family members of persons with serious mental illness were interviewed. Hierarchical regression analysis using five variables that may have contributed to adaptive coping was conducted. The five factors were demographic characteristics of the family member, severity of the relative's illness, the family member's subjective burden and grief, social support, and personal coping resources (self-efficacy and mastery). RESULTS: More extensive adaptive coping was associated with increased social support as measured by the density of the social network, the extent of affirming social support, and participation in a support group for families. Better coping was also associated with a greater sense of self-efficacy in dealing with the relative's mental illness. Adaptive coping was not associated with the severity of the relative's illness. CONCLUSIONS: The findings suggest that mental health professionals should encourage family members to use the support provided by community-based support groups and to form such groups if none are available.

Activities of Daily Living↗
PubMed1995

Interaction of the criminal justice system and psychiatric professionals in which civil commitment standards are prohibitive.

Three case studies are the basis for a discussion of the criminalization hypothesis as it may apply to psychiatric probationers and parolees in the criminal justice system. In each of these cases, the treating psychiatrist faced the problems of noncompliance with treatment and/or restrictive civil commitment standards. The patient's status as a probationer or parolee played a pivotal role in strategies for ensuring treatment through the criminal justice system as opposed to the mental health system or civil commitment process.

Adult↗
PubMed1995

Issues in serving the forensic client.

In the course of a study of a team model of intensive case management for people with serious mental illness who are homeless and leaving Philadelphia jails, several issues regarding the interaction of mental health and jail systems have arisen. Among these issues are continuity of care in an unpredictable jail system, extensive involvement of family members in the charges brought against clients, and the use of legal sanctions toward therapeutic outcomes. This article discusses these issues both as they have appeared in the literature and as they have affected the progress of the study. Implications for community mental health system interactions with jails in serving forensic clients are explored.

Community Mental Health Services↗
PubMed1994

Family perceptions of consumers as case managers.

Family members of clients participating in a randomized trial of consumer delivered case management services were found to be satisfied with the service, without regard to whether or not their ill relative was served by a consumer case management team. While family members did not necessarily know that their ill relative's case manager was a consumer, the attitude toward the capabilities of consumers serving as case managers was positive.

Adult↗
PubMed1994

Explaining attitudes toward medication compliance among a seriously mentally ill population.

Data from a clinical trial of consumer-delivered case management services were used to construct an explanatory model for attitudes toward medication compliance, focusing on psychosocial factors. A regression model explaining attitudes toward medication compliance shows that more positive attitudes toward compliance are related to older age, fewer symptoms, and a broader array of daily activities involving social relations. Participation in social activities is a practical goal of psychosocial rehabilitation services that support compliance with medication regimens and psychiatric treatment.

Activities of Daily Living↗
PubMed1994

Satisfaction with mental health treatment in a randomized trial of consumer case management.

It was hypothesized that the clients assigned to a consumer team of case managers, because they share similar life experiences interacting with the mental health system, would have greater satisfaction with mental health treatment than clients assigned to a team of nonconsumer case managers. Ninety-one clients with serious and persistent mental illness randomly assigned to consumer and nonconsumer case management teams were interviewed after 1 year of service. While clients served by a consumer team of case managers were less satisfied with mental health treatment, personal characteristics of individual case managers were more important in explaining differences in satisfaction with treatment than whether the client was served by the consumer or nonconsumer team.

Adult↗