Training teams to deliver better psychiatric rehabilitation programs.
Explore the source record for details and available documents.
Combined Modality Therapy↗
Biomedical subjects
P W Corrigan
Publications and source records attributed to P W Corrigan.
Social perception and social skill in schizophrenia.
The relationship of social perception to social skill in schizophrenia was investigated. Twenty-six outpatients completed three social perception tasks (i.e. facial affect recognition, social cue recognition, and self-ratings of social skill) and participated in two role-plays. Correlational analyses revealed that the self-ratings of social skill had the most consistent relationship with social skill among the social perception measures, even after controlling for symptomatology and subject demographics. Other measures of social perception (i.e. social cue recognition) had weaker relationships with social skills. Implications for future research and psychosocial interventions are discussed.
Adult↗
Factors that affect social cue recognition in schizophrenia.
Earlier research (Corrigan and Green, Am. J. Psychiatry, 150 (1993) 589-594) showed fairly symptomatic persons with schizophrenia give more false-positive responses when answering questions about abstract cues in a social situation (i.e. affect, rules, and goals inferred about an interpersonal situation) than concrete cues (i.e. actions and dialogue observed in a situation). It is unclear, however, whether differential cue recognition is due to schizophrenia per se, or some aspect of the illness commensurate with significant symptoms and in-patient care. Moreover, the abstract and concrete dimension in the earlier study had not been independently validated. In this study, the 288 items of the Social Cue Recognition Test (SCRT) were divided into three sets based on abstraction ratings provided by 38 college students. The SCRT was then completed by 48 participants with DSM-III-R diagnoses of schizophrenia or schizoaffective disorder. Participants with schizophrenia were divided into low and high symptom groups using scores from the Brief Psychiatric Rating Scale. Results showed both low symptom and high symptom groups exhibited a differential deficit in cue recognition. False positives were greater for items rated as more abstract. Implications for understanding the social cognitive deficits of persons with schizophrenia are discussed.
Adult↗
Results of a job analysis of psychologists working in state hospitals.
The graduate training of psychologists should prepare them for central roles in state hospitals, especially roles involving direct patient care and supervision of colleagues. To what extent do actual job practices match graduate preparation? To find out, 55 psychologists from 12 state hospitals in the Midwest were surveyed regarding their educational backgrounds and time currently spent in various job activities. Results indicated that paperwork consumes more time than any other activity, followed by therapeutic services, psychological assessment, supervision, and case management. Almost 50% of the sample was trained under a cognitive-behavioral orientation; however, more than 60% of survey participants now practice according to eclectic models. These results imply that psychologists in these settings may not be utilized to their full potential because of a variety of organizational constraints.
Administrative Personnel↗
An interactive approach to training teams and developing programs.
A combination of educational and organizational strategies help rehabilitation teams develop programs that effectively address the needs of their consumers.
Health Personnel↗
Developing effective team leaders.
For most staff, the most challenging leadership role they will play is their first. This chapter describes a research-based training program being developed to help these leaders increase their effectiveness in this first role.
Chicago↗
Building teams and programs for effective rehabilitation.
Carefully controlled, clinical research has shown psychiatric rehabilitation to significantly help persons with severe mental illness address their disabilities and obtain a higher quality of life. For psychiatric rehabilitation to yield its greatest effect, discrete principles and skills that are part of the rehabilitation paradigm must be disseminated to staff working in real-world settings. Staff training strategies that help the rehabilitation team develop effective programs are especially important. This paper reviews Interactive Staff Training (IST), an approach to team building and program development that combines educational and organizational strategies. IST comprises four stages--introduction to the system, program development, program implementation, and program maintenance--with each stage defined by behavioral tasks that engage the team and corresponding products that serve as markers of progress. Testing treatment dissemination strategies poses interesting problems for the researcher, some which are reviewed here. Outcome studies completed on IST are summarized in light of these problems. The paper ends with a consideration of some future directions for research in this area.
Humans↗
Staff attitudes that impede the implementation of behavioral treatment programs.
Staff who have negative attitudes about behavioral treatments are less likely to implement them. Previous research suggests that negative attitudes are associated with staff burnout and perceived collegial support. A path analysis is conducted in this study to determine the direction of these effects. Ninety staff members who work in treatment programs for severely mentally ill adults completed measures of attitudes about behavior therapy, experience with behavior therapy, burnout, and collegial support. Results of the path analysis yielded a model with good fit that confirmed our hypotheses; namely, burnout leads to negative attitudes and experience with behavior therapy yields positive attitudes. Insufficient collegial support leads to negative attitudes through burnout. Implications of these findings for improving the use of behavior treatments in real-world programs are discussed.
Adult↗
How mental health and developmental disabilities staff prioritize training and development needs.
This paper contrasts a staff training needs assessment distributed to three groups: staff serving persons with mental health needs in the community, staff serving persons with mental health needs in state hospitals, and staff serving persons with developmental disabilities in the community. Analyses revealed that all three groups rated team-related training as the area in greatest need of development. Further analyses suggested that community staff serving persons with developmental disabilities reported significantly less need for training on direct client care compared to community and inpatient staff who serve persons with mental health needs. The community staff serving persons with mental health needs did not differ significantly from the inpatient staff on any of the surveyed training areas. Results suggest that future development efforts should begin with team building skills.
Adult↗
Social cognition in schizophrenia.
The study of social cognition in schizophrenia may augment the understanding of clinical and behavioral manifestations of the disorder. In this article, the authors describe social cognition and differentiate it from nonsocial cognition. They garner evidence to support the role of social cognition in schizophrenia: Nonsocial information-processing models are limited to explain social dysfunction in schizophrenia, measures of social cognition may contribute greater variance to social functioning than measures of nonsocial cognition, task performance on nonsocial-cognitive measures may not parallel performance on social-cognitive tasks, and symptomatology may be best understood within a social-cognitive framework. They describe the potential implications of a social-cognitive model of schizophrenia for the etiology and development of the disorder.
Cognition Disorders↗
Social processing correlates of nonverbal social perception in schizophrenia.
This study examines the relationship of nonverbal social perception to other areas of social functioning in schizophrenia. One model of interpersonal problem-solving skills presents a sequence of receiving, processing, and sending skills. Social perception skills best fit the first stage in this model: receiving skills. As expected, schizophrenic subjects (N = 29) were less skillful than normal subjects (N = 15) on measures of social problem solving, understanding of social sequences, and social judgment. In addition, performance on these tasks was significantly related to nonverbal social perception, but only for the schizophrenic group. Thus, deficits in nonverbal social perception are related to other measures of social functioning in schizophrenia. Implications of these findings for understanding and treating social deficits in schizophrenia are discussed.
Adult↗
The social perceptual deficits of schizophrenia.
This article summarizes a series of studies conducted by our group that examined the social perceptual deficits of schizophrenia. Research suggested that social perceptual deficits are more pronounced in patients with nonparanoid schizophrenia than comparison groups comprising normal controls or individuals with paranoid schizophrenia. The social perceptual deficits of schizophrenia were affected by the level of abstraction of cue descriptors; the level of emotional arousal engendered by the situation; the presence of extraneous, emotionally arousing stimuli; and the familiarity of the situation. These deficits were not found in standardization and cross-validation samples of normal controls, suggesting that these differential deficits represent a characteristic of the disorder rather than a psychometric confound. Social perceptual deficits in schizophrenia were significantly associated with verbal recall memory and relatively unrelated to visual vigilance. These latter findings were used in a study on rehabilitation of cue perception which showed that memory rehabilitation significantly improved cue perception whereas attention focusing strategies had no appreciable effects.
Affect↗
Staff training to improve implementation and impact of behavioral rehabilitation programs.
Staff who provide services for persons with severe mental illness often have pessimistic attitudes about adopting behavioral innovations for their programs. Thirty-five staff members in psychiatric residential programs participated in eight months of interactive staff training, an organizational development strategy that helps the rehabilitation team develop behavioral approaches to changing clients' behavior. After the training, staff members reported significant improvement in their attitudes about behavioral interventions and increased perceptions of collegial support. Direct care staff reported significantly less emotional exhaustion. Interactive staff training may facilitate implementation of behavioral strategies by improving attitudes toward these interventions.
Adult↗
Considerations for research on consumer empowerment and psychosocial interventions.
Consumer empowerment is a political movement that, among many goals, seeks to diminish the stigma and discrimination experienced by people with severe and persistent psychiatric disorders. This paper reviews research strategies that address the methodological problems of studying consumer empowerment. Key issues include defining the subject of investigation, describing consumer-developed treatments using discovery-oriented research strategies, and sorting out the diverse roles of consumers in contemporary psychosocial programs. Consumer empowerment introduces a political paradigm into the understanding of severe mental illness, a paradigm that can be difficult to integrate with the goals of empirical research.
Empiricism↗
Behavior therapy empowers persons with severe mental illness.
Behavior therapy has been viewed by some as disempowering persons with severe mental illness (i.e., undermining their ability to make independent decisions). This is ironic because various behavioral strategies actually promote independent decision making. Behavioral interventions (a) provide a safe place for persons to consider their life decisions; (b) simplify the range of choices that comprise many of these decisions; (c) help persons with severe mental illness learn behaviors so that they can better meet the demands of independent decision making: (d) teach family members skills so that they can provide more resources to support independent decision making; and (e) facilitate self-control over behaviors and the settings in which they occur. Behavior therapists need to assert the important role that behavioral principles assume in empowering persons with mental illness so that these principles are not discarded by professionals who misunderstand, or otherwise stereotype, behavioral interventions.
Behavior Therapy↗
Construct validity of two tests of social cognition in schizophrenia.
The construct validity was examined of two measures of social cognition in schizophrenia: (1) a measure of differential deficit in concrete versus abstract social cue perception and (2) a measure of differential deficit in concrete versus abstract situational feature recognition. A significant relationship between the two difference scores would be expected if both measured differential cognition of abstract and concrete social information. This correlation would be expected to remain significant even after the influence of a generalized deficit in social cognition was partialed out. Twenty-three subjects with DSM-III-R diagnoses of schizophrenia completed a videotaped measure of social cue perception and a pencil-and-paper measure of situational feature recognition. Results showed that standardized residual scores representing the difference in abstract and concrete cue perception and representing the difference in abstract and concrete situational feature recognition were significantly associated. Implications of these strategies for understanding and remediating the social cognitive deficits of schizophrenia are discussed.
Adult↗
Situational feature recognition in schizophrenic outpatients.
Previous research has suggested that patients with schizophrenia are significantly better at identifying relatively concrete features that describe social situations (e.g., actions and roles) than more abstract features (e.g., rules and goals). Because participants in the earlier research were all inpatients, the results may have been confounded by various factors that are commensurate with a hospital stay. Thirty-one patients with DSM-III-R diagnoses of schizophrenia or schizoaffective disorder and 39 normal volunteers completed the Situational Feature Recognition Test to determine whether they also showed the differential deficit. Results showed that the outpatient group was, indeed, less symptomatic than the inpatient group; outpatients also showed better overall feature recognition than inpatients. Schizophrenic outpatients and normal volunteers are significantly better at identifying concrete features than abstract features. Additional analyses suggested that the differential deficit in outpatients is due, in part, to their disorder. Implications for the remediation of social functioning deficits are discussed.
Adult↗
Situational familiarity and feature recognition in schizophrenia.
Research has shown that schizophrenia patients are less able to identify a situation's abstract features (goals) than its concrete features (actions). However, it has been unclear whether this differential deficit represents a cognitive dysfunction or a lack of familiarity with many situations because of impoverished social experiences. Twenty-nine inpatients with DSM-III-R diagnosis of schizophrenia completed the Situational Feature Recognition Test, Version 2 (SFRT-2). The SFRT-2 included familiar and unfamiliar situations of which subjects were asked to identify characteristic goals and actions. A 2 x 2 x 2 analysis of variance (group by feature abstraction by situational familiarity) found a significant three-way interaction. Post-hoc analyses suggested that patients were better able to recognize concrete features in familiar situations. Differences in discriminating power of the four conditions of the SFRT-2 had been diminished on standardization and cross-validation groups. Therefore, the differential deficits shown by the patient sample probably do not represent psychometric confound. Implications for remediation of social cognitive deficits are discussed.
Adult↗