Enhancing return to work or school after a first episode of schizophrenia: the UCLA RCT of Individual Placement and Support and Workplace Fundamentals Module training.

Background: This study evaluated in a rigorous 18-month randomized controlled trial the efficacy of an enhanced vocational intervention for helping individuals with a recent first schizophrenia episode to return to and remain in competitive work or regular schooling.

Methods: Individual Placement and Support (IPS) was adapted to meet the goals of individuals whose goals might involve either employment or schooling. IPS was combined with a Workplace Fundamentals Module (WFM) for an enhanced, outpatient, vocational intervention.

Using the theory of planned behavior to improve treatment adherence in Mexican Americans with schizophrenia.

Objective: Failure to adhere to treatment with antipsychotic medication is the most common cause of relapse among patients with schizophrenia. A novel multifamily group (MFG) intervention, informed by the Theory of Planned Behavior (TPB), demonstrated efficacy in increasing medication adherence and decreasing rehospitalizations in schizophrenia patients. This report explores the hypothesis that the improved outcomes obtained through the MFG approach were mediated by changes in the patients' attitudes toward medications, subjective norms-social influences, and perceived behavioral control of resources.

The ability of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia.

Context: Evidence-based interventions to improve medication adherence among patients with schizophrenia are lacking. Although family psychoeducation has demonstrated efficacy in improving outcomes in schizophrenia, empirical support for its ability to enhance medication adherence is scarce.

Objective: To determine whether a culturally adapted, multifamily group (MFG) therapy would increase medication adherence and decrease psychiatric hospitalizations for Spanish-speaking Mexican Americans with schizophrenia.

Group cognitive behavior therapy or social skills training for individuals with a recent onset of psychosis? Results of a randomized controlled trial.

This study aimed at determining the effectiveness of group cognitive behavior therapy (CBT) for recent onset psychosis in comparison with a recognized intervention for individuals with severe mental illness-social skills training. One hundred twenty-nine participants took part in a single-blind randomized controlled trial with repeated measures (baseline, 3 months, and 9 months). Participants were randomized to 1 of 3 conditions: group CBT, group social skills training for symptom management, or a wait-list control group.

The effectiveness of skills training for improving outcomes in supported employment.

Objective: This study evaluated whether a supplementary skills training program improved work outcomes for clients enrolled in supported employment programs.

Methods: Thirty-five recently employed clients with severe mental illness who were receiving supported employment services at a free-standing agency were randomly assigned to participate in either the workplace fundamentals program, a skills training program designed to make work more "successful and satisfying," or treatment as usual. Knowledge of workplace fundamentals (for example, identifying workplace stressors, problem solving, and improving job performance) was assessed at baseline and at nine months; employment outcomes and use of additional vocational services were tracked for 18 months.

The micro-module learning tests: work-sample assessments of responsiveness to skills training.

While outcome of psychiatric rehabilitation has been successfully predicted by cognitive tests, efforts to design a measure to assess responsiveness to rehabilitation have been lacking. In this report, we describe the rationale for and development of a face-valid measure of responsivity to the three core components of skills training: responsiveness to verbal instruction, ability to learn from viewing the behavior of a model, and ability to demonstrate skills observed during a subsequent role-play. Seven alternate forms of the new measure, called the Micro-Module Learning Test (MMLT), demonstrated adequate internal consistency and alternate-form reliability.

Consumers' goals in psychiatric rehabilitation and their concordance with existing services.

The objective of this study was to describe the rehabilitation goals of 165 consumers with serious mental illness who were living in the community and to assess the level of concordance between the consumers' perceived importance of their goals and the services they received to help them meet those goals. A structured interview was used to facilitate the expression of rehabilitation goals by consumers in the psychiatric rehabilitation program of a hospital in Montreal, Canada. The most frequently mentioned rehabilitation goals pertained to improving consumers' financial situation, physical health, cognitive capacities, and symptoms.

Supplementing supported employment with workplace skills training.

Introduction by the column editors: Supported employment, as designed for persons with serious and persistent mental illness, has been termed individual placement and support. In two randomized controlled trials (1,2), clients who received individual placement and support services were more likely to obtain at least one job in the competitive sector, to work more hours, and to have a higher total income than their counterparts who received more traditional types of vocational rehabilitation. However, individual placement and support did not improve the length of time the employed participants kept their jobs.

Further validation of the Client Assessment of Strengths Interests and Goals.

The Client Assessment of Strengths Interests and Goals (CASIG), a measure that assesses the treatment outcomes of individuals with serious and persistent mental illness, has previously shown adequate psychometric properties with an American sample. Since it assesses quite specific skills and needs, it is necessary to assess its cultural relevance and psychometric characteristics before using it in a different country. Hence, the purposes of this study were to (1) adapt CASIG to the culture of a Canadian setting and translate its items and directions into French, (2) determine the psychometric characteristics of the adapted English and French versions of CASIG, and (3) identify its latent constructs via an exploratory factor analysis.