Assessing Causal Pathways and Targets of Implementation Variability for EBP use (Project ACTIVE): a study protocol.

Background: Advancing causal implementation theory is critical for designing tailored implementation strategies that target specific mechanisms associated with evidence-based practice (EBP) use. This study will test the generalizability of a conceptual model that integrates organizational constructs and behavioral theory to predict clinician use of cognitive-behavioral therapy (CBT) techniques in community mental health centers. CBT is a leading psychosocial EBP for psychiatric disorders that remains underused despite substantial efforts to increase its implementation.

Perspectives of Patients and Providers in Using Shared Decision Making in Psychiatry.

There is increased interest over the last decade in the use of Shared Decision Making with individuals with serious mental illness to improve engagement in treatment and clinical outcomes. We conducted semi-structured qualitative interviews with 15 individuals with serious mental illness treated in an outpatient transitional care clinic serving people immediately after discharge from a psychiatric hospitalization. Parallel interviews were conducted with a variety of clinical providers (n = 9).

Assessment of adherence to oral antipsychotic medications: What has changed over the past decade?

Introduction: In a previous review, spanning 3 decades, we found that self-report and other non-objective measures were the primary means of assessing adherence to oral antipsychotic medications for individuals with schizophrenia. Moreover, consensus regarding the definition of adherence was completely lacking. Here, we examined the next decade of studies to determine what may have changed.

Is cognitive adaptation training (CAT) compensatory, restorative, or both?

Cognitive adaptation training (CAT) is a psychosocial treatment incorporating environmental supports including signs, checklists to bypass the cognitive deficits of schizophrenia. Our objective was to examine the association between CAT, functional outcomes, and cognitive test performance (cognition). The two research questions were as follows: 1) Does cognition mediate the effect of CAT intervention on functional outcome? 2) Does CAT impact cognitive test performance? A total of 120 participants with schizophrenia were randomized to one of three treatments: 1) CAT (weekly for 9months; monthly thereafter), 2) generic environmental supports (given to participants on clinic visits to promote adaptive behavior), or 3) treatment as usual (TAU).

Improving functional outcomes for schizophrenia patients in the Netherlands using Cognitive Adaptation Training as a nursing intervention - A pilot study.

Cognitive Adaptation Training (CAT) improves functional outcomes in schizophrenia outpatients living in the United States. The effectiveness of CAT for patients living outside the US as well as for long-term hospitalized patients remains to be determined. In addition, it has not yet been studied whether CAT can be successful if patients receive the treatment from psychiatric nurses.

Can medication management coordinators help improve continuity of care after psychiatric hospitalization?

Objective: This demonstration project examined whether medication management coordinators enhanced continuity of care from inpatient facilities to an outpatient public mental health clinic.

Methods: From 2004 to 2008, patients (N=325) hospitalized with schizophrenia or schizoaffective or bipolar disorder enrolled in a medication management program before discharge or at their first clinic appointment. Medication management coordinators supplemented existing clinic practices by identifying recently hospitalized patients, providing inpatient and outpatient prescribing clinicians with patients' complete medication history, meeting with patients for six months postdischarge to assess clinical status and provide medication education, and advocating guideline-concordant prescribing.

Cognitive adaptation training for outpatients with schizophrenia.

Schizophrenia is a complex neurodevelopmental disorder characterized by cognitive deficits. These deficits in cognitive functioning have been shown to relate to a variety of functional and treatment outcomes. Cognitive adaptation training (CAT) is a home-based, manual-driven treatment that utilizes environmental supports and compensatory strategies to bypass cognitive deficits and improve target behaviors and functional outcomes in individuals with schizophrenia.

Comparing the efficacy of interventions that use environmental supports to improve outcomes in patients with schizophrenia.

We examined the efficacy of 2 treatments using environmental supports (e.g. signs, alarms, pill containers, checklists) to improve functional outcomes in individuals with schizophrenia.

Defining and assessing adherence to oral antipsychotics: a review of the literature.

The definition and assessment of adherence vary considerably across studies. Increasing consensus regarding these issues is necessary to improve our understanding of adherence and the development of more effective treatments. We review the adherence literature over the past 3 decades to explore the definitions and assessment of adherence to oral antipsychotics in schizophrenia patients.

Use of environmental supports among patients with schizophrenia.

Objective: Cognitive adaptation training is a psychosocial treatment that uses individually tailored environmental supports, such as signs, calendars, hygiene supplies, and pill containers, to cue and sequence adaptive behavior in the client's home environment. Generic environmental supports offer a less costly treatment that provides a predetermined package of helpful supports to clients at the time of their routine clinic visit. Previous studies have demonstrated the efficacy of cognitive adaptation training.