WORK IN FAMILY AIDED ASSERTIVE COMMUNITY TREATMENT

从事家庭辅助自信社区治疗工作

• 批准号: 3442834
• 负责人: WILLIAM R MCFARLANE
• 金额: $ 39.59万
• 依托单位: NEW YORK STATE OFFICE OF MENTAL HEALTH
• 依托单位国家: 美国
• 财政年份: 1990
• 资助国家: 美国
• 起止时间: 1990-09-28 至 1993-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3442834
• 关键词: community mental health services; health care cost /financing; health care service evaluation; health service demonstration project; human subject; human therapy evaluation; longitudinal human study; mental disorders; occupational therapy; psychosocial rehabilitation; vocational guidance; vocational rehabilitation

The project proposed here is an experimental field demonstration and evaluation of a recently developed mental health service model for the rehabilitation of severely mentally ill (SMI) patients, especially those involved in, or eligible, for Community Support Programs. This approach combines core elements of two of the most effective psychosocial treatments developed to date: the Training in Community Living (TCL) model and the psychoeducational multi-family group (PEMFG) approach. We call the resulting combination Family-Aided Assertive Community Treatment (FAACT). These family groups are a unique and powerful resource for the TCL team in job development and in solving problems of job finding and retention. Preliminary results in a nearly completed trial include a large main effect for FAACT on vocational achievement. This application proposes an experimental design which will compare vocational outcome in FAACT with that in conventional vocational rehabilitation (CVR). 144 unemployed but stabilized psychiatric patients meeting New York State Community Support Services criteria will be recruited, matched, randomly assigned to rehabilitation condition, rehabilitated and evaluated longitudinally. The project will be carried out in two typical community mental health centers which have close ties to excellent vocational rehabilitation services. Its results will serve as a guide to policy-making as New York State reconfigures its entire adult mental health system to emphasize psychiatric rehabilitation and consumer and family participation. The goals of the proposed project are to: 1. compare vocational adjustment, psychiatric symptoms, social functioning, quality of life, community tenure and costs of services in the two approaches; 2. compare cumulative effects over eighteen months; 3. identify patient and family characteristics that may be associated with better vocational adjustment in each approach; and 4. conduct the research through a meaningful Public- Academic Liaison. The research design includes: stratification and matching for work history and diagnosis, random assignment, fidelity-oriented clinical supervision, longitudinal assessments by independent raters and multivariate statistical analysis techniques to examine main effects and interactions of rehabilitation method with vocational, psychiatric and demographic variables.

这里提出的项目是一个实验场示范和 对最近开发的心理健康服务模式的评估 严重精神疾病（SMI）患者的康复，特别是那些 参与或有资格参加社区支持计划。 这种做法 结合了两种最有效的心理社会的核心要素 迄今为止开发的治疗方法：社区生活培训 (TCL) 模式 以及心理教育多家庭小组（PEMFG）方法。 我们打电话 由此产生的组合家庭辅助自信社区治疗 （FAACT）。 这些家庭团体是独特而强大的资源 TCL团队在岗位发展和解决求职问题中的作用 保留。 即将完成的试验的初步结果包括 FAACT 对职业成就的主效应较大。 该应用提出了一个实验设计，将比较 FAACT 中的职业成果与传统职业中的职业成果 康复（CVR）。 144名失业但病情稳定的精神病患者 满足纽约州社区支持服务标准将 招募、匹配、随机分配到康复条件， 进行纵向修复和评估。 该项目将进行 存在于两个有着密切联系的典型社区精神卫生中心 优质的职业康复服务。 其结果将服务于 作为纽约州重新配置整个州的政策制定指南 成人心理健康系统强调精神康复和 消费者和家庭的参与。 拟议项目的目标是： 1. 比较职业 调整、精神症状、社会功能、生活质量、 两种方法中的社区保有权和服务成本； 2.比较 十八个月内的累积效应； 3. 识别患者及其家属 可能与更好的职业调整相关的特征 在每种方法中； 4. 通过有意义的公众研究来进行研究 学术联络。 研究设计包括：工作经历的分层与匹配 和诊断、随机分配、以保真度为导向的临床监督、 由独立评估者和多变量进行纵向评估 检查主要效应和相互作用的统计分析技术 职业、精神和人口康复方法的研究 变量。