Obsolete Etiological Theories

The scientific community has made real progress in its understanding of the etiology of the major mental illnesses. At the same time, the public is still exposed to a number of discredited or obsolete theories about what causes major mental illness. Most of these obsolete theories center on early childhood psychological trauma or abusive family environments as causal factors. Harding and Zahniser (1994) describe the familial role in etiology as one of the great myths about schizophrenia. While...

Evidence Based Practices

From its earliest beginnings, psychiatric rehabilitation has sought, usually by trial and error, to develop effective services for persons with severe mental illness. This process has led to the existence of a large number of essentially idiosyncratic services, some of which are effective and some not. The adoption of an evidence-based practice approach is addressing this problem. The EBP process employs controlled clinical trials to identify effective services and define the critical elements...

Some Ineffective Treatments

In the past, some treatments deservedly received a bad name for their ineffectiveness or actual harm in helping people with serious and persistent mental illness. There were efforts to treat people with schizophrenia without antipsychotic medication (available since the 1950s) and with only psychotherapies, such as traditional insight-oriented individual and group therapy. These resulted in very poor outcomes for the treatment recipients (Hogarty, 1993 Lehman & Steinwachs, 1998)....

The Goals of Psychiatric Rehabilitation

As we stated above, the goals of PsyR represent the objectives of PsyR services. These are what all PsyR services strive to achieve for their clients. In that sense, goals are guidelines for service and go hand in hand with PsyR values. The combination of goals and values helps determine the guiding principles. Our review of several efforts to identify these ideas Anthony et al., 2002 Anthony amp Nemec, 1983 Cnaan, Blankertz, Messinger, amp Gardner, 1988, 1989, 1990 International Association of...

Guiding Principles of Psychiatric Rehabilitation

The guiding principles of psychiatric rehabilitation comprise a set of rules that can be applied to specific situations in order to achieve the goals and reflect the values of the field. In a sense, they constitute rules of thumb that PsyR practitioners can refer to when faced with important decisions. The principles are important tools for providing day-today guidance in clinical situations and for systematizing the practice of PsyR. Although the higher order values and goals are widely shared...

The Stress VulnerabilityCoping Competence Model

The stress vulnerability coping competence model was proposed by two individuals who are well known in the field of psychiatric rehabilitation, William A. Anthony and Robert Paul Liberman (1986). An elaboration of the diathesis stress model described earlier, the stress vulnerability coping competence model provides both a theory about the cause of severe mental illness and an explanatory framework for the impact that psychiatric rehabilitation and treatment interventions can have on the...

The History of the Self Help Movement

Self-help and mutual support among persons coping with severe mental illnesses has been an important part of psychiatric rehabilitation since the field's beginning. In fact, there are some peer support initiatives that predate the establishment of PsyR as a distinct practice. For example, the group of ex-psychiatric patients described in Chapter 6, who dubbed themselves WANA (We Are Not Alone) in the 1940s, and then went on to establish Fountain House, began as a self-help group. Alcoholics...

Individual Placement Models

The individual placement model is the most individualized approach to SE. In this model, a job coach works with an individual to identify and achieve the person's vocational goal. The services used to achieve this goal will differ depending on the client's needs and wishes as well as the agencies' approach. The best-defined examples of the individual placement model for people with mental illness are the individual placement and support approach (IPS) articulated by the New Hampshire-Dartmouth...

Physiological Evidence of the Disease Process in the Brain

Psychiatric Rehabilitation

Many persons with schizophrenia and their families attribute the illness to psychological stress alone, a conclusion that is inconsistent with psychiatric research (Holzinger, Kilian, Lindenbach, Petscheleit, & Angermeyer, 2003). However, why would we assume that individuals who experience or observe a condition would necessarily know its origins Does being bald give you insight into the hormonal changes that have taken place to bring about hair loss Certainly not. Summarizing all available...