The Hope Scale by Snyder and the Recovery Attitudes Questionnaire-7 were used to explore the patterns of hope and attitude toward recovery from schizophrenia in a sample of 100 adults diagnosed with schizophrenia or schizoaffective disorder participating in five psychiatric rehabilitation programs in an affluent suburban setting. Using the Hope Scale, which is based on a definition of hope as a future-goal oriented cognitive process, and the Recovery Attitudes Questionnaire-7(RAQ-7), this study concluded that the construct of hope is not synonymous with a positive attitude about attaining the goal of recovery. Though participants reported being generally hopeful and having positive attitudes toward recovery from serious mental illness, the two variables, hope and attitude do not correlate with each other. Nor do individual items from the Hope Scale and the Recovery Attitudes Questionnaire-7 load on the same components during principal components factor analysis, though hope and attitude each account for more than 20% of the total variance of the data set. A serendipitous finding was the statistically significant difference between the means on the RAQ-7 of the sample of the current study and the sample of the instrument development process; across all levels of recovery, a more positive attitude towards recovery was expressed than was expressed seven years earlier. An additional statistically significant finding was the direct positive correlation between level of recovery and number of hours of volunteer service per week. Rather than concentrating on talk therapy with persons with schizophrenia to increase levels of hope and positive attitude before recovery begins, a more effective means of encouraging recovery may be to involve individuals with schizophrenia in meaningful social roles through volunteer work. / Ph. D.

Syftet med studien var att undersöka vilka faktorer i psykiatrisk rehabiliteringsteori som var de viktigaste stödjande och hindrande faktorerna för att deltagare i arbetslivsinriktad rehabilitering skulle kunna slutföra gymnasial/eftergymnasial utbildning och få ett arbete på dagens arbetsmarknad. Deltagarna i denna studie kom från fyra verksamheter inom Supported Education (SEd) i Sverige. Faktorerna för både stödjande och hindrande faktorer ville jag få fram i prioritetsordning, eftersom jag från tidigare forskning upplevde det svårt att veta vad som först ska prioriteras i arbetet med rehabilitering genom utbildning och arbete/anställning. Detta för att skapa en djupare förståelse för vad som är viktigt för personer med psykiska funktionshinder/ohälsa för att påbörja och slutföra utbildning, men också för att se om tjänsten SEd har potential att användas inom socialt arbete i form av arbetslivsinriktad rehabilitering och återhämtningsinriktat stöd för psykisk ohälsa och psykiska funktionshinder. För att besvara detta använde jag en enkät med tio kvantitativa slutna frågor och sju kvalitativa öppna frågor.      SEd är ett stödprogram inom arbetslivsinriktad rehabilitering för att välja, påbörja och slutföra utbildning på gymnasial och eftergymnasial nivå främst för personer med psykiska funktionshinder/psykisk ohälsa. Diskussioner pågår om att andra målgrupper utan psykiska funktionshinder/psykisk ohälsa ska kunna få detta stöd för att slutföra utbildningar.      Från resultatet av studien fick jag fram ett antal teman för vad som stödjer och hindrar slutförandet av utbildning. Resultatet visade att deltagarna generellt är nöjda med stödet de får från SEd. Mest framträdde personalens genuina engagemang, förmåga till empati och ett respektfullt bemötande som de avgörande faktorerna för att deltagarna skulle påbörja och slutföra utbildning. Andra faktorer som stödde deltagarna var att de fick stöd att slutföra studieuppgifter, att stödet inte var tidsbegränsat, att deltagarna hade regelbundna enskilda stödsamtal med personal, att de upplevde gemenskap och tillhörighet i SEd och att studie- och yrkesvägledning genomfördes som ledde till en individuell handlingsplan som följdes upp kontinuerligt.        Hindrande faktorer för deltagarna med SEd var att lokalerna var för små och studiecoacherna var för få. Generella hinder för deltagarna att slutföra utbildning var psykisk ohälsa (till exempel ångest, fobi, depression), svårigheter med studieekonomin, svårigheter med socialt samspel, svårigheter med koncentration, brist på studieteknik och svårigheter att slutföra uppgifter, ADHD, ADD, dyslexi, missbruk, svårigheter med att orka med ett högt studietempo och brist på stöd med att slutföra uppgifter. Detta resultat analyserade jag med hjälp av psykiatrisk rehabiliteringsteori. Jag förde sedan en diskussion där jag lyfte fram de utmaningar och möjligheter som vi kan se i framtiden för SEd. / The purpose of this study was to examine which factors in the psychiatric rehabilitation theory that were the most important supporting and hindering factors for getting participants in Vocational Rehabilitation to complete secondary/postsecondary education and get a job in todays labour market. The participants in this study came from four Supported Education (SEd-) projects in Sweden. I wanted to get forth the factors in order of priority since I found it difficult to find which factors to prioritize first in the work of rehabilitation through education and employment. I did this to get a deeper understanding of what is most important for persons with psychiatric disabilities/mental illness to be able to complete secondary/postsecondary education, but I also did it to investigate if the service of SEd has the potential of being used in social work in the shape of vocational rehabilitation and recoveryoriented support for mental illness and psychiatric disabilities. To be able to answer those questions I used a questionnaire with ten quantitative closed questions and seven qualitative open questions..      Supported Education (SEd) is a supportprogram aimed at supporting persons mainly with psychiatric disabilities/mental illness to choose, start and complete education on secondary and postsecondary level. There are ongoing discussions about whether other target groups without psychiatric disabilites/ mental illness could get this support to complete education.       From the results of the study I found a number of themes for what supported or hindered the participants in completing their education. The results showed that the participants generally were very satisfied with the support they got from the staff in SEd. Most of all it was the staffs genuine engagement, empathy and a respectful treatment that stood forth as the crucial factors that affected the participants to complete their education. Other factors that also supported the participants to complete their education is that they got support with completing their study tasks, there were no time limit for the support, the recurrent individual counseling sessions with staff, the experience of fellowship and belonging and educational and vocational guidance that supported the participants in forming an individual action plan which was followed up continuosly.       Hindering factors with SEd for the participants were that the localities were too small and that the study coaches were too few. Hindering factors in completing education in general was mental illness (e.g. anxiety, phobia and depression), difficulties with economy, difficulties in socialising with people, difficulties with concentration, lack of a technique for studying and difficulties with completing tasks, ADHD,ADD, dyslexia, addiction, problems to adjust to a high tempo in the education and lack of support with completing tasks. I analyzed these results by using the psychiatric rehabilitation theory. I then discussed the challenges and possibilities that we can see in the future with the SEd-method.

Compreender como moram e se inserem socialmente os milhares de usuários de Centros de Atenção Psicossocial pode contribuir para a ampliação qualitativa e quantitativa da oferta, por meio de políticas públicas, de alternativas de moradia para pessoas com Transtornos Mentais Graves. Nesse sentido, apresentamos dois estudos articulados: revisão bibliográfica e bibliometria somada à retomada e subsídios à qualificação de instrumento voltado às condições de moradia e inserção social de usuários de CAPS. Por meio da revisão, feita nas bases de dados Scopus e Lilacs, e considerando o período entre os anos 2000 e 2017, identificamos que os estudos raramente extrapolam os Serviços Residenciais Terapêuticos, negligenciando as diferentes necessidades de moradias de pessoas com TMG e apresentando desenhos metodológicos pouco variados e referenciais teóricos predominantemente oriundos de textos seminais que embasaram o início da reforma psiquiátrica brasileira. Por sua vez, a qualificação de um instrumento poderá criar condições para conhecer de forma detalhada e em escala ampliada como efetivamente essa clientela equaciona questões de moradias. Para isso retomamos questionário sobre as condições de moradia e inserção social de usuários de CAPS, desenvolvido por pesquisadores brasileiros, e realizamos um estudo sobre sua confiabilidade. Este estudo se deu a partir da verificação da estabilidade temporal e consistência interna dos itens correspondentes às dimensões que compõe o conceito de inserção social: convívio, suporte, morar e habitar. Participaram deste estudo 46 usuários de CAPS III do município de Santos, entrevistados entre agosto e outubro de 2018, sendo que 24 participaram da técnica teste-reteste. A estabilidade temporal foi analisada por meio dos coeficientes Kappa de Cohen e Kappa ponderado, enquanto a consistência interna foi analisada por meio dos coeficientes KR20 e alfa de Cronbach. Os itens apresentaram valores de Kappa e Kappa ponderado que variaram de 0,37 a 1, os valores do coeficiente KR20 variaram de 0,67 a 0,96 e o alfa de Cronbach foi de 0,85 para a dimensão morar. Consideramos como fatores limitantes: a possibilidade de não termos abrangido a totalidade de publicações existentes, na análise sobre a produção teórica, bem como o reduzido número de participantes do estudo de confiabilidade. Concluímos que o tema moradia para pessoas com TMG carece de ampliação em quantidade e formas de investigações, que utilizem novas abordagens teóricas e metodológicas. O questionário proposto para o estudo de condições de moradia apresentou boa confiabilidade para maioria dos itens analisados, porém não foi suficiente para abordar todas as dimensões que compõem o conceito inserção social. Além disso, outros aspectos do referido instrumento precisam ser analisados e a reformulação de alguns itens poderia contribuir para resultados com maior precisão / Understanding how thousands of Psychosocial Care Centers´ (CAPS) clients live and socialize can contribute to the qualitative and quantitative expansion of the offer, through public policies, of housing alternatives for people with Serious Mental Disorders. In this sense, we present two articulated studies: bibliographical review and bibliometrics analysis added to the qualification of an instrument focused on housing conditions and social insertion of CAPS clients. By reviewing the Scopus and Lilacs databases from the period 2000 and 2017, we identified that the studies rarely extrapolate the Therapeutic Residential Services, neglecting the different housing needs of people with SMD, and presenting slightly different methodological designs and theoretical references predominantly from seminal texts that underpinned the beginning of the Brazilian psychiatric reform. In turn, the qualification of an instrument may create conditions to know in detail and in an enlarged scale how effectively these clientele equates housing issues. For this, we retrieve a questionnaire about the conditions of housing and social insertion of CAPS users, developed by Brazilian researchers and carried out a study about its reliability. This study was based on the verification of the temporal stability and internal consistency of the items corresponding to the dimensions that make up the concept of social insertion: socializing, support, living and dwelling. Participants of this study were 46 CAPS III users from the city of Santos, interviewed between August and October 2018, of whom 24 participated in the test-retest method. The temporal stability was analyzed using the Cohen\'s Kappa coefficient and weighted Kappa coefficient, while the internal consistency was analyzed using the KR20 and Cronbach alpha coefficients. The items presented weighted Kappa and Kappa values ranging from 0.37 to 1, values of the KR20 coefficient varied from 0.67 to 0.96 and the Cronbach\'s alpha was 0.85 for the living dimension. We considered as limiting factors: the possibility of not including all the existing publications on the theoretical production analysis, and the reduced number of participants in the reliability study. We conclude that the housing issue for people with SMD needs to be expanded in quantity and forms of research, using new theoretical and methodological approaches. The questionnaire proposed for the study of housing conditions presented good reliability for most of the items analyzed, but it was not enough to address all the dimensions that make up the concept of social insertion. In addition, other aspects of the instrument need to be analyzed and reformulation of some items could contribute to results more accurately

Social Work With Clients With Schizophrenia is a disertation concerninig the problematics of schizophrenia as a serious mental disorder. It presents the most important matters of this disorder, such as how its manifestated, what are its types and how it progreses. It handles the information about how the social work with this focus group is being executed in Czech Republic, what is a psychiatric rehabilitation and how it should be processed, how should social workers approach clients with this disorder and what are the specifcs of social work with those clients. It presents examples of organisations and associations working with this focus group in Czech Republic. The experimental part is a reasearch concerning how clients with schizophrenia percieves life, how the disorder started and continued and mainly how informed those clients are about the possibilities of social services.

ABSTRACT AN ANALYSIS OF ADA TITLE I ALLEGATIONS OF WORKPLACE DISCRIMINATION AS FILED WITH THE EEOC BY PERSONS WITH MENTAL ILLNESS Jessica Erin Hurley A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Health Related Sciences—Rehabilitation Leadership Virginia Commonwealth University, 2011 Dissertation Chair: Brian T. McMahon, Ph.D., CRC This study explores employment discrimination as experienced by persons with mental illness who filed allegations under Title I (the employment provisions) of the Americans with Disabilities Act (ADA) of 1990. The entire universe of employment discrimination allegations filed under Title I of the ADA from July 26, 1992 (its first effective date) until the present is maintained by the Equal Employment Opportunity Commission (EEOC) in a database named the Intermission System (IMS). This database contains over 2 million allegations of workplace discrimination filed not only under Title I of the ADA, but also under all statutes in its jurisdiction. From the IMS, two extractions containing ADA Title I allegations only and ranging from July 26,1992 through December 31, 2008 [the last date before the Americans with Disabilities Act Amendments Act (ADAAA) of 2008 went into effect] were made: the first including all Title I allegations for all impairments, not just mental illness (402,291); and the second containing only those Title I allegations filed by persons with mental illness (56,846 total: depression (25,375); unknown mental illness (11,977); anxiety disorder (10,370); bipolar disorder (7,675); and schizophrenia 1,449). Using nonparametric tests of proportion, each group of allegations is compared to the balance of mental illness allegations that is left once the group of allegations is removed. In addition, each group individually, as well as the complete group of all mental illness allegations, is evaluated with an exploratory technique called the Exhaustive Chi Squared Interaction Detector. Lastly, findings are provided and implications for employees, employers, rehabilitation professionals, policy makers, and future researchers are discussed.

Indiana University-Purdue University Indianapolis (IUPUI) / Assertive Community Treatment (ACT) represents an effective treatment for individuals with severe mental illness. Though studies estimate that as many as half of all people with severe mental illness are parents, little is known about consumers receiving ACT services who are parents. Thus, the purpose of the present study was to 1) estimate the prevalence of parent ACT consumers, 2) identify current ACT team policies and practices for treating parent consumers, and 3) examine the perspective of parent consumers served by ACT teams. Quantitative and qualitative data were collected and analyzed via two separate studies. In study 1, eighty-two ACT providers from 76 teams across the United States and Canada were surveyed to determine the prevalence of parent ACT consumers, ACT team policies for identifying the parental status of consumers, treatment services available for parent consumers, and provider attitudes about parent consumers. Providers estimated roughly 21.6% of ACT consumers were parents. Less than half of providers (46.3%) reported formally asking about parental status during intake and only 20.7% providers belonged to ACT teams that provide special programs/services designed for parent consumers. The majority of providers (75.6%) reported negative or mixed attitudes about parents with severe mental illness. In study 2, seventeen parents with severe mental illness being served by ACT teams were interviewed about parenting, the relationship between parenting and severe mental illness, parenting needs, and suggestions for improved treatment services for parents. All parents were able to identify at least one positive aspect of parenting and most parents (76.5%) also identified negative aspects of parenting. Loss of custody emerged as a significant parenting problem, with the majority of parents (88.2%) experiencing loss of custody at least once. Given the difficulties of being a parent and having to manage a severe mental illness, parents expressed interest in several parent-focused treatment services, including family therapy, parenting skills, communication skills training, resources/finances for children, and social support groups with peers. When asked about overall satisfaction with ACT services, most participants with adult children (87.5%) reported having no unmet parent-related needs and high satisfaction (4.63 out of 5) with ACT services, whereas parents with young children (77.8%) reported having numerous unmet parenting needs and low satisfaction (3.78 out of 5) with ACT services. Thus, the age of participants’ children was a significant factor, indicating that the ACT treatment model may not be adequately serving parents of young, dependent children. Overall, findings suggest the need for more attention and focus on parent consumers, including formal identification of consumers’ parental status and improved parent-related treatment services and support