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Interest in the ability of people to recover from a severe mental illness has a long history. During the 1980s, however, there was a paradigm shift away research driven by clinicians immersed in the quantitative, objective microcosm of anatomy and physiology towards understanding recovery from a consumer perspective. Even so the experiences of consumers has remained relatively unexplored, with the lion's share of research emanating from the United States of America. At the time of writing the proposal for this study in 2000, there was not even one Australian study of a mental health consumer perspective of recovery from severe mental illness reported in the literature. The principal aim of conducting this research was to address this need. The author, therefore, undertook this grounded theory study to: (a) explore what recovery from the effects of a severe mental illness meant to the consumers in Western Australia; (b) identify what consumers of mental health services in Western Australia wanted in their lives; and thus (c) develop a substantive theory of recovery. Fifteen participants diagnosed with either an affective disorder or schizophrenia were each interviewed and the resultant data were analysed using the constant comparative method. Comparative analysis is a long-held method of analysing data in sociology. Analysis is achieved by asking questions such as what, when, where, how, of the data and comparing similarities and differences with the various concepts within and across sets of data. The findings revealed that the basic social psychological problem (BSPP) for participants was LOSS. In order to address this problem, participants engaged in the basic social process (BSP) of OVERCOMING LOSS. The BSP is a title given to the central theme that emerges from the data and illustrates that a social process occurs overtime. The BSP emerged as a process comprising three phases: First Recuperation, second Moving Forward and third Getting Back. The analysis further revealed that the participants viewed recovery as either

BACKGROUND: Despite the high number of methamphetamine users in the Czech Republic, the treatment is still only abstinent. Pharmacotherapy in terms of substitution treatment is not yet in place. No study has yet been conducted to examine the views of workers working with methamphetamine users on the possibility of introducing substitution treatment for methamphetamine dependence in the Czech Republic. OBJECTIVE: The aim of the practical part was to map the opinions of outpatient staff on the possibility of introducing substitution treatment for methamphetamine dependence. The monitored area included the evaluation of the success of the treatment of methamphetamine dependence in outpatient settings, disparity in working with users by substance use, percentage of methamphetamine users in the facilities, the suitability of drug addiction to methamphetamine for clients of outpatient facilities and position of substitution treatment for methamphetamine, according to respondents. METHOD: The sample was elected on the basis of deliberate targeted selection through the institutions. Data capture was performed using a semi-structured interview method, which was recorded using audio recording and then transcribed. The data capture method was used to analyze the data. FILES: The research team consisted of...

[Truncated abstract] Physical healthcare uses a suite of tools for measuring response to treatment. However, reliable systems of regular patient monitoring are rare in mental healthcare. Mental health services often measure a treatment response from pre- to post- therapy, yet measurement between those occasions is less common. This omission is problematic since arguably there is a need for an alarm system in psychotherapy (Andrews & Page, 2005). A substantial minority of patients do not experience reliable change following treatment, and a small proportion deteriorates (Hansen, Lambert, & Forman, 2002; Newnham, Harwood, & Page, 2007). Without monitoring, it is not always possible to know which patients are progressing poorly. Since the publication of Howard and colleagues' (1996) proposal that patient progress be monitored routinely during therapy and the results fed back to clinicians to direct treatment, this monitoring regime has garnered attention in the United States and Europe (Lambert, 2007; Lutz, et al., 2006). Findings in outpatient psychotherapy have demonstrated that providing real-time feedback on patient progress to clinicians and patients significantly improves clinical outcomes for those patients demonstrating a negative response to treatment (Harmon et al., 2007; Lambert et al., 2001; Lambert et al., 2002). What is not yet apparent is how these processes would generalize to inpatient and day patient (i.e. patients attending hospital for a whole day of treatment) psychiatric care. Inpatients often present with greater severity and are treated in an intensive setting. ... Deviations from this expected pattern would highlight possible differences between inpatient and outpatient care. To develop an appropriate system for monitoring patient progress, it was important to first define clinically significant recovery in inpatient psychiatric care, and provide criteria for clinicians to judge outcome in routine practice (Newnham, Harwood, & Page, 2007). Second, a quick and easy-to-administer system of progress monitoring and real-time feedback was developed to enhance treatment decision making (Newnham, Hooke, & Page, 2009). Third, the system was evaluated to determine clinical effectiveness. Using the World Health Organization’s Wellbeing Index, a program for monitoring patient progress and providing feedback to clinicians and patients was established at Western Australia's largest private psychiatric service. The sample consisted of 1308 consecutive inpatients and day patients whose primary diagnoses were predominantly depressive (67.7%) and anxiety (25.9%) disorders. Feedback to patients and clinicians was effective in reducing depressive symptoms (F (1,649) = 6.29, p<.05) for those patients at risk of poor outcome, but not effective in improving wellbeing (F (1,569) = 1.14, p>.05). The findings support the use of progress monitoring and feedback in psychiatric care to improve symptom outcomes, but raise questions about changes in wellbeing during psychotherapy. The effectiveness study was conducted as a historical cohort trial, consistent with quality improvement efforts, and replication with a randomized controlled design is warranted. Feedback of progress information appears to be an important process within psychotherapy, and further investigation of the means by which clinicians and patients use that information is necessary.

Substance abusing women with children are a diverse group, but some of them are among the most disadvantaged individuals in the United States. These women are in dire need of effective treatment modalities in order to sustain sobriety. Using a quantitative research design, this study examines the perception of motivation in the recovery process among African American women with children. Through research surveys these women identify the motivating factors necessary for successful treatment outcomes. Scales were created to measure extrinsic motivators, intrinsic motivators, and barriers to treatment. Factors examined included attendance at twelve step meetings, church attendance, court mandates, family support, assistance from Children's Services Workers, participation in residential and outpatient treatment programs, training in life skills such as assertivenesss, stress management, effective communication, vocational skills, and parenting, and intrinsic spiritual beliefs. The study also examined barriers to treatment such as lack of transporation, child care, employment, housing and money.

The ability to monitor client change in psychotherapy over time is vital to quality assurance in service delivery as well as the continuing improvement of psychotherapy research. Unfortunately, there is not currently a comprehensive, affordable, and easily utilized outcome measure for psychotherapy specifically normed and standardized for use in psychology training clinics. The current study took the first steps in creating such an outcome measure. Following development of an item bank, factor analysis and item-response theory analyses were applied to data gathered from a stratified sample of university (n = 101) and community (n = 261) participants. The factor structure did not support a phase model conceptualization, but did reveal a structure consistent with the theoretical framework of the research domain criteria (RDoC). Suggestions for next steps in the measure development process are provided and implications discussed.

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This study measured the effectiveness of rehabilitative day treatment (RDT) programs for persons with severe and persistant mental illness in San Bernardino County. The effectiveness of RDT services was determined by rates of recidivism.

The purpose of this thesis was to develop methodology by which treatments for the cognitive impairments in Huntington's disease (HD) could be tested. As such, the thesis focused mainly on evaluating rats with quinolinic acid (QA) lesions of the striatum, as this manipulation mimics some aspects of the neural damage in Huntington's disease, to try to identify cognitive deficits of HD resulting from cell loss in the striatum. In the first part (Chapters 3-5), the role of the striatum in implicit memory was investigated. Chapter 3 compared the performance of rats and humans on a reaction time task that evaluated implicit memory by presenting visual stimuli with differing probabilities which change over time. Although rats made higher percentage of incorrect responses and late errors, both groups showed a similar pattern of reaction times. Chapter 4 investigated whether implicit memory (the computation of probabilities to predict the location of a stimulus) was affected by selective blockade of dopaminergic transmission at the D1 or D2 receptors by SCH-23390 and raclopride, respectively. Reaction times were slower with SCH-23390 and raclopride, but only SCH-23390 reduced errors to the least probable target location. Chapter 5 used the same task to evaluate implicit memory in rats with QA lesions of the dorsomedial striatum (DMS). Implicit memory was not affected by lesions of the DMS, which suggested that once a task that requires implicit memory has been learned, the DMS was not involved in sustaining the performance of the task. The second part of this thesis (Chapter 6), explored the contribution of the DMS in habit formation. DMS lesioned rats did not show habitual responding, and were not impaired in learning a new goal-directed behaviour. The third part (Chapters 7 and 8), investigated the role of the dorsal striatum in reversal learning, attentional set-formation, and set-shifting. Dorsal striatum lesioned rats were not impaired in reversal learning, but had a diminished shift-cost, which suggested that dorsal striatum lesions disrupted the formation of attentional sets. These results showed that although QA lesions of the dorsal striatum mimic some aspects of the neural damage in HD, they did not result in the same cognitive deficits observed in patients with HD, at least using the tasks presented in this thesis. However, other animal models of HD could be evaluated using the different tasks presented in this thesis to continue the search of a reliable animal model of HD in which treatments for the disease could be evaluated.

Indicators of quality early intensive behavioral intervention (EIBI) include comprehensive interventions, adequately trained staff, high rates of effective instruction delivery, happy interactions between children and their teachers, and socially valid outcomes. When these are in place, high quality EIBI is more likely to increase progress that children with autism make during treatment. When not in place, progress is not as likely, as rapid, or as meaningful. To date, there is limited research regarding the correlation between these indicators of high-quality EIBI and the degree to which their effects are meaningful to direct consumers. The purpose of this methodological study was to compare direct, quantitative measures of teaching interactions (child initiations, teacher initiations, child affect, teacher affect) with qualitative measures (stakeholder ratings of teacher effectiveness, amount of opportunities for interaction and interest in the child) of teaching interactions to determine what sets the occasion for expert stakeholders to describe a teaching interaction as effective, quality therapy.