Due to the deinstitutionalization movement which began over thirty years ago, community treatment programs for persons with severe mental illness have had to be developed to replace the services and support that were previously available in psychiatric hospitals. Apart from the Assertive Community Treatment (ACT) model, which has been much studied and shown to be superior both to other types of treatment and to controls, few consistent differences have been found among the different community treatment models. This may be partially due to the fact that the contribution of worker characteristics to client well being has not previously been taken into account. The effect that the individual worker has on the client and on treatment outcomes is comparable to therapist effects in the psychotherapy literature. This study was designed to examine the effects of worker characteristics on the well being of persons with severe mental illness living in the community. A sample of 65 people served by an ACT program were interviewed to obtain self-reports of subjective quality of life, symptoms and the relationship with their worker. The workers also rated their clients' level of functioning and each completed a self-report measure of attitudes toward mental illness. In addition, supervisors were asked to rate workers' competence on a newly-developed Competency Rating Scale. It was hypothesized that greater worker competency, a more positive attitude to mental illness, and a greater number of years working in the mental health field would have both direct and indirect effects (through the working alliance) on client well being in the form of better quality of life, fewer symptoms and improved functioning. It was found that a closer working alliance was associated with greater client well being in the form of greater quality of life and better functioning. Surprisingly, the strongest association found was between a greater number of worker years in mental health and quality of life, with workers who had more years experience in the field of mental health having clients who reported a lower subjective quality of life. It was suggested that workers who started in the field earlier may have learned and adopted a more restrictive philosophy about mental health treatment than that which is currently being taught.
| Identifer | oai:union.ndltd.org:uottawa.ca/oai:ruor.uottawa.ca:10393/29024 |
| Date | January 2003 |
| Creators | Kroitor, Yvanna |
| Contributors | Gerber, Gary, |
| Publisher | University of Ottawa (Canada) |
| Source Sets | Université d’Ottawa |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 116 p. |
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