• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Helping the Severely Mentally Ill to Help Themselves

Helping the Severely Mentally Ill to Help Themselves

March 1, 2012
Glen Spielmans, PhD
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Glen Spielmans, PhD Associate professor of psychology, Metropolitan State University, St. Paul, MN Glen Spielmans, PhD, has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Subject:
RECOVERY

Short Description:
Helping the Severely Mentally Ill to Help Themselves

Background:

“Self-management” is a newly popular buzzword among clinicians treating the seriously mentally ill. Self-management programs include psychoeducation for patients about their illness, training to help patients communicate more effectively with their doctors, and instruction on how to advocate for themselves in treatment settings.

One of the more popular self-management programs is Wellness Recovery Action Planning (WRAP). In WRAP, trained peer instructors lead weekly sessions consisting of group exercises, lectures, and voluntary homework. Group topics include such items as maintaining wellness, recognizing symptoms, managing crises, and learning where to obtain credible information about one’s condition. In a controlled trial early last year, patients of public mental health clinics who participated in WRAP had fewer psychiatric symptoms and an enhanced quality of life than those not receiving WRAP training (Cook JA et al, Schiz Bull 2011;online ahead of print).

One possible explanation for the efficacy of WRAP is that it facilitates a patient’s self-determination and builds self-advocacy skills. To test this hypothesis, the researchers randomized 555 community mental health patients, most of whom had been diagnosed with psychotic or mood disorders (but no substance use disorders), to either a two-month WRAP intervention (276 patients) or to treatment as usual (279 patients). All patients continued to receive medications, case management, and therapy if and when indicated. “Self-advocacy” was measured by the Brashers’ Patient Self-Advocacy Score (PSAS). This scale consists of three subscales: education, the patient’s willingness to learn about his/her illness; assertiveness, the patient’s ability to be assertive during a health-care encounter; and mindful non-adherence, the patient’s inclination to disregard a provider’s recommendations (while we often consider “non-adherence” an undesirable outcome, in this case, it represents the patient’s ability to act autonomously in an informed way) (Brashers et al, Health Communication 1999;11(2):97–121).

Patients who received WRAP training had greater self-advocacy scores over time than those assigned to treatment as usual. This was particularly true on the measure of mindful non-adherence; scores on the other subscales did not change significantly. Higher overall self-advocacy scores were significantly correlated with higher levels of hopefulness (correlation coefficient r = 0.45), better quality of life (r = 0.28), and lower symptom severity, as measured by the Brief Symptom Inventory (BSI) Global Severity Index (r = -0.23). (Jonikas JA et al, Comm Ment Health J Dec 2011;online ahead of print).

TCPR's Take:
WRAP training appears to be a simple and inexpensive way of increasing the assertiveness of the seriously mentally ill. We’d like to see longer term follow-up, but meanwhile we recommend referring patients to such a program if you can find one in your community.
General Psychiatry
KEYWORDS psychotherapy research_updates
    Ccpr octnovdec2020 qa1 headshot spielmans 150x150
    Glen Spielmans, PhD

    L-Methylfolate May Offer Modest Boost to Antidepressants

    More from this author
    www.thecarlatreport.com
    Issue Date: March 1, 2012
    SUBSCRIBE NOW
    Table Of Contents
    Does Counseling Add to Suboxone’s Efficacy?
    Helping the Severely Mentally Ill to Help Themselves
    Dialectical Behavior Therapy: A Primer
    Differentiating Borderline Personality Disorder from Bipolar Disorder
    Diagnosing Personality Disorders: The Latest Trends
    Please Join Us in Welcoming our New Editor-in-Chief, Dr. Steve Balt!
    DOWNLOAD NOW
    Featured Book
    • PB4e_Cover2.png

      Psychiatry Practice Boosters, Fourth Edition (2023)

      Teaches you the key points of 63 of the most clinically relevant studies in psychiatry.
      READ MORE
    Featured Video
    • therapist_canstockphoto9201097.jpg
      General Psychiatry

      Using SAMe In Clinical Practice with Garrett Rossi, MD

      Read More
    Featured Podcast
    • canstockphoto6759394.jpg
      General Psychiatry

      Throwback Thursday: Brief Therapy for ADHD

      You started a stimulant medication for a young woman with ADHD. When she returns her symptoms are 70% better, but what can we do about the rest? Today a conversation with...

      Listen now
    Recommended
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    info@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.