Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-25T17:13:08.580Z Has data issue: false hasContentIssue false

3 - The Rehabilitation Model for Persons with Psychosis

History, Challenges, Controversies, and Future Prospects

from Part I - The Past

Published online by Cambridge University Press:  03 March 2022

By
Jerome Yoman
Edited by
Meaghan Stacy  and
Charlie A. Davidson
Meaghan Stacy
Affiliation:
Yale University, Connecticut
Charlie A. Davidson
Affiliation:
Emory University, Atlanta
Get access

Summary

“Decades ago, the rehabilitation model emerged as an innovative tool for planning services and clarifying clients’ goals. Central to the model are disadvantages. Yoman and Edelstein (1994) defined disadvantages in terms of the relationship between clients’ performance and environmental demands. This definition of disadvantage incorporates social constraints such as discrimination and is consistent with the biopsychosocial model of disability. Defining disadvantage this way is also highly compatible with behavioral assessment, and readily yields skills training and advocacy/support goals to improve the client’s quality of life. Viewed from a present day perspective, the rehabilitation model played an important historical role, in part as a transition from the medical model to the recovery model. It continues to be relevant today. As alluded to above, many of the disadvantages people with serious mental illnesses face are systemic, and held in common across many individuals. This chapter will describe the implications of the rehabilitation model for addressing both individual and systemic disadvantages. With a view toward the future, the chapter will show how the rehabilitation model can be reconciled with the recovery model, and how it can be used to continue to improve services for those with serious mental illnesses.”

Keywords

Disabilitydisadvantagepsychiatric rehabilitationtreatment planninghistoryconsumer/survivor/ex-patient (CSX)token economiesbehavioral interventionsrecoveryoutcomes
Type
Chapter
Information
Recovering the US Mental Healthcare System
The Past, Present, and Future of Psychosocial Interventions for Psychosis
 , pp. 52 - 77
Publisher: Cambridge University Press
Print publication year: 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author.Google Scholar
American Psychological Association, Division 12. (n.d.). Research-supported psychological treatments. American Psychological Association, Division 12. https://div12.org/psychological-treatments/.Google Scholar
Anthony, W. A. (1972). Societal rehabilitation: Changing society's attitudes toward the physically and mentally disabled. Rehabilitation Psychology, 19(3), 117–126.Google Scholar
Anthony, W. A. (1977). Psychological rehabilitation: A concept in need of a method. American Psychologist, 32(8), 658–662.Google Scholar
Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16, 11, 13.CrossRefGoogle Scholar
Anthony, W., Cohen, M., & Farkas, M. (1990). Psychiatric rehabilitation. Boston, MA: Center For Psychiatric Rehabilitation.Google Scholar
Anthony, W. A., & Liberman, R. P. (1986). The practice of psychiatric rehabilitation: Historical, conceptual, and research base. Schizophrenia Bulletin, 12, 542–559.Google Scholar
Ayllon, T., & Azrin, N. H. (1965). The measurement and reinforcement of behavior of psychotics. Journal of the Experimental Analysis of Behavior, 8, 357–383.Google Scholar
Ayllon, T., & Azrin, N. H. (1968). The token economy: A motivational system for therapy and rehabilitation. New York: Appleton-Century-Crofts.Google Scholar
Ball, R. M. (1973). Social Security amendments of 1972: Summary and legislative history. Social Security. https://www.ssa.gov/history/1972amend.html#:~:text=On%20February%2023%2C%201972%2C%20Chairman,the%20contribution%20and%20benefit%20base.Google Scholar
Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Barton, R. (1999). Community support systems: A review of outcomes and policy recommendations. Psychiatric Services, 50, 525–534.CrossRefGoogle ScholarPubMed
Beck, A. T. (1988). Beck Hopelessness Scale. New York: The Psychological Corporation.Google Scholar
Beers, C. W. (1953). A mind that found itself: An autobiography. Garden City, NY: Doubleday.Google Scholar
Bellack, A. S. (2006). Scientific and consumer models of recovery in schizophrenia: Concordance, contrasts, and implications. Schizophrenia Bulletin, 32(3), 432–442.Google Scholar
Beutler, L. E., & Harwood, T. M. (2000). Prescriptive psychotherapy: A practical guide to systematic treatment selection. Oxford University Press.CrossRefGoogle Scholar
Biklen, D. P. (1976). Behavior modification in a state mental hospital: A participant-observer’s critique. American Journal of Orthopsychiatry, 46, 53–61.CrossRefGoogle Scholar
Bluebird, G. (n.d.). History of the consumer/survivor movement. National Empowerment Center, Inc. https://power2u.org/wp-content/uploads/2017/01/History-of-the-Consumer-Survivor-Movement-by-Gayle-Bluebird.pdf.Google Scholar
Carling, P. J. (1995). Return to community: Building support systems for people with psychiatric disabilities. New York: Guilford Press.Google Scholar
Carter, I. (2019). Positive and negative liberty. In Zalta, Edward N. (Ed.), The Stanford Encyclopedia of Philosophy (Winter Edition), https://plato.stanford.edu/archives/win2019/entries/liberty-positive-negative/.Google Scholar
Center for Psychiatric Rehabilitation (n.d.). About our founder. https://cpr.bu.edu/about/history/about- our-founder/.Google Scholar
Chamberlin, J. (1978). On our own: Patient-controlled alternatives to the mental health system. New York, NY, USA: McGraw-Hill.Google Scholar
Chandler, D., Spicer, G., Wagner, M., & Hargreaves, W. (1999). Cost-effectiveness of a capitated assertive community treatment program. Psychiatric Rehabilitation Journal, 22(4), 327–336.CrossRefGoogle Scholar
Cohen, O. (2005). How do we recover? An analysis of psychiatric survivor oral histories. Journal of Humanistic Psychology, 45(3), 333–354.Google Scholar
Cook, T. D., & Shadish, W. R. Jr. (1987). Program evaluation: The worldly science (pp. 31–70). In Shadish, W. R. Jr.,& Reichardt, (Eds.), Evaluation studies review annual (Vol. 12). Newbury Park, CA: Sage Publications.Google Scholar
Corrigan, P. W. (1991). Strategies that overcome barriers to token economies in community programs for severe mentally ill adults. Community Mental Health Journal, 27(1), 17–30.CrossRefGoogle ScholarPubMed
Corrigan, P. W. (1995). Use of a token economy with seriously mentally ill patients: Criticisms and misconceptions. Psychiatric Services, 46(12), 1258–1263.Google ScholarPubMed
Corrigan, P. W. (1997). Behavior therapy empowers persons with severe mental illness. Behavior Modification, 21(1), 45–61.Google Scholar
Corrigan, P. W. (2016). Principles and practice of psychiatric rehabilitation: An empirical approach (2nd ed.). New York: Guilford Press.Google Scholar
Corrigan, P. W., & McCracken, S. G. (1995). Refocusing the training of psychiatric rehabilitation staff. Psychiatric Services, 46, 1172–1177.Google Scholar
Crow, L. (1996). Including all of our lives: Renewing the social model of disability. In Barnes, C. & Mercer, G. (Eds.), Disability and Illness: Exploring the Divide (pp. 55–72). Leeds, UK: The Disability Press.Google Scholar
Danley, K. S., Sciarappa, K., & MacDonald-Wilson, K. (1992). Choose-get-keep: A psychiatric rehabilitation approach to supported employment. New Directions for Mental Health Services, 53, 87–96.Google Scholar
Davidson, L. (2016). The recovery movement: Implications for mental health care and enabling people to participate fully in life. Health Affairs, 35, 1091–1097.CrossRefGoogle ScholarPubMed
Davidson, L., Stayner, D. A., Nickou, C., Styron, T. H., Rowe, M., & Chinman, M. L. (2001). “Simply to be let in”: Inclusion as a basis for recovery. Psychiatric Rehabilitation Journal, 24(4), 375–388Google Scholar
Department of Health and Human Services. (1994). Revitalizing the Community Support Program. Washington, DC: Office of Inspector General, Department of Health and Human Services.Google Scholar
Dickerson, F., Ringel, N., Parente, F., & Boronow, J. (1994). Seclusion and restraint, assaultiveness, and patient performance in a token economy. Hospital and Community Psychiatry, 45(2), 168–170.Google Scholar
Dickerson, F. D., Tenhula, W. N., & Green-Paden, L. (2005). The token economy for schizophrenia: Review of the literature and recommendations for future research. Schizophrenia Research, 75, 405–416.Google Scholar
Drake, R. E., Deegan, P. E., & Rapp, C. (2010). The promise of shared decision making in mental health [Editorial]. Psychiatric Rehabilitation Journal, 34(1), 7–13.Google Scholar
Drake, R. E., Skinner, J. S., Bond, G. R., & Goldman, H. H. (2009). Social Security and mental illness: Reducing disability with supported employment. Health Affairs, 28(3), 761–770.Google Scholar
Fairweather, G. W., Sanders, D. H., & Tornatzky, L. G. (1974). Creating change in mental health organizations. New York: Pergamon.CrossRefGoogle Scholar
Falloon, I. R. H., & Liberman, R. P. (1983). Behavioral family interventions in the management of chronic schizophrenia. In McFarlane, W. R. (Ed.), Family therapy in schizophrenia (pp. 117–140). New York: Guilford.Google Scholar
Farkas, M., Anthony, W., Montenegro, R., & Gayvoronskaya, E. (2016). Person-centered psychiatric rehabilitation. In Mezzich, J. E., Botbol, M., Christodoulou, G. N., Cloninger, C. R., & Salloum, I. M. (Eds.), Person Centered Psychiatry (pp. 277–289). Springer International Publishing.Google Scholar
Fisher, D. (2010). The evolution of the concept of recovery. E-News, Issue 2, Recovery to Practice Resource Center for Mental Health Professionals, U.S. Department of Health and Human Service, Substance Abuse and Mental Health Services Administration.Google Scholar
Foundations for Evidence-Based Policymaking Act of 2018. 5 USC 101 (2019). Retrieved July 16, 2020 from https://www.congress.gov/bill/115th-congress/house-bill/4174.Google Scholar
Frese, F. J., Stanley, J., Kress, K., & Vogel-Scribilia, S. (2001). Integrating evidence-based practices and the recovery model. Psychiatric Services, 52, 1462–1468.Google Scholar
Frisch, M. B. (1994). Quality of life inventory. Minneapolis, MN: National Computer Systems.Google Scholar
Glynn, S. M. (1990). Token economy approaches for psychiatric patients: Progress and pitfalls over 25 years. Behavior Modification, 14(4), 383–407.Google Scholar
Glynn, S. M. (2014). Bridging psychiatric rehabilitation and recovery in schizophrenia: A life’s work. American Journal of Psychiatric Rehabilitation, 17(3), 214–224.CrossRefGoogle Scholar
Goffman, E. (1961). Asylums: Essays on the social situation of mental patient and other inmates. New York: Anchor Books.Google Scholar
Greenwood, K. E., Sweeney, A., Williams, S., Garety, P., Kuipers, E., Scott, J., & Peters, E. (2010). Choice of outcome in CBT for psychoses (CHOICE): The development of a new service user-led outcome measure of CBT for psychosis. Schizophrenia Bulletin, 36(1), 126–135.Google Scholar
Grim, A. (July 8, 2015). Sitting-in for disability rights: The Section 504 protests of the 1970s. National Museum of American History. https://americanhistory.si.edu/blog/sitting-disability-rights-section-504-protests-1970s.Google Scholar
Grob, G. N. (1992). Mental health policy in America: Myths and realities. Health Affairs, 11(3), 7–22.Google Scholar
Harding, C., Brooks, G., Ashikaga, T., Strauss, J., & Breier, A. (1987). The Vermont longitudinal study of persons with severe mental illness: Methodology, study sample, and overall status 32 years later. American Journal of Psychiatry, 144, 718–726.Google ScholarPubMed
Hogan, M. F. (2003). New Freedom Commission report: The President’s New Freedom Commission recommendations to transform mental health are in America. Psychiatric Services, 54, 1467–1474.Google Scholar
Kanfer, F. H., & Schefft, B. K. (1988). Guiding the process of therapeutic change. Research Press.Google Scholar
Kazdin, A. E. (1982). The token economy: A decade later. Journal of Applied Behavior Analysis, 15(3), 431–445.Google Scholar
Kopelowicz, A., & Zarate, R. (2014). The role of Robert Liberman in the development of family psychoeducation. American Journal of Psychiatric Rehabilitation, 17(3), 197–213.Google Scholar
Kopelowicz, A., Zarate, R., Wallace, C. J., Liberman, R. P., Lopez, S. R., & Mintz, J. (2012). The impact of multifamily groups to improve treatment adherence in Mexican Americans with schizophrenia. Archives of General Psychiatry, 69, 265–273.Google Scholar
Leary, M. R., Kelly, K. M., Cottrell, C. A., Schreindorfer, L. S. (2013). Construct validity of the need to belong scale: Mapping the nomological network. Journal of Personality Assessment, 95(6), 610–624.Google Scholar
Lehman, A. F. (1983). The effects of psychiatric symptoms on quality of life assessments among the chronically mentally ill. Evaluation and Programme Planning, 6, 143–151.Google Scholar
Lehman, A. F., Steinwachs, D., & PORT Co-investigators (1998). The Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophrenia Bulletin, 24, 1–10.CrossRefGoogle ScholarPubMed
LePage, J. P. (1999). The impact of a token economy on injuries and negative events on an acute psychiatric unit. Psychiatric Services, 50(7), 941–944.Google Scholar
Liberman, R. P. (1980). A review of Paul and Lentz's psychological treatment for chronic mental patients: Milieu versus social-learning programs. Journal of Applied Behavior Analysis, 13, 367–371.Google Scholar
Liberman, R. P. (2012). Recovery from schizophrenia: Form follows functioning. World Psychiatry, 11, 161–162.Google Scholar
Liberman, R. P., & Foy, D. W. (1983). Psychiatric rehabilitation for chronic mental patients. Psychiatric Annals, 13(7), 539–545.Google Scholar
Liberman, R. P., Glynn, S., Blair, K. E., Ross, D., & Marder, S. R. (2002). In Vivo Amplified Skills Training: Promoting generalization of independent living skills for clients with schizophrenia. Psychiatry: Interpersonal and Biological Processes, 65(2), 137–155.Google Scholar
Liberman, R. P., King, L. W., DeRisi, W. J., & McCann, M. (1975). Personal effectiveness: Guiding people to assert themselves and improve their social skills. Champaign, IL: Research Press.Google Scholar
Liberman, R. P., Mueser, K. T., & Wallace, C. J. (1986). Social skills training for schizophrenic individuals at risk for relapse. American Journal of Psychiatry, 143(4), 523–526.Google Scholar
Liberman, R. P., Mueser, K. T., Wallace, C. J., Jacobs, H. E., Eckman, T., & Massel, H. K. (1986). Training skills in the psychiatrically disabled: Learning coping and competence. Schizophrenia Bulletin, 12, 631–647.Google Scholar
Maddux, J. E., Gosselin, J. T., & Winstead, B. A. (2008). Conceptions of psychopathology: A social constructionist perspective. In Maddux, J. E. & Winstead, B. A., (Eds.) Psychopathology: Foundations for a contemporary understanding (2nd ed.) (pp. 3–18). New York, NY: Routledge/Taylor & Francis.Google Scholar
McCall, S. (1975). Quality of life. Social Indicator Research, 2, 229–248.Google Scholar
Medalia, A., & Choi, J. (2009). Cognitive remediation in schizophrenia. Neuropsychology Review, 19(3), 353–364.Google Scholar
MindFreedom (n.d.a). Origins of the C/S/X movement. https://mindfreedom.org/kb/voices-for-choices/origins-of-the-c-s-x-movement-voices-for-choices/.Google Scholar
MindFreedom (n.d.b). The Highlander Statement of Concern and Call to Action March 25, 2000. https://mindfreedom.org/kb/highlander-2000/.Google Scholar
Mueser, K. T., & Glynn, S. M. (1999). Behavioral family therapy for psychiatric disorders (2nd ed.). Oakland, CA: New Harbinger.Google Scholar
Mueser, K. T., Meyer, P. S., Penn, D. L., Clancy, R., Clancy, D. M., & Salyers, M. P. (2006). The Illness Management and Recovery program: Rationale, development, and preliminary findings. Schizophrenia Bulletin, 32(Suppl 1), S32–43.CrossRefGoogle ScholarPubMed
National Mental Health Services Survey (https://www.samhsa.gov/data/sites/default/files/reports/rpt29388/2019_NMHSS/2019-NMHSS-R.pdf)Google Scholar
Office of Technology Assessment. (1994). Psychiatric disabilities, employment, and the Americans with Disabilities Act. Washington, DC: U.S. Government Printing Office.Google Scholar
PASS-SIG (n.d.). Trailblazer Award. https://schizpsychosis.org/trailblazer-award/Google Scholar
Paul, G. L. (1967). Strategy of outcome research in psychotherapy. Journal of Consulting Psychology, 31, 109–118.Google Scholar
Paul, G. L., & Lentz, R. J. (1977). Psychosocial treatment of chronic mental patients: Milieu versus social learning programs. Cambridge, MA: Harvard University Press.Google Scholar
Pratt, C. W., Gill, K. J., Barrett, N. M., & Roberts, M. M. (1999). Psychiatric rehabilitation. San Diego, CA: Academic Press.Google Scholar
Propst, R. N. (1997). Stages in realizing the international diffusion of a single way of working: The clubhouse model. New Directions in Mental Health Services, 74, 53–66.Google Scholar
Psychiatric Rehabilitation Consultants (1990). Social and independent living skills: Basic conversation skills module. Camarillo, CA: Psychiatric Rehabilitation Consultants.Google Scholar
Rogers, C. R. (1956). Client-centered theory. Journal of Counseling Psychology 3, 115–120.Google Scholar
Rogers, E. S. (1997). Cost-benefit studies in vocational services. Psychiatric Rehabilitation Journal, 20(3), 25–33.Google Scholar
Royse, D., Thyer, B. A., & Padgett, D. K. (2015). Program evaluation: An introduction to an evidence-based approach. Boston, MA: Cengage Learning, Inc.Google Scholar
SAMHSA. (2012). SAMHSA’s working definition of recovery: 10 guiding principles of recovery. Rockville, MD: Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/d7/priv/pep12-recdef.pdf.Google Scholar
Scherbaum, C. A., Cohen-Charash, Y., & Kern, M. J. (2006). Measuring general self-efficacy: A comparison of three measures using item response theory. Educational and Psychological Measurement, 66, 1047–1063.Google Scholar
Sharif, Z., Bradford, D., Stroup, S., & Lieberman, J. (2007). Pharmacological treatment of schizophrenia. In Nathan, P. E. & Gorman, J. M. (Eds.), A Guide to Treatments that Work (pp. 203–242). New York: Oxford University Press.Google Scholar
Snyder, C. R., Sympson, S. C., Ybasco, F. C., Borders, T. F., Babyak, M. A., & Higgins, R. L. (1996). Development and validation of the State Hope Scale. Journal of Personality and Social Psychology, 70(2), 321–335.Google Scholar
Spaulding, W. D., Sullivan, M. E., & Poland, J. S. (2003). Treatment and rehabilitation of severe mental illness. New York, NY, USA: The Guilford Press.Google Scholar
Stein, L. I., & Test, M. A. (1980). Alternative to mental hospital treatment, I: Conceptual model, treatment, program and clinical evaluation. Archives of General Psychiatry, 37, 392–397.Google Scholar
Stokes, T. F., & Baer, D. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10, 349–367.Google Scholar
Thresholds (n.d.). About. https://www.thresholds.org/about/.Google Scholar
Treichler, E. B. H., & Spaulding, W. D. (2017). Beyond shared decision-making: Collaboration in the age of recovery from serious mental illness. American Journal of Orthopsychiatry, 87(5), 567–574.Google Scholar
Unger, K. V., Anthony, W. A., Sciarappa, K., & Rogers, E. S. (1991). A supported education program for young adults with long-term mental illness. Psychiatric Services, 42(8), 838–842.Google Scholar
World Health Organization (1980). International classification of impairments, disabilities, and handicaps: A manual of classification relating to the consequences of disease. Geneva, Switzerland: World Health Organization.Google Scholar
World Health Organization. (2002). Towards a common language for functioning, disability and health: The International Classification of Functioning, Disability and Health. Geneva: World Health Organization.Google Scholar
Yoman, J. (2008). A primer on functional analysis. Cognitive and Behavioral Practice, 15, 325–340.Google Scholar
Yoman, J., & Edelstein, B. A. (1994). Functional assessment in psychiatric disability. In Bedell, J. R. (Ed.), Psychological assessment and treatment of persons with severe mental disorders (pp. 31–56). Washington, DC: Taylor and Francis.Google Scholar
Zeldow, P. B. (1976). Some antitherapeutic effects of the token economy: A case in point. Psychiatry, 39(4), 318–24.Google Scholar
Zipple, A., Spaniol, L., & Rogers, E. S. (1990). Training mental health practitioners to assist families of persons who have a psychiatric disability. Rehabilitation Psychology, 35(2), 121–129.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×