Browsing by Author "Cohen, Amy N."

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    A Cluster Randomized Trial of Adding Peer Specialists To Intensive Case Management Teams in the Veterans Health Administration
    (Springer, 2015-01) Chinman, Matthew; Oberman, Rebecca S.; Hanusa, Barbara H.; Cohen, Amy N.; Salyers, Michelle P.; Twamley, Elizabeth W.; Young, Alexander S.; Psychology, School of Science
    Use of Peer Specialists (PSs)—individuals with serious mental illness who use their experiences to help others with serious mental illness—is increasing. However, their impact on patient outcomes has not been demonstrated definitively. This cluster randomized, controlled trial within the Veterans Health Administration compared patients served by three intensive case management teams that each deployed two PSs for one year, to the patients of three similar teams without PSs (Usual Care). All patients (PS group=149, Usual Care=133) had substantial psychiatric inpatient histories and a primary Axis 1 psychiatric disorder. Before and after the year PSs worked, patients were surveyed on their recovery, quality of life, activation (health self-management efficacy), interpersonal relations, and symptoms. Patients in the PS group improved significantly more (z=2.00, df=1, p=0.05) than those receiving Usual Care on activation. There were no other significant differences. PSs helped patients become more active in treatment, which can promote recovery.
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    Skills-based intervention to enhance collaborative decision-making: systematic adaptation and open trial protocol for veterans with psychosis
    (Springer, 2021) Treichler, Emily B. H.; Rabin, Borsika A.; Spaulding, William D.; Thomas, Michael L.; Salyers, Michelle P.; Granholm, Eric L.; Cohen, Amy N.; Light, Gregory A.; Psychology, School of Science
    Background Collaborative decision-making is an innovative decision-making approach that assigns equal power and responsibility to patients and providers. Most veterans with serious mental illnesses like schizophrenia want a greater role in treatment decisions, but there are no interventions targeted for this population. A skills-based intervention is promising because it is well-aligned with the recovery model, uses similar mechanisms as other evidence-based interventions in this population, and generalizes across decisional contexts while empowering veterans to decide when to initiate collaborative decision-making. Collaborative Decision Skills Training (CDST) was developed in a civilian serious mental illness sample and may fill this gap but needs to undergo a systematic adaptation process to ensure fit for veterans. Methods In aim 1, the IM Adapt systematic process will be used to adapt CDST for veterans with serious mental illness. Veterans and Veteran’s Affairs (VA) staff will join an Adaptation Resource Team and complete qualitative interviews to identify how elements of CDST or service delivery may need to be adapted to optimize its effectiveness or viability for veterans and the VA context. During aim 2, an open trial will be conducted with veterans in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) to assess additional adaptations, feasibility, and initial evidence of effectiveness. Discussion This study will be the first to evaluate a collaborative decision-making intervention among veterans with serious mental illness. It will also contribute to the field’s understanding of perceptions of collaborative decision-making among veterans with serious mental illness and VA clinicians, and result in a service delivery manual that may be used to understand adaptation needs generally in VA PRRCs.