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Browsing by Author "Fiszdon, Joanna M."
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Item Decisional Informatics for Psychosocial Rehabilitation: A Feasibility Pilot on Tailored and Fluid Treatment Algorithms for Serious Mental Illness(Wolters Kluwer, 2017-11) Choi, Jimmy; Lysaker, Paul H.; Bell, Morris D.; Dixon, Lisa; Margolies, Paul; Gold, Matthew; Golden-Roose, Elizabeth; Thime, Warren; Haber, Lawrence C.; Dewberry, Michael J.; Stevens, Michael; Pearlson, Godfrey D.; Fiszdon, Joanna M.; Medicine, School of MedicineThis study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility. Of participants who identified obtaining a General Education Diploma as their goal, 73% in FORT passed the examination compared with 18% in traditional treatment planning. FORT was also associated with higher agency cost-effectiveness and a better average benefit-cost ratio, even when considering diagnosis, baseline symptoms, and education. Although the comparison groups were not completely equivalent, the findings suggest computerized decision support systems that collaborate with human decision-makers to personalize psychiatric rehabilitation and address critical decisions may have a role in improving treatment effectiveness and efficiency.Item Effects of the Indianapolis Vocational Intervention Program (IVIP) on defeatist beliefs, work motivation, and work outcomes in serious mental illness(Elsevier, 2017-04) Mervis, Joshua E.; Fiszdon, Joanna M.; Lysaker, Paul H.; Nienow, Tasha M.; Mathews, Laura; Wardwel, Patricia; Petrik, Tammy; Thime, Warren; Choi, Jimmy; Medicine, School of MedicineDefeatist beliefs and amotivation are prominent obstacles in vocational rehabilitation for people with serious mental illnesses (SMI). The CBT-based Indianapolis Vocational Intervention Program (IVIP) was specifically designed to reduce defeatist beliefs related to work functioning. In the current study, we examined the impact of IVIP on defeatist beliefs and motivation for work, hypothesizing that IVIP would be associated with a reduction in defeatist beliefs and greater motivation for work. We also examined the effects of IVIP on these variables as well as work outcomes during a 12-month follow-up. Participants with SMI (n=64) enrolled in a four-month work therapy program were randomized to IVIP or a support therapy group (SG). Assessments were conducted at baseline, post-treatment (4months), and follow-up (1year). Compared to those in SG condition, individuals randomized to IVIP condition reported greater reductions in defeatist beliefs and greater motivation for work at follow-up, along with greater supported employment retention rates. Specifically treating and targeting negative expectations for work therapy improves outcomes, even once active supports of the IVIP program and work therapy are withdrawn.Item Group-Based Metacognitive Reflection and Insight Therapy (MERITg) and Its Relationship to Recovery-Oriented Beliefs in Serious Mental Illness(MDPI, 2024-06-22) Musket, Christie W.; Bullock, Joshua; Fiszdon, Joanna M.; Stacy, Meaghan; Martino, Steve; James, Alison; Lysaker, Paul H.; Schnakenberg Martin, Ashley M.; Psychiatry, School of MedicineGroup-based Metacognitive Reflection and Insight Therapy (MERITg) is the group application of Metacognitive Reflection and Insight Therapy (MERIT), an evidence-based, integrative, recovery-oriented intervention to enhance insight and understanding of oneself and others in individuals with serious mental illness (SMI). MERITg may offer therapeutic interactions between participants that uniquely support recovery. The goal of the current study was to examine the relationship between MERITg participation and recovery-oriented beliefs. Thirty-one participants (outpatient = 21; inpatient = 10) in SMI treatment programs participated in MERITg as an adjunctive treatment. A short form of the Maryland Assessment of Recovery in Serious Mental Illness (MARS-12) was used to assess recovery-oriented beliefs before and after group participation. Recovery-oriented beliefs significantly improved in the outpatient MERITg group but not in the inpatient group, and change in recovery-oriented beliefs was positively correlated with the total number of groups attended. These findings suggest the promise of MERITg for enhancing recovery-oriented beliefs. The potential role of treatment setting is discussed.