Browsing by Author "Mueser, Kim T."

Now showing 1 - 7 of 7
  • Thumbnail Image
    Item
    Consumer and Provider Responses to a Computerized Version of the Illness Management and Recovery Program
    (2013) Wright-Berryman, Jennifer L.; Salyers, Michelle P.; O'Halloran, James P.; Kemp, Aaron; Mueser, Kim T.; Diazoni, Amanda
  • Thumbnail Image
    Item
    Development and Reliability of a Measure of Clinician Competence in Providing Illness Management and Recovery
    (2012-08) McGuire, Alan B.; Stull, Laura G.; Mueser, Kim T.; Santos, Meghan; Mook, Abigail; Rose, Nicole; Tunze, Chloe; White, Laura; Salyers, Michelle P.
    Objective: Illness management and recovery (IMR) is an evidence-based, manualized illness self-management program for people with severe mental illness. This study sought to develop a measure of IMR clinician competence and test its reliability and validity. Methods: Two groups of subject matter experts each independently created a clinician-level IMR competence scale based on the IMR Fidelity Scale and on two unpublished instruments used to evaluate provider competence. The two versions were merged, and investigators used the initial version to independently rate recordings of IMR sessions. Ratings were compared and discussed, discrepancies were resolved, and the scale was revised through 14 iterations. The resulting IMR Treatment Integrity Scale (IT-IS) includes 13 required items and three optional items rated only when the particular skill is attempted. Four independent raters then used the IT-IS to score tapes of 60 IMR sessions and 20 control group sessions. Results: The IT-IS showed excellent interrater reliability (.92). A factor analysis supported a one-factor model that showed good internal consistency. The scale successfully differentiated between IMR and control groups. Reliability and validity of individual items varied widely. Conclusions: The IT-IS is a promising measure of clinician competence in providing IMR. The scale could be used for research and quality assurance and as a supervisory feedback tool. Future research is needed to examine item-level changes, predictive validity of the IT-IS, discriminant validity compared with other more structured interventions, and the reliability and validity of the scale for nongroup IMR.
  • Thumbnail Image
    Item
    Factor structure of the autonomy preference index in people with severe mental illness
    (Elsevier, 2015-08-30) Bonfils, Kelsey A.; Adams, Erin L.; Mueser, Kim T.; Wright-Berryman, Jennifer L.; Salyers, Michelle P.; Department of Psychology, School of Science
    People vary in the amount of control they want to exercise over decisions about their healthcare. Given the importance of patient-centered care, accurate measurement of these autonomy preferences is critical. This study aimed to assess the factor structure of the Autonomy Preference Index (API), used widely in general healthcare, in individuals with severe mental illness. Data came from two studies of people with severe mental illness (N=293) who were receiving mental health and/or primary care/integrated care services. Autonomy preferences were assessed with the API regarding both psychiatric and primary care services. Confirmatory factor analysis was used to evaluate fit of the hypothesized two-factor structure of the API (decision-making autonomy and information-seeking autonomy). Results indicated the hypothesized structure for the API did not adequately fit the data for either psychiatric or primary care services. Three problematic items were dropped, resulting in adequate fit for both types of treatment. These results suggest that with relatively minor modifications the API has an acceptable factor structure when asking people with severe mental illness about their preferences to be involved in decision-making. The modified API has clinical and research utility for this population in the burgeoning field of autonomy in patient-centered healthcare.
  • Thumbnail Image
    Item
    Illness Management and Recovery: A Review of the Literature
    (2014) McGuire, Alan B.; Kukla, Marina; Green, Amethyst; Gilbride, Daniel; Mueser, Kim T.; Salyers, Michelle P.
  • Thumbnail Image
    Item
    Integrating Assertive Community Treatment and Illness Management and Recovery for Consumers with Severe Mental Illness
    (2010-08) Salyers, Michelle P.; McGuire, Alan B.; Rollins, Angela L.; Bond, Gary R.; Mueser, Kim T.; Macy, Veronica R.
    This study examined the integration of two evidence-based practices for adults with severe mental illness: Assertive community treatment (ACT) and illness management and recovery (IMR) with peer specialists as IMR practitioners. Two of four ACT teams were randomly assigned to implement IMR. Over 2 years, the ACT–IMR teams achieved moderate fidelity to the IMR model, but low penetration rates: 47 (25.7%) consumers participated in any IMR sessions and 7 (3.8%) completed the program during the study period. Overall, there were no differences in consumer outcomes at the ACT team level; however, consumers exposed to IMR showed reduced hospital use over time.
  • Thumbnail Image
    Item
    A randomized controlled trial of Illness Management and Recovery with an active control condition
    (2014-08) Salyers, Michelle P.; McGuire, Alan B.; Kukla, Marina; Fukui, Sadaaki; Lysaker, Paul H.; Mueser, Kim T.
    Objective The purpose of the study was to rigorously test Illness Management and Recovery (IMR) against an active control group in a sample that included veterans. Methods A total of 118 participants with schizophrenia spectrum disorders, 56 of whom were veterans, were recruited from a Department of Veterans Affairs medical center and a community mental health center in the same city and were randomly assigned to an IMR group (N=60) or a weekly problem-solving group intervention (N=58). Groups met weekly for nine months. Blinded assessments were conducted at baseline, nine months, and 18 months on measures of symptoms, functioning, illness self-management, medication adherence, subjective recovery experiences, and service utilization. Results No significant differences were found between IMR and problem-solving groups. Participants in both groups improved significantly over time in symptom severity, illness management, and quality of life and had fewer emergency department visits. Participation rates in both interventions were low. Only 28% of consumers assigned to IMR and 17% of those assigned to the problem-solving group participated in more than half the scheduled groups, and 23% and 34%, respectively, attended no sessions. Conclusions This is the first randomized controlled trial of IMR to report negative findings. Given the inclusion of an active control group and the low participation rates, further research is needed to understand factors affecting IMR effectiveness. Increased attention may need to be paid to facilitate more active participation in IMR, such as individual follow-up with consumers and the integration of IMR with ongoing treatment.
  • Thumbnail Image
    Item
    The Relationship Between Provider Competence, Content Exposure, and Consumer Outcomes in Illness Management and Recovery Programs
    (Springer, 2015) McGuire, Alan B.; White, Dominique A.; Bartholomew, Tom; Flanagan, Mindy E.; McGrew, John H.; Rollins, Angela L.; Mueser, Kim T.; Salyers, Michelle P.; Department of Psychology, School of Science
    Provider competence may affect the impact of a practice. The current study examined this relationship in sixty-three providers engaging in Illness Management and Recovery with 236 consumers. Improving upon previous research, the present study utilized a psychometrically validated competence measure in the ratings of multiple Illness Management and Recovery sessions from community providers, and mapped outcomes onto the theory underlying the practice. Provider competence was positively associated with illness self-management and adaptive coping. Results also indicated baseline self-management skills and working alliance may affect the relationship between competence and outcomes.