The trainee project: family-aided vocational rehabilitation of young people with schizophrenia

Poor response to treatment: beyond medication

In psychiatry, one of the main factors contributing to poor response to pharmacological treatment is adherence. Noncompliance with maintenance treatments for chronic illnesses such as schizophrenia and affective disorders can exceed 50%, Poor adherence can be due to drug-related factors (tolerance, complexity of prescription, side effects, or cost), patient-related variables (illness symptoms, comorbidity, insight capacity, belief system, or sociocultural environment), and physician-related factors (communication or psychoeducational style). Psychosocial treatments must be used in conjunction with medication during the maintenance phase to improve adherence to treatment and to achieve - through the management of psychological variables - better social, work, and family functioning. This article reviews the concepts of adherence and noncompliance, and their impact on maintenance treatments, as well as the effect of dealing with psychosocial factors in psychiatric treatment.

Additional interventions to enhance the effectiveness of individual placement and support: a rapid evidence assessment

Topic. Additional interventions used to enhance the effectiveness of individual placement and support (IPS). Aim. To establish whether additional interventions improve the vocational outcomes of IPS alone for people with severe mental illness. Method. A rapid evidence assessment of the literature was conducted for studies where behavioural or psychological interventions have been used to supplement standard IPS. Published and unpublished empirical studies of IPS with additional interventions were considered for inclusion. Conclusions. Six published studies were found which compared IPS alone to IPS plus a supplementary intervention. Of these, three used skills training and three used cognitive remediation. The contribution of each discrete intervention is difficult to establish. Some evidence suggests that work-related social skills and cognitive training are effective adjuncts, but this is an area where large RCTs are required to yield conclusive evidence.

The Generic Work Behavior Questionnaire (GWBQ): assessment of core dimensions of generic work behavior of people with severe mental illnesses in vocational rehabilitation

The purpose of this study was the development of a short self-reporting and supervisor-reporting questionnaire to assess generic work behavior of people with severe mental illnesses participating in psychiatric vocational rehabilitation. An 18-item generic work behavior questionnaire (GWBQ) was developed, which contains core dimensions derived from both supervisor scores and self-report scores. The factor structure of the GWBQ was replicated for both versions (supervisor and self reports). The GWBQ was very reliable for supervisor reports and moderately so for self-reports. Although self-report scores and supervisor scores correlated significantly, participants rated their own work behavior consistently higher than supervisors did.