1
|
Howie JH, Faith LA, Jarvis SP, Rempfer MV. Social Cognition and Other Determinants of Perceived Social Support in Individuals With Serious Mental Illness. J Nerv Ment Dis 2023; 211:848-855. [PMID: 37647619 DOI: 10.1097/nmd.0000000000001708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
ABSTRACT Social support provides protective effects for those with serious mental illness (SMI), but these effects may be attenuated by factors that hinder positive perceptions of support. Improved understanding of social support and its determinants may hold relevance for clinical interventions and provide avenues to promote recovery and improve functioning. The present study is a cross-sectional, correlational analysis investigating the relationships among social cognition (Mayer-Salovey-Caruso Emotional Intelligence Test-Managing Emotions subscale), social anxiety (Liebowitz Social Anxiety Scale), negative symptoms (Scale for the Assessment of Negative Symptoms), and perceived social support (Interpersonal Support Evaluation List) among individuals with SMI. Data were analyzed for 59 participants from a psychosocial rehabilitation treatment study at a public, urban academic-affiliated medical center in the Midwest. Bivariate Pearson correlations revealed statistically significant associations among perceived social support and social cognition (total perceived social support, p < 0.05; appraisal support, p < 0.01), negative symptoms (appraisal support, p < 0.05), and social anxiety (self-esteem support, p < 0.05). Further, multiple linear regression revealed social cognition remained a significant predictor of perceived social support ( p < 0.05) when controlling for social anxiety and negative symptoms. Overall findings suggest a correlative relationship between social cognition and perceived social support. Conclusions, limitations, and future directions are discussed.
Collapse
Affiliation(s)
- J Hunter Howie
- Department of Psychology, The University of Missouri, Kansas City, Missouri
| | | | | | - Melisa V Rempfer
- Department of Psychology, The University of Missouri, Kansas City, Missouri
| |
Collapse
|
2
|
Faith LA, Howie JH, Blanco E, Jarvis SP, Rempfer MV. Therapeutic alliance in a cognitive rehabilitation programme for people with serious mental illness: A qualitative analysis. Psychol Psychother 2022; 95:958-969. [PMID: 35810321 DOI: 10.1111/papt.12412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 06/12/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Therapeutic alliance is an important element of evidence-based treatments for people diagnosed with a serious mental illness. Cognitive enhancement therapy (CET) is an efficacious cognitive rehabilitation programme that emphasizes coach-participant relationships. The purpose of this study was to examine experiences of therapeutic alliance among CET participants. DESIGN We used an exploratory qualitative approach. METHODS Semi-structured interviews were conducted with 24 participants diagnosed with a serious mental illness. Interview transcripts were analysed by three independent coders using thematic analysis. RESULTS Four themes related to therapeutic alliance emerged: (1) positive regard; (2) collaboration; (3) authenticity; (4) negative alliance. CONCLUSIONS Findings suggest that therapeutic alliance is an important component of CET that bolsters the learning environment and ensures a positive group experience. Our qualitative analyses contribute greater understanding of how strong therapeutic relationships impact people with serious mental illnesses participating in evidence-based treatments beyond psychotherapy context.
Collapse
Affiliation(s)
- Laura A Faith
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
| | - J Hunter Howie
- Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
| | - Emily Blanco
- Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
| | - Stephen P Jarvis
- University Health Behavioral Health, Kansas City, Missouri, USA.,University of Missouri School of Medicine, Kansas City, Missouri, USA
| | - Melisa V Rempfer
- Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
| |
Collapse
|
3
|
Faith LA, Lecomte T, Corbière M, Lysaker PH. Metacognitive mastery moderates the relationship between positive symptoms and distress in adults with serious mental illness. J Ment Health 2022:1-8. [PMID: 35766302 DOI: 10.1080/09638237.2022.2091758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Research supports the possibility that a person's metacognitive ability may influence the impact of positive symptoms. This connection is important because understanding how metacognitive capacity relates to positive symptoms and distress can guide treatment and bolster recovery. AIMS To explore this, we assessed the moderating role of Metacognitive Mastery on the relationship of positive symptoms to affective symptoms, or markers of distress, measured both concurrently and at a later time point (to assess durability of metacognition) with persons with serious mental illness. To rule out the possibility that any findings were the result of cognitive impairments or general psychopathology we included measures of neurocognition and symptoms as potential covariates. METHODS Participants were 67 individuals with the majority diagnosed with either schizophrenia spectrum disorder, major depressive disorder, or bipolar disorder. Metacognition was measured with the Metacognitive Assessment Scale-Abbreviated, symptoms were measured using the Brief Psychiatric Rating Scale and verbal memory was measured using the California Verbal Learning Test. RESULTS Metacognitive Mastery moderated the relationship between positive symptoms and affective symptoms at both time points with differential patterns at each point. CONCLUSIONS Metacognitive Mastery may exert a complex influence upon the effects of positive symptoms on distress.
Collapse
Affiliation(s)
- Laura A Faith
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychology, University of Missouri, Kansas City, MO, USA
| | - Tania Lecomte
- Department of Psychology, University of Montreal, Montreal, QC, USA
| | - Marc Corbière
- Department of Psychology, University of Montreal, Montreal, QC, USA
| | - Paul H Lysaker
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
4
|
Faith LA, Grove A, Jarvis SP, Rempfer MV. Implementation and preliminary outcomes of cognitive enhancement therapy for serious mental illness in an outpatient mental health program. Behav Cogn Psychother 2022; 50:1-6. [PMID: 35105400 DOI: 10.1017/s1352465822000017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although numerous evidence-based treatments for serious mental illnesses (SMI) exist, the majority are not widely utilized in clinical settings. Cognitive enhancement therapy (CET) has been tested in randomized trials; however, knowledge regarding implementation and outcomes in naturalistic environments is scarce. AIMS The current study is an uncontrolled, observational study describing implementation and pre- to post-outcomes of CETCleveland®, a community-based version of CET in an outpatient mental health program in the United States. METHOD We included n = 34 diverse individuals with SMI. Data include qualitative implementation information and participant outcomes, including measures of cognition, symptoms, satisfaction and adherence. RESULTS Overall, participant satisfaction was positive, and adherence was comparable with previous studies. Implementation information includes training, clinician and setting characteristics, and barriers and solutions. Preliminary outcomes showed that participants significantly improved in areas of neurocognition and symptoms. CONCLUSIONS Overall, our results demonstrated successful early implementation of CET in a diverse, outpatient mental health program and provided preliminary support for the clinical utilization of CET. We hope these results will promote further access to CET and other evidence-based psychiatric rehabilitation programs in community clinics.
Collapse
Affiliation(s)
- Laura A Faith
- Richard L Roudebush VA Medical Center, Health Services Research and Development (HSR&D) Center for Health Information and Communication (CHIC), 1481 West 10th Street, Indianapolis, IN 46202, USA
| | - Amber Grove
- Department of Psychology, University of Missouri, Kansas City, 5030 Cherry Street, #324, Kansas City, MO 64110, USA
| | - Stephen P Jarvis
- University Health Behavioral Health, 300 West 19th Terrace, Kansas City, MO 64108, USA
- Department of Psychiatry, University of Missouri, Kansas City, 1000 E. 24th Street, Kansas City, MO 64108, USA
| | - Melisa V Rempfer
- Department of Psychology, University of Missouri, Kansas City, 5030 Cherry Street, #324, Kansas City, MO 64110, USA
| |
Collapse
|
5
|
Hasson‐Ohayon I, Jong S, Igra L, Carter SA, Faith LA, Lysaker P. Longitudinal changes in therapeutic alliance with people with psychosis: Relationship between client and therapist assessments. Clin Psychol Psychother 2021; 28:1243-1253. [DOI: 10.1002/cpp.2572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 12/16/2022]
Affiliation(s)
| | | | - Libby Igra
- Department of Psychology Bar‐Ilan University Ramat‐Gan Israel
| | - Sarah A. Carter
- Utrecht University: University College Roosevelt Middelburg The Netherlands
| | - Laura A. Faith
- Department of Psychology University of Missouri‐Kansas City Kansas City Missouri USA
| | - Paul Lysaker
- Department of Psychiatry Roudebush VA Medical Center and the Indiana University School of Medicine Indianapolis Indiana USA
| |
Collapse
|
6
|
Lysaker PH, Gagen E, Klion R, Zalzala A, Vohs J, Faith LA, Leonhardt B, Hamm J, Hasson-Ohayon I. Metacognitive Reflection and Insight Therapy: A Recovery-Oriented Treatment Approach for Psychosis. Psychol Res Behav Manag 2020; 13:331-341. [PMID: 32308511 PMCID: PMC7135118 DOI: 10.2147/prbm.s198628] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/15/2020] [Indexed: 12/18/2022] Open
Abstract
Recent research has suggested that recovery from psychosis is a complex process that involves recapturing a coherent sense of self and personal agency. This poses important challenges to existing treatment models. While current evidence-based practices are designed to ameliorate symptoms and skill deficits, they are less able to address issues of subjectivity and self-experience. In this paper, we present Metacognitive Insight and Reflection Therapy (MERIT), a treatment approach that is explicitly concerned with self-experience in psychosis. This approach uses the term metacognition to describe those cognitive processes that underpin self-experience and posits that addressing metacognitive deficits will aid persons diagnosed with psychosis in making sense of the challenges they face and deciding how to effectively manage them. This review will first explore the conceptualization of psychosis as the interruption of a life and how persons experience themselves, and then discuss in more depth the construct of metacognition. We will next examine the background, practices and evidence supporting MERIT. This will be followed by a discussion of how MERIT overlaps with other emerging treatments as well as how it differs. MERIT's capacity to engage patients who reject the idea that they have mental illness as well as cope with entrenched illness identities is highlighted. Finally, limitations and directions for future research are discussed.
Collapse
Affiliation(s)
- Paul H Lysaker
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Emily Gagen
- Providence VA Medical Center Department of Psychology, Providence, RI, USA
| | | | | | - Jenifer Vohs
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Laura A Faith
- Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
- University of Missouri - Kansas City, KS, USA
| | - Bethany Leonhardt
- Indiana University School of Medicine, Indianapolis, IN, USA
- Eskenazi Health- Midtown Community Mental Health, Indianapolis, IN, USA
| | - Jay Hamm
- Eskenazi Health- Midtown Community Mental Health, Indianapolis, IN, USA
| | | |
Collapse
|
7
|
Faith LA, Collins JO, Decker J, Grove A, Jarvis SP, Rempfer MV. Experiences of empowerment in a community cognitive enhancement therapy program: an exploratory qualitative study. Psychosis 2019. [DOI: 10.1080/17522439.2019.1632920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Laura A. Faith
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jen O. Collins
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jenna Decker
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Amber Grove
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Stephen P. Jarvis
- Truman Medical Center Behavioral Health, Kansas City, MO, USA
- Department of Psychiatry, University of Missouri, Kansas City, MO, USA
| | - Melisa V. Rempfer
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| |
Collapse
|
8
|
Faith LA, Rempfer MV. Comparison of performance-based assessment and real world skill in people with serious mental illness: Ecological validity of the Test of Grocery Shopping Skills. Psychiatry Res 2018; 266:11-17. [PMID: 29793078 DOI: 10.1016/j.psychres.2018.04.060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 02/06/2018] [Accepted: 04/28/2018] [Indexed: 11/18/2022]
Abstract
Valid functional measures are essential for clinical and research efforts that address recovery and community functioning in people with serious mental illness. Although there is a great deal of interest in functional assessment, there is limited research supporting how well current evaluation methods provide a true assessment of real world functioning or naturalistic behavior. To address this gap in the literature, the present study examined the performance of individuals with serious mental illness (i.e., diagnosis of schizophrenia-spectrum, bipolar disorder, or other depression/anxiety diagnoses and accompanying functional disability) on the Test of Grocery Shopping Skills (TOGSS), a performance-based naturalistic task. We compared TOGSS performance to two dimensions of real world functioning: directly observed real world grocery shopping and ratings of community functioning. Results indicated that the TOGSS was significantly associated with real life grocery shopping, in terms of both shopping accuracy (r = 0.424) and time (r = 0.491). Further, self-report and observer-rated methods of assessing real world shopping behaviors were significantly correlated (r = 0.455). To our knowledge, this is one of the first studies to directly compare a performance-based naturalistic skill assessment with carefully observed real world performance of that skill in people with serious mental illness. These findings support the feasibility and ecological validity of performance-based naturalistic assessment with the TOGSS.
Collapse
Affiliation(s)
- Laura A Faith
- Department of Psychology, University of Missouri-Kansas City, 324 Cherry Hall, Kansas City, MO 64110, USA
| | - Melisa V Rempfer
- Department of Psychology, University of Missouri-Kansas City, 324 Cherry Hall, Kansas City, MO 64110, USA.
| |
Collapse
|