The comparative effectiveness of various psychiatric rehabilitation procedures on posthospital adjustment was surveyed using the outcome criteria of hospital recidivism and posthospital employment. The percentage of psychiatric patients who receive the traditional hospital regimen of drug treatment, and perhaps some form of individual or group therapy, and who are able to remain out of the hospital or find employment was established as a base line against which the unique effects of rehabilitation procedures could be evaluated. Several of the conclusions that evolved out of the survey are as follows: (a) Most all types of inpatient treatment innovations improve the patients' in-hospital behavior, but the research does not indicate that these approaches can singularly effect posthospital adjustment. ( 6) Ex-patients who attend aftercare clinics have a lower rate of recidivism than nonattenders. (c) Transitional facilities reduce recidivism but demonstrate little effect on enabling patients to function independently, as measured by posthospital employment, in the community, (d) There is a definite need for the continued use of specific outcome criteria so that the comparative effectiveness of various psychiatric rehabilitation procedures can be meaningfully evaluated.1 Requests for reprints should be sent to William

The relationship between patient demographic characteristics and psychiatric outcome as measured by recidivism and posthospital employment was analyzed using multiple linear regression. Specific hypotheses were advanced based on a previous review of the literature. Results indicated that the overwhelming amount of variance in recidivism accounted for by demographic data could be attributed to one characteristic-number of previous hospitalizations. Similarly, one demographic variable (employment history) accounted for the major amount of variance in posthospital employment. Implications of these results for research investigations of psychiatric treatment outcome were discussed.

A replication was undertaken of a recent study conducted by Buell and Anthony which had found that recidivism and posthospital employment each could be predicted by a single demographic variable, number of previous hospitalizations and employment history, respectively. Using multiple linear regression analyses the results of the replication were consistent with the findings of the original study for posthospital employment but not for recidivism. Based on this replication and Lorei and Gurel's recent study, the usefulness of attempting to predict recidivism from demographic data must be questioned.

Professionals engaged in psychiatric rehabilitation need to know what specific factors contribute to the success or failure of attempts to reintegrate the psychiatric patient back into the community. A review of the research literature succeeded in identifying various demographic charcteristics of expsychiatric patients that are related to recidivism and posthospital employment. A composite picture of patients who are more likely to be recidivists or unemployed (or both) was advanced. The factors that appear to be related to posthospital employment are not consistently the same factors that are related to recidivism.

The efficacy of assertiveness training was examined by comparing it to a structured interview/empathic responding procedure and an activity-control procedure. The participants were 48 children and adolescents who were identified as nonproblematic, mildly problematic, or moderately problematic in reference to school performance, classroom behavior, and interpersonal skills. Assertiveness uaining resulted in enhanced effectiveness of responding on a behavioral role-play test, and these effects persisted after treatment. Generalization to nontrained role-play scenes was established, but there was no evidence of generalization to interpersonal performance in school. Training of social skills was not more effective than the other procedures in reducing self-reporred anxiety or anger. The effectiveness of assertiveness uaining was not dependent upon age or the occurrence of problematic behavior.