Comparative impact of professional mental health background on ratings of consumer outcome and fidelity in an illness management and recovery program.

Garber-Epstein, Paula; Zisman‐Ilani, Yaara; Levine, Stephen Z.; Roe, David

doi:10.1037/prj0000026

Cited by 23 publications

(13 citation statements)

References 37 publications

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“…The most widely researched of the five programs is IMR (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50). Like WRAP, several studies included researchers who were also involved in the development of the program.…”

Section: Empirical Evidencementioning

confidence: 99%

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Reviewing Illness Self-Management Programs: A Selection Guide for Consumers, Practitioners, and Administrators

Petros¹,

Solomon²

2015

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Illness self-management (ISM) programs for adults with serious mental illness offer strategies to increase self-directed recovery activities to maximize wellness and increase independence from the service delivery system. This article describes five of the most popular ISM programs: Pathways to Recovery, The Recovery Workbook, Building Recovery of Individual Dreams and Goals through Education and Support, Wellness and Recovery Action Planning, and Illness Management and Recovery. It provides guidance for administrators, practitioners, and consumers for the purposes of selecting the program or programs providing the best fit. The framework for describing the five programs encompasses four contextual domains that supplement empirical evidence for a more comprehensive evaluation: structure, value orientation toward recovery, methods of teaching, and educational content. Contextual domains distinguish programs from one another, including length and time commitment, requisite resources, inclusion of group support, utilization of medical language and pathology, degree of traditional didactic education, and prioritization of consumer-driven self-exploration. The authors also searched PsycINFO, Google Scholar, and Cochrane Reviews for empirical evidence and evaluated the five programs on the strength of the evidence and the effectiveness of the intervention. Evidence of program effectiveness was found to range from low to moderate. However, empirical evidence alone is insufficient for selecting among the five programs, and contextual domains may offer the most relevant guidance by matching program features with goals of consumers, practitioners, and administrators.

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Section: Empirical Evidencementioning

confidence: 99%

“…The major quasi-experimental study occurred in Israel (38). Only IMR scales were used, and two of the 15 items were excluded, along with the associated module covering drug and alcohol use.…”

Section: Empirical Evidencementioning

confidence: 99%

Reviewing Illness Self-Management Programs: A Selection Guide for Consumers, Practitioners, and Administrators

Petros¹,

Solomon²

2015

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“…Our first secondary feasibility criterion was that the institute could achieve total scores on the IMR Fidelity Scale of ≥ 4.0, which is considered to reflect good fidelity [51, 55]; in other earlier research on IMR, cut-off scores for good or high IMR fidelity were > 3.7 [6], > 3.8 [56]. In their review, McGuire et al reported a weighted mean of 4.05 on fidelity for “all studies” (SD = .93) [5].…”

Section: Methodsmentioning

confidence: 99%

Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial

et al. 2016

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BackgroundIllness Management & Recovery (IMR) is a curriculum-based program for people with severe and persistent mental illness. To date, four randomized controlled trials (RCTs) have been published on it. As these produced mixed results, we conducted a pilot study to test the feasibility of conducting a new RCT in a Dutch psychiatric institute. Because our primary objective was to evaluate support for implementing IMR on a broader scale, we examined participant recruitment, client outcomes, and clients’ and clinicians’ satisfaction. Secondary objectives were to evaluate fidelity, trainers’ training and supervision, and to explore program duration, dropout, and client characteristics related to dropout. For reporting, we used the checklist for pilot studies adopted from the CONSORT Statement.MethodsThis program evaluation included a process-evaluation and an outcome evaluation with a One Group Pre-Posttest Design (N = 81). Interviews and internal reports were used to monitor participant numbers, program duration, dropout, and completers’ characteristics. Clients’ and clinicians’ satisfaction and provision of trainers’ training and supervision were assessed through interviews. Fidelity was assessed on the IMR Fidelity Scale; client outcomes were assessed on the IMR scale (client and clinician versions) and the Recovery Markers Questionnaire (RMQ).ResultsEighty-one participants were recruited of 167 people who were assessed for eligibility. Completers and clinicians were satisfied, and scores for completers improved significantly on the IMR scale (clinician version) (d = 0.84) and RMQ (d = 0.52), and not significantly on the IMR scale client version (d = 0.41). Mean fidelity was good, but three groups had only moderate fidelity. Our feasibility criterion for trainers’ education and supervision was partly attained. Dropout from treatment was 51 %; female participants and people who scored higher on both IMR-scales at baseline had a significantly lower chance of dropping out. The duration of IMR varied (M = 12.7 months, SD = 2.87).ConclusionsResults suggested that feasibility of conducting an RCT on IMR was good. Special attention is required to fidelity, IMR duration, trainers’ education and supervision, and dropout, especially of men. One study limitation was our inability to conduct follow-up measurements of non-completers.

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“…We included studies that investigated the efficacy of a psychosocial (i.e., non-medicationbased) intervention delivered by a non-licensed paraprofessional via coaching [34]. Across studies, equivalent, and at times superior, outcomes have been reported for paraprofessional-delivered interventions when compared to professionally led treatments [35][36][37][38]. Despite these promising findings, given the variability in the characteristics and severity of illnesses investigated, it is important not to assume that paraprofessional-delivered interventions will be as promising when applied to PTSD populations.…”

Section: Step 3: Selecting the Studiesmentioning

confidence: 99%

A Scoping Review of the Role and Training of Para-professionals Delivering Psychological Interventions for Adults with Post-traumatic Stress Disorder

Xiong¹,

Wozney²,

Olthuis³

et al. 2019

J Dep Anxiety

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Background: The delivery of interventions for traumatic stress disorders by paraprofessionals is of interest across mental health systems as decision-makers work to meet growing need for services and demand for evidence-based care. Given the need for any system change to reflect scientific evidence, our scoping review aimed to identify and summarize the research on paraprofessional-delivered trauma-focused psychological interventions for adults, with a particular focus on the role and training of paraprofessionals. Method: We searched seven databases for peerreviewed published studies that employed controlled trial designs to evaluate paraprofessional-led interventions for traumatic stress. Using Covidence software, we completed iterative eligibility screening and extracted study data. Descriptive statistics were used to identify trends and gaps in the literature and inform synthesis of findings. Results: Fourteen studies met inclusion criteria. The majority of studies (71%; 10/14) evaluated interventions that were delivered face-to-face across a diverse patient populations and clinical contexts. Training of paraprofessionals ranged in length from two training sessions (approx. 16 hours) to a 6-week full day, in-person course. Ongoing supervision of paraprofessionals during the intervention was reported in 64% (9/14) of the studies, but few details of supervision processes were reported. Conclusion: Paraprofessionals are taking on therapeutic roles in the delivery of trauma-focused psychological interventions but there are significant knowledge gaps around training and supervision they require. Lack of consensus on the defining characteristics of a "paraprofessional" makes synthesizing this literature particularly challenging.

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Comparative impact of professional mental health background on ratings of consumer outcome and fidelity in an illness management and recovery program.

Abstract: The results demonstrate that IMR can be implemented with good fidelity and generate positive outcomes when delivered by practitioners who receive sufficient training and supervision regardless of their professional background.

Cited by 23 publications

References 37 publications

Reviewing Illness Self-Management Programs: A Selection Guide for Consumers, Practitioners, and Administrators

Reviewing Illness Self-Management Programs: A Selection Guide for Consumers, Practitioners, and Administrators

Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial

A Scoping Review of the Role and Training of Para-professionals Delivering Psychological Interventions for Adults with Post-traumatic Stress Disorder

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