Factors Associated with Early Attrition from Psychosocial Rehabilitation Programs

Harding, Brian; Torres-Harding, Susan; Bond, Gary R.; Salyers, Michelle P.; Rollins, Angela L.; Hardin, Teresa

doi:10.1007/s10597-008-9128-9

Cited by 22 publications

(26 citation statements)

References 29 publications

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“…Clients with less than a high school degree were less likely to find employment (Burke-Miller et al 2006) as was the case with low-skilled clients (Van Erp et al 2007). Clients with at least a high school degree were not only more likely to obtain work, they were also more likely to stay within the SE program and in treatment (Cook 2007;Harding et al 2008). Accordingly, some researchers suggest that vocational rehabilitation should support clients' completion of secondary and post-secondary education (Burke-Miller et al 2006).…”

Section: Intrinsic Characteristicsmentioning

confidence: 99%

Client, Contextual and Program Elements Influencing Supported Employment: A Literature Review

Kirsh

2016

Community Ment Health J

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Supported employment is an evidence-based practice with a well-established research base. Most studies track such outcomes as employment rates, time to employment and wages earned. Few studies address client and contextual factors that impact outcomes or consider program elements beyond those that comprise the individual placement and support model. This paper reviews existing literature to shed light on the following questions: (1) What impact do labour market trends have on the effectiveness of SE? (2) How lasting are the effects of SE and what factors influence longevity of SE effects? (3) What levels and types of employment are targeted by SE? (4) What are the characteristics of people who benefit from SE? (5) What is the role of peer support in SE? and (6) What are the barriers to effective SE implementation? Research findings are synthesized and suggestions for service enhancements are offered so that the model can continue to evolve.

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Section: Intrinsic Characteristicsmentioning

confidence: 99%

Client, Contextual and Program Elements Influencing Supported Employment: A Literature Review

Kirsh

2016

Community Ment Health J

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“…These findings are important as studies that have followed drop-outs from PSR programs have typically shown poorer employment and rehospitalization outcomes (Harding et al 2008; Beard et al 1978; Bond 1992; Cook and Razzano 1995) for these clients. These findings emphasize the importance of identifying factors that may be associated with early drop-out, to help develop methods for enhancing participation in PSR activities.…”

Section: Introductionmentioning

confidence: 95%

“…Despite these findings, high-rates of early drop-out from PSR community day programs that treat clients with severe mental illness and include interventions recommended by PORT are common, with rates ranging from mid-20% (e.g., Harding et al 2008) to nearly 50% (e.g., Cohen et al 1995) in some studies, with differences most likely linked to sample diagnoses, definitions for attrition and other individual and program factors. These findings are important as studies that have followed drop-outs from PSR programs have typically shown poorer employment and rehospitalization outcomes (Harding et al 2008; Beard et al 1978; Bond 1992; Cook and Razzano 1995) for these clients.…”

Section: Introductionmentioning

confidence: 99%

“…Demographic factors that have been linked to PSR attrition include age (Young et al 2000), and education (Harding et al 2008), while chronic psychosis (Atwood and Beck 1985), hostile, labile or bizarre affect (Cohen et al 1995) and total positive symptoms (Harding et al 2008) are symptom factors that have been linked to attrition (but see Primm et al 2000 for an exception). There is growing evidence that drop-out rates from PSR programs vary between individuals with a diagnosis of schizophrenia-spectrum illness and other diagnoses (e.g., Harding et al 2008; Young et al 2000), and thus the factors influencing drop-out for clients with schizophrenia remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of Participation in Community Outpatient Psychosocial Rehabilitation in Schizophrenia

Kurtz

Rose

Wexler

2010

Community Ment Health J

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This study investigated demographic, clinical and neurocognitive factors predicting drop-out from an intensive, community outpatient psychosocial rehabilitation program for people with schizophrenia or schizoaffective disorder. One-hundred and twenty-seven outpatients with DSM-IV schizophrenia or schizoaffective disorder participated. Demographic variables of age, sex, education and race/ethnicity were recorded and formal symptom measures and a neurocognitive assessment consisting of measures of crystallized verbal ability, sustained visual vigilance, verbal learning, verbal fluency and problem-solving were administered at study entry. Thirty-seven percent of the sample dropped-out of the program. In a final multivariate model, younger age, and lower verbal fluency scores in clients with a history of a high number of hospitalizations predicted a greater likelihood of drop-out. The implications of these findings are discussed.

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“…Cognitive impairment is a central feature of schizophrenia, affects everyday functioning, and limits benefit from psychiatric rehabilitation (Green, 1996; Harding et al, 2008; McGurk et al, 2004; Velligan et al, 1997; Walsh et al, 2003). Cognitive training or remediation is an intervention to improve cognition in this population; the most recent meta-analysis of 2,104 participants demonstrated effect sizes of 0.45 on cognition and 0.42 on functioning, with no evidence that treatment approach or duration affected cognitive outcome (Wykes et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive insight, treatment utilization, and cognitive training outcomes in schizophrenia

Burton

Twamley

2015

Schizophrenia Research

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Background The degree to which people with schizophrenia show awareness of cognitive dysfunction and whether this neurocognitive insight affects treatment use or outcome is understudied. We aimed to examine neurocognitive insight among a treatment-seeking sample of patients with psychotic disorders, and whether neurocognitive insight affected treatment utilization or outcome. Method 69 individuals with schizophrenia-spectrum disorders enrolled in a trial comparing Compensatory Cognitive Training (CCT) to standard pharmacotherapy. Participants with objective cognitive impairment were identified and grouped into “intact” vs. “impaired” neurocognitive insight groups. These groups were then compared via ANCOVA on three treatment utilization variables and six post-treatment cognitive/functional variables. Results 43 participants demonstrated objective cognitive impairment. Among those individuals, 31 were considered to have intact neurocognitive insight and 12 showed impaired neurocognitive insight. These two groups did not differ on CCT attendance, satisfaction with the intervention, or self-reported cognitive strategy use at post-treatment. There were significant treatment group by neurocognitive insight group interactions for verbal memory and functional capacity outcomes, such that individuals with impaired neurocognitive insight who received treatment performed better than those who did not receive treatment. Conclusions Even among individuals who self-select into a cognitive treatment study, many show minimal awareness of cognitive dysfunction. Impaired neurocognitive insight, however, was not associated with decreased treatment utilization, and was associated with positive treatment outcomes in some cognitive domains as well as functional capacity. As cognitive training treatments become increasingly available, impaired neurocognitive insight need not be a barrier to participation.

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Factors Associated with Early Attrition from Psychosocial Rehabilitation Programs

Cited by 22 publications

References 29 publications

Client, Contextual and Program Elements Influencing Supported Employment: A Literature Review

Client, Contextual and Program Elements Influencing Supported Employment: A Literature Review

Predictors of Participation in Community Outpatient Psychosocial Rehabilitation in Schizophrenia

Neurocognitive insight, treatment utilization, and cognitive training outcomes in schizophrenia

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