Skip to main content
SpringerLink
Log in

Identifying clinical competencies that support rehabilitation and empowerment in individuals with severe mental illness

  • Brief Reports
  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

Individuals with severe mental illness often do not receive appropriate treatment or rehabilitation. One approach to improving their care begins by identifying competencies that clinicians should possess. This project developed a set of core clinical competencies that pertain to community-based care and support the goals of empowerment and rehabilitation. Development of the competency set began with review of existing literature and competency statements, and focus groups and interviews with clients, family members, clinicians, managers, experts, and advocates. Representatives from each of these groups participated in a national panel and used a structured process to identify 37 final competencies. Panel members agreed that these competencies are very important in determining outcomes and often are not present in current clinicians. This project demonstrates that it is possible to develop a core competency set that can be strongly supported by diverse groups of stakeholders. These competencies may be useful in clinician training, recruitment, and credentialing efforts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Lehman AF: Quality of care in mental health: The case of schizophrenia.Health Affairs 1999; 18:52–65.

    Google Scholar 

  2. Geller JL, Brown JM, Fisher WH, et al.: A national survey of “consumer empowerment” at the state level.Psychiatric Services 1998; 49:498–503.

    Google Scholar 

  3. National Advisory Mental Health Council's Clinical Treatment and Services Research Workgroup:Bridging Science and Service. NIH Pub. No. 99-4353. Bethesda, MD: National Institutes of Health/National Institute of Mental Health, 1999.

    Google Scholar 

  4. Young AS, Sullivan G, Burnam MA, et al.: Measuring the quality of outpatient treatment for schizophrenia.Archives of General Psychiatry 1998; 55:611–617.

    Google Scholar 

  5. Lehman AF, Steinwachs DM: Patterns of usual care for schizophrenia: Initial results from the Schizophrenia Patient Outcomes Research Team (PORT) Client Survey.Schizophrenia Bulletin 1998; 24:11–20.

    Google Scholar 

  6. Grusky O, Podus D, Webster C, et al.: Measuring the cost and outcome effects of case management teams.Research in the Sociology of Health Care 1997; 14:305–325.

    Google Scholar 

  7. Kissling W: Compliance, quality assurance and standards for relapse prevention in schizophrenia.Acta Psychiatrica Scandinavica Supplement 1994; 382:16–24.

    Google Scholar 

  8. Chassin MR: Quality of health care. Part 3: Improving the quality of care.New England Journal of Medicine 1996; 335:1060–1063.

    Google Scholar 

  9. Soumerai SB, Avorn J: Principles of educational outreach (“academic detailing”) to improve clinical decision making.Journal of the American Medical Association 1990; 263:549–556.

    Google Scholar 

  10. Coursey RD:CMHS Adult Panel of Managed Care Initiative: Competencies for Direct Service Staff who Work with Adults with Serious Mental Illness in Public Mental Health/Managed Care Systems. 3rd rev. ed. Philadelphia: University of Pennsylvania Center for Mental Health Policy and Services Research, 1998.

    Google Scholar 

  11. Drake RE, McHugo GJ, Bebout RR, et al.: A randomized clinical trial of supported employment for inner-city patients with severe mental disorders.Archives of General Psychiatry 1999; 56:627–633.

    Google Scholar 

  12. Marder SR, Wirshing WC, Mintz J, et al.: Two-year outcome of social skills training and group psychotherapy for outpatients with schizophrenia.American Journal of Psychiatry 1996; 153:1585–1592.

    Google Scholar 

  13. Lehman AF, Steinwachs DM: Translating research into practice: The Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations.Schizophrenia Bulletin 1998; 24:1–10.

    Google Scholar 

  14. American Psychiatric Association: Practice guideline for psychiatric evaluation of adults.American Journal of Psychiatry 1995; 152:63–80.

    Google Scholar 

  15. American Psychiatric Association: Practice guidelines for the treatment of patients with bipolar disorder.American Journal of Psychiatry 1994; 151:S1-S36.

    Google Scholar 

  16. American Psychiatric Association: Practice guidelines for major depressive disorder in adults.American Journal of Psychiatry 1993; 150:S1-S26.

    Google Scholar 

  17. American Psychiatric Association: Practice guideline for the treatment of patients with schizophrenia.American Journal of Psychiatry 1997; 154:1–63.

    Google Scholar 

  18. Zarate CA, Jr., Daniel DG, Kinon BJ, et al.: Algorithms for the treatment of schizophrenia.Psychopharmacology Bulletin 1995; 31:461–467.

    Google Scholar 

  19. Suppes T, Calabrese JR, Mitchell PB, et al.: Algorithms for the treatment of bipolar manic-depressive illness.Psychopharmacology Bulletin 1995; 31:469–474.

    Google Scholar 

  20. Department of Veterans Affairs:Clinical Guideline for Management of Persons with Psychoses, Version 1.0. Washington, DC: Veterans Health Administration, 1997.

    Google Scholar 

  21. Chiles JA, Miller AL, Crismon ML, et al.: The Texas Medication Algorithm Project: Development and implementation of the schizophrenia algorithm.Psychiatric Services 1999; 50:69–74.

    Google Scholar 

  22. American Psychiatric Association: Practice guideline for the treatment of patients with substance use disorders: Alcohol, cocaine, opioids.American Journal of Psychiatry 1995; 152:1–80.

    Google Scholar 

  23. American Psychiatric Association Steering Committee: The expert consensus guideline series: Treatment of schizophrenia.Journal of Clinical Psychiatry 1996; 57:3–58.

    Google Scholar 

  24. American Psychiatric Association Steering Committee: The expert consensus guideline series: Treatment of bipolar disorder.Journal of Clinical Psychiatry 1996; 57:3–88.

    Google Scholar 

  25. American Psychological Association: Guidelines for providers of psychological services to ethnic, linguistic, and culturally diverse populations.American Psychologist 1993; 48:45–48.

    Google Scholar 

  26. Trochim W, Cook J:Workforce Competencies for Psychosocial Rehabilitation Workers: A Concept Mapping Project (final report). The International Association of Psychosocial Rehabilitation Services, 1993.

  27. Jonikas J:Staff Competencies for Service-Delivery Staff in Psychosocial Rehabilitation Programs. Chicago: Thresholds National Research and Training Center on Rehabilitation and Mental Illness, 1993.

    Google Scholar 

  28. Kuehnel TG, Liberman RP:Competencies for Psychiatric Rehabilitation Workers. Camarillo, CA: Psychiatric Rehabilitation Consultants, 1997.

    Google Scholar 

  29. Glynn SM, Liberman RP, Backer TE:Involving Families in Mental Health Services: Competencies for Mental Health Workers. Northridge, CA: Center for Improving Mental Health Systems, 1997.

    Google Scholar 

  30. International Association of Psychosocial Rehabilitation Services:Practice Guidelines for the Psychiatric Rehabilitation of Persons with Severe and Persistent Mental Illness in a Managed Care Environment. Columbia, MD: IAPSRS, 1997.

    Google Scholar 

  31. International Association of Psychosocial Rehabilitation Services:Code of Ethics for Psychiatric Rehabilitation Practitioners. Columbia, MD: IAPSRS, 1996.

    Google Scholar 

  32. Carling P, Curtis L:Training Standards for Staff Who Work with Serous Mental Illnesses in Public Mental Health Services. Waterbury, VT: Vermont Department of Mental Health and Mental Retardation, 1993.

    Google Scholar 

  33. Young AS, Clark GH, Jr.: Guidelines for community psychiatric practice. In: Vaccaro JV, Clark GH, Jr. (Eds.):Practicing Psychiatry in the Community: A Manual. Washington, DC: American Psychiatric Press, 1996, pp. 331–341.

    Google Scholar 

  34. Torrey WC, Wyzik PF:New Hampshire Clinical Practice Guidelines for Adults in Community Support Programs. Concord: New Hampshire-Dartmouth Psychiatric Research Center, 1997.

    Google Scholar 

  35. Gill KJ, Pratt CW, Barrett N: Preparing psychiatric rehabilitation specialists through undergraduate education.Community Mental Health Journal 1997; 33:323–329.

    Google Scholar 

  36. University of Pennsylvania Center for Mental Health Policy and Services Research:Managed Care Initiative Panel Reports. http://www.med.upenn.edu/~cmhpsr/cmhs_reports.htm, accessed March 10, 2000.

  37. Lehman AF: Vocational rehabilitation in schizophrenia.Schizophrenia Bulletin 1995; 21:645–656.

    Google Scholar 

  38. Drake RE, Becker DR: The individual placement and support model of supported employment.Psychiatric Services 1996; 47:473–475.

    Google Scholar 

  39. Kaplan SH, Greenfield S, Ware JE, Jr.: Assessing the effects of physician-patient interactions on the outcomes of chronic disease.Medical Care 1989; 27:S110-S127.

    Google Scholar 

  40. Liberman RP, Kopelowicz A, Young AS: Biobehavioral treatment and rehabilitation of schizophrenia.Behavior Therapy 1994; 25:89–107.

    Google Scholar 

  41. Mueser KT, Glynn SM: Family intervention for schizophrenia. In: Dobson KS, Craig KD (Eds.):Emprically-Supported Therapies: Best Practices in Professional Psychology. Thousand Oaks, CA: Sage, 1998, pp. 157–185.

    Google Scholar 

  42. Anthony WA: Recovery from mental illness: The guiding vision of the mental health service system in the 1990s.Psychosocial Rehabilitation Journal 1993; 16:11–23.

    Google Scholar 

  43. Rogers ES, Chamberlin J, Ellison ML, et al.: A consumer-constructed scale to measure empowerment among users of mental health services.Psychiatric Services 1997; 48:1042–1047.

    Google Scholar 

  44. American Nurses Association:Position Statements: Psychiatric Mental Health Nursing and Managed Care. Kansas City, MO: American Nurses Association, 1997.

    Google Scholar 

  45. Kissling W (Eds.):Guidelines for Neuroleptic Relapse Prevention in Schizophrenia. New York: Springer-Verlag, 1991, p. 166.

    Google Scholar 

  46. Lu FG, Lim RF, Mezzich JE: Issues in the assessment and diagnosis of culturally diverse individuals. In: Oldham J, Riba M (Eds.):Review of Psychiatry. Washington, DC: American Psychiatric Press, 1995, pp. 477–509.

    Google Scholar 

  47. Stein LI: The community psychiatrist: Skills and personal characteristics.Community Mental Health Journal 1998; 34:437–445.

    Google Scholar 

  48. Taylor M, Bradley V, Warren R (Eds.):The Community Support Skill Standards: Tools for Managing Change and Achieving Outcomes, Skill Standards for Direct Service Workers in the Human Service. Cambridge, MA: Human Services Research Institute, 1996.

    Google Scholar 

  49. Yager J, Docherty JP, Tischler GL: Preparing psychiatric residents for managed care: Values, proficiencies, curriculum, and implications for psychotherapy training.Journal of Psychotherapy Practice and Research 1997; 6:108–122.

    Google Scholar 

  50. Brook RH, Chassin MR, Fink A, et al.: A method for the detailed assessment of the appropriateness of medical technologies.International Journal of Technology Assessment in Health Care 1986; 2:53–63.

    Google Scholar 

  51. Shekelle PG, Kahan JP, Bernstein SJ, et al.: The reproducibility of a method to identify the overuse and underuse of medical procedures.New England Journal of Medicine 1998; 338:1888–1895.

    Google Scholar 

  52. Essock SM, Drake RE, Burns BJ: A research network to evaluate assertive community treatment: Introduction.American Journal of Orthopsychiatry 1998; 68:176–178.

    Google Scholar 

  53. Corrigan PW, McCracken SG: Training teams to deliver better psychiatric rehabilitation programs.Psychiatric Services 1999; 50:43–45.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Veterans Affairs, West Los Angeles Veterans Healthcare Center, 11301 Wilshire Blvd., MIRECC, Bldg. 210A, 90073, Los Angeles, CA

    Alexander S. Young M.D., M.S.H.S. (Associate Director)

  2. Value-Options Healthcare, Colorado Health Networks, USA

    Sandra L. Forquer Ph.D. (senior vice president)

  3. the Department of Veterans Affairs at the West Los Angeles Veterans Healthcare Center, USA

    Anh Tran M.P.H. (health science specialist)

  4. Colorado Health Networks, USA

    Midge Starzynski R.N., Ph.D. (clinical director)

  5. the Department of Psychiatry, the University of California Los Angeles, USA

    Jess Shatkin M.D., M.P.H. (fellow)

Authors
  1. Alexander S. Young M.D., M.S.H.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sandra L. Forquer Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anh Tran M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Midge Starzynski R.N., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jess Shatkin M.D., M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

VISN 22 MIRECC.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Young, A.S., Forquer, S.L., Tran, A. et al. Identifying clinical competencies that support rehabilitation and empowerment in individuals with severe mental illness. The Journal of Behavioral Health Services & Research 27, 321–333 (2000). https://doi.org/10.1007/BF02291743

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02291743

Keywords

Search

Navigation