Abstract
Psychometric properties of the Illness Management and Recovery (IMR) Scales (consumer and clinician versions), new 15–item instruments measuring illness self-management and pursuit of recovery goals, were evaluated in consumers with severe mental illness. Both versions had moderate internal consistency and high 2-week test-retest reliability. In addition, the consumer version was correlated with self-ratings of recovery and symptoms, and the clinician version was correlated with clinician ratings of community functioning, indicating convergent validity. The results suggest the IMR Scales have adequate psychometric properties and may be useful in treatment planning and assessing recovery in individuals with severe mental illness.
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References
Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16, 11–23
Barker, S., Barron, N., McFarland, B., & Bigelow, D. (1994). A community ability scale for chronically mentally ill consumers: Part I. Reliability and validity. Community Mental Health Journal, 30, 363–383
Barker, S., Barron, N., & McFarlane, B. (1994). Multnomah community ability scale: Users manual. Portland, OR: Western Mental Health Research Center, Oregon Health Sciences University
Bellack, A. S. (2006). Scientific and consumer models of recovery in schizophrenia: Concordance, contrasts, and implications. Schizophrenia Bulletin, 32, 432–442
Bond, G. R., Resnick, S. R., Drake, R. E., Xie, H., McHugo, G. J., & Bebout, R. R. (2001). Does competitive employment improve nonvocational outcomes for people with severe mental illness? Journal of Consulting and Clinical Psychology, 69, 489–501
Copeland, M. E. (1997). Wellness recovery action plan. Brattleboro, VT: Peach Press
Corrigan, P. W., Giffort, D., Rashid, F., Leary, M., & Okeke, I. (1999). Recovery as a psychological construct. Community Mental Health Journal, 35(3), 231–240
Deegan, P. E. (1988). Recovery: The lived experience of rehabilitation. Psychosocial Rehabilitation Journal, 11(4), 12–19
Drake, R. E., Goldman, H. H., Leff, H. S., Lehman, A. F., Dixon, L., Mueser, K. T., et al. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services, 52, 179–182
Drake, R. E., Mueser, K. T., & McHugo, G. J. (1996). Clinician Rating Scales: Alcohol Use Scale (AUS), Drug Use Scale (DUS), and Substance Abuse Treatment Scale (SATS). In L. I. Sederer, & B. Dickey (Eds.). Outcomes assessment in clinical practice (pp. 113–116). Baltimore, MD: Williams & Wilkins
Gingerich, S., & Mueser, K. T. (2005). Illness management and recovery. In R. E. Drake, M. R. Merrens, & D. W. Lynde (Eds.). Evidence-based mental health practice: A textbook (pp. 395–424). New York: Norton
Hendryx, M., Dyck, D., McBride, M., & Whitbeck, J. (2001). A test of the reliability and validity of the Multnomah Community Ability Scale. Community Mental Health Journal, 37, 157–168
Liberman, R. P., Mueser, K. T., Wallace, C. J., Jacobs, H. E., Eckman, T., & Massel, H. K. (1986). Training skills in the psychiatrically disabled: Learning coping and competence. Schizophrenia Bulletin, 12, 631–647
McHugo, G. J., Drake, R. E., Burton, H. L., & Ackerson, T. H. (1995). A scale for assessing the stage of substance abuse treatment in persons with severe mental illness. Journal of Nervous and Mental Disease, 183(12), 762–767
Mead, S., & Copeland, M. (2000). What recovery means to us: Consumers’ perspectives. Community Mental Health Journal, 36, 315–328
Mueser, K. T., Corrigan, P. W., Hilton, D., Tanzman, B., Schaub, A., Gingerich, S., et al. (2002). Illness management and recovery for severe mental illness: A review of the research. Psychiatric Services, 53(10), 1272–1284
Mueser, K. T., & Gingerich, S. (2005). Illness Management and Recovery (IMR) Scales. In T. Campbell-Orde, J. Chamberlin, J. Carpenter, & H. S. Leff (Eds.). Measuring the promise: A compendium of recovery measures (pp. 124–132). Cambridge, MA: The Evaluation Center @ Human Services Research Institute
Mueser, K. T., Meyer, P. S., Penn, D. L., Clancy, R., Clancy, D. M., & Salyers, M. P. (2006). The Illness Management and Recovery program: Rationale, development, and preliminary findings. Schizophrenia Bulletin, 32(Suppl. 1), S32–S43
Mueser, K. T., Torrey, W. C., Lynde, D., Singer, P., & Drake, R. E. (2003). Implementing evidence-based practices for people with severe mental illness. Behavior Modification, 27, 387–411
Noordsy, D., Torrey, W., Mueser, K. T., Mead, S., O’Keefe, C., & Fox, L. (2002). Recovery from severe mental illness: An interpersonal and functional outcome definition. International Review of Psychiatry, 14(4), 318–326
Nuechterlein, K. H., & Dawson, M. E. (1984). A heuristic vulnerability/stress model of schizophrenic episodes. Schizophrenia Bulletin, 10, 300–312
Nuechterlein, K. H., Dawson, M. E., Gitlin, M., Ventura, J., Goldstein, M. J., Snyder, K. S., Yee, C. M., & Mintz, J. (1992). Developmental processes in schizophrenic disorders: Longitudinal studies of vulnerability and stress. Schizophrenia Bulletin, 18, 387–425
Resnick, S. G., Rosenheck, R. A., & Lehman, A. F. (2004). An exploratory analysis of correlates of recovery. Psychiatric Services, 55(5), 540–547
Ridgway, P. (2001). Restorying psychiatric disability: Learning from first person recovery narratives. Psychiatric Rehabilitation Journal, 24(4), 335–343
Shern, D., Lee, B., & Coen, A. (1996). The Colorado Symptom Inventory: A self-report measure for psychiatric symptoms. Unpublished manuscript, Tampa, FL: Louis de la Parte Mental Health Institute
Zani, B., McFarland, B., Wachal, M., Barker, S., & Barron, N. (1999). Statewide replication of predictive validation for the Multnomah Community Ability Scale. Community Mental Health Journal, 35(3), 223–229
Zubin, J., & Spring, B. (1977). Vulnerability: A new view of schizophrenia. Journal of Abnormal Psychology, 86, 103–126
Acknowledgments
The study was funded in part by National Institute of Disability and Rehabilitation Research (NIDRR) H133G030106 (Integrating Assertive Community Treatment (ACT) and Illness Management and Recovery (IMR) for Clients with Severe Mental Illness (SMI)) and Substance Abuse and Mental Health Services Administration (SAMHSA) SM56140 Implementing and Evaluating IMR in Indiana. We would like to thank Thresholds Psychiatric Rehabilitation Centers in Chicago, IL for their participation in this study.
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Results were presented at Annual Conference of the NASMHPD Research Institute 2006 in Baltimore, Maryland and to the Mental Health Statistics Improvement Program (MHSIP) Midwest Users Group (MUG) in Indianapolis, Indiana.
Michelle P. Salyers, Co-Director at ACT Center of Indiana and Associate Research Professor at Department of Psychology, Indiana University Purdue University Indianapolis, USA and also an Research Scientist at VA HSR&D Center on Implementing Evidence-based Practice, Roudebush VAMC and Research Scientist at Regenstrief Institute, Inc., Indianapolis,IN, USA.
Jenna L. Godfrey, Research Assistant and doctoral student at Indiana University Purdue University Indianapolis, USA.
Kim T. Mueser is affiliated with the Departments of Psychiatry and Community and Family Medicine, Dartmouth Medical School, and the New Hampshire-Dartmouth Psychiatric Research Center, USA.
Shauna Labriola is affiliated with Thresholds Research Department, USA.
Appendices
Appendices
Illness Management and Recovery Scale: Clinician Rating
Please take a few moments to fill out the following survey regarding your perception of your client’s ability to manage her or his illness, as well as her or his progress toward recovery. We are interested in the way you feel about how things are going for your client, so please answer with your honest opinion. If you are not sure about an item, just answer as best as you can. Please circle the answer that fits your client the best.
1. Progress toward goals: In the past 3 months, s/he has come up with...
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
No personal goals | A personal goal, but has not done anything to finish the goal | A personal goal and made it a little way toward finishing it | A personal goal and has gotten pretty far in finishing the goal | A personal goal and has finished it |
2. Knowledge: How much do you feel your client knows about symptoms, treatment, coping strategies (coping methods), and medication?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Not very much | A little | Some | Quite a bit | A great deal |
3. Involvement of family and friends in his/her mental health treatment: How much are people like family, friends, boyfriends/girlfriends, and other people who are important to your client (outside the mental health agency) involved in his/her treatment?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Not at all | Only when there is a serious problem | Sometimes, like when things are starting to go badly | Much of the time | A lot of the time and they really help with his/her mental health |
4. Contact with people outside of the family: In a normal week, how many times does s/he talk to someone outside of her/his family and outside of treatment providers (like a friend, co-worker, classmate, roommate, etc.)?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
0 times/week | 1–2 times/week | 3–4 times/week | 6–7 times/week | 8 or more times/week |
5. Time in Structured Roles: How much time does s/he spend working, volunteering, being a student, being a parent, taking care of someone else or someone else’s house or apartment? That is, how much time does s/he spend in doing activities for or with another person that are expected of him/her? (This would not include self-care or personal home maintenance.)
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
2 hours or less/week | 3–5 hours/week | 6 to 15 hours/week | 16–30 hours/week | More than 30 hours/week |
6. Symptom distress: How much do symptoms bother him/her?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Symptoms really bother him/her a lot | Symptoms bother him/her quite a bit | Symptoms bother him/her somewhat | Symptoms bother him/her very little | Symptoms don’t bother him/her at all |
7. Impairment of functioning: How much do symptoms get in the way of him/her doing things that s/he would like to do or needs to do?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Symptoms really get in her/his way a lot | Symptoms get in his/her way quite a bit | Symptoms get in his/her way somewhat | Symptoms get in his/her way very little | Symptoms don’t get in his/her way at all |
8. Relapse Prevention Planning: Which of the following would best describe what s/he knows and has done in order not to have a relapse?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Doesn’t know how to prevent relapses | Knows a little, but hasn’t made a relapse prevention plan | Knows 1 or 2 things to do, but doesn’t have a written plan | Knows several things to do, but doesn’t have a written plan | Has a written plan and has shared it with others |
9. Relapse of Symptoms: When is the last time s/he had a relapse of symptoms (that is, when his/her symptoms have gotten much worse)?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Within the last month | In the past 2 to 3 months | In the past 4 to 6 months | In the past 7 to 12 months | Hasn’t had a relapse in the past year |
10. Psychiatric Hospitalizations: When is the last time s/he has been hospitalized for mental health or substance abuse reasons?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Within the last month | In the past 2 to 3 months | In the past 4 to 6 months | In the past 7 to 12 months | No hospitalization in the past year |
11. Coping: How well do feel your client is coping with her/his mental or emotional illness from day to day?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Not well at all | Not very well | Alright | Well | Very well |
12. Involvement with self-help activities: How involved is s/he in consumer run services, peer support groups, Alcoholics Anonymous, drop-in centers, WRAP (Wellness Recovery Action Plan), or other similar self-help programs?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Doesn’t know about any self-help activities | Knows about some self-help activities, but isn’t interested | Is interested in self-help activities, but hasn’t participated in the past year | Participates in self-help activities occasionally | Participates in self-help activities regularly |
13. Using Medication Effectively: (Don’t answer this question if her/his doctor has not prescribed medication). How often does s/he take his/her medication as prescribed?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Never | Occasionally | About half the time | Most of the time | Every day |
14. Impairment of functioning through alcohol use: Drinking can interfere with functioning when it contributes to conflict in relationships, or to financial, housing and legal concerns, to difficulty attending appointments or focusing during them, or to increases of symptoms. Over the past 3 months, did alcohol use get in the way of his/her functioning?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Alcohol use really gets in her/his way a lot | Alcohol use gets in his/her way quite a bit | Alcohol use gets in his/her way somewhat | Alcohol use gets in his/her way very little | Alcohol use is not a factor in his/her functioning |
15. Impairment of functioning through drug use: Using street drugs, and misusing prescription or over-the-counter medication can interfere with functioning when it contributes to conflict in relationships, or to financial, housing and legal concerns, to difficulty attending appointments or focusing during them, or to increases of symptoms. Over the past 3 months, did drug use get in the way of his/her functioning?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Drug use really gets in her/his way a lot | Drug use gets in his/her way quite a bit | Drug use gets in his/her way somewhat | Drug use gets in his/her way very little | Drug use is not a factor in his/her functioning |
Illness Management and Recovery Scale: Consumer Self-Rating
Please take a few minutes to fill out this survey. We are interested in the way things are for you, so there is no right or wrong answer. If you are not sure about a question, just answer it as best as you can.
Please circle the number of the answer that fits you best.
1. Progress towards personal goals: In the past 3 months, I have come up with...
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
No personal goals | A personal goal, but have not done anything to finish my goal | A personal goal and made it a little way toward finishing it | A personal goal and have gotten pretty far in finishing my goal | A personal goal and have finished it |
2. Knowledge: How much do you feel like you know about symptoms, treatment, coping strategies (coping methods), and medication?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Not very much | A little | Some | Quite a bit | A great deal |
3. Involvement of family and friends in my mental health treatment: How much are people like family members, friends, boyfriend/girlfriend, and other people who are important to you (outside your mental health agency) involved in your mental health treatment?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Not at all | Only when there is a serious problem | Sometimes, like when things are starting to go badly | Much of the time | A lot of the time and they really help me with my mental health |
4. Contact with people outside of my family: In a normal week, how many times do you talk to someone outside of your family and outside of your mental health providers (like a friend, co-worker, classmate, roommate, etc.)
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
0 times/ week | 1–2 times/week | 3–4 times/week | 6–7 times/week | 8 or more times/week |
5. Time in Structured Roles: How much time do you spend working, volunteering, being a student, being a parent, taking care of someone else or someone else’s house or apartment? That is, how much time do you spend in doing activities for or with another person that are expected of you? (This would not include self-care or personal home maintenance.)
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
2 hours or less/week | 3–5 hours/week | 6 to 15 hours/week | 16–30 hours/week | More than 30 hours/week |
6. Symptom distress: How much do your symptoms bother you?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
My symptoms really bother me a lot | My symptoms bother me quite a bit | My symptoms bother me somewhat | My symptoms bother me very little | My symptoms don’t bother me at all |
7. Impairment of functioning: How much do your symptoms get in the way of you doing things that you would like to do or need to do?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
My symptoms really get in my way a lot | My symptoms get in my way quite a bit | My symptoms get in my way somewhat | My symptoms get in my way very little | My symptoms get in my way hardly at all |
8. Relapse Prevention Planning: Which of the following would best describe what you know and what you have done in order to not have a relapse.
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
I don’t know how to prevent relapses | I know a little, but I haven’t made a relapse prevention plan | I know 1 or 2 things I can do, but I don’t have a written plan | I have several things that I can do, but I don’t have a written plan | I have a written plan that I have shared with others |
9. Relapse of Symptoms: When is the last time you had a relapse of symptoms (that is, when your symptoms have gotten much worse)?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Within the last month | In the past 2 to 3 months | In the past 4 to 6 months | In the past 7 to 12 months | I haven’t had a relapse in the past year |
10. Psychiatric Hospitalizations: When is the last time you have been hospitalized for mental health or substance abuse reasons?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Within the last month | In the past 2 to 3 months | In the past 4 to 6 months | In the past 7 to 12 months | I haven’t been hospitalized in the past year |
11. Coping: How well do you feel like you are coping with your mental or emotional illness from day to day?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Not well at all | Not very well | Alright | Well | Very well |
12. Involvement with self-help activities: How involved are you in consumer run services, peer support groups, Alcoholics Anonymous, drop-in centers, or other similar self-help programs?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
I don’t know about any self-help activities | I know about some self-help activities, but I’m not interested | I’m interested in self-help activities, but I have not participated in the past year | I participate in self-help activities occasionally | I take part in self-help activities regularly |
13. Using Medication Effectively: (Don’t answer this question if your doctor has not prescribed medication for you). How often do you take your medication as prescribed?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Never | Occasionally | About half the time | Most of the time | Every day |
14. Functioning affected by alcohol use. Drinking can interfere with functioning when it contributes to conflict in relationships, or to money, housing and legal concerns, to difficulty showing up at appointments or paying attention during them, or to increased symptoms. Over the past 3 months, how much did drinking get in the way of your functioning?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Alcohol use really gets in my way a lot | Alcohol use gets in my way quite a bit | Alcohol use gets in my way somewhat | Alcohol use gets in my way very little | Alcohol use is not a factor in my functioning |
15. Functioning affected by drug use. Using street drugs, and misusing prescription or over-the-counter medication can interfere with functioning when it contributes to conflict in relationships, or to money, housing and legal concerns, to difficulty showing up at appointments or paying attention during them, or to increased symptoms. Over the past 3 months, how much did drug use get in the way of your functioning?
1 | 2 | 3 | 4 | 5 |
|---|---|---|---|---|
Drug use really gets in my way a lot | Drug use gets in my way quite a bit | Drug use gets in my way somewhat | Drug use gets in my way very little | Drug use is not a factor in my functioning |
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Salyers, M.P., Godfrey, J.L., Mueser, K.T. et al. Measuring Illness Management Outcomes: A Psychometric Study of Clinician and Consumer Rating Scales for Illness Self Management and Recovery. Community Ment Health J 43, 459–480 (2007). https://doi.org/10.1007/s10597-007-9087-6
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DOI: https://doi.org/10.1007/s10597-007-9087-6