From Housing to Homes: A Review of the Literature on Housing Approaches for Psychiatric Consumers/Survivors

In this paper, we review the literature on housing for psychiatric consumer/survivors since the publication of the Nelson and Smith Fowler (1987) review more than a decade ago. First, we review research and propose a definition to contrast key features of three approaches to housing: (a) custodial, (b) supportive, and (c) supported. Second, we examine studies of the relationships between the characteristics of housing and adaptational outcomes for residents (e.g., personal empowerment). Third, we review studies which have examined out-comes for residents for these three different housing approaches. We conclude by critically reflecting on the values and research of the different approaches to housing, to make recommendations for future policy and planning, practice, and research

Recovery Compromised: Tracing the Structural Conditions that Perpetuate and Maintain Social Exclusion in Assertive Community Treatment

Concerns have been raised regarding the extent to which the services provided through the Assertive Community Treatment (ACT) model are based on an understanding of recovery as primarily a clinical phenomenon rather than a journey that is fundamentally about self-determination, social inclusion, citizenship and civil rights. Until recently, the limited degree of social inclusion experienced by users of ACT has been assumed to result from individual functioning or inadequate practitioner training. These explanations negate the role of organizing conditions in shaping a systematic approach to everyday practice that diminishes opportunities for inclusion. The current study identifies key areas where practices consistent with the current recovery vision and theories of social inclusion are superseded by accepted and legitimized forms of practice that are aligned with a medical model approach. The study explicates both how and why this happens in the course of everyday practice.Des inquiétudes ont été soulevées à savoir si les services fournis par le modèle de traitement communautaire intensif sont basés sur une compréhension du rétablissement en tant que phénomène principalement clinique plutôt qu’une progression fondamentalement liée à l’autodétermination, à l’inclusion sociale, à la citoyenneté et aux droits civiques. Jusqu’à récemment, on a présumé que le niveau limité d’inclusion sociale, dont les utilisateurs de traitement communautaire intensif faisaient l’expérience, résultait du travail individuel ou de la formation insuffisante des praticiens. Ces explications nient le rôle qu’ont les conditions organisationnelles dans l’adoption de pratiques quotidiennes diminuant systématiquement les opportunités d’inclusion. La présente étude identifie des domaines clés où des pratiques compatibles à la vision actuelle du rétablissement et aux théories courantes d’inclusion sociale sont remplacées par des pratiques acceptées et légitimées par une approche reposant sur le modèle médical. L’étude démontre comment et pourquoi cela se produit dans le cadre de la pratique quotidienne des praticiens

Exploring how social networking sites impact youth with anxiety: A qualitative study of Facebook stressors among adolescents with an anxiety disorder diagnosis

Adolescents with anxiety disorders often have low self-esteem, poor problem-solving, and a strong desire to be accepted. Combined, these qualities may predispose them to experience unique stressors when using social network sites (SNSs). Focus groups of adolescent Facebook users who have a primary anxiety diagnosis uncovered narratives describing individuals’ perspectives related to how Facebook can influence their anxiety. Qualitative analysis revealed six themes related to Facebook stressors: seeking approval, fearing judgment, escalating interpersonal issues, wanting privacy, negotiating self and social identity, and connecting & disconnecting. Many participants reported a fear of receiving negative comments online and discussed strategies to avoid them, such as posting less content (i.e., comments, photographs) than their peers. Some participants described feeling positive emotions when they received a “like” from a SNS user, however, they also tended to describe these positive emotions as “false”, “unreal” and “fleeting.” Notably, many participants reported comparing themselves to peers on Facebook, which increased feelings of anxiety, as well as compulsive checking behaviours, such as monitoring posted content and friend lists. These findings were coupled with discussions surrounding rumination, privacy, and elevated personal conflict due in part to the public nature of Facebook. The narratives from our exploratory study suggest there are various mechanisms through which Facebook may exacerbate anxiety in adolescents who have pre-existing anxiety disorders and thereby may make them vulnerable to negative online experiences. Understanding the underlying themes of this phenomenon can aid clinicians, school staff, and parents in identifying potential stressors for anxious adolescents who use SNSs, and provide strategies around social media use for this specific patient population. Future quantitative studies are recommended to further understand the relationships between Facebook stressors and expressed anxiety in clinical populations