IN OUR OWN VOICE (LIVING WITH MENTAL ILLNESS): EVALUATING THE IMPACT OF A CONSUMER-DELIVERED EDUCATIONAL OUTREACH PROGRAM ON THE PUBLIC

poster abstractPsychoeducation programs can help correct misperceptions and offer hope about the ability of the mentally ill to recover. Consumer presentation programs, such as NAMI’s In Our Own Voice (IOOV), were designed in part for this purpose. The study used mixed methods to examine archival IOOV evaluations (n = 599) to understand: 1) viewers’ responses to the program in natural settings, 2) differences between consumer and nonconsumer viewers, and 3) the program’s ability to satisfy IOOV goals for audience members. Results indicate that the majority of viewers respond positively, with few differences between consumer and nonconsumer viewers. However, consumers more frequently reported personally relating to presenters while nonconsumers more frequently reported feeling educated by the program. Finally, IOOV is meeting its two program goals for audience members: edu-cating the public and offering a hopeful message of recovery. IOOV appears to be a valuable addition to recovery-oriented programming that is freely available to the public

An empirical study of multidimensional fidelity of COMPASS consultation

Consultation is essential to the daily practice of school psychologists (National Association of School Psychologist, 2010). Successful consultation requires fidelity at both the consultant (implementation) and consultee (intervention) levels. We applied a multidimensional, multilevel conception of fidelity (Dunst, Trivette, & Raab, 2013) to a consultative intervention called the Collaborative Model for Promoting Competence and Success (COMPASS) for students with autism. The study provided 3 main findings. First, multidimensional, multilevel fidelity is a stable construct and increases over time with consultation support. Second, mediation analyses revealed that implementation-level fidelity components had distant, indirect effects on student Individualized Education Program (IEP) outcomes. Third, 3 fidelity components correlated with IEP outcomes: teacher coaching responsiveness at the implementation level, and teacher quality of delivery and student responsiveness at the intervention levels. Implications and future directions are discussed. (PsycINFO Database Record

Parents Served by Assertive Community Treatment: A Needs Based Assessment

poster abstractAssertive Community Treatment (ACT) represents an effective treatment for individuals with severe mental illness. Though studies estimate roughly half of all people with severe mental illness are parents, little is known about consumers receiving ACT services who are parents. Thus, the purpose of the present study was to 1) estimate the prevalence of parent ACT consumers, 2) identify current ACT team policies and services for parent consumers, and 3) examine the perspective of parent consumers served by ACT teams. Quantitative and qualitative data were collected and analyzed via two studies. In study 1, 82 ACT providers from 76 teams in the US and Canada were surveyed. Providers estimated roughly 21.6% of ACT consumers were parents. Only 46.3% of providers reported formally asking consumers about parental status and 20.7% of providers belonged to ACT teams that offer services designed for parent consumers. The majority of providers (75.6%) reported negative or mixed attitudes about parents with severe mental illness. In study 2, seventeen parents receiving ACT services were interviewed. All parents endorsed positive attitudes about parenting, though most (76.5%) also identified negative aspects of parenting. Almost all parents (88.2%) reported loss of custody at least once. Parents expressed interest in parent-focused treatment services like family therapy, parenting skills, communication skills training, and peer support groups. Regarding satisfaction with ACT services, most parents with adult children (87.5%) reported no unmet parent-related needs and high satisfaction (4.63 of 5) with ACT services, whereas parents with young children (77.8%) reported unmet parenting needs and low satisfaction (3.78 of 5) with ACT services. Thus, results indicate the ACT treatment model may not be adequately serving parents with young, dependent children. Overall, findings suggest the need for more focus on parents with severe mental illness, including formal identification of parental status and parent-related treatment services and support

Stigma resistance at the personal, peer, and public levels: A new conceptual model.

Stigma resistance is consistently linked with key recovery outcomes, yet theoretical work is limited. This study explored stigma resistance from the perspective of individuals with serious mental illness (SMI). Twenty-four individuals with SMI who were either peer-service providers (those with lived experience providing services; N = 14) or consumers of mental health services (N = 10) engaged in semistructured interviews regarding experiences with stigma, self-stigma, and stigma resistance, including key elements of this process and examples of situations in which they resisted stigma. Stigma resistance is an ongoing, active process that involves using one’s experiences, knowledge, and sets of skills at the (1) personal, (2) peer, and (3) public levels. Stigma resistance at the personal level involves (a) not believing stigma or catching and challenging stigmatizing thoughts, (b) empowering oneself by learning about mental health and recovery, (c) maintaining one’s recovery and proving stigma wrong, and (d) developing a meaningful identity apart from mental illness. Stigma resistance at the peer level involves using one’s experiences to help others fight stigma and at the public level, resistance involved (a) education, (b) challenging stigma, (c) disclosing one’s lived experience, and (d) advocacy work. Findings present a more nuanced conceptualization of resisting stigma, grounded in the experiences of people with SMI. Stigma resistance is an ongoing, active process of using one’s experiences, skills, and knowledge to develop a positive identity. Interventions should consider focusing on personal stigma resistance early on and increasing the incorporation of peers into services

Pre-diagnostic and Diagnostic Stages of Autism Spectrum Disorder: A Parent Perspective

This study examined the experiences of parents receiving an autism spectrum disorder (ASD) diagnosis for their child. Mixed methods were used to give a detailed account of the sequence of events, parents’ experiences and actions associated with the ASD diagnosis. Parents waited nearly two and a half years (mean = 28.72 months) before receiving the ASD diagnosis. Parents with lower general and autism-specific social support, poorer physical health functioning and children with more severe communication problems reported longer wait times. Surprisingly, parents reported more positive than negative experiences from receiving the diagnosis. Paediatricians and psychologists were consulted most frequently; paediatricians and general physicians were rated most likely to neglect early ASD symptoms and least likely to make appropriate referrals. Qualitative analyses revealed seven themes describing the parent experience during the diagnostic process: “heightened awareness”, “initial search”, “dissatisfaction with medical or associated processionals”, “long process/delay”, “feeling uninformed”, “parent psychological and relational experiences” and “diagnosis goals”. A set of commonly experienced stages characterising the process of obtaining a diagnosis were identified and formulated into a six-stage model of diagnostic delay adapted from the patients’ health-seeking model

Too Stressed to Teach? Teaching Quality, Student Engagement and IEP Outcomes

Teacher stress and burnout have a detrimental effect on the stability of the teaching workforce. However, the possible consequences of teacher burnout on teaching quality and on student learning outcomes are less clear, especially in special education settings. We applied Maslach and Leiter’s (1999) model to understand the direct effects of burnout on teaching in general and stress arising from interaction with a specific student on the individualized education program (IEP) outcomes of young children with autism spectrum disorder. We also examined indirect effects through teaching quality and student engagement. The results indicated that one of the three components of burnout—teacher personal accomplishment—was directly related to IEP outcomes, a distal effect, whereas stress was directly related to teaching quality and student engagement, which were more proximal effects. In addition, teacher stress, emotional exhaustion, and depersonalization had indirect effects on IEP outcomes through teaching quality and student engagement

Explicit and Implicit Stigma of Mental Illness as Predictors of Recovery Attitudes of Assertive Community Treatment Practitioners

While explicit negative stereotypes of mental illness are well established as barriers to recovery, implicit attitudes also may negatively impact outcomes. The current study is unique in its focus on both explicit and implicit stigma as predictors of recovery attitudes of mental health practitioners.Assertive Community Treatment practitioners (n = 154) from 55 teams completed online measures of stigma, recovery attitudes, and an Implicit Association Test (IAT).Three of four explicit stigma variables (perceptions of blameworthiness, helplessness, and dangerousness) and all three implicit stigma variables were associated with lower recovery attitudes. In a multivariate, hierarchical model, however, implicit stigma did not explain additional variance in recovery attitudes. In the overall model, perceptions of dangerousness and implicitly associating mental illness with "bad" were significant individual predictors of lower recovery attitudes.The current study demonstrates a need for interventions to lower explicit stigma, particularly perceptions of dangerousness, to increase mental health providers' expectations for recovery. The extent to which implicit and explicit stigma differentially predict outcomes, including recovery attitudes, needs further research

Using a model of family adaptation to examine outcomes of caregivers of individuals with autism spectrum disorder transitioning into adulthood

Background The study examined the burden of caring for individuals with autism spectrum disorder (ASD) transitioning from high school and factors associated with burden derived from the Double ABCX model of family adaptation (i.e., autism symptom severity, problem behaviors, pile-up life demands, personality traits, social support, cognitive appraisals, and coping strategies). In particular, we were interested in the potential association between the “big 5” personality traits and burden. Method Participants (N = 105) were caregivers of individuals with ASD within two years pre- or post-graduation from high school. Results Primary caregivers reported moderate levels of burden. As hypothesized, burden was significantly associated with both child (i.e., increased autism symptom severity and problem behaviors) and caregiver characteristics (i.e., greater neuroticism, lower levels of extraversion, conscientiousness, agreeableness, and social support, and increased use of threat appraisals and passive-avoidance coping strategies). Using multiple regression, increased child behavior problems and increased caregiver use of passive-avoidance coping were identified as independent predictors of burden. Passive-avoidance coping mediated the relationship between caregiver burden and individual personality traits (i.e., neuroticism, extraversion, conscientiousness). Conclusions The results suggest that proximal variables, such as caregivers’ use of maladaptive coping strategies, explain the associations between burden and personality. Suggestions for interventions to relieve burden are discussed

Implicit and Explicit Stigma of Mental Illness: Attitudes in an Evidence-Based Practice

The extent to which explicit and implicit stigma are endorsed by mental health practitioners using evidence-based practices is unknown. The purposes of the current study were to a) examine implicit and explicit biases among Assertive Community Treatment (ACT) staff and b) explore the extent to which biases predicted the use of treatment control mechanisms. Participants were 154 ACT staff from nine states. Overall, the participants exhibited positive explicit and implicit attitudes toward people with mental illness. When modeled using latent factors, greater implicit, but not explicit, bias significantly predicted greater endorsement of restrictive or controlling clinical interventions. Thus, despite overall positive attitudes toward those with mental illness for the sample as a whole, individual differences in provider stigma were related to clinical care. Mental health professionals, and specifically ACT clinicians, should be educated on types of bias and ways in which biases influence clinical interventions