Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 1: Theoretical and practical foundations

Authors

  • Gretchen Snethen, PhD, LRT/CTRS
  • Bryan P. McCormick, PhD, CTRS
  • Marieke Van Puymbroeck, PhD, CTRS

DOI:

https://doi.org/10.5055/ajrt.2011.0004

Keywords:

schizophrenia, community, self-determination, negative symptoms, functioning, recovery, recreational therapy

Abstract

Negative symptoms and cognitive dysfunction are two symptomatic categories of schizophrenia spectrum disorders (SSDs) that significantly impair functioning. Treatment for adults with SSDs continues to focus primarily on medication adherence and positive symptom reduction, despite the fact that medication has little impact on negative and cognitive symptoms within this population and, thus, little impact on improving community functioning. This two-part series presents an intervention developed to increase community participation in adults with SSDs. This article presents a comprehensive description of the functional impairments experienced by this population, framed within the World Health Organization’s International Classification of Functioning, Disability, and Health. This article will also apply Self-Determination Theory to this population of adults with SSDs as a foundation to help this population increase community participation and successful integration.

Author Biographies

Gretchen Snethen, PhD, LRT/CTRS

Department of Recreation and Leisure Studies, East Carolina University, Greenville, North Carolina.

Bryan P. McCormick, PhD, CTRS

Department of Recreation, Park, and Tourism Studies, Indiana University, Bloomington, Indiana.

Marieke Van Puymbroeck, PhD, CTRS

Department of Recreation, Park, and Tourism Studies, Indiana University, Bloomington, Indiana.

References

Narrow WE, Rae DS, Robins LN, et al.: Revised prevalence estimates of mental disorders in the United States: Using a clinical significance criterion to reconcile two surveys’ estimates. Arch Gen Psychiatry. 2002; 59: 115-123.

APA: Diagnositic and Statistical Manual of Mental Disorders. Washington, DC: APA, 2000.

Mueser KT, McGurk SR: Schizophrenia. Lancet. 2004; 363: 2063-2072.

Everett A, Mahler J, Biblin J, et al.: Improving the health of mental health consumers: Effective policies and practices. Int J Ment Health. 2008; 37(2): 8-48.

Wu EQ, Birnbaum HG, Shi L, et al.: The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry. 2005; 66(9): 1122-1129.

Wunderink L, Sytema S, Nienhuis FJ, et al.: Clinical recovery in first-episode psychosis. Schizophr Bull. 2009; 35(2): 362-369.

Bowie CR, Reichenberg A, Patterson TL, et al.: Determinants of real-world functional performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms. Am J Psychiatry. 2006; 163(3): 418-425.

Krupa T, McLean H, Eastabrook S, et al.: Daily time use as a measure of community adjustment for persons served by assertive community treatment teams. Am J Occup Ther. 2003; 57(5): 558-565.

Tenorio-Martinez R, del Carmen Lara-Munoz M, Medina- Mora ME: Measurement of problems in activities and participation in patients with anxiety, depression and schizophrenia using the ICF checklist. Soc Psychiatry Psychiatr Epidemiol. 2009; 44: 377-384.

Drake RJ, Haley CJ, Akhtar S, et al.: Causes and consequences of duration of untreated psychosis in schizophrenia. Br J Psychiatry. 2000; 177(6): 511-515.

Nilsson L-L, Lögdberg B: Dead and forgotten— Postmortem time before discovery as indicator of social isolation and inadequate mental healthcare in schizophrenia. Schizophr Res. 2008; 102(1-3): 337-339.

Graham C, Arthur A, Howard R: The social functioning of older adults with schizophrenia. Aging Ment Health. 2002; 6(2): 149-152.

Granerud A, Severinsson E: The struggle for social integration in the community—The experiences of people with mental health problems. J Psychiatr Ment Health Nurs. 2006; 13(3): 288-293.

Link BG, Phelan J: Social conditions as fundamental causes of disease. J Health Soc Behav. 1995; 35 (Extra Issue): 80-94.

McCormick BP, Lee Y, Van Puymbroeck M: Research in practice: Building knowledge through emperical practice. In Stumbo NJ (ed.): Professional Issues in Therapeutic Recreation: On Competence and Outcomes. 2nd ed. Urbana, IL: Sagamore, 2009.

Harvey PD, Bellack AS: Toward a terminology for functional recovery in schizophrenia: Is functional remission a viable concept? Schizophr Bull. 2009; 35(2): 300-306.

Oades L, Deane F, Crowe T, et al.: Collaborative recovery: An integrative model for working with indivdiuals who experience chronic and recurring mental illness. Psychiatr Serv. 2005; 13(3): 279-284.

Richeson NE: Effects of animal-assisted therapy on agitated behaviors and social interactions of older adults with dementia. Am J Alzheimers Dis Other Demen. 2003; 18: 353-358.

Howard D, Browning C, Lee Y: The International Classification of Functioning, Disability, and Health: Therapeutic recreation code sets and salient diagnostic core sets. Ther Recreation J. 2007; 41(1): 61-81.

Goranson TE, Graves RE, Allison D, et al.: Commiunity integration following multidiciplinary rehabilitation for traumatic brain injury. Brain Inj. 2003; 17(9): 759-774.

Snethen G, McCormick BP, Smith RL, Van Puymbroeck M: Independence through Community Access and Navigation (I-CAN) in adults with schizophrenia spectrum disorders, Part 2: Treatment planning and implementation. Am J Recreation Ther. in press.

Buchanan RW: Persistent negative symptoms in schizphrenia: An overview. Schizophr Bull. 2007; 33(4): 1013-1022.

Kurtz MM, Wexler BE, Fujimoto M, et al.: Symptoms versus neurocognition as predictors of change in life skills in schizophrenia after outpatient rehabilitation. Schizophr Res. 2008; 102(1-3): 303-311.

Kirkpatrick B, Fenton WS, Carpenter WT Jr, et al.: The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull. 2006; 32(2): 214-219.

Addington J, Addington D: Positive and negative symptoms of schizophrenia: Their course and relationship over time. Schizophr Res. 1991; 5(1): 51-59.

Green MF: What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry. 1996; 153(3): 321-330.

Schultz SK, Andreasen NC: Schizophrenia. Lancet. 1999; 353(9162): 1425-1430.

Blanchard JJ, Horan WP, Collins LM: Examining the latent structure of negative symptoms: Is there a distinct subtype of negative symptom schizophrenia? Schizophr Res. 2005; 77(2-3): 151-165.

Lysaker P, Davis L: Social function in schizophrenia and schizoaffective disorder: Associations with personality, symptoms and neurocognition. Health Qual Life Outcomes. 2004; 2(1): 15.

Reid Y, Johnson S, Bebbington PE, et al.: The longer term outcomes of community care: A 12 year follow-up of the Camberwell High Contact Survey. Psychol Med. 2001; 31(2): 351-359.

Mittal DMD, Davis CEP, Depp CP, et al.: Correlates of health-related quality of well-being in older patients with schizophrenia. J Nerv Ment Dis. 2006; 194(5): 335-340.

Lysaker PH, Lancaster RS, Nees MA, et al.: Attributional style and symptoms as predictors of social function in schizophrenia. J Rehabil Res Dev. 2004; 41(2): 225-232.

Copolov DL, Castle DJ: Management of negative symptoms. In Castle DJ, Copolov DL, Wykes T, Mueser KT (eds.): Pharmacological and Psychosocial Treatments in Schizo - phrenia. London: Informa UK Ltd, 2009: 35-45.

Mancini MA, Hardiman ER, Lawson HA: Making sense of it all: Consumer providers’ theories about factors facilitating and impeding recovery from psychiatric disabilities. Psychiatr Rehabil J. 2005; 29(1): 48-55.

Wykes T, Castle DJ: Cognitive dysfunction in schizophrenia. In Castle DJ, Copolov DL, Wykes T, Mueser KT (eds.): Pharmacological and Psychosocial Treatments in Schizophrenia. 2nd ed. London: Informa UK Ltd, 2009: 47- 60.

Badcock JC, Michie PT, Rock D: Spatial working memory and planning ability: Contrasts between schizophrenia and bipolar I disorder. Cortex. 2005; 41: 753-763.

Glynn SM, Lui A: Enhancing socialization capacities in people with schizophrenia. In Castle DJ, Copolov DL, Wykes T, Mueser KT (eds.): Pharmacological and Psychosocial Treatments in Schizophrenia. 2nd ed. London: Informa UK Ltd, 2009: 165-177.

Cohen AS, Forbes CB, Mann MC, et al.: Specific cognitive deficits and differential domains of social functioning impairment in schizophrenia. Schizophr Res. 2006; 81: 227-238.

Heinssen RK, Liberman RP, Kopelowicz A: Psychosocial skills training for schizophrenia: Lessons from the laboratory. Schizophr Bull. 2000; 26(1): 21-46.

Snethen G, Gilbert R, McCormick BP: Boredom and Anxiety in the Daily Lives of People with Severe and Persistent Mental Illness. Minneapolis, MN: American Therapeutic Recreation Association Research Institute, 2009: 18-22.

Burns T, Patrick DL: Social functioning as an outcome measure in schizophrenia studies. Acta Psychiatr Scand. 2007; 116: 403-418.

Erickson DH, Beiser M, Iacono WG: Social support predict 5-year outcome in 1st-episode schizophrenia. J Abnorm Psychol. 1998; 107(4): 681-685.

Evert H, Harvey C, Trauer T, et al.: The relationship between social networks and occupational and self-care functioning in people with psychosis. Soc Psychiatry Psychiatr Epidemiol. 2003; 38: 180-188.

WHO: International Classification of Functioning, Disability and Health. Geneva, Switzerland: World Health Organization, 2001.

Deci EL, Ryan RM: The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychol Inq. 2000; 11(4): 227-268.

Deci EL, Vansteenkiste M: Self-determination theory and basic need satisfaction: Understanding human development in positive psychology. Recerche di Psichologia. 2004; 27: 17-34.

Becker DR, Drake RE: A Working Life for People with Severe Mental Illness. New York: Oxford University Press, 2003.

Bond GR: Principles of the individual placement and support model: Empirical support. J Psychiatr Rehabil. 1998; 22(1): 11-24.

Miller WR, Rollnick S: Motivational Interviewing: Preparing People for Change. New York: Guilford Press, 2002.

Van Puymbroeck M, Porter HR, McCormick BP, et al.: The role of the International Classification of Functioning, Disability, andHealth (ICF) in therapeutic recreation practice, research, and education. In Stumbo NJ (ed.): Professional Issues in Therapeutic Recreation: On Competence and Outcomes. 2nd ed. Urbana, IL: Sagamore Publishing, 2009: 43-57.

McCormick BP, Funderburk JA, Lee Y, et al.: Activity characteristics and emotional experience: Predicting boredom and anxiety in the daily life of community mental health clients. J Leis Res. 2005; 37(2): 236-253.

Todman M: Boredom and psychotic disorders: Cognitive and motivational issues. Psychiatry. 2003; 66(2): 146-167.

Bracke P, Bruynooghe K, Verhaeghe M: Boredom during day activity programs in rehabilitation centers. Sociol Perspect. 2006; 49(2): 191-215.

Bengtsson-Tops A: Mastery in patients with schizophrenia living in the community: Relationship to sociodemographic and clinical characteristics, needs for care and support, and social network. J Psychiatr Ment Health Nurs. 2004; 11(3): 298-304.

Mancini MA: The role of self-efficacy in recovery from serious psychiatric disabilities: A qualitative study with fifteen psychiatric survivors. Qual Soc Work. 2007; 6: 49-74.

Cantor N, Sanderson CA: Life task participation and well-being: The importance of taking part in daily life. In Kahneman D, Diener E, Schwartz N (eds.): Well-Being: The Foundations of Hedonic Psychology. New York: Russell Sage Foundation, 1999: 230-243.

Emmons RA: Personal strivings: An approach to personality and subjective well-being. J Pers Soc Psychol. 1986; 51(5): 1058-1068.

Becker DR, Bebout RR, Drake RE: Job preferences of people with severe mental illness: A replication. Psychiatr Rehabil J. 1998; 22(1): 46.

Becker DR, Drake RE, Farabaugh A, et al.: Job preferences of clients with severe psychiatric disorders participating in supported employment programs. Psychiatr Serv. 1996; 47(11): 1223-1226.

Carling PJ: Return to Community: Building Support Systems for People with Psychiatric Disabilities. New York: Guilford Press, 1995.

Bond GR, Drake RE, Becker DR: Beyond evidence-based practice: Nine ideal features of a mental health intervention. Res Soc Work Pract. 2010; 20(5): 493-501.

Mannell RC, Kleiber DA: A Social Psychology of Leisure. State College, PA: Venture, 1997.

Coleman D, Iso-Ahola SE: Leisure and health: The role of social support and self-determination. J Leis Res. 1993; 25(2): 111-128.

Bandura A: Self-Efficacy: The Exercise of Control. New York: W. H. Freeman, 1997.

Lloyd C, King R, McCarthy M, et al.: The association between leisure motivation and recovery: A pilot study. Aust Occup Ther J. 2007; 54(1): 33-41.

Kelly JR, Godbey G: The Sociology of Leisure. State College, PA: Venture, 1992.

Sorgaard KW, Hansson L, Heikkilã J, et al.: Predictors of social relations in persons with schizophrenia living in the community: A Nordic multicentre study. Soc Psychiatry Psychiatr Epidemiol. 2001; 36(1): 13.

Rudnick A: Psychiatric leisure rehabilitation: Con - ceptualization and illustration. Psychiatr Rehabil J. 2005; 29(1): 63-65.

Coleman D: Leisure based social support, leisure dispositions and health. J Leis Res. 1993; 25(4): 350-361.

Iso-Ahola SE, Park CJ: Leisure-related social support and self-determination as buffers of stress-illness relationship. J Leis Res. 1996; 28(3): 169-187.

Iwasaki Y, Mannell RC: Hierarchical dimensions of leisure stress coping. Leis Sci. 2000; 22(3): 163-181.

Iwasaki Y, Schneider IE: Leisure, stress, and coping: An evolving area of inquiry. Leis Sci. 2003; 25(2/3): 107-113.

Davidson L, Shahar G, Stayner DA, et al.: Supported socialization for people with psychiatric disabilities: Lessons from a randomized controlled trial. J Commun Psychol. 2004; 32(4): 453-477.

Published

01/01/2011

How to Cite

Snethen, PhD, LRT/CTRS, G., McCormick, PhD, CTRS, B. P., & Van Puymbroeck, PhD, CTRS, M. (2011). Independence through Community Access and Navigation in adults with schizophrenia spectrum disorders Part 1: Theoretical and practical foundations. American Journal of Recreation Therapy, 10(1), 25–33. https://doi.org/10.5055/ajrt.2011.0004

Issue

Section

Articles

Most read articles by the same author(s)

<< < 1 2