Rozprawy doktorskie: „Psychiatric disability”

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Titone, John Christopher. "Predicting vocational rehabilitation outcome among clients with a psychiatric disability". Diss., The University of Arizona, 1988. http://hdl.handle.net/10150/184413.

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Individuals with a psychiatric disability have had the poorest vocational outcomes of all the disabled populations when comparing rehabilitation success rates. The purpose of this study was to explore the relationships between selected background, social, and service variables and vocational rehabilitation outcome in order to identify potential indicators of success or failure. Data was gathered from records in the Tucson, Arizona offices of the state-federal vocational rehabilitation program. The sample included 210 White and Hispanic subjects with a psychiatric disability. Their records had been closed in the years 1983 through 1987. The independent variables were the background variables of Age, Age of Onset, Ethnicity, and Educational Level, the social variables of Living Situation, Ability To Get Along With Others, and Employment History, and the service variables of Training and Support. The dependent variable was Employment Status as determined by the vocational rehabilitation program: Successful subjects, coded a Status 26, were closed having been employed at least 60 days; unsuccessful subjects, coded a Status 08, 28, or 30, left the program unemployed. The study followed a correlational design using a regression approach. Logistic Regression Analysis with forward selection was the strategy employed to identify the best predictive model. A chi-square test of independence was used to further study variables that showed some predictive potential. An effort was made to control for the presence of one or more additional disabilities. The results indicated that the variables most highly related to Employment Outcome, in the order of their importance, were Training, Employment History, and Ability To Get Along With Others. Ability To Get Along With Others disappeared as a key indicator when the sample was divided into single and multiple disability groups. However, the findings suggest that Ability To Get Along With Others and Support Services may contribute to the effect of the two more powerful variables. It is also cautiously suggested that Training that is job-related and skill-building in nature may be more useful than formal education for this population.

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Duncan, Madeleine. "Human occupation in the context of chronic poverty and psychiatric disability". Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/1120.

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Thesis (DPhil (Psychology))—University of Stellenbosch, 2009.
ABSTRACT: This study, within the fields of occupational therapy and occupational science, describes the occupations of isiXhosa-speaking individuals with longstanding histories of mental illness living in chronic poverty. Occupation refers to the daily tasks and purposeful activities which, in occupying people’s time, establish the patterns of their lives and give expression to their roles, identity, interests and abilities. The aim of this study was to describe how poor households and persons with psychiatric disability living in those households coped with their circumstances and how they viewed, orchestrated, drew meaning from and attributed purpose to the everyday things they did, in particular the self-identified, primary income generating occupation of the disabled person. The research questions elicited information about the genesis, characteristics, meanings and functions of occupation, in particular those occupations performed by the disabled member that contributed to the survival of the household. Using case study methodology, the research involved prolonged engagement with five households living in a peri-urban, informal settlement on the outskirts of Cape Town, South Africa. Qualitative data about occupation was derived through demographic screening, multiple interviews with key informants in each household, participant observation and focus group discussion. In addition, discussions were held with mental health professionals familiar with the context and the Xhosa culture. Four forms of data analysis and interpretation (Kavale, 1996; Stake,1995) were applied to develop substantive case studies: condensation (identification of major organising ideas); categorisation (thematic categorical aggregation); patterning (narrative structuring) and generalisation (naturalistic interpretation). In addition, discussions were held with mental health professionals familiar with the context and the Xhosa culture. Four forms of data analysis and interpretation (Kavale, 1996; Stake, 1995) were applied were applied to develop substantive case studies: condensation (identification of major organising ideas); categorisation (thematic categorical aggregation); patterning (narrative structuring) and generalisation (naturalistic interpretation). Thematic descriptions of the basics of occupation are used to illustrate the various ways participants negotiated the challenges of life at the margins of society through the ordinary things they did everyday. Cross case analysis provided insights into the financial and social costs of mental illness as well as the strategies, embedded in occupation, adopted by participants in dealing with their circumstances. The central thesis of this dissertation is that psychiatrically disabled people, as economic actors functioning in complex structural, social and occupational matrices, contribute in paradoxical ways to the survival of their households. While their illness behaviour may increase the vulnerability of the household from time to time, they nevertheless facilitate its functioning either as providers of a disability grant; as contributors of additional labour or as productive income generating agents. The individual, the social and the structural are co-constituted in what poor and disabled people are able to do everyday. The less resources that are available in the occupational form, the more effort is needed to perform occupations and the more reliance is placed on the informal relational economy. Relative mastery of constrained circumstances occurred by optimising the goodness of fit between occupational form and occupational performance through adaptive capacity, an under-recognised form of agency in the context of chronic poverty. Looking beyond the obscuring façade of psychiatric disability at the ordinary things people did everyday revealed their capacity to strategise practically and attitudinally in support of the household’s survival. The study heightens awareness of human experiences that have been overlooked in the occupational science and occupational therapy literature, in particular how the basics of occupation operate in resource constrained environments. This contribution to knowledge about human occupation will inform mental health occupational therapy practice and community based psychiatric services concerned with the inclusion of disabled people in promoting social development.
OPSOMMING: Hierdie studie val binne die gebied van arbeidsterapie en ‘occupational science’. Dit beskryf die ‘occupations’ van Xhosa-sprekende individue met ‘n geskiedenis van geestesongesteldheid wat in kroniese armoede in informele nedersettings aan die buitewyke van Kaapstad, Suid-Afrika woon. ‘Occupation’ verwys na die daaglikse take en doelgerigte aktiwiteite wat mense se tyd in beslag neem; die patrone en ritmes van hul lewens bevestig en wat uitdrukking gee aan hul verskeie rolle, identiteit, belangstellings en vermoëns. Die doel van die studie was om inligting te verkry oor die oorsprong, eienskappe, betekenis en funksies van ’occupation’ in die konteks van armoede en veral met betrekking tot die psigiatries gestremde lid se belewenis en bydrae tot die huishouding se oorlewing deur sy of haar self-geidentifiseerde, primêre winsgewende ‘occupation’. Verlengde verbintenis met vyf huishoudings en sleutel informante as gevalstudies het die verkryging van kwalitatiewe data oor ‘occupation’ deur onderhoude, waarneming en fokusgroepe moontlik gemaak. Onderhoude met geestesgesondheidspesialiste vertroud met die konteks en die Xhosakultuur is ook gevoer. Vier tipes data-analise en interpretasie (Kavale, 1996; Stake, 1995) is toegepas om die ontwikkeling van substantiewe gevallestudies moontlik te maak: kondensasie (identifisering en organisasie van belangrike idees); kategorisering (tematiese sorteering van eenhede van betekenis); motief (narratiewe strukturering) en veralgemening (naturalistiese interpretasie). Kruisgevalanalise is toegepas om inligting oor die finansiële en sosiale kostes van ‘n psigiatriese stoornis in die konteks van armoede te bekom asook die ‘occupational’ strategieë waarvan informante in die hantering van hul omstandighede gebruik gemaak het. Die slotsom van hierdie verhandeling is dat psigiatries gestremde persone wat in die konteks van kroniese armoede ‘n bestaan probeer voer, op paradoksale maniere ‘n bydrae tot die voortbestaan van hul huishoudings lewer. Terwyl hulle siektegedrag die kwesbaarheid van die huishouding van tyd tot tyd laat toeneem, maak hulle nieteenstaande die oorlewing van die huishouding moontlik deur ‘n kombinasie van die volgende bydraes: die verskaffing van bykomende arbeid; die beskikbaarstelling van ‘n ongeskiktheidstoelaag en die produktiewe uitvoering van winsgewende ‘occupations’ in die sogenaamde ‘tweede’ of informele ekonomie. Die individuele, die sosiale en die strukturele is aan mekaar verbonde en beinvloed sodanig wat arm en gestremde mense daagliks in staat is om te doen. Hoe minder materiele komponente en hulpbronne in die ‘occupational form’ beskikbaar is, hoe groter is die inspanning wat benodig word om ‘occupation’ uit te voer en hoe meer afhanklik word die gestremde persoon op die informele sosiale ekonomie. Die teenoorgestelde is ook waar. Die kapasiteit vir aanpasbaarheid, ‘n miskende vorm van agentskap in die konteks van kroniese armoede, maak die bemeestering van beperkte omstandighede moontlik. Die kapasiteit vir aanpasbaarheid is geleë in die vermoë om strategies, prakties en sielkundig te funksioneer. Die studie vergroot die bewustheid van menslike ervarings wat oor die hoof gesien is in die arbeidsterapie en ‘occupational science’ literatuur, veral hoe die basiese beginsels van ‘occupation’ funksioneer in omgewings wat gekenmerk word deur deprivasie en beperkte materiële besittings. Hierdie bydrae tot kennis oor ‘occupation’ sal arbeidsterapiepraktyk en gemeenskaps-gebaseerde psigiatriese dienste toelig asook die insluiting van psigiatries gestremde persone in maatskaplike ontwikkeling bevorder.

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Rock, Daniel. "A revision of the World Health Organisation psychiatric disability assessment schedule". Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1999. https://ro.ecu.edu.au/theses/1225.

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The burden schizophrenia places on the individual, on the family and on society in general is determined more by the associated disability rather than the manifest symptoms. Therefore, measurement of disability provides a baseline for evaluating change and directing treatment. This research has two main aims. The primary purpose of this study was to develop and validate a contemporary revision of the World Health Organisation-Psychiatric Disability Assessment Schedule (1988). Data used was based on data from the WHO Collaborative Study on Determinants of Outcome of Severe Mental Disorders (Sartorius et al., 1986). The second aim of this study was to develop a methodology for the construction of a psychometrically rigorous instrument. This involved the use of standard, modified and original data checking and analysis techniques and input from content-experts. Results from this process indicated that the criteria and selection of experts is based upon the considered judgement of the researcher that the sum of the advantages of the expert validation process outweigh the disadvantages. This study has two discrete outcomes: The revised DAS can be used to assess disability in schizophrenia, and a "gold standard" methodology which can be applied during instrument development.

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Battams, Samantha Jane, i sam battams@flinders edu au. "Housing for people with a psychiatric disability; community empowerment, partnerships and politics". Flinders University. Public Health, 2008. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20080926.215213.

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This research examined intersectoral relationships and community participation in policy processes across the mental health and housing sectors. The focus was on the development of suitable housing options for people with a psychiatric disability. The study period covered five years of mental health system reform in South Australia (2000-2005). The research found a shortage of housing and support options for people with psychiatric disability and lack of significant strategic policy coordination or ongoing cross-sectoral programmes. The problems faced by people in gaining access to housing and disability support services and the ways in which families provide housing or support in the absence of public services are documented. This case study used qualitative research methods which were triangulated across four stages: 1) a thematic analysis of national and state policies in the health, housing and disability sectors; 2) participant observation of NGO activity, a thematic analysis of NGO documents, and interviews and focus groups with NGOs; 3) interviews and focus groups with consumer and carer representatives and a thematic analysis of the minutes from state-level groups; 4) interviews with professionals from the health, housing and disability sectors The housing situation for people with psychiatric disability was explained in terms of a number of key issues in the policy environment; X The overarching neo-liberal policy context synonymous with a decline in public housing resources and increasing tension between NGOs service provider and advocacy roles. X The political nature of the local mental health policy context and lack of political commitment to ongoing resources. Broad community stigma reflected in the media and government, affecting ongoing political commitment to mental health and housing and the introduction and progress of housing ¡¥projects¡¦. X The slow development of peak NGO and consumer organisations and alliances in South Australia which affected access to policy networks and contributed to the dominance of professional interests within policy processes. X The separation of health, housing and disability policy and networks within and across levels of government. This was associated with bilateral agreements (between Australian and state governments) tied to resources within departments, the programme objectives and the goals of bureaucrats. X The separation of policy networks by sector was also connected to the dominance of bio-medical discourses and interventions and associated professional interests in the health policy sector. Medical discourses on health and disability and ¡¥consumerist¡¦ discourses on participation also led to social determinants of health such as housing being overlooked within policy processes. X Governance reform at a state level contributed to organisational instability within departments, causing some problems for cross-sectoral initiatives and protocols. Kingdon¡¦s (2003) multiple streams analysis of policy helped to explain what missed or reached political agendas within each policy sector of the case study. Kingdon predicts that the unity of policy networks is important for the realization of policy solutions, and the lack of unity in policy sectors was an obstacle to policy agendas on housing for people with a psychiatric disability. However, the way in which problems were being represented (Bacchi 1999) was also important to understanding this policy environment. For example, a medical discourse on disability (Fulcher 1989) tied to the health sector led to a narrow focus on clinical mental health services. Similarly, neo-liberal discourse (Dean 1999) supported private housing solutions and resources or NGOs advocating ¡¥within sectors¡¦ for the types of services they already provided or wished to provide. The case study suggested strategies for ¡¥policy change¡¦ need to address a number of factors across service delivery, policy and political realms. Firstly, better recognition is warranted of the difficulty experienced by many people with psychiatric disability in achieving stable housing, and the need for indicators on housing access and stability for this group. Secondly, processes to address stigma (particularly that perpetuated in the media) will be instrumental for policy change and political commitment. Thirdly, ongoing cross sectoral advocacy and alliances require development at both a national and state level and support by a political culture which encourages advocacy. Developing processes for working across sectors such as policy learning forums involving both experts and community groups could counter problems arising from professional culture and territories that were documented in this study. Finally, the cross-sectoral development of policy, programmes and accountability mechanisms and the stability of policy networks will be important to ensuring stable housing for people with psychiatric disability.

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Trunk, Daniel. "Disability Stigma and Intention to Graduate in College Students with Psychiatric Impairments". University of Dayton / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=dayton1489661242531328.

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Lund, Emily M. "Suicide and Disability: Three Different Analyses of a Nation-Wide Sample of American Adults". DigitalCommons@USU, 2016. https://digitalcommons.usu.edu/etd/5076.

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Suicidality is a major public health issue and is more common among people with disabilities. However, relatively little is known about the context and specifics of suicidality among adults with disabilities compared to their peers without disabilities. This dissertation presents three different analyses of suicidality and disability using a sample of American adults. Chapter I introduces the topic and dataset. Chapter II presents an analysis of the internal consistency, mean scores, and response patterns on the Suicidal Behavior Questionnaire—Revised (SBQ-R) by disability status in order to establish the internal of the measure in people with disabilities and explore the uniformity of suicidality in people with and without disabilities. Participants with disabilities tended to more frequently endorse response choices consistent with increased past, current, and perceived future suicidality. Chapter III presents an analysis of the relationship between suicidality, disability, and psychiatric disability. Disability remained a significant predictor of suicidality even when depressive symptoms were included in the analysis, and psychiatric disability predicted greater suicidality within the disability subsample, even when depressive symptoms were controlled for via statistical analysis. Chapter IV presents an analysis of suicidality and disability within the context of both depressive symptoms and sociodemographic risk and protective factors for suicidality. Participants with disabilities experienced more sociodemographic risk factors than participants without disabilities; however, disability status remained a significant predictor of suicidality even when sociodemographic risk and protective factors, as well as depressive symptoms, were included in the analysis. Chapter V summarizes and concludes the dissertation, including our consistent and major finding that disability is linked to significantly higher suicidality, even when depression and sociodemographic risk factor are accounted for in statistical analysis.

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Brewer, Elizabeth Marie. "Psychiatric Disability and Rhetoricity: Refiguring Rhetoric and Composition Studies in the 21st Century". The Ohio State University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=osu1404691985.

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Rosenberg, David. "Psychiatric disability in the community : Surveying the social landscape in the post-deinstitutional era". Doctoral thesis, Umeå universitet, Institutionen för socialt arbete, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-26004.

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This dissertation presents a discussion of life in the community for people experiencing psychiatric disabilities in the post-deinstitutional era, with the goal of developing knowledge that can suggest a focus for planning more relevant services and supports. While evaluations of deinsitutionalization have focused on possibilities for providing community, rather than hospital-based services for these individuals, the intention was to support a participatory life in the community, a life defined by much more than just care and treatment. The Mental Health Care Reform of 1995 in Sweden paved the way for this more community-based view of needs related to psychiatric disabilities, as local social services became responsible for supports to a participatory life, “like all others”. The general aim of this dissertation was to explore and analyze the results of a series of surveys of psychiatric disability, in order to develop knowledge of the social context of the lives which individuals experiencing these disabilities live in the community. More specifically, the aim was to; • describe contacts/interactions between these individuals and the societal organisations with which they seek services or support. • describe characteristics and needs of the individuals identified in these studies as expressed by representatives of the helping system and users who participated in the studies. • develop knowledge of the mechanisms involved in these patterns of seeking support by exploring and analyzing the empirical results within the context of theoretical (social) approaches to understanding psychiatric disability. The findings of this research are based on an analysis of the quantitative and qualitative results of three studies involving seven municipalities in northern Sweden. Of the 2385 individuals who personnel identified as meeting the criteria for a serious psychiatric disability, approximately half did not have active contact with the formal mental health system. They did however seek services, supports and opportunities that they saw as relevant to their lives and needs as community members. These included health, housing and financial assistance as well as opportunities for education and employment. Various mechanisms operating in the community, including stigmatizing attitudes, exclusionary practices and organizational systems and rules, were seen by respondents as obstacles to these individuals developing meaningful and participatory roles. Social approaches, when utilized to explore and understand issues regarding psychiatric disability in the community, support a focus on the social landscape in which ndividuals experience disability-related needs, as well as the dynamics of the disability experience. While in the deinstitutional era, needs were assessed relative to the individual’s relationship to the psychiatric care system, in the post-deinstitutional era, they should be assessed from a participation-relative perspective, where their position as community member, rather than as patient or client, describes the social location of need. Specialized support to general community resources and services in addition to psychiatrically defined supports, would likely reach many, especially younger individuals who might otherwise become seriously disabled.

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Alexander, Michelle M. "The Experiences of People with Psychiatric Disabilities in Disability Income and Employment Support Programs". Fogler Library, University of Maine, 2007. http://www.library.umaine.edu/theses/pdf/AlexanderMM2007.pdf.

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Dunlap, Paige Nicole. "Patterns of Service Delivery to Transition-Age Vocational Rehabilitation Consumers with Psychiatric Disabilities". OpenSIUC, 2009. https://opensiuc.lib.siu.edu/dissertations/102.

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With psychiatric disabilities representing a large number of transition-age youth in the US and low employment rates for individuals with disabilities in general, it is necessary to identify the patterns of service variables that are more likely to lead to a competitive employment outcome for this population. This study was an investigation of the vocational rehabilitation case service variables provided through the federal-state vocational rehabilitation system to transition-age consumers with psychiatric disabilities. The identified variables were then studied to determine relationships that exist as they pertain to employment outcomes. The population of vocational rehabilitation consumers was accessed using the Rehabilitation Services Administration 911 database for fiscal year 2007. The database was analyzed using a series of cluster analyses to determine patterns of services associated with competitively employed or unemployment outcomes for this population. A total of 5744 cases were analyzed in this study. The results indicated that there were three distinct clusters of vocational rehabilitation services delivered to this population: Basic services, Job Focused, and College Plus. The results also showed that employment status at application, medical insurance at closure, Job Focused Cluster, and race - African American were significant predictors of rehabilitation outcome. Significant predictors of yearly earnings at closure were employment status at application, medical insurance at closure, Basic Services Cluster, and Job Focused Cluster. The Hispanic race was not found to be a significant predictor in this study. Implications, suggestions for future research, and limitations of the study are discussed.

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Kiviniemi, M. (Marjo). "Mortality, disability, psychiatric treatment and medication in first-onset schizophrenia in Finland:the register linkage study". Doctoral thesis, Oulun yliopisto, 2014. http://urn.fi/urn:isbn:9789526206325.

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Abstract The focus of this study was to examine mortality, disability, psychiatric treatment and medication utilizing register-based five-year follow-up data on all first-onset schizophrenia patients between the years 1995 to 2003 in Finland. The data were obtained from the Finnish Hospital Discharge Register, the national Finnish Causes of Death Register, and registers of pensions and reimbursed medicines. People with first-onset schizophrenia had a 4.45-fold higher mortality rate than the general population. Mortality was significantly elevated in all age groups. The most prominent single unnatural cause of death was suicide and the most common natural cause of death was circulatory diseases. Half of all first-onset schizophrenia patients retired on disability pension within the five-year follow-up period. Men retired at an earlier age and more commonly than women. Regional differences in mortality and disability retirement were evident. Patients first identified as outpatients had better outcomes than patients first identified following hospitalization. In total, 40% of outpatient-treated patients and 74% of hospital-treated patients had experienced a relapse during follow-up period. The use of second generation antipsychotics (SGAs) was associated with reduced risk of all-cause mortality, while clozapine was associated with lower suicide risk. First generation antipsychotics (FGAs) were associated with increased all-cause mortality and, particularly chlorprothixene, with increased suicide mortality. An increased likelihood of cardiovascular death was found among users of levomepromazine. In antidepressants, use of mirtazapine was associated with increased risk of suicide. In this study, the results and outcomes of first-onset schizophrenia patient treatment were analysed using register-based data. The results indicate that the outcome of first-onset schizophrenia is not good enough. Regional differences were seen in mortality and treatment practices. In clinical work more attention should be paid to health promotion and somatic screening, but also treatment of depressive symptoms. The results indicate that more effective treatments and rehabilitation are needed along with improved equality of treatment practices between hospital districts
Tiivistelmä Tavoitteena oli tutkia skitsofreniaan sairastuneiden kuolleisuutta, työkyvyttömyyttä ja sairaalahoitoa sekä selvittää lääkehoidon yhteyttä kuolleisuuteen. Tutkimusaineistona olivat hoitoilmoitus-, kuolinsyyrekisteri-, eläkerekisteri- ja lääkekorvattavuustiedot. Tutkimusjoukkona olivat vuosien 1995-2003 aikana skitsofreniaan sairastuneet henkilöt. Seuranta-aika oli 5 vuotta. Skitsofreniaa sairastavien kuolleisuus oli 4.4 -kertainen normaaliväestöön verrattuna. Kuolleisuus oli korkeaa kaikissa ikäryhmissä sairastumisiästä riippumatta. Yleisin kuolinsyy oli itsemurha. Yleisin luonnollinen kuolinsyy olivat sydän- ja verenkiertoelinten sairaudet. Skitsofreniaan sairastuneista puolet jäi työkyvyttömyyseläkkeelle viiden vuoden seurannan aikana. Miehet eläköityivät nuorempina ja useammin kuin naiset. Kuolleisuudessa ja eläkkeelle siirtymisessä oli havaittavissa alueellista vaihtelua. Avohoidossa hoidetuilla vasta skitsofreniaan sairastuneilla oli parempi ennuste kuin sairaalahoitoon joutuneilla. Heidän kuolleisuutensa sekä sairaalahoitopäivien, relapsien ja vastentahtoisen hoidon määrät olivat alhaisemmat kuin sairaalassa hoidetuilla. Toisen polven antipsykoottien käyttö oli yhteydessä alentuneeseen kuolleisuuteen ja ensimmäisen polven antipsykootit kohonneeseen kuolemanriskiin. Klotsapiinin käyttö oli yhteydessä alhaisempaan itsemurhariskiin, kun taas masennuslääkkeistä mirtatsepiinin käyttö liittyi kohonneeseen itsemurhariskiin. Skitsofrenian hoidon kehittymisestä huolimatta sairauden ennuste on edelleen huono. Skitsofreniaa sairastavilla on yhä korkeampi kuolleisuusriski kuin muulla väestöllä. Hoitomenetelmien kehittymisestä huolimatta puolet sairastuneista on työkyvyttömyyseläkkeellä viiden vuoden kuluessa sairastumisesta. Sairauden vakavuutta osoittaa myös se, että iso osa skitsofreniaan sairastuneista tarvitsee useamman sairaalahoitojakson ja tahdosta riippumatonta hoitoa. Lisäksi useat tarvitsevat tuettua asumispalvelua. Skitsofrenian somaattisten sairauksien ja masennusoireiden arviointi vaatii edelleen huomioita. Hoitoon ja kuntoutukseen pitää panostaa ja taata, että skitsofrenian hoito olisi yhtä laadukasta koko Suomessa. Potilaat ovat eriarvoisessa asemassa, mikäli hoitokäytännöt ja mahdollisuus saada kuntoutusta vaihtelevat asuinpaikasta riippuen

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Morgan, Vera Anne. "Intellectual disability co-occurring with schizophrenia and other psychiatric illness : epidemiology, risk factors and outcome". University of Western Australia. School of Psychiatry and Clinical Neurosciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0209.

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(Truncated abstract) The aims of this thesis are: (i) To estimate the prevalence of psychiatric illness among persons with intellectual disability and, conversely, the prevalence of intellectual disability among persons with a psychiatric illness; (ii) To describe the disability and service utilisation profile of persons with conjoint disorder; (iii) To examine, in particular, intellectual disability co-occurring with schizophrenia; and (iv) To explore the role of hereditary and environmental (specifically obstetric) risk factors in the aetiology of (i) intellectual disability and (ii) intellectual disability co-occurring with psychiatric illness. This thesis has a special interest in the relationship between intellectual disability and schizophrenia. Where data and sample sizes permit, it explores that relationship at some depth and has included sections on the putative nature of the link between intellectual disability and schizophrenia in the introductory and discussion chapters. To realise its objectives, the thesis comprises a core study focusing on aims (i) (iii) and a supplementary study whose focus is aim (iv). It also draws on work from an ancillary study completed prior to the period of candidacy...This thesis found that, overall, 31.7% of persons with an intellectual disability had a psychiatric illness; 1.8% of persons with a psychiatric illness had an intellectual disability. The rate of schizophrenia, but not bipolar disorder or unipolar major depression, was greatly increased among cases of conjoint disorder: depending on birth cohort, 3.7-5.2% of individuals with intellectual disability had co-occurring schizophrenia. Down syndrome was much less prevalent among conjoint disorder cases despite being the most predominant cause of intellectual disability while pervasive developmental disorder was over-represented. Persons with conjoint disorder had a more severe clinical profile including higher mortality rates than those with a single disability. The supplementary study confirmed the findings in the core body of work with respect to the extent of conjoint disorder, its severity, and its relationship with pervasive development disorder and Down syndrome. Moreover, the supplementary study and the ancillary influenza study indicated a role for neurodevelopmental insults including obstetric complications in the adverse neuropsychiatric outcomes, with timing of the insult a potentially critical element in defining the specific outcome. The supplementary study also added new information on familiality in intellectual disability. It found that, in addition to parental intellectual disability status and exposure to labour and delivery complications at birth, parental psychiatric status was an independent predictor of intellectual disability in offspring as well as a predictor of conjoint disorder. In conclusion, the facility to collect and integrate records held by separate State administrative health jurisdictions, and to analyse them within the one database has had a marked impact on the capacity for this thesis to estimate the prevalence of conjoint disorder among intellectually disabled and psychiatric populations, and to understand more about its clinical manifestations and aetiological underpinnings.

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Cockshell, Susan. "Factors effecting the maintenance of people with a psychiatric disability in hospital and community settings /". Title page, contents and abstract only, 1996. http://web4.library.adelaide.edu.au/theses/09SPS/09spsc666.pdf.

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Lindström, Maria. "Promoting agency among people with severe psychiatric disability : occupation-oriented interventions in home and community settings". Doctoral thesis, Umeå universitet, Arbetsterapi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-50038.

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In general, people with severe psychiatric disability living in sheltered or supported housing lead passive, solitary lives. Current rehabilitative approaches often neglect considering an agentic perspective of the residents in sheltered or supported housing. Furthermore, the outreach and societal contexts are often not considered. Thus, practitioners tend to overlook the potential in providing support and rehabilitation that is adapted to their individual, collective and changing needs. My approach was to develop a model for Everyday Life Rehabilitation (ELR), which has a potential to promote agency while targeting recovery, meaningful daily occupations, social participation, and person-driven goals. We employed two occupational therapists (OT) and offered an intervention with ELR in a medium-sized municipality in northernSwedenand evaluated this intervention from the perspectives of residents and community care workers (CCW), using a combination of quantitative and qualitative methods. This thesis comprises four studies that focus on a home and community context, late rehabilitation efforts, daily occupations, and client-centredness. The overall aim is to understand and evaluate the impact of recovery- and occupation-oriented interventions in a home context for people with severe psychiatric disability. The study settings are sheltered and supported housing facilities. The first study (n=6) explores the significance of home for occupational transformations. The analysis reveals how residential conditions facilitate rehabilitative interactions, generating occupational transformations such as increasing social competence and taking charge of daily occupations. The second study evaluates occupation- and health-related outcomes of the ELR-intervention for residents (n=17). Pre-, post-, and follow-up differences in tests scores on goal attainment, occupation, and health-related factors indicate that important progress is made. The third study explores residents’ (n=16) narratives about occupational transformations in the context of everyday life and life history. Narrative analysis discloses stories of ‘rediscovering agency’, referring to occupational and identity transformations. The fourth study illuminates community care workers’ (n=21) experiences of collaborating with residents and OTs, using ELR. The CCW’ view on residents, rehabilitation, and the own role, along with organisational conditions in the housing facility, seem to characterise different outlooks influencing the CCWs responsiveness or resistance to the intervention. In conclusion, rehabilitation in a supported housing context appears paradoxical due to tensions between opposing values such as authentic versus artificial, and independence versus dependence. However, if residents are engaged in challenging these tensions, they can function as ‘progressive tensions’ generating change. Considering the personal and social meaning of home also appears to be valuable. The intervention studies on ELR, demonstrate its value for participants and indicates that a recovery approach applying ELR would promote shared perspectives among residents, CCWs, and OTs, while facilitating ‘agent-supported rehabilitation’ and ‘out-of-housing strategies’. The thesis provides initial support for the use of ELR-interventions and proposes continued research.
Vardagslivets Rehabilitering (Everyday Life Rehabilitation)

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Van, Niekerk Lana. "The influences that impact on the work-lives of people with psychiatric disability : an interpretive biography". Doctoral thesis, University of Cape Town, 2004. http://hdl.handle.net/11427/2987.

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Gustafsson, Carina. "Intellectual Disability and Mental Health Problems : Evaluation of Two Clinical Assessment Instruments, Occurrence of Mental Health Problems and Psychiatric Care Utilisation". Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3531.

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O'Shea, Amber M. "Identity of College Students with Psychiatric Disabilities and Use of Support Services". Diss., Temple University Libraries, 2016. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/378538.

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Educational Psychology
Ph.D.
Given the increasing number of undergraduate students with psychiatric disabilities enrolling in college and the disproportionately high attrition rates among this group, it is important that researchers understand the experiences of these students and identify and address the barriers to higher education that face this population. While most college campuses make a number of modifications, accommodations, and services available to students with registered disabilities, researchers suggest that many students with psychiatric disabilities fail to either register or make effective use of such services. Research has found that the endorsement of disability identity impacts the proactive utilization of valuable academic accommodations and promotes students’ academic success. However, little is known about how disability identity is shaped and maintained within the context of college. Still, even less is known about the experiences of students with psychiatric disabilities or how they construct meaning pertaining to their disability within college. The current study explored the processes by which undergraduate students with psychiatric disabilities make meaning of their disability identity through interaction and participation within the college context. Furthermore, I explored students’ decisions regarding disability disclosure and the utilization of support services as one means of understanding a motivated action indicative of disability identity. I employed an interpretative phenomenological approach to gain insight into the perceptions, meaning making, and lived experiences of undergraduate college students with psychiatric disabilities regarding the contextualized construction of disability identity. The results of the analysis suggest that disability identity is dynamic and constructed through interactions with others and participation in various activities and experiences presented in the college environment. These findings contribute to the literature on identity formation in college students with psychiatric disabilities and provide important implications for theory, research, and practice.
Temple University--Theses

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Shearer, Amy Leigh. "Neighbor Perceptions of Psychiatric Supportive Housing : the Role of Knowledge, Attitudes, and Behaviors". PDXScholar, 2018. https://pdxscholar.library.pdx.edu/open_access_etds/4501.

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Purpose: Historically, communities have opposed the development of residential programs for adults with psychiatric disabilities. In the last two decades, national and local campaigns have made targeted efforts to improve public knowledge about mental illness, and attitudes and behaviors towards mental health clients. Supportive housing policies have also been revised to better facilitate integration and independence for clients with psychiatric disabilities. Despite these changes, the number of studies on perceptions of psychiatric supportive housing has dramatically declined in recent years. Little is known about how neighbors currently perceive psychiatric housing and neighbors with mental illness, or the role that mental health knowledge, attitudes, and behaviors play in neighborhoods where housing clients live. Methods: Knowledge, attitudes, and behaviors of 139 neighbors living in close proximity to psychiatric supportive housing sites were assessed. Follow up qualitative interviews were conducted with 16 neighbors who correctly identified the housing site in their neighborhood to understand the perceived impact of the housing site and elicit suggestions for improving relations between clients and their neighbors. Individual and neighborhood social experiences of neighbors are compared with those of 68 clients living in the referent housing sites. Results: Neighbors had high rates of personal experience with mental illness and were familiar with mental health diagnoses and facts. Neighbors had positive opinions about and neighboring intentions towards neighbors with mental illness. Increased mental health knowledge and close relationships with individuals with mental illness were associated with decreased stigma. Being able to correctly identify the housing and population was not associated with differences in opinions about individuals with mental illness. Compared to clients, neighbors perceived the neighborhood as being less safe. Clients were lonelier than their neighbors. Neighbors reported the housing had a positive impact on the neighborhood and had few concerns. They suggested awareness, education, and social contact strategies to improve relations with housing clients. Conclusions: Suggestions for improving client integration and public acceptance of psychiatric supportive housing are discussed, as well implications in light of recent policy changes and ongoing public anti-stigma campaigns.

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Carlsson, Byttner Lina, i Edita Durakovic. "Homesupport for elderly people with psychiatric disabilities". Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26908.

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This essay deals with the support and help offered to elderly people over 65 with mental disabilities out of personnel from a special support team. We have chosen to use the qualitative method to answer our questions. We have four semi-structured interviews with all staff from the support team we have been in contact with, three nurses/nursing assistants and project manager for the support team. We have recognized five themes and divided the text into six different categories and disciplines that answers and highlights the importance of meeting clients' needs, increase their independence and quality of life. Our theme is security, continuity, time, treatment and relations. Our topics are quality of life and health, personalized and holistic, empowerment, motivation and participation, activity and disengagement and stigma.The conclusion of our essay is that there is a need for a special team to meet the needs of older people with mental disabilities. The support team has more time and can give clients the support they need. The time gives staff the opportunity to increase clients' quality of life by listening and understanding. The staff provides security with their presence and attitude while becoming a social contact for the client. The staff has the knowledge required to provide good treatment. The staff of the support team works with high professionalism and flexibility. The support team is working from the client's needs when the operation should be given and how it should be. The support team works with the continuity that provides a better and deeper relationship with the client.We have found that staff in the support team is working to get their clients to feel that they are able to do things themselves and build up their confidence and self esteem. This is the support team doing by lifting up what clients can and try to motivate clients to do things. By the support teams encouragement and support clients can find faith in themselves to handle things and become independent. Support team works with their clients so that they feel the meaningfulness of everyday life. By the motivation from the support team clients has managed to become more involved in their daily work.The support team provides personalized care to their clients. We have found it impossible to generalize and think that all older people with mental disabilities can be satisfied by for example activity and interaction with other people. For many of these clients their need may change. Passivity and aloofness can be an experience of tranquility and well-being and to decrease stress. Another aspect we have found, the reason why clients withdraw and isolate themselves at home is that clients put “stamp” on themselves as mentally ill. This negative self-image can be influenced by impressions from the surroundings. By that clients are treated with respect and sensitivity of personnel, client's view of themselves can change. The support team works to ensure opportunities in their clients' daily lives and not obstacles.

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Sommers, Kimberly M. "Disability Identity Formation in People with Severe Mental Illness and Treatment Seeking and Compliance: A Participatory Action Research Study". Wright State University Professional Psychology Program / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=wsupsych1373616415.

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Gingi, Pelisa. "Factors associated with the psychological response of nurses’ victims of inpatients violence in a psychiatric facility for adults with intellectual disability in cape town". Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4024.

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Background and Research Problem: It is well-known that nurses around the world are exposed to various forms of violence at their workplaces. In psychiatric facilities, many of these incidents are perpetrated by patients against nurses. There is a perception that the current legislation and regulations in the country do not adequately protect psychiatric nurses (health care workers in general) against workplace violence. The preliminary literature suggested that most quantitative studies on workplace violence in psychiatric facilities have concentrated on secondary and tertiary psychiatric hospitals looking at the prevalence, the association between demographic factors and violence behaviour, nurses‟ therapeutic responses, and the impacts on the quality of care. Studies on workplace violence in a psychiatric facility for adults with intellectual disability in the country are limited. Secondly, it appeared from the preliminary literature review that similar studies have not looked at this phenomenon from the individual resilience perspective.Therefore, this study will seek to determine the factors associated with the psychological response of nurses‟ victims of inpatient violence in a psychiatric facility for adults with intellectual disability in Cape Town.Aim: To determine factors associated with the psychological response of nurses‟ victims of in-patient violence in a psychiatric facility for adults with intellectual disability in Cape Town. Objectives: To describe the (1) individual resilience of nurses working at a psychiatric facility for adults with intellectual disability; (2) psychological response of nurses‟ victims of in-patients‟ violence at a psychiatric facility for adults with intellectual disability; and (3) association between the individual resilience characteristics and the psychological responses of nurses victims of in-patients‟ violence in a psychiatric facility for adults with intellectual disability.Methodology: Descriptive-exploratory design using a quantitative approach was used.All categories of nurses (professional nurse, enrolled nurse and enrolled nursing assistance) working at the psychiatric facility for adults with intellectual disability were eligible for the study. Convenient sampling was conducted to select 127 participants who met the inclusion criteria. Self-administered questionnaire was used to collect data. Data was analysed using the SAS V9.3 computer programme. Ethical clearance was obtained from University as well as approval from the management of the psychiatric facility prior to approaching the study participants. Results: The results of the study showed high level of resilience among nurses on Assessment of Resilience Scale (82.9%, n=104); nurses psychological responses to violence were equally distributed between avoidance (mean =4.65 and SD=1.36), intrusion (mean= 4.55 and SD=1.50), hyper arousal (mean=4.46 and SD=1.60) resulting in total mean of 13.67 (SD=4.14) on the revised Impact of Event Scale (IES-R). Measure of association between resilience and the impact of violence on the psychological wellbeing of nurses showed that nurses with high resilience score (82.9%, n=104) fitted the symptoms of PTSD on the IES-R. Spearman Rank correlations (r) analysis showed the total scores of IES-R (r=0.04, p=0.68), avoidance (r=0.01, p= 0.34), intrusion (r=0.08,p=0.34), and hyper-arousal (r= -0.002, p=0.97). Further research looking at the nurses‟ reliance and their responses using resilience theory is needed.
Magister Curationis - MCur

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Mgandela, Sibongile Princess S. P. "Experiences of nurses who care for patients with severe/profound intellectual disabilities at a level 3 Psychiatric hospital in the Western Cape". University of the Western Cape, 2013. http://hdl.handle.net/11394/4077.

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Magister Curationis - MCur
The study explores the experiences of nurses who care for severe/profound intellectual disabled patients at Level 3 Psychiatric Hospital in Cape Town. People with severe intellectual disabilities require constant care and supervision which can only be provided in specialised units. In the Western Cape, one such facility is a special section for the intellectually disabled at a level three hospital. Intellectual disability is a serious lifelong disability that places a heavy burden on affected individuals. Caring for these patients may affect the individuals who work within the intellectual disability services. This study explores the experiences of nurses who care for these patients. A Phenomenological research design was chosen as the researcher identified it as the most appropriate method to describe the lived experiences of the nurses. Purposive sampling was used to select 10 participants. However, data saturation was reached after interviewing eight participants. Data was collected through in-depth unstructured interviews. The audio-taped responses were transcribed verbatim and phenomenological data analysis done. Ethical clearance was obtained from the Higher Degrees Committee of the University of the Western Cape. Permission to do the research at the level three hospitals was sought from the Associated Psychiatric Hospital Committee. Consent to participate in the study was obtained from the participants, and ethical principles were adhered to. Participants were informed of the right to withdraw at any stage of the study and intervention offered when required. Trustworthiness of the research process was ensured. Findings: from this study the nurses who care for severe/profound intellectual disabled patients reported that they were not adequately prepared to care for these patients. It has also been reported that caring for the severely/profound disabled comes with some consequences, where emotional (negative and positive), physical and professional consequences were mentioned. The shortage of resources was found to be one of the challenges the nurses experienced. The nurses felt unappreciated for the work they did and less supported by their employer.

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Macfarlane, Selma Ingeborg, i simacfar@deakin edu au. "Support and recovery in a therapeutic community". RMIT University. Global Studies, Social Science and Planning, 2007. http://adt.lib.rmit.edu.au/adt/public/adt-VIT20080205.152052.

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This research project began from an interest in 'what happened' at a residential psychiatric disability support service (therapeutic community) where I had previously worked as a social worker, or, as it was termed in the program, support worker. Residents used the program in various ways, to get back on track with their lives, and workers aimed to support them in that process. My approach to data collection was, as for many social work researchers, qualitative. As my work on the project developed over time, I was consistently informed and re-informed not only by ideas arising from my engagement with participants and relevant literature, but also by new concepts and areas of interest that opened up as a result of my teaching in a progressive Bachelor of Social Work course. Gradually, as my understanding of critical and reflective postmodern social work theory evolved, new interpretations crept into my writing. Some of the tensions that arose as a result of th is overlaying of new conceptual frameworks are evident in the thesis. While I have tried to create internal cohesion, the layers of different approaches that informed me are sometimes evident, like the sides of a canyon that display evidence of its historical and ongoing formation. This may not be dissimilar to social work itself in the new millennium, as new ideas variously challenge, consolidate, destabilise and/or reshape theory and practice. While this thesis began as an exploration of the experiences of individuals in a therapeutic community and the role of support workers in that process, it became, additionally, an exploration of ways in which the role and practice of social work is constructed. However, the stories of participants remain a central feature. Chapters include: the professional gaze and the construction of subjects; problematising worker power and professionalism; boundaries, vulnerability and authority; therapeutic community; sensemaking, meaning ascription and the creation of cul ture; change and turning points; and problematising and exploring outcomes in mental health.

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Carbone, Lisa Ann S. "Autonomy in the California Disability Services System". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1818.

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Legislation concerning California residents with intellectual and developmental disabilities (ID/DD) requires recipients of services to be treated as independent individuals while emphasizing self-determination. At the same time, under regulatory procedures, recipients are considered dependent on the delivered services and not self-determinant. Neither the California Department of Developmental Services nor the trade associations representing community service providers have established a unified, systematic practice to support self-determination. This phenomenological study explored the experience of adults with ID/DD working toward self-determination. Specifically, it explored how medical and social models contribute to shaping and actualizing the independence of this population. Interviews with eight adults with ID/DD explored the perceived barriers to, and opportunities for, achieving independence through self-determination. Under the current statutory regulations, the study viewed two conceptual lenses. The first lens, social role valorization, is based on the study of normalization. The second lens, social reaction, emphasizes a response to the disparities that acknowledge the political, cultural, and social beliefs associated with theories of deviance and social role valorization. The findings demonstrated that self-determination requires collaboration between coordinated services, primary social systems, and theoretical services supporting social role value. The discovery of these key elements may help California's disability service system fulfill legislative requirements to increase opportunities for personal choice.

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Grönberg, Eskel Marit. "Från slutna institutioner till institutionaliserat omhändertagande". Doctoral thesis, Karlstads universitet, Avdelningen för sociala studier, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-12544.

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In recent years, a number of reforms have been made regarding the provision of care to people experiencing psychiatric disabilities. The aim of these reforms was to enable these people to participate in society and to ”live as others”. This political ambition, as well as research on recovery, stands to a certain extent in contrast to the message conveyed in the media, where the mentally ill/disabled to a great extent are represented as dangerous and incurable. The aim of the thesis is to analyse if, and how a group of people experiencing psychiatric disabilities create a sense of being like others, and to relate the analysis to the historical emergence of the contemporary conception of mental illness/psychiatric disability. This thesis employs the method of interviews. I highlight the informants encounter with the historically based stereotype that defines the persons as unreasonable, irrational and incapable of taking care of themselves. When the informants face the stereotype, they act to reduce the negative consequences. The informants’ actions can be interpreted in terms of approaches and in this perspective the informants appear as strong actors, who, contrary to the stereotype, are capable of take care of themselves. Three approaches are described: expertise, adaptation, and distancing. In situations where the stereotype is not present, the informants can create a feeling of being like anyone else. Their stories show that the feeling of being like others is individual. The development taking place in the field is “path-dependent”, meaning that the initial activity, the differentiation of persons with mental illness and the subsequent events is a development following a pattern which could explain the failure of the good political intentions. It has progressed from closed institutions to an institutionalized care service.

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Clegg, Carl B. "Utility of the structured inventory of malingered symptomatology (SIMS) and the assessment of depression inventory (ADI) in screening for malingering among disability seeking outpatients". Morgantown, W. Va. : [West Virginia University Libraries], 2007. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5256.

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Thesis (M.S.)--West Virginia University, 2007.
Title from document title page. Document formatted into pages; contains vii, 29 p. : ill. Vita. Includes abstract. Includes bibliographical references (p. 25-26).

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Ruckel, Emily. "A Room for History: Professionalizing the Archives Room at Northwest Ohio Psychiatric Hospital to Create the Toledo State Hospital Museum". University of Toledo / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1418388533.

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Littmann-Power, Sarah. "Ongoing monitoring of dual diagnosis patients : evaluation of the Psychiatric Assessment Schedule for adults with a developmental disability - checklist (PAS-ADD Checklist) /". [St Lucia, Qld], 2004. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe18230.pdf.

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Athwal, Palwinder. "An evaluation of interventions offered to nursing staff working in learning disability psychiatric settings to reduce the psychological impact of patient aggression". Thesis, University of Birmingham, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.739397.

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Valodius, Ove. "Supported Education (SEd) - Utbildning med stöd : En kvantitativ studie om individanpassat stöd till att slutföra högre utbildning, främst för personer med psykiska funktionshinder". Thesis, Ersta Sköndal högskola, Institutionen för socialvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-5472.

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Syftet med studien var att undersöka vilka faktorer i psykiatrisk rehabiliteringsteori som var de viktigaste stödjande och hindrande faktorerna för att deltagare i arbetslivsinriktad rehabilitering skulle kunna slutföra gymnasial/eftergymnasial utbildning och få ett arbete på dagens arbetsmarknad. Deltagarna i denna studie kom från fyra verksamheter inom Supported Education (SEd) i Sverige. Faktorerna för både stödjande och hindrande faktorer ville jag få fram i prioritetsordning, eftersom jag från tidigare forskning upplevde det svårt att veta vad som först ska prioriteras i arbetet med rehabilitering genom utbildning och arbete/anställning. Detta för att skapa en djupare förståelse för vad som är viktigt för personer med psykiska funktionshinder/ohälsa för att påbörja och slutföra utbildning, men också för att se om tjänsten SEd har potential att användas inom socialt arbete i form av arbetslivsinriktad rehabilitering och återhämtningsinriktat stöd för psykisk ohälsa och psykiska funktionshinder. För att besvara detta använde jag en enkät med tio kvantitativa slutna frågor och sju kvalitativa öppna frågor. SEd är ett stödprogram inom arbetslivsinriktad rehabilitering för att välja, påbörja och slutföra utbildning på gymnasial och eftergymnasial nivå främst för personer med psykiska funktionshinder/psykisk ohälsa. Diskussioner pågår om att andra målgrupper utan psykiska funktionshinder/psykisk ohälsa ska kunna få detta stöd för att slutföra utbildningar. Från resultatet av studien fick jag fram ett antal teman för vad som stödjer och hindrar slutförandet av utbildning. Resultatet visade att deltagarna generellt är nöjda med stödet de får från SEd. Mest framträdde personalens genuina engagemang, förmåga till empati och ett respektfullt bemötande som de avgörande faktorerna för att deltagarna skulle påbörja och slutföra utbildning. Andra faktorer som stödde deltagarna var att de fick stöd att slutföra studieuppgifter, att stödet inte var tidsbegränsat, att deltagarna hade regelbundna enskilda stödsamtal med personal, att de upplevde gemenskap och tillhörighet i SEd och att studie- och yrkesvägledning genomfördes som ledde till en individuell handlingsplan som följdes upp kontinuerligt. Hindrande faktorer för deltagarna med SEd var att lokalerna var för små och studiecoacherna var för få. Generella hinder för deltagarna att slutföra utbildning var psykisk ohälsa (till exempel ångest, fobi, depression), svårigheter med studieekonomin, svårigheter med socialt samspel, svårigheter med koncentration, brist på studieteknik och svårigheter att slutföra uppgifter, ADHD, ADD, dyslexi, missbruk, svårigheter med att orka med ett högt studietempo och brist på stöd med att slutföra uppgifter. Detta resultat analyserade jag med hjälp av psykiatrisk rehabiliteringsteori. Jag förde sedan en diskussion där jag lyfte fram de utmaningar och möjligheter som vi kan se i framtiden för SEd.
The purpose of this study was to examine which factors in the psychiatric rehabilitation theory that were the most important supporting and hindering factors for getting participants in Vocational Rehabilitation to complete secondary/postsecondary education and get a job in todays labour market. The participants in this study came from four Supported Education (SEd-) projects in Sweden. I wanted to get forth the factors in order of priority since I found it difficult to find which factors to prioritize first in the work of rehabilitation through education and employment. I did this to get a deeper understanding of what is most important for persons with psychiatric disabilities/mental illness to be able to complete secondary/postsecondary education, but I also did it to investigate if the service of SEd has the potential of being used in social work in the shape of vocational rehabilitation and recoveryoriented support for mental illness and psychiatric disabilities. To be able to answer those questions I used a questionnaire with ten quantitative closed questions and seven qualitative open questions.. Supported Education (SEd) is a supportprogram aimed at supporting persons mainly with psychiatric disabilities/mental illness to choose, start and complete education on secondary and postsecondary level. There are ongoing discussions about whether other target groups without psychiatric disabilites/ mental illness could get this support to complete education. From the results of the study I found a number of themes for what supported or hindered the participants in completing their education. The results showed that the participants generally were very satisfied with the support they got from the staff in SEd. Most of all it was the staffs genuine engagement, empathy and a respectful treatment that stood forth as the crucial factors that affected the participants to complete their education. Other factors that also supported the participants to complete their education is that they got support with completing their study tasks, there were no time limit for the support, the recurrent individual counseling sessions with staff, the experience of fellowship and belonging and educational and vocational guidance that supported the participants in forming an individual action plan which was followed up continuosly. Hindering factors with SEd for the participants were that the localities were too small and that the study coaches were too few. Hindering factors in completing education in general was mental illness (e.g. anxiety, phobia and depression), difficulties with economy, difficulties in socialising with people, difficulties with concentration, lack of a technique for studying and difficulties with completing tasks, ADHD,ADD, dyslexia, addiction, problems to adjust to a high tempo in the education and lack of support with completing tasks. I analyzed these results by using the psychiatric rehabilitation theory. I then discussed the challenges and possibilities that we can see in the future with the SEd-method.

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Burke, Thomas James. "Detecting Malingering on the MMPI-2: An Examination of the Utility of Combining the Validity Scales in a Non-Compensatory Model". TopSCHOLAR®, 2007. http://digitalcommons.wku.edu/theses/27.

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Bricout, John Constantine. "The Relationship Between Employers' Perceived Organizational Context and Their Impressions of the Employability of Job Applicants with Either a Severe Psychiatric or Physical Disability". VCU Scholars Compass, 1998. http://scholarscompass.vcu.edu/etd/4393.

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This study investigated the relationship between favorable employability ratings of hypothetical job applicants with a severe disability and two aspects of employers' perceived organizational context: organizational climate and negotiation latitude, using a cross-sectional, correlational design. A survey including a hypothetical job applicant vignette in one of three conditions: non-disabled, severe physical disability (acquired brain injury), severe psychiatric disability (schizophrenia) was mailed out to a random sample of 1,000 employers selected from a national human resource membership list. Responses were received from 248 employers. The chief purpose of this study was to explore the relationship between employers' perceived organizational context and their impressions of job applicant employability. A secondary purpose was to explore the hierarchy of job applicant disability condition (non-disabled, acquired brain injury, schizophrenia) by employability rating. The concept of perceived organizational context was operationalized using two related constructs: organizational climate and negotiation latitude. Organizational climate was measured using a proxy instrument, the 10-item Knowledge and Acceptance of the ADA Scale. Negotiation latitude was measured using the eight-item Information Exchange Scale. The concept of employability impressions was measured using the 22-item Employment Characteristics Scale. Data analyses were conducted using a variety of univariate and bivariate statistical procedures. Logistical regression was used as the single multivariate procedure. The first study hypothesis predicted that the odds of obtaining a favorable employability impression for the hypothetical job applicant would increase when the organizational climate for hiring disabled workers was favorable and employer negotiation latitude was high. This prediction was partially supported inasmuch as the odds of obtaining a favorable employability impression did increase slightly when the hiring climate was also favorable. Although the odds of obtaining a favorable employability impression also increased slightly when negotiation latitude was high, that relationship failed to achieve statistical significance. A possible explanation for the failure of high negotiation to obtain significance as a predictor in logit may lie in the lack of empirical evidence for the predicted role of risk-taking in the context of hiring, and calls for further refinement of the construct in that context. The second study hypothesis was that non-disabled applicants would be viewed as most employable, followed by applicants with a physical disability and, ultimately, applicants with a psychiatric disability. This hypothesis also received partial support. As predicted, non-disabled job applicants received mean employability ratings that were higher than applicants in either disabled condition, and this difference obtained statistical significance. However, contrary to predictions, applicants with a psychiatric disability received substantially the same employability ratings as applicants with a physical disability. This unexpected finding may be due to: (1) lack of employer familiarity with both severe disabilities in the workplace, (2) more positive views of psychiatric disabilities due to recent positive changes in societal views on mental illness, or (3) because the acquired brain injury was viewed in light of the cognitive deficits that sometimes accompany it, rendering the individual multiply disabled. The implications of this study for social work practice include a new focus on employment interventions at the organizational level and relationship building between employers, consumers and practitioners to help create a favorable organizational context for the employment of workers with a disability. Implications for theory and research include a new focus on how hiring manager's evaluative and decision-making processes are influenced by the shared expectations of organizational members and leaders. Future studies may refine the concept of negotiation latitude in the hiring context and investigate the link between organizational context and the employment decision-making process.

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Wiener, Diane Rochelle. "Narrativity, Emplotment, and Voice in Autobiographical and Cinematic Representations of "Mentally Ill" Women, 1942-2003". Diss., The University of Arizona, 2005. http://hdl.handle.net/10150/195156.

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This dissertation presents an historical overview of the interdependent representations of gender, class, ethnicity, race, nationality, sexuality, and (dis)ability in a selection of films and first-person written autobiographical texts from the 1940s to the early twenty-first century. Cinematic and written autobiographical representations of “mental illness” reflect and shape various models of psychological trauma and wellness. I explore the ways that these two genres of representation underscore, exert influence upon, and interrogate socio-cultural understandings and interpretations of deviance and normalcy, madness and sanity, and pathology and health. Some models of health and illness carry more ideological weight than others, and thus differentially contour public policy formation and the materiality of people’s daily lives. My project is distinct from other kinds of scholarship on the subject of women’s “madness.” Whereas scholarship has been written on “madness” and cinema, and on “madness” and autobiography, this related academic work has not consistently drawn linkages between multiple genres or utilized interdisciplinary methodologies to critically explore texts. Feminist scholars who address the interconnections between autobiographies and cinematic representations often pay only limited attention to psychiatric survivors. I draw parallels and distinctions between these genres, based upon my training in social work, cultural studies, film and autobiography theory, medical and linguistic anthropology, and disability studies. My perspective hinges upon my longstanding involvement with and commitment to the subject of women’s “madness” in both personal and professional arenas.

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Friberg, Isak, i Maria Resén. "Utanför tillsammans? : En allmän litteraturstudie om dagverksamheters betydelse för individer med psykiatriska funktionshinder". Thesis, Ersta Sköndal Bräcke högskola, Institutionen för socialvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-8301.

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Bakgrund: Den vanligaste anledningen att personer med psykiatriska funktionshinder lämnar hemmet är för att besöka en dagverksamhet. Samtidigt kritiseras dagverksamheter för att vara stigmatiserande. Forskning inom området återger en i stora drag homogen bild av dagverksamheters betydelse för individen där positiva aspekter lyfts fram. Emellertid återfinns kontrasterande bilder där dessa verksamheter kan tänkas påverka besökarna negativt. Syfte: Syftet med denna studie är att utifrån tidigare forskning ge kunskap om vad dagverksamheter för personer med psykiatriska funktionshinder betyder för dess besökare. Vi ämnar kartlägga kunskapsläget samt med efterföljande analys skapa en djupare förståelse för dagverksamheters betydelse för individen. Metod och teori: Studien är i form av en allmän litteraturstudie där tolv utvalda artiklar utgör empirin. För att förstå betydelsen av dagverksamheter har vi satt ihop ett teoretiskt ramverk av stigma, självstigma och empowerment. Resultat:Studien utmynnar i tre huvudteman: betydelsen av dagverksamheten som socialt sammanhang, betydelsen av dagverksamheten som sysselsättning, olika aspekter av dagverksamhetens betydelse för måendet. Slutsatser: Vi fann att dagverksamheter är av stor vikt för besökarna genom att erbjuda en trygg plats för social gemenskap, en del i ett socialt sammanhang, erbjuda meningsfull sysselsättning och en motivation till att lämna hemmet. Vi ser i resultatet att målgruppen har svårt att ta sig in på arbetsmarknaden. Det är därför viktigt att dagverksamheter finns så besökarna kan komma dit och delta i olika typer av aktiviteter, samt för att ge vardagen en struktur. En annan slutsats är att i de positiva aspekter som lyfts i empirin kan vi skönja problematiska sidor av dagverksamhetens betydelse, även i det som framhävs som positivt. Detta kan röra sig om slutenheten som präglar dessa institutioner, deltagarnas beroende av dagverksamheterna samt verksamheternas svårigheter att vara en brygga till nya utvecklingsmöjligheter.
Title: Left out together? A general literature study on the meaning of daycare centers to individuals with psychiatric disabilities. Background: The most common reason why people with psychiatric disabilities leave home is to visit a daycare center. At the same time, daycare centers are criticized for being stigmatizing. The research in the area provides a fairly homogeneous picture of what daycare centers mean to the individual where positive aspects are highlighted. However, contrasting images are found in which daycare centers may have a negative impact on its visitors. Aim: The aim of this study is to provide knowledge of what daycare centers for people with psychiatric disabilities mean to their visitors based on previous research. We intend to map the state of knowledge and, with subsequent anlays, create a deeper understanding of what daycare centers mean for the individual. Method and theory: This study is a general literature study in which twelve selected articles constitute the empiric. To understand the meaning of daycare centers, we have put together a theoretical framework of stigma, self-stigma and empowerment. Findings: The study generates three main themes: the meaning of daycare centers as a social context, the meaning of daycare centers as occupation, different aspects of what daycare centers mean for well-being. Conclusion: We found that daycare centers are of great importance to visitors in providing a safe place for social community, part of a social context, offering meaningful occupation and a motivation to leave home. We see in the result that the target group has difficulty in entering the labor market. It is therefore important that daycare centers exist so that visitors can come there and participate in different types of activities, as well as to provide structure to everyday life . Another conclusion is that in the positive aspects highlighted in the empiricism, we can discern problematic aspects of the importance of daycare centers, even in what is emphasized as positive. This may concern the introversion that characterizes these institutions, the participants' dependence on daycare centers and the difficulties of the centers to be a bridge to new development opportunities.

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Butler, D. A. "An evaluation of judicial approaches to determining tortious liability in negligence for psychiatric injury independent of physical injury in Australia and England". Thesis, Queensland University of Technology, 1996. https://eprints.qut.edu.au/35787/1/35787_Digitised%20Thesis.pdf.

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This thesis comprises an evaluation of existing and suggested approaches, and promulgation and defence of a preferred approach, to liability for psychiatric injury (or 'nervous shock') resulting from the unintentional conduct of another and occurring independently of any physical injury to the sufferer. Such a claim was first recognised a little over one hundred years ago but since that time the precise limits of liability for psychiatric injury has been an issue that has vexed courts in many jurisdictions. Even today there is no common approach to liability for psychiatric injury in Australia and England. This position is contributed to by the recent divergence in approaches to the determination of the existence of a duty of care in negligence in those countries. The thesis establishes a yardstick which is argued as being reflective of good judicial reasoning, at least as is appropriate to the subject of the enquiry, psychiatric injury. It then lays a foundation for the evaluation by an historical and analytical analysis of liability for psychiatric injury. The historical trace is set in the context of the development of the elements of the cause of action for negligence, including the recent divergence in approaches to duty, while the comparative analysis embraces decisions in Australia, England, Ireland, Scotland, New Zealand, Canada and the United States. In relation to the last mentioned, due to the lack of a federal attribute each state jurisdiction determines its own approach to the equivalent of liability for psychiatric injury, and there is no uniformly accepted response. Against this analysis, the thesis juxtaposes a medical perspective of 'nervous shock'. This perspective facilitates an evaluation of the medical legitimacy of past and current approaches and concepts and informs the promulgation of a preferred approach, including a more refined definition of the damage deemed worthy of compensation. The thesis also analyses the policy factors, or considerations of community welfare external to the interests of the parties to a particular dispute, that have shaped the limits of liability for psychiatric injury, including an assessment of the continued legitimacy of policy factors as measured against the yardstick for good judicial reasoning. It then proceeds to assess against the yardstick the continued legitimacy of individual concepts which have been promoted as being the appropriate limitations of liability. The thesis proceeds to critique the current approaches to duty of care in Australia and England, utilising psychiatric injury as a catalyst and evaluating the approaches against the yardstick. A literature review which critiques alternative approaches that have been suggested then follows. The climax of the thesis is the promulgation of a preferred approach, which draws on the analysis and evaluation throughout the thesis. This preferred approach advocates a more specific definition of the damage deemed worthy of compensation, an accommodation of an overt identification and assessment of relevant policy considerations, an incremental approach to the establishment of duty of care and greater emphasis upon the other elements of the negligence cause of action. This preferred approach is demonstrated as conforming to the yardstick and is accordingly defended as reflective of good judicial reasoning.

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Koch, Andrea, Anke Vogel, Marco Holzmann, Andrea Pfennig, Hans Joachim Salize, Bernd Puschner i Matthias Schützwohl. "MEMENTA—‘Mental healthcare provision for adults with intellectual disability and a mental disorder’. A cross-sectional epidemiological multisite study assessing prevalence of psychiatric symptomatology, needs for care and quality of healthcare provision for adults with intellectual disability in Germany: a study protocol". Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-148191.

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Introduction: The study ‘Mental healthcare provision for adults with intellectual disability and a mental disorder’ (MEMENTA) is a cross-sectional epidemiological study carried out in three different regions of Germany. Its main aim is to assess the prevalence of mental disorders in adults with intellectual disability (ID) as well as quality of mental healthcare for this population. Methods and analysis: The target population are persons aged between 18 and 65 years with a mild or moderate ID. The study population will be recruited through service providers. A representative sample is realised by two-stage sampling. First, institutions providing services for people with ID (sheltered workshops) are selected in a stratified cluster sampling, with strata being (1) types of service-providing non-governmental organisations and (2) sizes of their sheltered workshops. Then persons working in selected sheltered workshops are selected by simple random sampling. An estimated number of 600 adults with ID will be included. Information will be obtained from the group leaders in the sheltered workshops, informal carers or staff members in sheltered housing institutions and the person with ID. Besides the main outcome parameter of psychiatric symptomatology and problem behaviour, other outcome parameters such as needs for care, quality of life, caregiver burden, health services utilisation and costs for care are assessed using well-established standardised instruments. If a comorbid mental disorder is diagnosed, quality of mental healthcare will be assessed with open questions to all interview partners and, in addition, problem-focused interviews with a small subgroup. Analyses will be carried out using quantitative and qualitative methods. Ethics and dissemination: Approval of all three local ethics committees was obtained. Research findings will add much needed empirical information in order to improve services provided to this vulnerable group of patients.

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Nel, Maretha. "The adaptation of an appropriate screening tool for the early detection of malnutrition in individuals with intellectual disability (ID) in a psychiatric hospital in North West Province (South Africa)". Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71867.

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Thesis (MNutr)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Background: Considering the myriad of risk factors causing nutritional deficiency, as well as the prevalence of malnutrition and feeding problems experienced by individuals with intellectual disability (ID), early detection and diagnosis of malnutrition in this population group is essential. Objectives: The main aim and objectives of the study were to determine the degree of malnutrition and body composition in individuals with ID living in a psychiatric hospital (North West Province, South Africa), to determine which degree of ID was more prone to malnutrition, to investigate the different risk factors for malnutrition in this group of individuals, and to use this data to adapt an existing screening tool used to facilitate the easier identification of malnutrition. Methodology: An observational descriptive cross-sectional study, with an analytical component, was conducted. The study consisted of two phases. During the first phase, measurements were taken of individuals with ID to determine body composition and nutritional status. During the second phase, said data, as well as other factors influencing the nutritional status of individuals with ID, were used to adapt an existing screening tool to allow for easier identification of malnutrition in the study population. The adapted screening tool was tested by nursing staff. Results: The anthropometric measurements of 244 individuals with ID were determined. The overall anthropometrical status indicated that half of the study population (52,1%, n=127) had a normal nutritional status, that 38,1% (n=93) was undernourished or at risk of becoming undernourished, and that 10,0% (n=24) was either at risk of becoming or was overnourished . Men were more prone to being undernourished or at risk of becoming undernourished (48,0%, n=73), compared to women (21,7%, n=20). Although no significant difference was found in anthropometrical status across the four severities of ID (Pearson Chi-square test (ρ=0,15)), individuals with mild ID were more likely to become obese (19,4%, n=6), and individuals with profound ID were more prone to being underweight (57,1%, n=8). It was found that 41,8% (n=102) of the total study population had a waist circumference (WC) above the normal values. A significant difference was found between increased WC and severity of ID (Pearson Chi-square test (ρ=0,00)). Other risk factors that can influence nutritional status in said population included medical conditions such as hypertension (13,0%, n=32) and epilepsy (EP) (46,0%, n=112), as well as polypharmacy (71,7%, n=175). An existing malnutrition screening tool for the population with ID was adapted by means of the addition of prevalent factors (WC measurements, presence of EP and use of medications), as well as through adaptation of the scoring system. Conclusion: Using anthropometric measurements and indices for body composition, a high prevalence of malnutrition was identified in the study population of individuals with ID. The adapted screening tool was more sensitive than the original tool in identifying individuals who were at risk of malnutrition, or who were already malnourished in this study population. The research undertaken in this respect can help health care professionals to be more aware of the interaction between the severity of ID and malnutrition.
AFRIKAANSE OPSOMMING: Agtergrond: Wanneer daar gelet word op die magdom faktore wat voedingstekorte veroorsaak en op die voorkoms van wanvoeding en voedingsprobleme onder individue met intellektuele gestremdheid (IG), is dit duidelik dat vroegtydige waarneming en diagnose van wanvoeding noodsaaklik is. Doelwitte: Die hoofdoel en doelwitte van die studie was om die graad van wanvoeding sowel as die liggaamsamestelling van individue met IG te bepaal wat in ’n psigiatriese hospitaal (Noordwes Provinsie, Suid-Afrika) inwoon. Daar is bepaal watter graad van IG individue is meer geneig tot wanvoeding. Verskillende risiko faktore van wanvoeding in hierdie groep individue is ondersoek en die data is gebruik om ’n bestaande siftingshulpmiddel aan te pas om wanvoeding makliker te kan identifiseer. Metodologie: Die studie-ontwerp was ‘n dwarssnitwaarnemingstudie met ‘n analitiese komponent. Die studie het uit twee fases bestaan. Gedurende die eerste fase is antropometriese metings van individue met IG geneem om liggaamsamestelling en voedingstatus te bereken. Gedurende die tweede fase is hierdie data, sowel as ander risiko faktore wat die voedingstatus van individue beïnvloed, gebruik om ’n bestaande siftingshulpmiddel aan te pas wat die identifisering van wanvoeding in hierdie populasie kan vergemaklik. Verpleegpersoneel het die aangepaste siftingshulpmiddel uitgetoets. Resultate: Die antropometriese metings van 244 individue met IG is bepaal. Hulle algemene antropometriese status het aangedui dat die helfte van die studiepopulasie (52,1%, n=127) ’n normale voedingstatus gehad het; 38,1% (n=93) was ondervoed of het ’n risiko gehad vir ondervoeding en 10,0% (n=24) was reeds oorvoed of het ’n risiko gehad vir oorvoeding. Mans (48,0%, n=73) was meer geneig om ondervoed te wees of het ‘n groter risiko tot ondervoeding as vroue (21,7%, n=20). Daar was geen beduidende statistiese verskille in antropometriese status tussen die vier grade van IG nie (Pearson Chi-square-toets, p=0,15), alhoewel individue met matige IG ‘n groter neiging het tot obesiteit (19,35%, n=6), terwyl uitgesproke IG ’n groter neiging tot ondergewig gehad het (57,1%, n=8). Daar is bevind dat 41,8% (n=102) van die totale studiepopulasie ’n verhoogde middelomtrek gehad het. Daar was ŉ beduidende statistiese verskil tussen verhoogde middelomtrek en graad van IG (Pearson Chi-square-toets, p=0,00). Ander risiko faktore wat die voedingstatus van hierdie populasie kan beïnvloed sluit in mediese toestande soos hipertensie (13,0%, n=32) en epilepsie (46,0%, n=112), asook die gebruik van veelvuldige medikasie (71,7%, n=175). ’n Bestaande wanvoedingsiftingshulpmiddel vir die IG populasie is aangepas deur algemene faktore (middelomtrek, voorkoms van epilepsie en gebruik van veelvuldige medikasie) in te sluit en die puntestelsel aan te pas. Gevolgtrekking: Met behulp van antropometriese metings en liggaamsmassa indekse is ’n hoë voorkoms van wanvoeding in die studiepopulasie van individue met IG waargeneem. Die aangepaste siftingshulpmiddel was meer sensitief as die oorspronklike hulpmiddel om individue wat ’n risiko loop vir wanvoeding of wat reeds wangevoed is, te identifiseer in hierdie studie populasie. Hierdie navorsing kan help om gesondheidswerkers meer bewus te maak van die interaksie tussen die graad van IG en wanvoeding.

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Staal, Rozemarijn Nathalie. "Diagnostic Accuracy in Dual Diagnosis: The Development of the Screen for Symptoms of Psychopathology in Individuals with Intellectual Disability (SSP-ID)". Wright State University Professional Psychology Program / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=wsupsych1347493083.

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Söderberg, Katarina. "”Här flyttas man hem till någonstans man kanske inte väljer” : Tankar och erfarenheter kring att ge stöd till personer med psykisk funktionsnedsättning på särskild boende". Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-3978.

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Bakgrund: Många personer med psykisk funktionsnedsättning har en upplevelse av låg livskvalitet. De har också en sämre utgångspunkt materiellt, ekonomiskt, socialt och hälsomässigt. Att beviljas insatsen särskilt boende innebär att få stöd, service och omsorg i sin vardagstillvaro. Tidigare studier har visat att för att ett stöd ska upplevas stödjande behöver personalen ha både kunskap och vissa egenskaper, lyssnande, medkännande och lyhördhet. Syfte: Att beskriva vårdpersonals erfarenheter och tankar kring hur man utformar vardagligt stöd till livskvalitet för personer som bor i särskilt boende. Metod: Halvstrukturerade intervjuer gjordes där sammantaget tio personal deltog från fem särskilda boenden. Som analysmetod användes kvalitativ innehållsanalys med induktiv ansats. Resultat: Personalens erfarenheter av att ge stöd till livskvalitet rörde sig inom tre olika områden. Hur dessa områden, vårdrelation, organisation och miljö var beskaffade och upplevdes påverkade stödets insats och kvalitet. Det framkom att en viktig komponent i det vardagliga stödet utgjordes av ett omfattande motivationsarbete. Det fanns en bristande överensstämmelse mellan de boendes uppfattning om stöd behov och det som personalen ansåg att de behövde. Ett samband som visade sig var personalens uttryckta maktlöshet i vissa stödjande situationer och samtidig frånvaro eller bristande kontinuitet av handledning. Diskussion: Det särskilda boendet har som konstruktion stora utmaningar i att göra anspråk på att vara ett hem och inte en institution. Redan språkbruket etiketterar; man bor inte i en lägenhet utan på ett gruppboende och man är inte hyresgäst utan boende. De yttre strukturerna kan förstärka ett vi och dom tänkande där behov och svårigheter riskerar att bli beskrivna utifrån grupptillhörighet.
Background: Many people with psychiatric disabilities have a perception of low quality of life. They also have lower standard, materially, economically, socially and health-wise. To be granted supportive housing means getting daily support, service and care. Previous studies have shown that the supporting staff have to be knowledgeable and have special features, compassionate, responsive and attentive. Aim: To describe a health care professional experiences and thoughts on how to style casual support to the quality of life for people living in sheltered housing. Methods: Semi-structured interviews were conducted as with ten staff members from five supportive housing. The method of analysis was qualitative content analysis with an inductive approach. Results: The staffs’ experiences of providing support for quality of life was categorized into three different areas. How these areas, care relationship, organization and environment was constituted and perceived made impact on support effort and quality. It emerged that a key component of the everyday support consisted of a comprehensive motivational work. There was a mismatch between the residents' perception of support needs and what the staff felt that they needed. A relationship that turned out was the staff expressed powerlessness in some supportive situations and the absence or lack of continuity of supervision. Discussions: Supportive housing has as major challenges in claiming to be a home and not an institution. The language used; you do not live in your own apartment, but in a group home and you are not a tenant, but a person living there. The outer structures can reinforce an “us” and “them” thinking where the needs and difficulties might be described on the basis of group membership.

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Kock, Elizabeth. "De-institutionalisation of people with mental illness and intellectual disability : the family perspective". Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/2231.

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Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: South Africa has transformed its mental health service provision from in-hospital care to community-based rehabilitation. Although the idea is sound, the process places the caregiving families under an immense pressure. The aim of this study was to explore the impact that the de-institutionalisation process has had on the families as they care for their child with intellectual disability. The study was conducted by means of qualitative, unstructured interviews with families that have had a child de-institutionalised from Alexandra Hospital in the Western Cape. All of the patients were diagnosed with a dual diagnosis of intellectual disability and mental illness. Even though the patients were in group-homes or attended a day care centre, final responsibility for the patients lay with the parents. Three main themes emerged from the interviews that describe the impact of deinstitutionalisation, viz. the characteristics of the family member with intellectual disability (aggressive, abusive and self-destructive behaviour of the patient), the effect that these characteristics had on the family (marital stress and health risks to the care giver), and community and resource factors. The study placed the family central to its environment and discussed the impact deinstitutionalisation had on its environment as a whole. It was concluded that the burden that de-institutionalisation places on the families far exceeded their ability to cope with these circumstances. This status quo could be improved if adequate resources and skills are given to families prior to de-institutional
AFRIKAANSE OPSOMMING: In Suid-Afrika is geestesgesondheidsorg van hospitaliserende na gemeenskapsgebaseerde rehabilitasie, omskep. Terwyl hierdie stap wel as lewensvatbaar mag voorkom, plaas die proses ‘n hewige las op die sorggewende gesin. Die doel van hierdie studie was om die omvang van die impak hiervan op ‘n gesin met ’n lid met intellektuele gestremdheid en psiegiatriese siekte, te bepaal – nadat so ‘n pasient uit die inrigting ontslaan is. Die ondersoek is uitgevoer by wyse van kwalitatiewe, ongestruktureerde onderhoude met gesinne wie se lede met die diagnose uitgeplaas is deur die Alexandra Hospitaal in die Wes-Kaap. Elkeen van die pasïente is gediagnoseer met ernstige intellektuele gestremdheid, asook bykomende gedragsafwykings. Ten spyte van die feit dat die betrokke pasïente deur groepshuise of dagsorg eenhede versorg word, bly hulle hul ouers se verantwoordelikheid. Drie temas het ontstaan wat die impak van ontslag uit die inrigting omskryf, te wete die karaktertrekke van die gestremde gesinslid (aggressie, misbruikende en vernielsugtige gedrag van die pasïent), die effek van hierdie karaktertrekke op die gesin (stres op die huwelik en potensiële gesondheidsrisiko wat dit vir die versorger inhou), en die gemeenskap en ondersteunende faktore. Tydens die ondersoek is die gesin sentraal geplaas ten opsigte van die omgewing. Die impak van ontslag van die gediagnoseerde pasïent uit die inrigting op die omgewing as geheel, word bespreek. Daar is tot die slotsom gekom dat die vermoë van die gesin wat die las moet dra as gevolg van die ontslag, ver oorspan word. Hierdie toedrag van sake sou egter verlig kon word indien toereikende hulpbronne en vaardighede aan sulke gesinne beskikbaar gestel word alvorens so ‘n pasïent ontslaan is.

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Andreou, Froso. "Marital Status and Burdensomeness as Risk Factors of Suicide Ideation in Poststroke Patients". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5051.

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Suicide ideation, suicide attempts, and suicide (SISAS) are increased in poststroke patients, yet not everyone who has suffered a stroke is at risk for SISAS. Two risk factors for SISAS, marital status and burdensomeness, may be of particular relevance to poststroke patients. The majority of poststroke patients have a disability that may require help from a family member with basic functions such as dressing and bathing. It was not known if being married decreases risk of SISAS for stoke victims as shown in studies with nonpoststroke subjects or increases risk for SISAS due to its influence on feelings of burdensomeness. Guided by the interpersonal psychological theory of suicidal behavior, the purpose of this study was to examine if marital status moderates the association between burdensomeness (measured by disability level) and suicide ideation. A secondary analysis was performed of the Outcome and Assessment Information Set data, which was collected by the National Centers for Medicare and Medicaid Services. A data sample of 1,596,962 records was obtained. This data sample included 5% of the Home Health Outcome Information and Assessment Set for the year 2008. Of those, 8,6381 (5.4%) individuals had suffered a stroke. The results suggested partial support for the hypotheses presented in this study. However, a significant moderation was found. As burdensomeness increased, suicide ideation increased in patients who were married. High levels of burdensomeness increase suicide risk to those who are married. Identifying a vulnerable population can provide potential positive social change by serving as basis for future research regarding program implementation in reducing suicide rates.

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42

Klamas, Maria. "Av egen kraft tillsammans med andra : Personer med psykiska funktionshinder, socialt stöd och återhämtning". Doctoral thesis, Högskolan Väst, Avd för socialpedagogik och sociologi, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-3171.

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The purpose of this study was to describe and analyse the significance of social support to adults with psychiatric disabilities, based on the individual's experiences. This includes research questions concerning what type of social support was perceived to be beneficial or restrictive, which relational aspects were considered having a beneficial or restrictive effect on the support- and recovery process, as well as what strategies and capacities the individual developed on their own in order to cope with their obstacles and disadvantages. The empirical material was based on qualitative inteviews with ten individuals that defined themselves as having psychiatric disabilities. They were each interviewed on three occasions. The repetetive form of the interviews lead to three separate interview guides being created over the course of the data collection process. The goal of the first interview was to get a general idea of the subject's daily life, activities, arenas, relationships and support. The second interview focused on meaningful relationships. The third and final interview had one general and one individual part. The general part focused on the subject's psychiatric disabilities, their opportunities as well as existing and desired support measures. The subject matters in the individual part were related to the previous interviews with each of the participants and aimed to develop or expand on previous discussion. The material was analysed using theories about social support and recovery and was presented with roots in four different networking entities: close and extended family, friends, coworkers and fellow students, as well as formal support instances. The result showed that it is the support with mobilising qualities that is beneficial to the recovery process. It increases the individual's degree of control over their illness, obstacles and challenges. In addition, it appeals to the individual as a central actor and as a person with difficulties as well as resources. The fact that the social support from the various support agencies have varying focus and direction benefits recovery since it increases the individual's opportunity to maintain as well as develop their social bonds and roles within the community. A relational prerequisite for social support is an equal relationship, which benefits the recovery process as it encompasses acknowledgement and acceptance of both the individual on a personal level and of their situation. The type of social support that hinders recovery is the kind that lacks a connection between the individual's perceived problems, their need for support and their over time fluctuating ability to handle their psychiatric disability. This is due to the fact that it robs the individual of control over the situation, increases the need for support and strengthens their perception of themselves as sick. Recovery comes to a halt when the individual isn't included in the support and recovery process, which is clarified in relational aspects such as lacking attentiveness, subpar acceptance as well as rejection. The individual's will and capacity to actively take on the responsibility to steer their recovery in a positive direction was made visible through four groups of strategies that were crystallised through the course of the research; creation of understanding and legitimisation, cultivation, including strategies and the creation of boundaries.

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Ikegami, Makoto. "Social Workers' Experiences With Deaf and Hard of Hearing People With Mental Illness". ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6906.

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The social work practice problem for this study was a lack of knowledge about social workers' experiences of working with deaf and hard of hearing people with mental illness. This study was needed to fill a practice gap by increasing an understanding of the experiences of social workers to inform best practices and address the needs of deaf and hard of hearing population through culturally and linguistically competent mental health services. The research questions focused on the experiences and challenges of social workers working with deaf and hard of hearing people and best practices identified by these social workers. Ecological systems theory was used to guide this study. Data were collected from a focus group comprising 9 social workers working with deaf and hard of hearing people with mental illness at a healthcare provider on the east coast of the United States that offered culturally and linguistically therapeutic services. Themes identified through thematic analysis of the data were cultural competence, empowerment and advocacy, professional education, and leadership to advance cultural competence. The findings of this study may be used to help healthcare providers identify key components of program design and service delivery that support culturally and linguistically competent mental health services for the population. This knowledge may also be used by social work practitioners and administrators to bring about positive social change by enhancing social work practice related to deaf and hard of hearing clients with mental illness, improving mental health outcomes, and supporting recognition of the importance of culturally and linguistically competent mental health services.

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Sheets, Willard A. "The Process People with Schizophrenia or Schizoaffective Disorder Use to Return to or Initialy Secure Eemployment Following Diagnosis". Ohio University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1241734324.

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Clegg, Jennifer. "Interactions and relationships in adults with intellectual disability". Thesis, University of Nottingham, 1990. http://eprints.nottingham.ac.uk/11065/.

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This research concerned the social experience of two groups of adults with intellectual disability (mental handicap), those with verbal skills who could describe their experience and those with profound disabilities whose needs were interpreted by carers. Conceptual issues have been discussed to provide a framework for understanding their relationships and also for understanding intellectual disability itself. Social constructionism, has influenced the investigations. Previous research shows that disabled people experience relatively little social contact regardless of their level of ability. Interactions and relationships were investigated so that practitioners aiming to improve intellectually disabled adults' social experience may have relevant information. It has been assumed that more interaction is better as it allows people to reflect upon themselves with regard to others, to construct themselves through their interactions. These investigations fall into two main sections, the first a discussion of attitudes toward self and others held by people who had, or did not have, a peer-group friend. Results suggested that further examination of the role of the self-concept in friendship formation would be fruitful and that people without a peer-group friend were similar to lonely non-disabled adults. The second section examines profound disability and contains a linked series of studies of adults' interactions with key workers. Results suggested that two interaction strategies used by staff were associated with increased positive responding from clients; that the developmental age of clients did not distinguish between them in their social responses to staff; that there was little evidence of turn-taking or the importance of staff making responses which follow the client's lead. Results were discussed in terms of their contribution to an alternative model for understanding profound disability. The project as a whole was discussed in terms of the interaction between method and conceptualisation and concludes with a number of recommendations for practitioners.

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Pierrefeu, Inès de. "Les ESAT de transition, une voie de rétablissement "par et vers" l’emploi pour les personnes vivant avec des troubles psychiques". Thesis, Sorbonne Paris Cité, 2017. http://www.theses.fr/2017USPCC291/document.

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Le travail constitue un levier de rétablissement pour les personnes vivant avec des troubles psychiques ; de nombreux dispositifs existent pour favoriser leur insertion professionnelle. En France, l'accès à l'emploi pour ce public est encore faible et peu de recherches sont réalistes alors que des pratiques existantes sont intéressantes, notamment celle des ESAT de transition de l'association Messidor, qui visent une insertion en milieu ordinaire pour ces personnes. L'objectif de cette thèse était de décrire ce dispositif de transition "par et vers l'emploi" , en le comparant aux pratiques de référence au plan international, et de comprendre comment il peut contribuer à un processus de rétablissement pour les personnes accompagnées.Un volet Accompagnants (étude mixte qualitative puis quantitative) a été consacré à décrire et comparer le dispositif par rapport aux pratiques référencées, et à décrire les métiers des accompagnants, conseiller d'insertion et responsable d'unité de production, afin de voir comment ils contribuent au rétablissement des personnes accompagnées. Un volet Travailleurs (étude quantitative longitudinale, n=160) a été consacré à évaluer la perception des bénéficiaires en début de parcours et à documenter les facteurs prédictifs de leur maintien en emploi dans l'ESAT, d'une évolution positive vers l'insertion en milieu ordinaire et de leur rétablissement.Les ESAT de transition constituent un modèle hybride entre une structure protégée, une entreprise d' économie sociale et un programme d'emploi accompagné. Le binôme d'accompagnants complémentaires, grâce à une posture relationnelle subtile, favorise un changement de regard sur soi. La mise en situation de travail "réelle", avec ses difficultés productives, conjointement à l'étayage des accompagnants qui soutiennent sans assister, conduit la personne accompagnée à retrouver une estime de soi comme travailleur, un regard sur soi valorisé et un espoir en l'avenir, aspects-clés d'un processus de rétablissement. Les bénéficiaires ont une évaluation positive de leur situation en ESAT de transition et confirment le rôle-clé de leurs accompagnants et de l'estime de soi comme travailleur, pour favoriser aussi bien leur maintien en emploi dans l'ESAT, une évolution vers le milieu ordinaire que leur rétablissement. Les implications pratiques concernent le type d'accompagnement à mettre en oeuvre pour ce public ainsi que la formation et l'encadrement à développer pour les accompagnants, afin d'améliorer l'insertion professionnelle et le rétablissement des personnes vivant avec des troubles psychiques en France
Work is a key-factor of recovery for people with severe mental illness. Various programs exist to support them to gain and maintain competitive employment. In France, the rate of employment remains low for this population and only scarce researches are developed in this field, although some French practices, such as the Ç ESAT de transition È (transitional workshops) of the MESSIDOR association, appear to be performing well. Theses transitional workshops support people with psychiatric disability to gain a competitive employment on the regular labor market while working in a sheltered activity. The goal of this research was to describe the Ç ESAT de transition È program, comparing it to international evidence-based practices, such as supported-employment programs, and to define how this program can facilitate a recovery process for people with a severe mental illness.The first part of this research is intended to describe the program with a mixed method (qualitative then quantitative) in order to compare it with international evidence-based practices and to describe the roles, tasks and competencies of the two professionals supervising people with a severe mental illness, counselors and supervisors, and to define how they contribute to a recovery process for them. A second part of the research is dedicated to clients of this program, with a longitudinal study (n=160) of clinical and psychosocial variables, at the beginning of the program, and in order to document predictive factors of their job tenure in the program, of their positive evolution to work integration on the regular labor market and of their recovery.These Ç ESAT de transition È are an hybrid form of a sheltered workshop, social enterprise and supported-employment program for people with a severe mental illness. In a workplace close to the context of regular labor market, thanks to a subtle relational posture, the two professionals supervising the workers help them to develop a new positive identity, self-esteem as a worker and hope in the future, which are key-factors of a recovery process. Clients have a positive perception of their situation in this program, on clinical and psychosocial variables, and this perception is stable on the 9 months follow-up of the study. They confirm that self-esteem as a worker, counselors and supervisors are key-factors to ensure their job tenure in the program, their positive evolution to work integration on the regular labor market and their recovery. Practical implications and recommendations from this research are the type of support that should be developed in France for people a with severe mental illness to help their work integration, as well as the type of training and supervision that should be offered to the professionals supporting them

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Borelle, Céline. "Le traitement social de l'autisme : étude sociologique du diagnostic médical". Thesis, Grenoble, 2013. http://www.theses.fr/2013GRENH002/document.

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La notion de « traitement social » permet de considérer que l'autisme présente une certaine forme de réalité avant de faire l'objet d'un certain nombre de savoirs et de pratiques. La notion de traitement social a été privilégiée par rapport à la notion de « construction sociale » pour éviter l'idée que l'autisme acquiert une forme de réalité uniquement par le biais de sa construction sociale. Le choix de ce titre marque donc une volonté de déplacement par rapport au constructivisme. Toutes les catégories ont une origine sociale, dans la mesure où elles reposent sur un cadre socialement produit, mais les catégorisations sont sans cesse mises à l'épreuve de la matérialité du monde par le biais nos expériences. Le présupposé de cette thèse est que la réalité de l'autisme fait l'objet d'un constant processus collectif de réaffirmation et de révision. L'autisme est désigné comme un diagnostic médical car c'est l'autisme en tant qu'il fait l'objet d'une connaissance humaine, et parce qu'il devient de ce fait une réalité socialement produite, qui devient analysable par le sociologue. Cette thèse vise à saisir l'accomplissement pratique et continu de la catégorisation de l'autisme. Cette thèse s'appuie méthodologiquement sur une démarche ethnographique et théoriquement sur la sociologie pragmatique pour proposer une étude sociologique du diagnostic médical à partir du cas de l'autisme. La première partie traite du diagnostic médical comme catégorie et vise à montrer que cette catégorie est prise dans différents enjeux socio-politiques. Ces enjeux socio-politiques sont mis en évidence en distinguant quatre dimensions qui travaillent le diagnostic d'autisme : son institution, son institutionnalisation, sa politisation et sa controverse. Ces dimensions permettent de saisir les enjeux qui façonnement le diagnostic tels qu'ils se structurent dans le monde médical, mais également en dehors de ce monde. Cette partie montre comment la catégorie diagnostique est construite au croisement de plusieurs logiques qui circulent dans différents mondes, dans des rapports de pouvoir qui s'établissent entre des acteurs de différentes natures, dans une configuration susceptible d'évoluer au fil du temps. La deuxième partie traite du diagnostic comme processus de qualification. À partir de l'observation menée dans un centre de diagnostic spécialisé sur l'autisme, cette partie propose une sociologie de l'opération de qualification médicale. Dans cette perspective, le diagnostic est appréhendé comme une activité, un travail que l'on peut suivre pas à pas. Ce sont bien les pratiques en elles-mêmes, témoignant de la manière dont le diagnostic médical est produit en situation, qui sont étudiées. Après avoir inscrit la démarche dans une approche pragmatique de l'expertise médicale et proposé une grille d'analyse de l'opération de qualification, cette partie étudie l'enchaînement des différentes étapes de la démarche diagnostique pour penser le diagnostic comme un processus déterminé par la configuration et les supports de la qualification, et situé dans un contexte marqué par la pluralité des pratiques diagnostiques. La troisième partie traite des implications pratiques du diagnostic. Cette partie permet de faire sortir le diagnostic d'autisme du monde médical pour saisir ses implications non seulement dans d'autres contextes d'actions, dans le monde scolaire et le monde administratif, mais également sur la famille, à travers l'étude de la production domestique de soin. Cette partie propose également de saisir les implications du diagnostic sur le traitement de la subjectivité de l'enfant. Elle se termine sur le constat d'un phénomène de dualisation des parcours, en termes d'arrangements pratiques de soin et de quête diagnostique, qui peut être analysé selon différentes grilles de lecture n'appuyant pas la même forme de critique des inégalités sociales
The notion of “social treatment” allows considering that autism presents a certain form of reality before being the object of different kinds of practices and knowledge. The notion of “social treatment” is preferred to that of “social construction” to avoid the idea that autism acquires a form of reality only through its social construction. The title's choice traduces a will to take distance from constructivism. All the categories have a social origin insofar as they are based on a socially produced frame, but categorizations are always put to the test of the world's materiality through our experiences. This thesis presupposes that autism's reality is the object of a continual and collective process of reassertion and revision. Why designating autism as a medical diagnosis? It is autism as the object of a human knowledge, which makes of it a socially produced reality, that becomes analyzable by the sociologist. To characterize autism as a medical diagnosis indicates that the purpose of this thesis is to grasp the continual and practical accomplishment of autism's categorization. This thesis relies methodologically on an ethnographical approach, and theoretically on the pragmatic sociology, to propose a sociological study of medical diagnosis from the case of autism. The first part deals with diagnosis as a category and aims at showing how this category is caught in different socio-political stakes. These socio-political stakes are highlighted through distinguishing four dimensions that shape the diagnosis of autism: its institution, its institutionalization, its politicization and its controversy. Theses dimensions permit to understand the stakes that shape diagnosis in the medical world and beyond. This part shows how diagnosis as a category is constructed at the crossroads of several logics that circulate in different worlds, through power relations between different kinds of actors, in a configuration that is likely to evolve over time. The second part deals with diagnosis as a process of qualification. From the observation of an evaluation center specialized in autism diagnosis, this part proposes a sociological analysis of the medical qualification. In this perspective, diagnosis is regarded as an activity, a work that can be traced step by step, and the sociologist is interested in the practices through which diagnosis is locally produced. After situating my work in a pragmatic approach of medical expertise, and proposing an analysis grid of the operation of qualification, this part studies the linkage between the different steps of the diagnostic process. This part allows conceiving diagnosis as a process that is determined by the configuration and the supports of the qualification, and situated in a context characterized by a plurality of diagnostic practices. The third part deals with the practical implications of diagnosis. This part grasps the implications of diagnosis outside of the medical world, in other contexts of action, in the administrative and school worlds. It also highlights the implications of diagnosis on family, through the analysis of the domestic production of care. It proposes to analyze the implications of diagnosis on the ways the child's subjectivity is treated. Eventually, this part underlines a phenomenon of paths dualization, in terms of practical arrangements of care and diagnosis quest, which may be analyzed through different reading grids that do not support the same criticism of social inequalities

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Biswas, Sanchia Rima. "Transitions into adulthood for children with a severe intellectual disability : parents' views". Thesis, University of Nottingham, 2015. http://eprints.nottingham.ac.uk/30489/.

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Introduction: Despite a growing body of intellectual disabilities literature around the transition into adulthood, most studies have focused upon physical aspects of the transition e.g. from school to employment or into adult services. My study sought to explore the transition into adulthood from a developmental/lifecourse perspective in order to address this current gap within the literature. Given that parents are often regarded as primary witnesses to their child’s transition into adulthood, their views were explored in order to access knowledge around this particular transition. Objectives: My study used a grounded theory approach to explore parents’ views of the transition into adulthood of their child with a severe intellectual disability. A further aim was to understand whether and how parents made psychological adjustments for their child’s transition into adulthood. This included an exploration of the emotional regulation processes that parents engaged in. Method: Twelve parents of 11 children with a severe intellectual disability were recruited from charitable organisations. A Straussian grounded theory methodology was adopted to analyse the data. Results: Parents viewed their child’s transition into adulthood as a process over time. The core process involved making frequent comparisons with their perceived “norms” of adulthood. Parents engaged in a further five processes which included “defining adulthood”, “noticing adult development”, “perceiving barriers to adulthood”, “worrying” and “making adjustments. My study highlighted that parents who defined adulthood as “turning 18” were likely to make adjustments to facilitate their child’s adult development (e.g., “encourage age appropriateness”). Those who viewed chronological age as being unhelpful/meaningless were more likely to be accepting of their child’s difficulties. Contrasting views appeared throughout these processes, demonstrating the diversity of parents’ experiences and adjustments made. Discussion: Parents engaged in a series of interactional processes for their child’s transition trajectory, which was likely to influence how they made adjustments. These processes were explained using existing psychological theory and/or relating them to findings from previous studies. With regards to a grounded theory model, I proposed a transition model of parents’ views and adjustment grounded in the study findings. The visual representation of this model helped to shift away from the staged/linear idea of transition. Future intellectual disabilities studies could seek to explore the types (and function) of comparisons that parents make with others. Additionally, further research could explore fathers’ views which are under-represented within this field. Clinical interventions may aim to challenge parent perceptions; encourage peer support; and embrace systemic working with parents through their child’s transition into adulthood.

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Gammon, Hannah Lee. "The Student Perspective: An Exploration of the Experiences and Needs of University Students with Mental Illness". Wright State University Professional Psychology Program / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=wsupsych1374611249.

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Coetzee, Jacobus (Ockert). "Caregiving experiences of South African mothers of adults with intellectual disability who display aggression: clinical case studies". Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23048.

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Background: Adults who have an intellectual disability (ID) often continue to live with their parents long after their siblings have left home. While an increasing body of research has described positive parental experiences, research has also found that parents of adults who have ID and behavioural difficulties are more vulnerable to develop parental stress and depression. Aggression is one of the most difficult forms of problem behaviours to manage and could have a negative impact on the parent-child relationship, the child's social inclusivity and the psychological well-being of parents. Method: A case-based psychotherapy design was used to explore maternal experiences among mothers of adults with ID and aggression who access a specialised mental health service in Cape Town. Psychotherapy was used with six participants to attempt to reduce parental stress and other negative psychological states. In an area of research that has received scant attention in South Africa, the study extensively describes the psychotherapy process and the role of contextual factors in the lives of the participating mothers. The study used a mixed methods design which included psychometric measurements that were conducted at various intervals of intervention. Thematic analysis was used in all the case studies and interviews were scheduled before and after completing psychotherapy. External credibility was enhanced through the use of different qualitative strategies that included peer supervision and reflexivity. Findings: Besides elevated parental stress, the majority of participants presented with symptoms of depression and other mental health problems that varied according to their individual profiles. Although parental stress showed a discernible relationship with the child's behavioural difficulties, other significant life stressors contributed to maternal stress and depressive symptoms. Psychotherapy produced only modest improvement of parental stress among some of the participants. However, therapeutic input appeared to be more effective in reducing depressive symptoms among the majority of mothers. Critical reflection and discussion are centred on the clinical implications and meaning of findings on a psychological level.

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