Early lapsing is highly related to ultimate relapse, and lapsing in frequently experienced contexts seemed most strongly linked with progression to full relapse.

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Purpose:The purpose of this study was to validate the Vocational Rehabilitation Engagement Scale (VRES) for use in the Clubhouse Model of Psychosocial Rehabilitation.Method:There were 124 individuals with serious mental illness recruited from 8 Clubhouse programs in Hawaii. Measurement structure of the VRES was evaluated using exploratory factor analysis.Results:Exploratory factor analysis of the Clubhouse version of the VRES yielded 2 reliable factors (cognitive-affective engagement and behavioral engagement). Both the cognitive-affective engagement and behavioral engagement factors were found to correlate with other self-determination theory constructs including autonomy support, relatedness, and outcome expectancy.Conclusions:The Clubhouse version of the VRES is a brief, reliable, and valid instrument for assessing vocational rehabilitation (VR) engagement and contributes to the use of self-determination as a paradigm for improving recovery outcomes in psychiatric rehabilitation.

Diabetes mellitus is a group of metabolic disorders characterized by impaired blood glucose regulation. For most individuals with diabetes, the condition is chronic, and it can lead to severe health complications if not managed effectively. This chapter begins with a review of the biological, psychological, and social aspects of diabetes. The chapter then describes the key facets of comprehensive diabetes self-management, providing a review of current literature on health promotion and self-care behaviors for individuals with diabetes. Unique considerations for type 1 diabetes mellitus and type 2 diabetes mellitus are described when relevant. The chapter then concludes with a discussion of existing research on diabetes self-management interventions.