The Three R's Rehabilitation Program: A prevention approach for the management of relapse symptoms associated with psychiatric diagnoses.

Abstract

C on cern h a s b e e n e x p ressed th a t th e life tim e c a r e n e ed s o f m any p e o p le w ith p s y c h ia tric d is a b ilitie s su ch a s sch izop h ren ia, m a jo r d e p re s sion , a n d th e b ip o la r spectru m d is o r d e r s w ill le a d th e h e a lth c a r e in du stry in to ban kru ptcy. A pproxim ately 3 .3 m illion a d u lts 18 y e a r s o f a g e o r o ld e r in th e c iv ilia n , n on -in stitu tion alized U nited S tates p o p u la tio n h a v e a serio u s p s y c h ia tric d is a b ility d u rin g an y 12-m onth p e r io d . This p r ev a le n c e rep resen ts a r a t e o f 18.2 a d u lts p e r 1 000p erso n s, o r 41 m illion ad u lts. An ep id em io lo g y c a l c o n tr o lle d c a s e d esig n o f fin d in g s r e la t e d to 88 p a tie n ts d ia g n o se d with e ith e r sch iz o p h ren ia o r a m o od d is o r d e r w as co n d u cted to e v a lu a te i f e n r o ll m en t in a 12-session co u rse d e sig n ed to sim u ltan eou sly tr e a t p a tien ts, fa m ilie s , a n d p r o v id e r s w ou ld resu lt in a d e c r e a s e in in p a tien t days. When c o m p a red to a ra n d o m iz ed m a tch ed c o n tro l grou p , th e trea tm en t g rou p d e c r e a s e d fr o m a p retrea tm en t a v e r a g e o f 5 7 d a y s p e r 2 y e a r s p e r p a tie n t to 3 .8 d a y s p e r 2 y e a r s p e r p a tie n t. A co n serv a tiv e estim a te o f 2 1 7 3 .6 in p a tien t d ay s w ere s a v e d f o r th e study c o h o rt o v e r a 2 -y ea r tim e p e r io d . E stim ated sav in g s fr o m th is d e c r e a s e w as $1,086,800. R esults w ere s ig n ifica n t a t th e p = < 0 0 2 lev el. E arly id e n tific a tio n o f r e la p s e e ffe c ts a g r e a te r r e la p s e p rev en tio n r a t e th an th ose p rev iou sly r e p o r te d in th e litera tu re. U sual a n d cu stom ary d e c r e a s e in in p a tien t d a y s a ttr ib u te d to c a p ita tio n is 40%. The T hree R 's R e h a b ilita tio n P rogram d e c r e a s e d p s y c h ia tric in p a tien t d a y s 93-5% f o r th is coh ort.I n t r o d u c t i o n C o n c e rn has been expressed that the lifetime care needs of many persons diagnosed with psychiatric disabilities such as schizophrenia, major depres sion, and the bipolar spectrum disor ders will lead the health care industry into bankruptcy. An estimated 257,446 multiple-episode patients were dis charged from short-stay inpatient units

The BE SMART Trauma Reframing Psychoeducation Program

“…In 1999, a pilot group psychoeducational group program based on the Three R's Psychiatric Wellness Rehabilitation Program (Moller & Murphy, 1997;Murphy & Moller, 1996) was conducted in two independent nurse-managed outpatient clinics. The goal of the pilot program was to develop a curriculum that would specifically address interventions to promote wellness for those living with the aftermaths of trauma and abuse.…”

Recovery Paradigm: Confession of the Unenlightened

“…Of course nurses have worked with recovery/personcentered care concepts via initiatives aimed to create coercion free work place environments (National Technical Assistance Center, 2005) and the development of illness management programs (Buccheri, in press;Moller & Murphy, 1997). In the 1990s there was also interest in a related concept, psychosocial rehabilitation, and how nurses might work within this field (e.g., Donegan & Palmer-Erbs, 1998).…”

The Recovery Movement: Defining Evidence-Based Processes

“…The Three-R Program of Moller and Murphy (1997) also addresses recovery as well as symptom monitoring and building coping strategies. Finally, the Recovery and Monitoring Model of Warren and Lutz (2000) is ground in recovery with inclusion of strategies for symptom monitoring and management.…”