Training Skills in the Psychiatrically Disabled: Learning Coping and Competence

Abstract

Social skills training methods represent a major strategy for psychiatric rehabilitation. Building skills in patients with schizophrenic and other major mental disorders is based on the assumption that coping and competence can override stress and vulnerability in reducing relapses and improving psychosocial functioning. For maximum efficiency, skills training needs to incorporate procedures and principles of human learning and information processing. Several models for skills training have been designed and evaluated, each of which has proved to be effective in raising the social competence of chronic mental patients. The "basic" model involves role playing by the patient and modeling, prompting, feedback, and reinforcement by the therapist. A "problem-solving" model of training provides general strategies for dealing with a wide variety of social situations. This model uses role playing to enhance behavioral performance but also highlights the patient's abilities to perceive and process incoming social messages and meanings. It is essential that social skills training be imbedded in a comprehensive program of rehabilitation that features continuity of care, supportive community services, therapeutic relationships, and judicious prescription of psychotropic drugs.

The Relationship Between Provider Competence, Content Exposure, and Consumer Outcomes in Illness Management and Recovery Programs

“…The construct was assessed with the client-rated Illness Management and Recovery Scale (IMR Scale; Mueser et al, 2004). The IMR Scale was developed specifically to measure illness self-management outcomes and is based on the stress-vulnerability model (Liberman et al, 1986;Zubin & Spring, 1977). The IMR Scale has 15, Likert scale 5-point items.…”

Determinants of functioning and well-being among individuals with schizophrenia: An integrated model

“…This model did not specify how these factors may further influence social functioning and well-being in schizophrenia, which are the focus of the current analysis, but stated that the impact of vulnerability and stress factors on these outcomes deserved "separate evaluation" (Nuechterlein & Dawson, 1984, p. 308). Liberman (1988) and Liberman et al (1986) later expanded on the Vulnerability-Stress model by describing factors affecting social competence outcomes for schizophrenia and highlighting the importance of "psychobiological vulnerability," "socioenvironmental stressors" and "protective factors" (including social support and coping resources). We build on this model here by placing greater emphasis on the distinction between enduring and transitory environmental characteristics (both supportive and stressful ones), considering the distinction between coping style and coping strategies in more detail, and focusing on a broader range of personal and cognitive appraisal factors.…”

Outcomes of a Life Skills Intervention for Homeless Adults with Mental Illness

“…Situated learning allows for (1) client choice and involvement to address those skills the individual wants and needs to learn, (2) didactic learning with modeling and practice in a context preferred by the individual, (3) evaluation of the skill in a specific context to identify barriers and supports needed to be successful in the skill, and 4) an individualized process that considers the individual's level of functioning. This approach has been used to teach social skills but not to implement or evaluate life skills interventions in relation to homeless persons with mental illness developing the skills to maintain housing (Liberman and Kopelowicz 2002;Liberman et al 1986;Wallace 1998;Wong et al 1988).…”