Schizophrenia Clinical Trial
Official title:
Improving Representative Payeeship for People With Psychiatric Disabilities and Their Families
Representative payees, mostly family members, manage Social Security Administration funds of
more than one million people with psychiatric disabilities. Although studies show payeeship
can be used coercively, foster dependency, reduce work incentives, lead to family conflict
and even violence, there has been little systematic research on how to lower these
significant barriers to community integration.
The investigators' long term goal is to promote recovery among adults with psychiatric
disabilities who have payees by reducing downsides associated with what has been called "the
nation's largest guardianship system." The investigators' objective in the current
application is to evaluate a pilot-tested, stakeholder-informed intervention that is grounded
in principles of psychiatric rehabilitation and encourages consumers with psychiatric
disabilities and their family members to collaborate within the representative payee
arrangement.
To do this, we will test the Steps for Achieving Financial Empowerment (SAFE) intervention by
randomly assigning N=200 consumer-family payee dyads into one of two groups: (a) the SAFE
intervention (n=100); or (b) a "usual care" control (n=100). The SAFE is a brief, 5 component
educational intervention that aims to facilitate a cooperative consumer-payee relationship,
increase accurate knowledge about representative payeeship, promote collaborative money
management and effective budgeting, and prepare mutually developed plans for carrying out the
payeeship in the future.
We will interview people with psychiatric disabilities and their family payees at baseline
and six-months. This study aims to examine the effects of the SAFE intervention on community
participation, employment, and family support of adults with psychiatric disabilities who
have family representative payees. Our central hypothesis, based on strong preliminary data,
is that the SAFE will benefit consumers by enhancing autonomy, boosting motivation to work,
and reducing family conflict.
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