Psychotic Disorders Clinical Trial
Official title:
Culturally-responsive, Person-centered Care for Psychosis
This study will compare standard individualized care to person-centered care and community-integrating care for treating psychosis in adults of Hispanic or African descent.
Patient-centered care is a type of customized mental health care that is based on each
individual's needs, values, and preferences. This type of care has become increasingly
important, especially for members of ethnic minorities. However, although this type of care
is, in theory, more effective than standard, less personalized care in treating psychotic
disorders, there is a significant gap between theory and practice. Research has shown that
this gap is particularly evident in the treatment of psychotic disorders in individuals of
ethnic backgrounds. This study will address these disparities by comparing the effectiveness
of standard individualized care versus person-centered care and community-integrating care in
treating psychosis in adults of Hispanic and African descents.
This open-label study will consist of two phases. In Phase I, interview data on
self-management of mental illness and treatment seeking behaviors will be collected and
analyzed. In Phase II, participants from two urban mental health centers will be randomly
assigned to receive one of three treatment combinations: standard care incorporating illness
management recovery (IMR); IMR plus person-centered planning (PCP); or IMR plus PCP and
community integration (CI). IMR will focus on nine topic areas: recovery strategies; facts
about psychosis; a stress-vulnerability model; building social support; reducing relapses;
effective use of medications; coping with stress; coping with problems or symptoms; and
meeting health care needs. PCP will aid participants in discovering a vision of a desirable
future and developing a plan for achieving that goal. Techniques will include providing
direction in the planning process, involving significant others, generating focus on assets
and capacities, identifying and providing access to integrated community settings, and
promoting acceptance of setbacks as part of the path to success. CI will include recovery
group sessions and community integration activities. Recovery groups will consist of 10 to 12
people per group, and will aid participants in asserting the skills they learned in IMR and
PCP. Community integration activities will entail a variety of excursions and social and
recreational activities in the community to promote community involvement and acquisition of
social roles. All treatments will last a total of 6 months. Assessments of psychiatric
symptoms, social functioning, quality of life, and community integration will occur at Month
6 and at a follow-up visit at Month 18.
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