Contexts of Social Relationship Development Among Assertive Community Treatment Clients

Springer Science and Business Media LLC - Tập 5 - Trang 13-25 - 2003
Beth Angell1
1School of Social Service Administration, University of Chicago, Chicago

Tóm tắt

This exploratory qualitative study examined contexts and processes of social relationship development as experienced by adults with schizophrenia participating in assertive community treatment (ACT) programs. Semistructured interviews with 20 ACT clients diagnosed with schizophrenia-spectrum disorders and 2 ACT staff members were analyzed using grounded theory analysis methods. Results showed that aside from contacts with family members and providers, participants' interactions with fellow mental health clients tended to dominate social interactions, and that this pattern appeared to be influenced by both the concentration of social opportunities in daily activities of service utilization and the ACT program emphasis upon facilitating relationships between clients. Participants described their relationships with other mental health clients in primarily positive terms, yet several participants expressed dissatisfaction and desired greater integration into mainstream social networks. Implications for mental health service delivery are discussed.

Tài liệu tham khảo

Allan, G. (1989). Friendship: Developing a sociological perspective. Boulder, CO: Westview. Alverson, H., Alverson, M., & Drake, R. E. (2001). Social patterns of substance-use among people with dual diagnoses. Mental Health Services Research, 3, 3-14. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revised). Washington, DC: Author. Barrowclough, C., & Tarrier, N. (1990). Social functioning in schizophrenic patients. I: The effects of expressed emotion and family intervention. Social Psychiatry and Psychiatric Epidemiology, 25, 125-129. Bellack, A. S., & Mueser, K. T. (1993). Psychosocial treatment for schizophrenia. Schizophrenia Bulletin, 19, 317-336. Bott, E. (1957). Family and social network. London: Tavistock. Bowers, B. (1988). Grounded theory. In B. Sarter (Ed.), Paths to knowledge (pp. 33-59). New York: National League for Nursing Press. Brekke, J. S., & Mathiesen, S. G. (1995). Effects of parental involvement on the functioning of noninstitutionalized adults with schizophrenia. Psychiatric Services, 46, 1149-1155. Brown, C. (1996). A comparison of living situation and loneliness for people with mental illness. Psychiatric Rehabilitation Journal, 20, 59-63. Calsyn, R. J., Morse, G. A., Klinkenberg, W. D., Trusty, M. L., & Allen, G. (1998). The impact of assertive community treatment on the social relationships of people who are homeless and mentally ill. Community Mental Health Journal, 34, 579-593. Charmaz, K. (1983). The grounded theory method: An explication and interpretation. In R. Emerson (Ed.), Contemporary field research (pp. 109-126). Boston: Little, Brown. Clare, L., & Birchwood, M. (1998). Social adjustment of patients living at home. In K. T. Mueser & N. Tarrier (Eds.), Handbook of social functioning in schizophrenia (pp. 39-51). Boston: Allyn and Bacon. Cohen, C. I., & Sokolovsky, J. (1978). Schizophrenia and social networks: Ex-patients in the inner city. Schizophrenia Bulletin, 4, 546-560. Davidson, L., Chinman, M., Kloos, B., Weingarten, R., Stayner, D., & Tebes, J. K. (1999). Peer support among individuals with severe mental illness: A review of the evidence. Clinical Psychology: Science and Practice, 6, 165-187. Davidson, L., Haglund, K. E., Stayner, D., Raakfeldt, J., Chinman, M. J., & Tebes, J. K. (2001). 'It was just realizing...that life isn't one big horror': A qualitative study of supported socialization. Psychiatric Rehabilitation Journal, 24, 275-292. Davidson, L., Hoge, M. A., Merrill, M. E., Rakfeldt, J., & Griffith, E. E. H. (1995). The experiences of long-stay inpatients returning to the community. Psychiatry, 58, 122-132. Denoff, M. S., & Pilkonis, P. A. (1987). The social network of the schizophrenic: Patient and residential determinants. Journal of Community Psychology, 15, 228-244. Donahoe, C. P., Jr., & Driesenga, S. A. (1988). A review of social skills training with chronic mental patients. In M. Hersen, R. M. Eisler, & P. M. Miller (Eds.), Progress in behavior modification (Vol. 23, pp. 131-164). Newbury Park, CA: Sage. Edgerton, R. B. (1967). The cloak of competence: Stigma in the lives of the mentally retarded. Berkeley: University of California Press. Erickson, D. H., Beiser, M., Iacono, W. G., Fleming, J. A. E., & Lin, T. (1989). The role of social relationships in the course of first-episode schizophrenia and affective psychosis. American Journal of Psychiatry, 146, 1456-1461. Estroff, S. E. (1981). Making it crazy: An ethnography of psychiatric clients in an American community. Berkeley: University of California Press. Estroff, S. E. (1995). Whose story is it anyway? Authority, voice, and responsibility in narratives of chronic illness. In S. K. Toombs, D. Barnard, & R. A. Carson (Eds.), Chronic illness: From experience to policy (pp. 77-102). Bloomington: Indiana University Press. Feld, S. L. (1981). The focused organization of social ties. American Journal of Sociology, 85, 1015-1035. Feld, S. L. (1997). Structural embeddedness and the stability of interpersonal relations. Social Networks, 19, 91-95. Feld, S. L., & Carter, W. C. (1998). Foci of activity as changing contexts for friendship. In R. G. Adams & G. Allan (Eds.), Placing friendship in context (pp. 136-152). Cambridge: Cambridge University Press. Fischer, C. S. (1982). To dwell among friends: Personal networks in town and city. Chicago: University of Chicago Press. Gerstein, L. H., Bates, H. D., & Reindl, M. (1987). The experience of loneliness among schizophrenic and normal persons. Journal of Social Behavior and Personality, 2, 239-248. Glaser, B. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press. Glaser, B., & Strauss, A. (1967). The discovery of grounded theory. Chicago: Aldine. Glesne, C., & Peshkin, A. (1992). Becoming qualitative researchers. White Plains, NY: Longman. Glynn, S. M. (1998). Psychopathology and social functioning in schizophrenia. In K. T. Mueser & N. Tarrier (Eds.), Handbook of social functioning in schizophrenia (pp. 66-78). Boston: Allyn and Bacon. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall. Gouldner, A. W. (1960). The norm of reciprocity: A preliminary statement. American Sociological Review, 25, 161-178. Green, M. F., Kern, R. S., Braff, D. L., & Mintz, J. (2000). Neurocognitive deficits and functional outcome in schizophrenia: Are we measuring the 'right stuff?' Schizophrenia Bulletin, 26, 119-136. Greenberg, J. S. (1995). The other side of caring: Adult children with mental illness as supports to their mothers in late life. Social Work, 40, 414-424. Halford, W. K., & Hayes, R. (1991). Psychological rehabilitation of chronic schizophrenic patients: Recent findings on social skills training and family psychoeducation. Clinical Psychology Review, 11, 23-44. Herman, N. J. (1987). “Mixed nutters” and “looney tuners:” The emergence, development, nature, and functions of two informal, deviant subcultures of chronic, ex-psychiatric patients. Deviant Behavior, 8, 235-258. Herman, N. J. (1993). Return to sender: Reintegrative stigma-management strategies of ex-psychiatric patients. Journal of Contemporary Ethnography, 22, 295-330. Hogarty, G. E., McEvoy, J. P., Munetz, M., Di Barry, A. L., Bartone, P., Cather, R., et al. (1988). Dose of fluphenazine, familial expressed emotion, and outcome in schizophrenia. Archives of General Psychiatry, 45, 797-805. Holmes-Eber, P., & Riger, S. (1990). Hospitalization and the composition of mental patients' social networks. Schizophrenia Bulletin, 16, 157-164. Horwitz, A. V., Reinhard, S. C., & Howell-White, S. (1996). Caregiving as reciprocal exchange in families with seriously mentally ill members. Journal of Health and Social Behavior, 37, 149-162. Jackson, R. L. (2001). The clubhouse model: Empowering applications of theory to generalist practice. Belmont, CA: Wadsworth. Lally, S. J. (1989). “Does being in here mean there's something wrong with me?” Schizophrenia Bulletin, 15, 253-265. Lehman, A. L., Ward, N. C., & Linn, L. S. (1982). Chronic mental patients: The quality of life issue. American Journal of Psychiatry, 139, 1271-1276. Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA: Sage. Link, B. G., Cullen, F. T., Streuning, E., Shrout, P. E., & Dorhenwend, B. P. (1989). A modified labeling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54, 400-423. Lipton, F. R., Cohen, C. I., Fischer, E., & Katz, S. E. (1981). Schizophrenia: A network crisis. Schizophrenia Bulletin, 7, 144-151. Mandiberg, J. M. (1999). The sword of reform has two sharp edges: Normalcy, normalization, and the destruction of the social group. In M. Wasow (Ed.), Speculative interventions for helping people with serious mental illness. New Directions for Mental Health Services (Vol. 83, pp. 31-44). San Francisco: Jossey-Bass. Marshall, M., & Lockwood, A. (1998). Assertive community treatment for people with severe mental disorders. In C. Adams, C. Anderson, & J. De Jesus Mari (Eds.), Schizophrenia Module of the Cochrane Database of Systematic Reviews. London: The Cochrane Library, BMJ Publishing Group. Meeks, S., & Murrell, S. A. (1994). Service providers in the social networks of clients with severe mental illness. Schizophrenia Bulletin, 20, 399-406. Mueser, K. T., Bond, G. R., Drake, R. E., & Resnick, S. (1998). Models of community care for severe mental illness: A review of research on case management. Schizophrenia Bulletin, 24, 37-94. Nelson, G., Hall, G. B., & Walsh-Bowers, R. (1997). A comparative evaluation of supportive apartments, group homes, and board-and-care homes for psychiatric consumer/survivors. Journal of Community Psychology, 25, 167-188. Pascaris, A. (1991). Social recreation: A blind spot in rehabilitation? Psychosocial Rehabilitation Journal, 15, 43-54. Patai, D. (1991). U.S. academics and third world women: Is ethical research possible? In S. B. Gluck & D. Patai (Eds.), Women's words: The feminist practice of oral history (pp. 137-153). New York: Routledge. Pattison, E. M., DeFrancisco, D., Wood, P., Frazier, H., & Crowder, J. (1975). A psychosocial kinship model for family therapy. American Journal of Psychiatry, 132, 1246-1251. Pescosolido, B. A. (2001). The role of social networks in the lives of persons with disabilities. In G. L. Albrecht, K. D. Seelman, & M. Bury (Eds.), Handbook of disability studies (pp. 468-489). Thousand Oaks, CA: Sage. Phillips, S. D., Burns, B. J., Edgar, E. R., Mueser, K. T., Linkins, K. W., Rosenheck, R. A., et al. (2001). Moving assertive community treatment into standard practice. Psychiatric Services, 52, 771-779. Randolph, E. T. (1998). Social networks and schizophrenia. In K. T. Mueser & N. Tarrier (Eds.), Handbook of social functioning in schizophrenia (pp. 238-246). Boston: Allyn and Bacon. Salem, D. A., Seidman, E., & Rappaport, J. (1988). Community treatment of the mentally ill: The promise of mutual help organizations. Social Work, 33, 403-408. Segal, S. P., & Holschuh, J. (1991). Effects of sheltered care environments and resident characteristics on the development of social networks. Hospital and Community Psychiatry, 42, 1125-1131. Smith, J., Birchwood, M., Cochrane, R., & George, S. (1993). The needs of high and low expressed emotion families. Social Psychiatry and Psychiatric Epidemiology, 28, 11-16. Strauss, A. S. (1987). Qualitative analysis for social scientists. Cambridge: Cambridge University Press. Strauss, J. S., & Estroff, S. E. (1989). Subjective experience of schizophrenia [Issue theme]. Schizophrenia Bulletin, 15(2). Tanzman, B. (1993). An overview of surveys of mental health consumers' preferences for housing and support services. Hospital and Community Psychiatry, 44, 450-455. Test, M. A. (1992). The training in community living model. In R. P. Liberman (Ed.), Handbook of psychiatric rehabilitation (pp. 153-170). New York: Macmillan. Test, M. A., Knoedler, W. H., Allness, D. J., Burke, S. S., Kameshima, S., & Rounds, L. (1997). Comprehensive community care of persons with schizophrenia through the Programme of Assertive Community Treatment (PACT). In H. D. Brenner, W. Boker, & R. Genner (Eds.), Towards a comprehensive therapy for schizophrenia (pp. 167-180). Seattle, WA: Hogrefe & Huber. Thompson, K. S., Griffith, E. E. H., & Leaf, P. J. (1990). A historical review of the Madison model of community care. Hospital and Community Psychiatry, 4, 625-641. Tolsdorf, C. C. (1977). Social networks, support, and coping: An exploratory study. Family Process, 15, 407-417. Vaughn, C. (1986). Patterns of emotional response in the families of schizophrenic patients. In M. J. Goldstein, I. Hand, & K. Hahlweg (Eds.), Treatment of schizophrenia: Family assessment and intervention (pp. 76-78). Berlin: Springer-Verlag. Wisconsin Administrative Code HSS 63. (1989, April). Community Support Programs for Persons with chronic mental illness. Department of Health and Social Services, Wisconsin.