School of Social Policy and Practice, University of Pennsylvania, 3815 Walnut Street, Philadelphia, PA 19104-6214, USA.
Community Ment Health J. 2010 Oct;46(5):486-93. doi: 10.1007/s10597-010-9326-0. Epub 2010 Jun 12.
Following a randomized trial of case manager delivered HIV prevention intervention to persons with severe mental illness (SMI), this study sought to document changes within the service environment and with case managers themselves as a result of their experience and skills training. Utilizing qualitative methods, researchers conducted focus groups and in-depth interviews with 22 case managers and 3 administrators at an urban community mental health center. Beyond confirming previously established barriers to case manager delivery of HIV prevention interventions for persons with SMI, most noteworthy was the finding that case managers were generally unskilled in conducting assessments and tended to focus on "spoiled identity" and illness parts of their consumers. Experimental case managers revealed that they had been transformed by the training experience in a manner permitting them to both understand and work from a recovery model. Implications and directions for further study are discussed.
在对患有严重精神疾病 (SMI) 的人进行案例管理员提供的 HIV 预防干预的随机试验之后，本研究旨在记录服务环境内部的变化，以及案例管理员自身因经验和技能培训而发生的变化。研究人员采用定性方法，在城市社区心理健康中心对 22 名案例管理员和 3 名管理人员进行了焦点小组和深入访谈。除了证实先前确定的案例管理员为 SMI 患者提供 HIV 预防干预的障碍之外，最值得注意的是发现案例管理员通常不具备进行评估的技能，并且倾向于关注其消费者的“受损身份”和疾病部分。实验性案例管理员透露，他们通过培训经验发生了转变，从而使他们既能够理解又能够从恢复模式入手。讨论了对进一步研究的影响和方向。
