Albers Wendy M M, Roeg Diana P K, Nijssen Yolanda A M, Deen Mathijs L, Bongers Inge M B, van Weeghel Jaap
Tilburg University.
Parnassia Group Academy.
Psychiatr Rehabil J. 2021 Sep;44(3):254-265. doi: 10.1037/prj0000449. Epub 2021 May 6.
Individuals with severe mental illness often face (anticipated) discrimination and (criminal) victimization, which have severe consequences for their social participation. The aim of the present study is to assess the effectiveness of a new intervention to manage and prevent revictimization, and to support safe participation by recognizing and acknowledging the impact of their victimization experiences.
A multicenter cluster randomized controlled trial was performed by following clients from four intervention teams and four teams providing care as usual. The primary outcomes were social participation, victimization, and discrimination. The secondary outcomes were acknowledgment of difficulties, self-efficacy and empowerment, quality of life, and psychosocial functioning. Data were collected at baseline, and after 10- and 20-month follow-ups. The data were analyzed according to the intention-to-treat principle using linear mixed models and generalized estimating equations. In total, 400 clients were included in the analyses: 216 in the intervention group and 184 in the control group.
For experienced discrimination and acknowledgment of difficulties and recovery support, we found small but significant time by condition interactions after 20 months. Both experienced and anticipated discrimination, and self-efficacy increased slightly in both groups. No significant differences were found for other outcome measures.
The intervention had no effect on victimization and participation, but there were indications that it was successful in moderating experienced discrimination. The clients also felt significantly more acknowledged and supported in their recovery process. Further development of the intervention is needed, and future research should focus on improving implementation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
患有严重精神疾病的个体常常面临（预期的）歧视和（刑事）受害情况，这对他们的社会参与产生严重后果。本研究的目的是评估一种新的干预措施在管理和预防再次受害方面的有效性，并通过认识和承认其受害经历的影响来支持安全参与。
进行了一项多中心整群随机对照试验，跟踪来自四个干预小组和四个照常提供护理的小组的客户。主要结果是社会参与、受害情况和歧视。次要结果是对困难的认识、自我效能感和赋权、生活质量以及心理社会功能。在基线、10个月和20个月随访后收集数据。根据意向性分析原则，使用线性混合模型和广义估计方程对数据进行分析。总共有400名客户纳入分析：干预组216名，对照组184名。
对于经历的歧视以及对困难和康复支持的认识，我们在20个月后发现了微小但显著的条件与时间交互作用。两组中经历的和预期的歧视以及自我效能感均略有增加。其他结果指标未发现显著差异。
该干预措施对受害情况和参与没有影响，但有迹象表明它在减轻经历的歧视方面是成功的。客户在康复过程中也明显感到得到了更多的认可和支持。需要进一步发展该干预措施，未来的研究应侧重于改善实施情况。（PsycInfo数据库记录（c）2021美国心理学会，保留所有权利）
