Level of psychological functioning as a predictor of psychiatric rehabilitation outcome.

Traditional psychological measures, diagnostic levels, and biographical and demographic data have all failed as reliable predictors of the outcome for clients in psychiatric rehabilitation programs. An instrument called the Client Adjustment Rating Scales is an attempt to develop a reliable indicator; it consists of nine subscales on which client's attitudes and behaviors in such psychosocial areas as motivation, self-concept, and family functioning can be rated by clinicians. Analysis of the ratings of 89 clients from Horizon House, a community-based psychiatric rehabilitation program in Philadelphia, shows that those who successfully complete rehabilitation programs have higher (more positive) scores on the scales, while program dropouts have lower scores. The authors conclude that after further testing the CARS may be used both as a reliable predictor of client outcome and as a tool for planning rehabilitation programs.