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Culturally Responsive Person-Centered Care for Psychosis

Yale University logo

Yale University

Status and phase

Completed
Phase 1

Conditions

Psychotic Disorders

Treatments

Behavioral: Person-centered planning (PCP)
Behavioral: Community integration (CI)
Behavioral: Illness management recovery (IMR)

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT00231933
DSIR 82-SESC
0502027488
R01MH067687 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

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.

Full description

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.

Enrollment

290 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Of Hispanic and/or African origin
  • DSM-IV diagnosis of an axis I psychotic disorder (e.g., schizophrenia, schizoaffective disorder, or bipolar disorder with psychotic features)

Exclusion criteria

  • N/A

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

290 participants in 3 patient groups

1
Active Comparator group
Description:
Participants will receive standard care incorporating illness management recovery
Treatment:
Behavioral: Illness management recovery (IMR)
2
Experimental group
Description:
Participants will receive illness management recovery plus person-centered planning
Treatment:
Behavioral: Illness management recovery (IMR)
Behavioral: Person-centered planning (PCP)
3
Experimental group
Description:
Participants will receive illness management recovery plus person-centered planning and community integration
Treatment:
Behavioral: Illness management recovery (IMR)
Behavioral: Community integration (CI)
Behavioral: Person-centered planning (PCP)

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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