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The implementation of a psychosocial rehabilitation program at Hawaii state hospital
The purpose of the present research study was to examine the effectiveness of a new psychosocial rehabilitation program, based on principles of social learning theory, that was implemented at a state psychiatric hospital in Hawaii. The program incorporated elements that have been shown to be effective in psychiatric rehabilitation programs, including program-based lines of authority, psychoeducational groups and classes, individualized behavior management plans, a computerized clinical data tracking system, a token economy, and a level system that provides patients with increased privileges and responsibility. The program was implemented on two units at the state hospital, while two other units served as controls. The present study hypothesized that the program would produce desirable changes in staff attitudes and skills, patient functioning, and unit programming. Data were collected at baseline and at 5- and 10-month follow-ups. The results of the study indicated that the program produced some of the expected results, although it happened to different degrees on the two units. Specifically, changes were seen in the amount of unit programming, patient attendance at groups and classes, the quality of behavior management plans, characteristics of the ward atmosphere, and the number of needs and problems on one of the units. Staff in the program also displayed greater knowledge of behavioral principles compared to staff on other units. Nonsignificant reductions in the level of violence and the number of seclusions and restraints were also noted for one of the units. No changes were seen on measures of staff burnout, perceived organizational support, or acceptance of principles of social learning theory. Possible explanations for the differences between the two units as well as larger issues in state hospital reform are discussed. ^
Buican, Brett James, "The implementation of a psychosocial rehabilitation program at Hawaii state hospital" (2001). ETD collection for University of Nebraska - Lincoln. AAI3016305.