Psychology, Department of


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A DISSERTATION Presented to the Faculty of The Graduate College at the University of Nebraska In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy, Major: Psychology (Interdepartmental Area of Clinical Psychology), Under the Supervision of Professor William D. Spaulding. Lincoln, Nebraska: May, 2010
Copyright 2010 Robert W. Johnson


This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review process, program evaluations were conducted at five programs that reflected the diversity found in mental health systems. Service programs represented points on a continuum of services for an adult SMI population, varying by location, setting, security, service provision, and estimated levels of psychiatric rehabilitation and recovery-oriented services. Investigators assessed program organization, policy and procedures, fidelity to policies and procedures, and outcome.

Overall, the CIMHRRS demonstrated excellent internal consistency across all subjectively rated items and good to excellent internal consistency within each subjectively rated domains. The CIMHRRS demonstrated excellent interrater agreement and reliability and demonstrated an ability to differentiate qualitative dimensions of the various programs. The results indicate the CIMHRRS is a practical, reliable instrument for program evaluation and services research. It is expected to be especially valuable for studying the characteristics of psychiatric rehabilitation, recovery and related approaches to determine their impact on clinical outcome.