Complex Posttraumatic Stress Disorder and Rehabilitation Counseling

PurposeComplex posttraumatic stress disorder (CPTSD) is a multifaceted disorder, and the specific diagnostic criteria developed by the World Health Organization (WHO), which highlight symptoms of CPTSD (i.e., affect dysregulation, negative self-concept, disturbed relationships), that occur along with PTSD symptoms speak to this. Understanding the disorder itself and its ramifications is essential as our society is exposed to seemingly more and more traumatic and long-lasting events, all of which may lead to an increase in the number of overall cases. CPTSD is characterized by changes in three primary areas of the brain – hippocampus, amygdala, and medial prefrontal cortex (mPFC)– which are usually smaller in individuals with CPTSD, and there are certain subsets of individuals who have an increased likelihood of developing this disorder (e.g., individuals with physical and psychiatric disabilities, children exposed to long-term trauma).MethodThe authors conducted a scoping literature review on CPTSD, treatment approaches for individuals with CPTSD, and rehabilitation implications.ResultsTreatment for CPTSD is generally more extensive than treatment for PTSD and should be made available for those in need. There is a dearth of research on this topic in the rehabilitation literature; however, disability research has consistently shown that employment plays a huge role in successful recovery among individuals with psychiatric disabilities, which includes CPTSD.ConclusionIn order to ensure client success, rehabilitation counselors, educators, and researchers must understand the complexities associated with CPTSD and then how to best go about incorporating this information into individual plans for employment and our classrooms as well as making research in this area a priority for the field.

Fringe or Not Fringe? Strategies for Localizing Supported Accommodation in a Post‐Deinstitutional Era

Finding suitable locations for supported accommodations is crucial both for the wellbeing of individuals with psychiatric disabilities (PD) and to achieve the objectives of the mental health care reform in order to create opportunities for social inclusion. This article explores municipal strategies for localizing supported accommodations for people with PD. In a multiple case study, interviews with 20 municipal civil servants from social services and urban planning were conducted. Three strategies were identified and further analyzed with a public location theory approach: (1) re‐use, i.e., using existing facilities for a new purpose, (2) fill‐in, i.e., infilling new purpose‐built facilities in existing neighborhoods, and (3) insert, i.e., inserting new premises or facilities as part of a new development. The article shows that the “re‐use” strategy was employed primarily for pragmatic reasons, but also because re‐using former care facilities was found to cause less conflicts, as residents were supposedly used to neighbors with special needs. When the “fill‐in” and “insert” strategies were employed, new accommodations were more often located on the outskirts of neighborhoods. This was a way to balance potential conflicts between residents in ordinary housing and residents in supported accommodations, but also to meet alleged viewpoints of service users’ need for a quiet and secluded accommodation. Furthermore, ideas associated with social services’ view of social inclusion and urban planning’s notion of “tricky” tenants significantly influenced localization strategies. Finally, this article is also a call for more empirical research on the decision‐making processes, use of strategies (intended or not) and spatial outcomes, when localizing supported accommodation for people with PD and other groups in need of support and service.

Correlates of community rehabilitation service utilization among persons with psychiatric disabilities

Background: The use community psychiatric rehabilitation (CPR) service could facilitate community tenure, autonomy, and recovery among persons with psychiatric disabilities. Nevertheless, based on existing scientific evidence, the conformance rate with the treatment recommendations was modest and the existing services are underutilized in Taiwan. Aims: This study examined the correlates of CPR service utilization based on the Behavioral Model of Health Service Utilization. Especially, the effects of enabling factors were explored. Methods: Five hundred and ninety-two participants from 32 community psychiatric rehabilitation centers in Taiwan completed the questionnaire. There were three groups of independent variables: predisposing, enabling, and need factors. Multiple regression analysis with a hierarchical method of entry was performed. Results: The hypothesized model was significant. Eight independent variables in the model explained 29.3% of the variances in the service utilization. Three enabling factors were significant after controlling for the effects of other factors. The most important correlate was professional relationships followed by family support and welfare subsidy. Conclusions: The findings support that factors associated with CPR service utilization need to be examined separately from general mental health service. CPR program design and service delivery should consider the three most important enabling factors and the extent of service utilization could be enhanced.

Barriers and facilitators to requesting accommodation among individuals with psychiatric disabilities: A qualitative approach

BACKGROUND: Employees with psychiatric disabilities experience a great amount of workplace challenges such as lacking workplace supports and job accommodations. There is a lack of research surrounding job accommodations for persons with psychiatric disabilities within the United States. Thus, research is warranted to understand how to meet the needs of this population via accommodations. OBJECTIVE: This study examined barriers and facilitators to requesting accommodations among employees with psychiatric disabilities through a qualitative approach. METHODS: This study recruited 120 participants from multiple agencies serving individuals with psychiatric disabilities in the United States. Themes regarding barriers and facilitators were identified using the conventional content analysis approach. RESULTS: The most commonly identified themes were employees’ fear and anxiety negatively impacting accommodation seeking behaviors, employer discrimination and non-inclusive workplace culture, and employers lack knowledge of disabilities and ADA. Participants also identified positive experiences in requesting accommodations. CONCLUSION: Rehabilitation professionals and employers may utilize current findings, facilitate a positive and inclusive workplace environment and assist employees with disabilities to take full advantage of workplace resources and job accommodation to exert their potentials.

The importance of keeping a social perspective during pandemic times: Social psychiatry in Sweden

We discuss the pandemic strategies in Sweden concerning social psychiatry during the first wave. We argue that the omission of social workers’ perspective in the COVID-19 strategy has negatively impacted clients with psychiatric disabilities and has also weakened the overall pandemic strategy.

Benefits and Challenges to People with Psychiatric Disabilities Who Volunteer

This research follows from the research reported in CVSS Working Paper Series, Volume 2007 (2). In that paper we presented the results of our examination of volunteer programs in ten organizations serving people with psychiatric disabilities2. We described the nature of the programs, identified best practices and discussed the challenges and benefits they presented. This paper focuses on the responses of 27 people with psychiatric disabilities to a questionnaire probing their volunteering experiences. Please refer to the previous CVSS Working Paper titled “Client Volunteering in Organizations Serving Individuals with Psychiatric Disabilities” for a detailed review of the literature. Here we will briefly summarize the major thrust of the literature review. Keywords: CVSS, Centre for Voluntary Sector Studies, Working Paper Series,TRSM, Ted Rogers School of Management Citation: