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  • 51. Mowbray, C. T
    et al.
    Holter, Mark
    Bellamy, C
    Stark, L
    Initial Results from the Assessing Consumer-Centered Services (ACCS) Survey: What Do They Mean and How to Use The Results for Your Program2003Conference paper (Other academic)
  • 52. Mowbray, C. T
    et al.
    Holter, Mark
    Bybee, D
    Assessing Consumer-Centered Mental Health Services: Predicting Membership Differences in Drop-Ins Versus Clubhouses2006Conference paper (Refereed)
  • 53. Mowbray, C. T
    et al.
    Holter, Mark
    Stark, L
    Bellamy, C
    Lewandowski, L
    MacFarlane, P
    McCracken, K
    Workshop: ACCS, Finding the keys to Consumer-Run Programs: Critical Ingredients and Fidelity Criteria2004Conference paper (Other academic)
  • 54. Mowbray, C. T
    et al.
    McCracken, K
    Mowbray, O
    Holter, Mark
    Consumer Drop-In Centers: A State-wide Study2003Conference paper (Other academic)
  • 55.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Bybee, Deborah
    Michigan State University.
    Holter, Mark
    University of Michigan.
    Lewandowski, Lisa
    University of Michigan.
    Validation of a fidelity rating instrument for consumer-operated services2006In: American Journal of Evaluation, ISSN 1098-2140, E-ISSN 1557-0878, Vol. 27, no 1, p. 9-27Article in journal (Refereed)
    Abstract [en]

    With the emphasis on the use of evidence-based practices has come a need to measure the fidelity of replications to the operations and principles of original models. Recent reviews have focused on methods to develop fidelity measures for evidence-based program models. However, the issue of how to validate such measures has been given scant attention. The research reported here attempted to validate a fidelity rating instrument (FRI) for consumer-operated drop-in centers on the basis of convergent validation methods. That is, fidelity ratings by trained observers were validated in relation to reports about similar concepts from the users of the centers. The authors describe their methods and present results indicating that all but 4 of 14 fidelity variables from the FRI were validated, as hypothesized. The authors discuss the success of this approach as well as its limitations and identify issues in the further development of fidelity measures. 

  • 56.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Grazier, Kyle L
    University of Michigan.
    Holter, Mark
    University of Michigan.
    Managed behavioral health care in the public sector: Will it become the third shame of the states?2002In: Psychiatric Services, ISSN 1075-2730, E-ISSN 1557-9700, Vol. 53, no 2, p. 157-170Article in journal (Refereed)
    Abstract [en]

    Managed behavioral health care is increasingly being used in public mental health systems. While supporters cite potential benefits, critics describe dire consequences for individuals with serious, long-term mental illness. The situation has parallels with the major changes resulting from deinstitutionalization some four decades ago. Believing that analyzing history may prevent repeating some of its mistakes, the authors compare the antecedents, benefits, and negative effects of deinstitutionalization with those of the public-sector managed behavioral health care systems being developed today. Lessons learned from the earlier era include the need for careful general and technical planning; for assignment of responsibility, including monitoring, to the public sector; and for a focus on clients and the special needs generated by severe mental illnesses.

  • 57. Mowbray, Carol T
    et al.
    Holter, Mark
    University of Michigan.
    Fidelity Criteria: Development, Measurement, and Validation2003In: American Journal of Evaluation, ISSN 1098-2140, E-ISSN 1557-0878, Vol. 24, no 3, p. 315-340Article in journal (Refereed)
    Abstract [en]

    Fidelity may be defined as the extent to which delivery of an intervention adheres to the protocol or program model originally developed. Fidelity measurement has increasing significance for evaluation, treatment effectiveness research, and service administration. Yet few published studies using fidelity criteria provide details on the construction of a valid fidelity index. The purpose of this review article is to outline steps in the development, measurement, and validation of fidelity criteria, providing examples from health and education literatures. We further identify important issues in conducting each step. Finally, we raise questions about the dynamic nature of fidelity criteria, appropriate validation and statistical analysis methods, the inclusion of structure and process criteria in fidelity assessment, and the role of program theory in deciding on the balance between adaptation versus exact replication of model programs. Further attention to the use and refinement of fidelity criteria is important to evaluation practice.

  • 58.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Holter, Mark
    University of Michigan.
    Mental health and mental illness: Out of the closet?2002In: Social Service Review, ISSN 0037-7961, E-ISSN 1537-5404, Vol. 76, no 1, p. 133-179Article in journal (Refereed)
    Abstract [en]

    The extensive changes in mental health services over the past 25 years negate the possibility of an overall research summary. Instead, we identify six pivotal topics to explore in depth: (1) the paradigm shift to a biopsychosocial mental illness etiology, (2) the organization and financing of mental health care, (3) community-based programs for adults with serious mental illness, (4) the role of families and consumers, (5) services for children and adolescents with serious emotional or mental disturbances, and (6) the interface with criminal justice. The article concludes with a discussion of future issues in mental health services research and the role of social work researchers.

  • 59.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Holter, Mark
    University of Michigan.
    Mowbray, Orion P.
    Bybee, Deborah
    Consumer-run drop-in centers and clubhouses: Comparisons of services and resources in a statewide sample2005In: Psychological Services, ISSN 1541-1559, Vol. 2, no 1, p. 54-64Article in journal (Refereed)
    Abstract [en]

    Consumer-run programs and clubhouses are 2 important models in the emerging field of psychosocial rehabilitation according to the 1999 Surgeon General's report (U.S. Department of Health and Human Services, 1999). However, no published studies have compared the operations and services of these 2 models. The research reported here involves a statewide study of a matched sample of 29 clubhouses and 29 consumer-run drop-in centers (CDIs), with data gathered by obtaining documents from and conducting on-site interviews with agency directors. As expected, the authors found greater member control and involvement at CDIs and more instrumental services and activities at clubhouses. The authors also found that clubhouses had substantially more resources than CDIs and that CDIs showed significantly greater variance across programs on most measures. Implications for planning and further research are presented. © 2005 Educational Publishing Foundation.

  • 60.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Holter, Mark
    University of Michigan.
    Stark, Lori
    University of Michigan.
    Pfeffer, Carla
    University of Michigan.
    Bybee, Deborah
    Michigan State University.
    A Fidelity Rating Instrument for Consumer-Run Drop-in Centers (FRI-CRDI)2005In: Research on social work practice, ISSN 1049-7315, E-ISSN 1552-7581, Vol. 15, no 4, p. 278-290Article in journal (Refereed)
    Abstract [en]

    Objective: Given the present emphasis on accountability and maintaining quality, the objective of this study was to develop, apply, and assess the reliability of a fidelity rating instrument for consumer-operated services - a promising model, but one for which fidelity criteria are not yet established. Method: Based on observations, documents, and director interviews from 31 consumer-run drop-in centers, we developed a scale measuring fidelity to pre-established criteria and rated each center on scale items. A second study examined the interrater reliability of the measure. Results: Scale scores on the 31 centers showed substantial heterogeneity on the majority of the criteria. The fidelity rating scale demonstrated satisfactory interrater reliability on most items. Conclusions: The fidelity rating instrument is ready to be used by social work researchers evaluating consumer-operated services. Furthermore, social work researchers can use similar methods with other innovative services that should be evaluated but currently lack standards and fidelity criteria. 

  • 61.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Megivern, Deborah
    Holter, Mark
    University of Michigan.
    Supported education programming for adults with psychiatric disabilities: Results from a national survey2003In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 27, no 2, p. 159-167Article in journal (Refereed)
    Abstract [en]

    Over the last 10 years, supported education (SEd) programs have been the topic of many journal publications and conference presentations, but little is known about their numbers and types across the U.S. This article reports the results of a national survey of all known SEd programs, numbering over 100. The largest number was associated with clubhouses, where full and partial SEd models could be identified. On-site supported education programs were located in community colleges and universities. A dozen "free-standing" programs were also identified. Analyses documented differences across program types in services provided, budget amounts and sources, and coordination with mental health and higher educational institutions. If supported education is to move beyond a specialty program in mental health, providers need to do more to market these services and to work collaboratively with stakeholder groups to expand supported education programming.

  • 62.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Robinson, Elizabeth A. R
    University of Michigan.
    Holter, Mark
    University of Michigan.
    Consumer Drop-in Centers: Operations, Services, and Consumer Involvement2002In: Health & Social Work, ISSN 0360-7283, E-ISSN 1545-6854, Vol. 27, no 4, p. 248-261Article in journal (Refereed)
    Abstract [en]

    Interest in involvement of consumers in mental health and psychiatric rehabilitation services delivery has expanded in recent years, encompassing self-help approaches, consumers employed as providers in formal agencies, and consumers operating their own services. This study reports results from in-depth phone surveys conducted with 32 consumer drop-in centers in Michigan. Results indicate that centers operate in many ways like other human services businesses, albeit with much smaller budgets. Funding levels, salaries, and services showed great heterogeneity among the centers and in comparison with reports in the literature. Centers autonomously run by consumers and centers with consumer involvement (operated by a non-consumer agency) were found to differ significantly on several variables, including consumer control, funding and service levels, and challenges. Implications for the growth and increased use of consumer drop-in centers are discussed.

  • 63.
    Mowbray, Carol T
    et al.
    University of Michigan.
    Woodward, Amanda T
    Michigan State University.
    Holter, Mark
    University of Kansas.
    MacFarlane, Peter
    Ohio University.
    Bybee, Deborah
    Michigan State University.
    Characteristics of users of consumer-run drop-in centers versus clubhouses2009In: Journal of Behavioral Health Services & Research, ISSN 1094-3412, E-ISSN 1556-3308, Vol. 36, no 3, p. 361-371Article in journal (Refereed)
    Abstract [en]

    Clubhouses and consumer-run drop-in centers (CRDIs) are two of the most widely implemented models of consumer-centered services for persons with serious mental illness. Differences in structure and goals suggest that they may be useful to different types of consumers. Information on what types of consumers use which programs would be useful in service planning. This study analyzes data from the authors' NIMH-funded research on 31 geographically matched pairs of clubhouses and CRDIs involving more than 1,800 consumers to address the following question: are there significant differences in the characteristics and outcomes of members of clubhouses versus CRDIs? Results from multilevel analyses indicated that clubhouse members were more likely to be female, to receive SSI/SSDI, to report having a diagnosis of schizophrenia, and to live in dependent care; and they reported both a greater number of lifetime hospitalizations and current receipt of higher intensity traditional MH services. Controlling for differences in demographic characteristics, psychiatric history, and mental health service receipt, clubhouse members also reported higher quality of life and were more likely to report being in recovery. CRDI consumers were more likely to have substance abuse histories. Possible reasons for the differences are discussed. The results suggest that CRDIs are a viable alternative to more traditional mental health services for individuals who might not otherwise receive mental health services.

  • 64.
    Rapp, Charles A
    et al.
    University of Kansas.
    Etzel-Wise, Diane
    University of Kansas.
    Marty, Doug
    University of Kansas.
    Coffman, Melinda
    University of Kansas.
    Carlson, Linda
    University of Kansas.
    Asher, Dianne
    University of Kansas.
    Callaghan, Jennifer
    University of Kansas.
    Holter, Mark
    University of Kansas.
    Barriers to evidence-based practice implementation: Results of a qualitative study2010In: Community mental health journal, ISSN 0010-3853, E-ISSN 1573-2789, Vol. 46, no 2, p. 112-118Article in journal (Refereed)
    Abstract [en]

    This study reports on a qualitative study of barriers to EBP implementation in one state that sought to implement supported employment and integrated dual diagnosis treatment. The study found that the most significant obstacles emanated from the behavior of supervisors, front-line staff and other professionals in the agency. A lack of synergy profoundly impeded implementation. 

  • 65.
    Salyers, Michelle P
    et al.
    Indiana University-Purdue University Indianapolis.
    Matthias, Marianne S
    Roudebush Veterans Affairs Medical Center, Indianapolis; Indiana University-Purdue University Indianapolis.
    Fukui, Sadaaki
    University of Kansas.
    Holter, Mark
    University of Kansas.
    Collins, Linda
    Roudebush Veterans Affairs Medical Center, Indianapolis.
    Rose, Nichole
    Indiana University-Purdue University Indianapolis.
    Thompson, John B.
    University of Kansas.
    Coffman, Melinda A
    University of Kansas.
    Torrey, William C
    Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
    A coding system to measure elements of shared decision making during psychiatric visits2012In: Psychiatric Services, ISSN 1075-2730, E-ISSN 1557-9700, Vol. 63, no 8, p. 779-784Article in journal (Refereed)
    Abstract [en]

    Objective: Shared decision making is widely recognized to facilitate effective health care. The purpose of this study was to assess the applicability and usefulness of a scale to measure the presence and extent of shared decision making in clinical decisions in psychiatric practice. Methods: A coding scheme assessing shared decision making in general medical settings was adapted to mental health settings, and a manual for using the scheme was created. Trained raters used the adapted scale to analyze 170 audio-recordings of medication check-up visits with either psychiatrists or nurse practitioners. The scale assessed the level of shared decision making based on the presence of nine specific elements. Interrater reliability was examined, and the frequency with which elements of shared decision making were observed was documented. The association between visit length and extent of shared decision making was also examined. Results: Interrater reliability among three raters on a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of the nine elements of shared decision making and 100% for the agreement between provider and consumer on decisions made. Of the 170 sessions, 128 (75%) included a clinical decision. Just over half of the decisions (53%) met minimum criteria for shared decision making. Shared decision making was not related to visit length after the analysis controlled for the complexity of the decision. Conclusions: The rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts.

  • 66.
    Salyers, Michelle P.
    et al.
    Indiana University-Purdue University Indianapolis.
    Matthias, Marianne S.
    Indiana University-Purdue University Indianapolis.
    Fukui, Sadaaki
    University of Kansas.
    Holter, Mark
    University of Kansas.
    Collins, Linda
    Roudebush Veterans Affairs Medical Center, Indianapolis.
    Rose, Nichole
    Indiana University-Purdue University Indianapolis.
    Thompson, John Brandon
    University of Kansas.
    Coffman, Melinda A.
    University of Kansas.
    Torrey, William C.
    Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Dartmouth Psychiatric Research, Lebanon, New Hampshire.
    A Coding System to Measure Elements of Shared Decision Making During Psychiatric Visits2012In: Psychiatric Services, ISSN 1075-2730, E-ISSN 1557-9700, Vol. 63, no 8, p. 779-784Article in journal (Refereed)
    Abstract [en]

    Objective:Shared decision making is widely recognized to facilitate effective health care. The purpose of this study was to assess the applicability and usefulness of a scale to measure the presence and extent of shared decision making in clinical decisions in psychiatric practice.

    Methods:A coding scheme assessing shared decision making in general medical settings was adapted to mental health settings, and a manual for using the scheme was created. Trained raters used the adapted scale to analyze 170 audio-recordings of medication check-up visits with either psychiatrists or nurse practitioners. The scale assessed the level of shared decision making based on the presence of nine specific elements. Interrater reliability was examined, and the frequency with which elements of shared decision making were observed was documented. The association between visit length and extent of shared decision making was also examined.

    Results:Interrater reliability among three raters on a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of the nine elements of shared decision making and 100% for the agreement between provider and consumer on decisions made. Of the 170 sessions, 128 (75%) included a clinical decision. Just over half of the decisions (53%) met minimum criteria for shared decision making. Shared decision making was not related to visit length after the analysis controlled for the complexity of the decision.

    Conclusions:The rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts. (Psychiatric Services 63:779–784, 2012; doi: 10.1176/appi.ps.201100496)

  • 67. Saunders, D. G
    et al.
    Holter, Mark
    Pahl, L
    Tolman, R
    Evaluation of a Domestic Violence Training for Michigan's Family Independence Specialists and Managers (TANF) Workers in Michigan: Report to the State of Michigan's Family Independence Agency, Domestic Violence Prevention and Treatment Board2003Report (Other academic)
  • 68. Saunders, D. G
    et al.
    Holter, Mark
    Pahl, L
    Tolman, R
    Kenna, C
    Evaluation of Domestic Violence Training for Caseworkers: What Survivors Report2002Conference paper (Other academic)
  • 69. Saunders, D
    et al.
    Holter, Mark
    Predictors of Caseworkers' Use of the Family Violence Option2001Conference paper (Other academic)
  • 70. Saunders, D
    et al.
    Holter, Mark
    Pahl, L
    Tolman, R
    An Evaluation of Domestic Violence Training for Welfare Caseworkers1999Conference paper (Other academic)
  • 71. Saunders, D
    et al.
    Holter, Mark
    Tolman, R
    Pahl, L
    The Evaluation of a Statewide Domestic Violence Training for Caseworkers2002Conference paper (Other academic)
  • 72.
    Saunders, Daniel G
    et al.
    University of Michigan.
    Holter, Mark
    University of Michigan.
    Pahl, Lisa C
    Tolman, Richard M.
    University of Michigan.
    Welfare workers' responses to domestic violence cases: The effects of training and worker characteristics2006In: Families in society, ISSN 1044-3894, E-ISSN 1945-1350, Vol. 87, no 3, p. 329-338Article in journal (Refereed)
    Abstract [en]

    This study evaluated a one-day domestic violence training for Temporary Assistance for Needy Families (TANF) workers and analyzed the relationship between worker characteristics and the use of work exemptions. In a post-only evaluation, trained workers reported a greater tendency than untrained workers to refer clients to couples counseling, make a safety plan, and file a report to child protection services. In a pre/post evaluation, workers reported after training that they would be less likely to refer clients to couples counseling, and more likely to ask about the emotional and physical impact of abuse, make a safety plan, and ask about access to weapons. Workers most likely to offer a waiver from work requirements reported a higher likelihood of making referrals for a variety of services. 

  • 73.
    Saunders, Daniel G
    et al.
    University of Michigan.
    Holter, Mark
    University of Michigan.
    Pahl, Lisa C
    Aviva Family and Children’s Services, Los Angeles, California.
    Tolman, Richard M
    Kenna, Colleen E
    Children’s Center, Detroit, Michigan.
    TANF workers' responses to battered women and the impact of brief worker training: What survivors report2005In: Violence against Women, ISSN 1077-8012, E-ISSN 1552-8448, Vol. 11, no 2, p. 227-254Article in journal (Refereed)
    Abstract [en]

    Battered women (n = 159) report on their experiences with their Temporary Assistance to Needy Families (TANF) caseworkers. Workers most often ask about physical harm, feelings of fear, and police involvement. They least often create a safety plan, give information about work exemptions, and ask whether the partner had a gun. Women's major reasons for not talking about abuse are that the worker did not ask and a fear of negative outcomes. Workers who attended a 1-day training are more likely than untrained workers to discuss the women's fear and physical harm, to help develop a safety plan, and to be viewed as generally helpful.

  • 74. Stark, L
    et al.
    Mowbray, Carol T
    Holter, Mark
    Consumers hold the keys: A manual for consumer-run drop-in centers2004Report (Other academic)
  • 75. Starnino, Vincent R
    et al.
    Mariscal, Susana
    Holter, Mark
    Davidson, Lori J
    Cook, Karen S
    Fukui, Sadaaki
    Rapp, Charles A
    Outcomes of an illness self-management group using wellness recovery action planning2010In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 34, no 1, p. 57-60Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this preliminary study was to examine the impact of participation in an illness self-management recovery program (Wellness Recovery Action Planning - WRAP) on the ability of individuals with severe mental illnesses to achieve key recovery related outcomes. Methods: A total of 30 participants from three mental health centers were followed immediately before and after engaging in a 12-week WRAP program. Results: Three paired sample f-tests were conducted to determine the effectiveness of WRAP on hope, recovery orientation, and level of symptoms. A significant positive time effect was found for hope and recovery orientation. Participants showed improvement in symptoms, but the change was slightly below statistical significance. Conclusions: These preliminary results offer promising evidence that the use of WRAP has a positive effect on self-reported hope and recovery-related attitudes, thereby providing an effective complement to current mental health treatment.

  • 76. Szilvagyi, S
    et al.
    Madigan, S
    Holter, Mark
    Supported education: costs and funding sources2002In: Supported education & psychiatric rehabilitation : models and methods / [ed] C. T. Mowbray, K. Furlong-Norman, A. Sullivan-Soydan, Columbia, MD: IAPSRS , 2002Chapter in book (Other academic)
  • 77. Toler, A
    et al.
    Mowbray, C. T
    Holter, Mark
    Racial Differences in Perceptions of Social Support in Consumer-Centered Services2004Conference paper (Other academic)
  • 78. Toler, A
    et al.
    Mowbray, C. T
    Holter, Mark
    What is Social Support?: A Qualitative Look at How Consumers in Consumer-Centered Programs Talk about “Social Support” and “Sense of Community”2004Conference paper (Refereed)
  • 79.
    Toler Woodward, Amanada
    et al.
    Michigan State University.
    Mowbray, Carol T
    University of Michigan.
    Holter, Mark
    University of Kansas.
    Bybee, Deborah
    Michigan State University.
    Racial differences in perceptions of social support in consumer-centered services2007In: Social work research (Print), ISSN 1070-5309, E-ISSN 1545-6838, Vol. 31, no 4, p. 221-228Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to explore potential racial differences in the experience of support offered by consumer-centered services for adults with serious mental illness. The study used hierarchical linear modeling to examine the level of support consumers report receiving from programs and the extent to which program-level characteristics reflecting racial diversity differentially influence white and African American consumers. The study used data from interviews with 1,072 white and African American consumers throughout Michigan and from selected program-level data. African Americans reported that a smaller proportion of their network comes from their program, although this is not related to program-level characteristics. Interaction effects suggest that the proportion of consumers in a program who are African American differentially influences the sense of community reported by white and African Americans. Implications for understanding racial dynamics within consumer-centered services are provided.

12 51 - 79 of 79
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