The Transition to Independence Process: Promoting Self-Efficacy in Transition-Aged Youths.

Transition to adulthood is a developmental stage that presents unique and challenging problems. For individuals with dual diagnoses of mental disorders and substance abuse, the tragic dilemma confronting them is one of limited or nonexistent options as they attempt to navigate their way from child and adolescent services to adult programs. The Transition to Independence Process (TIP) is designed to facilitate more successful outcomes in the transition to adulthood by offering continuity of support. Nursing plays a crucial role in enabling young adults to develop a healthy sense of self-efficacy, thus facilitating the success of a TIP program. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 49-53.].

Transition-Aged Youths With Dual Diagnoses.

The current study provides an overview of the research knowledge about unique problems encountered by transition-aged youths with dual diagnoses. A description of the considerable physical and emotional changes experienced by transition-aged youths provides a foundation for exploring the pressures and challenges compounded by mental health issues and substance abuse. Programs that provide intensive support throughout the transition years pay valuable dividends. However, transition-aged youths with dual diagnoses of mental disorders and substance abuse find themselves faced with limited or nonexistent options. There is a confusing lack of continuity and consistency of supports and services, which complicates the already perplexing circumstances that beleaguer the lives of young adults with dual diagnoses.

Effects on resilience of women family caregivers of adults with serious mental illness: the role of positive cognitions.

This study examined the effects of risk and protective factors on resilience in 60 women family members of adults with serious mental illness. Both the risk factors constituting caregiver burden (strain, stigma, client dependence, and family disruption) and protective factors, including eight positive cognitions were found to predict two indicators of resilience: resourcefulness and sense of coherence. The effects of caregiver burden on resourcefulness and sense of coherence were mediated by positive cognitions, lending support to resilience theory and suggesting the need to develop interventions to encourage positive thinking among women caregivers of adults with mental illness.

Relationships among perceived burden, depressive cognitions, resourcefulness, and quality of life in female relatives of seriously mentally ill adults.

Providing care and support to a seriously mentally ill (SMI) family member can have deleterious effects on one's health and quality of life. This study explored relationships among perceived burden, depressive cognitions, resourcefulness, and quality of life in 60 African-American and Caucasian women family members of SMI adults. Caucasians reported greater burden than African-Americans; the groups were similar in depressive cognitions, resourcefulness, and quality of life. In Caucasians and African-Americans, burden correlated with depressive cognitions and both correlated with poorer mental health. In African-Americans, burden also correlated with lower personal resourcefulness and both correlated with poorer mental health. The findings suggest a mediating role by depressive cognitions for both groups and by resourcefulness in African-Americans. Thus, both groups of women may benefit from positive thinking while African-Americans also may benefit from learning personal resourcefulness skills.

Sense of coherence and quality of life in women family members of the seriously mentally ill.

Providing care to a family member with serious mental illness (SMI) can reduce a family's quality of life. Quality of life, however, can be positively influenced by the caregiver's sense of coherence (SOC). Antonovsky's Salutogenic Health Model was examined in this secondary analysis of data from 60 women family members of adults with SMI. The results indicated that greater perceived stress decreased SOC and QoL, greater SOC enhanced QoL, and SOC partially mediated the effects of perceived stress on QoL. The findings suggest the need for reducing stress and strengthening SOC to promote optimal QoL for family members of adults with SMI.

Moving from tradition to evidence: a review of psychiatric nursing intervention studies.

This state-of-the-evidence review summarizes characteristics of intervention studies published from January 2000 through December 2005 in five psychiatric nursing journals. Intervention studies were defined as those evaluating the application of nursing strategies/procedures/practices for enhancing/promoting health or preventing disability/dysfunction. Of 486 research studies published in those journals, 77 were intervention studies, including 77% conducted in the United States. Interventions reflected psychological (57%), social (9%), and biological (12%) dimensions of the biopsychosocial model; 22% of the studies tested interventions with overlapping dimensions. Some studies included persons of various ages; however, 7 focused on adolescents, 36 on adults, and 10 on elders; 2 included children. The findings describe the current state of published intervention research in five psychiatric nursing journals and suggest the need for increased dissemination of intervention research, more rigorous testing of interventions, and more focused programs of research to build evidence for effective psychiatric nursing interventions across the lifespan and globally.

Components of a TIP Model Program.

Transition-aged youth in need of services and supports find themselves in a quandary; in certain instances, they are considered children, whereas in other circumstances, they qualify as adults. Transition to Independence Process (TIP) provides a promising model for transition-aged youth programs. It is distinguished by an emphasis upon client-driven goals, as opposed to agency-defined goals. Another key feature is reliance upon collaboration among service providers in order to address the myriad of needs of young adults. From the perspective of transition-aged clients, an efficacious TIP program must offer support services, including mental health care. It must encourage natural supports, including family. All of the facets of a TIP model program should have as their ultimate focus the education and employment of transition-aged youth. Together, these contribute to the best possible outcomes for transition-aged youth.

Indicators of resilience in family members of adults with serious mental illness.

This integrative review summarizes current research on resilience in adult family members who have a relative with a diagnosed mental disorder considered serious. Within the context of resilience theory, studies identifying risk/vulnerability and positive/protective factors in family members are summarized, and studies examining 7 indicators of resilience, including acceptance, hardiness, hope, mastery, self-efficacy, sense of coherence, and resourcefulness, are described. Implications for clinical practice and recommendations for future research are presented.

Factors affecting disruption in families of adults with mental illness.

PURPOSE: This study examined relationships between vulnerability/risk and protective factors, and family functioning in women family members of adults with serious mental illness. DESIGN AND METHODS: Using a descriptive, correlational design, this secondary analysis examined characteristics of the family member with mental illness (e.g., diagnosis, level of care) and measures of caregiver stigma and strain, client dependence, family disruption, sense of coherence, and resourcefulness. FINDINGS: Family disruption was greatest in women who provided direct care and whose family member had major depression, followed by bipolar disorder, schizophrenia, and panic disorder. Sense of coherence and resourcefulness were associated with lower family disruption, but did not mediate the effects of caregiver strain. PRACTICE IMPLICATIONS: Interventions restricted to one family member may be insufficient for improving the family functioning.

Resilience in family members of persons with serious mental illness.

This integrative review summarizes current research on resilience in adult family members who have a relative with a diagnosed mental disorder that is considered serious. Within the context of resilience theory, studies identifying risk/vulnerability and positive/protective factors in family members are summarized, and studies examining seven indicators of resilience, including acceptance, hardiness, hope, mastery, self-efficacy, sense of coherence, and resourcefulness, are described. Implications for clinical practice and recommendations for future research are presented.

Factors associated with perceived burden, resourcefulness, and quality of life in female family members of adults with serious mental illness.

BACKGROUND: Each year, 54 million American adults are affected by serious mental illness. Most of these persons depend on female family members for support or assistance, and unless these women are resourceful, they may experience considerable burden, stigma by association, depressive thoughts, and poor quality of life. OBJECTIVE: In this study, we examined the associations between characteristics of female family members (age, race, education), adults with serious mental illness (age, diagnosis), and the family situation (relationship, living arrangements, care provided) and caregivers' burden, stigma, depressive cognitions, resourcefulness, and quality of life. STUDY DESIGN: In this descriptive, cross-sectional study, a convenience sample of 60 female relatives of adults with serious mental illness provided demographic information and completed established measures of the study variables. RESULTS: We discuss associations between contextual variables and process regulators, resourcefulness, and quality of life. CONCLUSIONS: The results highlight the importance of targeting interventions for caregivers of adults with serious mental illness who are parents, caregivers of younger seriously mentally ill persons in earlier stages of diagnosis, and caregivers of persons who have bipolar disorder. J Am Psychiatr Nurses Assoc, 2008; 14(2), 125-135. DOI: 10.1177/1078390308315612.