Effects of IMR: a randomized controlled trial 109 Introduction Patients with schizophrenia and other severe mental illnesses (SMIs) face major challenges in achieving personal goals and fully participating in society. This is due to their recurring symptomatology, cognitive impairment, loss of social support, and societal barriers, such as stigma (1, 2). Although treatment with psychopharmacological drugs facilitates reduction in symptom severity and relapse, there is a need for effective psychosocial interventions to support participants in illness self-management. The aim of these interventions is to develop fulfilling and valued workplace roles and social connections, to obtain housing, and to facilitate self-determination and well-being (1, 3-6). Illness management programs, including Illness Management and Recovery (IMR), have been developed to support individuals with SMIs in addressing the physical, social, and emotional impact of their persistent condition. These programs seek to improve the course of illness (1, 7, 8). IMR is a structured psychosocial program that promotes illness self-management in people with schizophrenia and other SMIs. It was developed based on an empirical literature review to teaching illness self-management strategies (9). IMR combines psychoeducation, behavioral tailoring for medication adherence, relapseprevention training, and cognitive-behavioral training in social and coping skills (3). The various individual components of the IMR program are not new; however, the novelty of IMR results from offering these components as an integrated, introductory package (6). The working mechanisms underlying IMR have been suggested in its previously published conceptual framework (Figure 1), indicating that progress toward recovery may be achieved by combining better illness management with the pursuit of personal goals (3). Recovery is a multidimensional concept comprised of three subtypes that are not mutually exclusive (10-14): clinical or symptomatic recovery (4, 15); functional or objective recovery (3), which is defined as the degree of vocational and social functioning (14, 16-18); and personal or subjective recovery (3, 19), whose key elements are summarized via the acronym CHIME: connectedness, hope, identity, meaning in life, and empowerment (20). IMR is currently used in various countries, including the US, the Netherlands, Denmark, Norway, Sweden, Spain, Japan, and Singapore.
RkJQdWJsaXNoZXIy MjY0ODMw