Chapter 1 14 In 1998, six community-based EBPs for adults with SMI were selected in initial attempts to demonstrate implementation on a broader scale (58). This selection was conducted by a panel of mental health experts guided by a review of the literature. An implementation package was created for each EBP, and a large-scale study was conducted to examine the dissemination success. One of the selected EBPs was Illness Management and Recovery (IMR). IMR is discussed in detail in the following sections. The other five EBPs were (58): (1) Collaborative Psychopharmacology/Medication Management, which deals with systematic, shared medication decision-making that involves patients; (2) Assertive Community Treatment (ACT): a new case management approach, with a low caseload size, outreach care, direct provision of services by ACT practitioners, 24-hour coverage, and a shared caseload; (3) Family Psychoeducation: family intervention programs, usually lasting for at least 6 months, providing psychoeducation information and illness management, social support, and empathy to decrease stress; (4) Individual Placement and Support (IPS): a supported employment model supporting people with SMI to acquire competitive employment, aiming to support someone’s identity and self-esteem and to reduce self-stigma; and (5) Integrated Dual Disorders Treatment (IDDT), in which the same clinicians treat both mental health and substance abuse disorders simultaneously. Treatment includes case management, medication, housing, vocational rehabilitation, family interventions, and motivation-based interventions for addictive behaviors. The six EBPs of the US National EBPs Project have also been implemented to varying extents in the Netherlands. In this country, FACT, the Dutch version of ACT, has been most widely implemented (62). IMR has been implemented at several sites in various regions of the Netherlands (63-65). First, we will present some background information on illness self-management. What is illness (self) management? According to mental health practitioners, people with SMI were previously assumed to be unable to actively participate in directing their own treatment. Therefore, they depended on others to manage their psychiatric illnesses, meet their basic needs, and reach their personal goals. However, inspired by the psychiatric consumer self-advocacy movement (66-68) and the trend toward shared decisionmaking in medical treatment (69), mental health care has begun to engage consumers actively in determining their own outcomes. Illness self-management concerns individuals’ ability to care for themselves and regain control of their lives (70). This includes the ability to perform tasks needed to manage and live successfully with the physical, social, and emotional
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