Chapter 1 16 management had a significant effect relative to control on subjective recovery measures, such as hope and empowerment at follow-up and self-rated recovery and self-efficacy at both time points (71). Although this review indicated the relevance of self-management interventions, it only included nine (24%) studies on IMR. The specific contribution of IMR to the various effects found is unknown. Therefore, additional IMR-specific experimental evidence was needed. What is Illness Management and Recovery (IMR)? IMR is a structured psychosocial program that aims to promote illness selfmanagement and recovery in individuals with schizophrenia and other SMIs (56). IMR aims to support consumers with SMI in acquiring the information and skills necessary to cooperate successfully with professionals and significant others in their treatment, to minimize the impact of mental illness on their lives, and to achieve meaningful personal goals. IMR includes a broad set of strategies designed to reduce susceptibility to illness and cope effectively with symptoms. The IMR program was developed based on a review of controlled research on teaching illness self-management strategies to clients with SMI (70). Five empirically supported strategies were identified in this review and incorporated into the program: (1) psychoeducation about mental illness and its treatment; (2) cognitive-behavioral approaches to medication adherence, assisting consumers who chose to use medications in integrating them into their everyday routines; (3) developing a relapse prevention plan; (4) strengthening social support through social skills training, using cognitive behavioral techniques such as reinforcement, modeling, role-play, and practicing skills in real-life situations; and (5) coping skills training for the management of persistent symptoms (56). To motivate clients to learn how to better manage their illness and help them move forward in their lives, IMR begins with an exploration of the meaning of recovery for the client and setting personal recovery goals to work toward in the program (56). The different parts of the IMR program were not new; the newness lay in offering them as an integrated package. The five empirically supported illness self-management strategies (70) are incorporated into the IMR program, which is organized into 11 curriculum topic areas. These topics are taught using a combination of educational, motivational, and cognitive-behavioral teaching strategies in weekly individual or group sessions that require approximately one year to complete. Homework assignments are developed collaboratively with the client. In addition, with clients’ consent, significant others (e.g., family and friends) are encouraged to be involved in helping
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