Chapter 2 38 study trip was made to Dartmouth Psychiatric Research Center New Hampshire, USA; an implementation plan was drawn up; plenary meetings were held with all outpatient clinicians at the institute and members of the clients council; a steering committee, an implementation committee and an education committee were established; translated handouts and workbooks were edited; a two-day training was held for 18 trainers and six supervisors; four supervision groups were established, a master class was given by Susan Gingerich, one of the creators of IMR; six IMR groups were started; and this pilot study was started. Interventions In essence, IMR is a structured training consisting of 11 modules, practitioner guides and handouts for participants. The 11 modules are 1.) Recovery Strategies, 2.) Practical Facts about Mental Illness, 3.) the Stress-Vulnerability Model, 4.) Building Social Support, 5.) Using Medication Effectively, 6.) Drug and Alcohol Use and Treatment Strategies, 7.) Reducing Relapses, 8.) Coping with Stress, 9.) Coping with Problems and Persistent Symptoms, 10.) Getting Your Needs Met in the Mental health System, and 11.) Health for You. The original American text had been translated into Dutch; where necessary, it was slightly adapted to the Dutch context. The IMR-training was given at the participating institute in a group format with weekly sessions. For the pilot, all six IMR groups completed the whole curriculum. During the first module, which was the only module that was done individually, the participants decided which personal goals they wanted to work on during the program. For half of each 90-minute session, some participants worked on their goals in the group. During the other half of each session, all participants worked with the help of the handouts on the subjects of the modules. Each IMR group was guided by two professional trainers (ten psychiatric nurses, one psychologist and one psychiatrist), who used 1.) motivation-enhancement strategies such as conveying confidence and exploring the pros and cons of change; 2.) educational strategies (psycho education) such as breaking down information, interactive teaching, and checking for understanding; and 3.) cognitive-behavioral techniques such as shaping, modeling and role-play. Peer-group support and coping & social skills training are integral to IMR. Homework assignments are provided. Whether all different aspects of the intervention were actually administered is part of the fidelity, which was assessed for feasibility (see below).
RkJQdWJsaXNoZXIy MjY0ODMw