Chapter 3 70 Most participants will have a psychotic disorder or a schizoaffective disorder with or without comorbid disorders such as substance abuse and personality disorders. Recruitment procedure Participants will be recruited from 14 community mental health teams at 11 branches of two mental health institutions in the greater Rotterdam area (the Netherlands). Eight teams throughout the city of Rotterdam serve an urban area of approximately 1.2 million inhabitants, one team serves a more rural environment to the west of Rotterdam, and five teams serve the neighboring city of Dordrecht (120,000 inhabitants) and four smaller communities of 20,000–35,000 inhabitants. During interviews with an assistant researcher, the caseloads of all clinicians in these teams will be assessed for their potential suitability for IMR. The clinicians will ask selected clients to participate in IMR and about their willingness to be informed about the study. If clients express interest and agree to be contacted by an assistant researcher for more detailed information, the assistant researcher will explain the research goals, randomization procedure and the three times of measurement. Clients will then be asked whether they want to participate in the study. After written informed consent has been given, the baseline interview will be followed by randomization. Intervention 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.) 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 Mentalhealth System, and 11.) Health for You. The IMR training will be given at the participating institutes in a group format with weekly sessions. The original American text (19) has been translated into Dutch and will be adapted to the Dutch context if necessary. During the first module, participants will decide which personal goals they want to work on during the programme. For the first half of each 90-min session, some will work on their goals in the group. During the second half, all participants will work with the help of the handouts on the subjects of the modules.
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