LAC Department of Mental Health Public Portal

CLINICAL QUALITY OF CARE – PRACTICE PARAMETERS

Office of the Chief Medical Officer
Clinical Operations

Psychosocial Rehabilitation Interventions

ClinP-04

Category: Clinical Programs
Published Date: December 2021

PARAMETER GOAL
1. Provide guidance to staff about the use of Psychosocial Rehabilitation (PSR).
TERMINOLOGY
1. Psychosocial Rehabilitation (PSR): A set of interventions used in conjunction with other services that is designed to teach emotional, cognitive, and social skills that help those diagnosed with mental illness live and work in their communities as independently as possible.
MEASURES
1. PSR is complementary and a part of comprehensive services provided to clients that may include:
  1. Psychotropic medications
  2. Medical and dental care
  3. Remediation of cognitive deficits
  4. Psychotherapy
  5. Substance use services
  6. Supported employment
  7. Supported Housing
2. A PSR assessment should include:
  1. Strengths and abilities
  2. Environmental setting
  3. Skill development
3. A PSR assessment should include the following domains:
  1. Daily living skills
  2. Symptom management skills (SAMHSA illness management and recovery)
  3. Social supports
  4. Interpersonal skills
  5. Finances and benefits
  6. Resource management skills
  7. Housing
  8. Education
  9. Employment
  10. Justice involvement
  11. Transportation
4. PSR assessment is an ongoing process.
  1. Goals, abilities, and interventions should be routinely re-evaluated.
  2. Goal attainment and service satisfaction should be included in the re-assessment process.
TREATMENT STRATEGY
1. Self-determination is a core principle of psychosocial rehabilitation.
  1. The selection of specific, individual goals is driven by the values and aspirations of the client working in a collegial relationship with mental health staff.
2. PSR is oriented toward increasing levels of independence in:
  1. Self-care
  2. Illness management
  3. Interpersonal relationships
  4. Residential stability
  5. Meaningful activity (i.e., employment, education, volunteerism)
PROVISION OF SERVICES
1. PSR should be coordinated with other services.
2. PSR interventions should:
  1. Be sensitive to the cultural values of the client
  2. Require active outreach in the client’s community
  3. Help clients develop skills they can generalize to their community
  4. Ensure that client’s basic needs for housing, finances, food, clothing, and transportation are met
  5. Support employment and educational goals
  6. Resource identification
  7. Training and/or tutoring
  8. Job coaching
  9. Job skill development
  10. Teaching, modeling, and rehearsing new skills
  11. Involve community education, and advocacy
  12. Include family members and other significant support persons in a client’s life.
    1. Involvement must be sensitive to the wishes of the client and their rights to privacy and confidentiality
  13. Include natural community supports (i.e., self-help programs).
OUTCOMES AND MONITORING
1. The goals of PSR are to:
  1. Reduce the use of emergency, inpatient, and institutional care
  2. Reduce the disabilities and limitations in role functioning
  3. Help clients utilize existing strengths
  4. Help clients develop new skills to maximize their ability to achieve goals
  5. Enhance the quality of life
2. PSR providers should monitor:
  1. Functional skill development
  2. Social supports
  3. Housing status and stability
  4. Employment and educational gains
  5. Justice involvement
  6. Utilization of inpatient and emergency services
STAFF TRAINING
SUPERVISION AND CONSULTATION
1. Regular supervision and consultation as needed with supervisor and treatment team.
RESOURCES