OBJECTIVE: The purpose of this study was to construct and validate an instrument that measures practitioners' competence to promote the recovery among individuals with psychiatric disabilities from the perspective of the person served. Items were developed based upon input from individuals served and practitioners as well as the extant literature on recovery. "Recovery-promoting competence" was conceptualized as a set of practitioner capabilities that promote the recovery process and enhance the working alliance. METHOD: A scale was developed using a two-stage process that initially identified specific recovery-promoting competencies and then tested candidate items measuring those competencies. Item Response Theory and Classical Test Theory approaches were used to validate the instrument and assess its psychometric properties with a national sample of 382 individuals with psychiatric disabilities. RESULTS: Analyses revealed two distinct sets of recovery-promoting competencies: (a) competencies that enhance clients' recovery, and (b) competencies that build and maintain a strong therapeutic or working alliance. The first set further differentiated into subcompetencies-enhancing clients' hopefulness, empowerment, and self-acceptance. The instrument had high internal consistency and acceptable stability over time, convergent, criterion, and known groups' validity. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This scale is a tool for assessing mental health and rehabilitation practitioners' competencies from the perspective of the individual served which can be used both in research and program evaluation of agencies serving individuals with psychiatric disabilities.

This study explored the predictors of financial self-sufficiency among Social Security beneficiaries with psychiatric disabilities. The study was conducted with individuals who were either past or current disability beneficiaries and who had sustained competitive employment as evidenced by their involvement in a longitudinal investigation on sustained employment among persons with serious mental illnesses. We conducted an exploratory cross-sectional study employing a survey methodology to determine what factors were associated with participants' capacity to leave the Social Security disability rolls due to gainful employment. We used a stepwise approach to data analysis to explore the association of demographic, clinical, vocational and motivational factors with financial self-sufficiency. Results suggested that individuals with higher occupational status, higher levels of proactive coping and without medical comorbidities were more likely to terminate Social Security disability benefits and achieve financial self-sufficiency due to gainful employment. Study findings can inform the development of innovative interventions targeting these malleable predictors associated with financial self-sufficiency among persons with psychiatric disabilities.

OBJECTIVES: The purpose of this study was to empirically validate a set of conceptually derived recovery-promoting competencies from the perspectives of mental health consumers, consumer-providers and providers. METHODS: A national sample of 603 consumers, 153 consumer-providers and 239 providers completed an anonymous survey via the Internet. The survey evaluated respondents' perceptions about a set of 37 competencies hypothesized to enhance clients' hope and empowerment and inquired about interactions with providers that enhanced clients' recovery process. We used descriptive statistics and ranking to establish the relevance of each competency and generalized linear models and post-hoc tests to examine differences in the consumers', consumer-providers' and providers' assessments of these competencies. RESULTS: Analyses confirmed the recovery relevance of several competencies and their relative importance within each group of study participants. They also revealed that while most competencies tended to have universal significance, others depended more strongly on the client's preferences. Finally, differences in the perceptions of consumers, consumer-providers and providers about the recovery relevance of these competencies were established. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The study highlighted the crucial role practitioners play in enhancing recovery from serious mental illnesses through specific strategies and attitudes that acknowledge clients' personhood and foster their hopefulness, empowerment and illness management. It informed the development of a new instrument measuring providers' recovery-promoting competence and provides guidelines for sharpening the recovery focus of a wide range of mental health and rehabilitation services.

This study explores the capacity of individuals with severe mental illness to be employed in managerial or professional jobs and the correlates of their vocational success. Using purposive sampling techniques, we identified a national sample of 347 individuals for a mail survey who had succeeded in obtaining and retaining mid to upper level managerial or professional positions. The majority worked full-time and held their job for more than 2 years. Their vocational success was operationalized based on 4 employment outcomes: employment status (full-time vs. part-time), job tenure, occupational rank, and annual income. Key factors that contributed to respondents' vocational success were lesser severity of the illness as indicated by lack of lifetime receipt of disability benefits, capacity to manage one's own psychiatric condition, and higher education. Study findings point to the role of supported education and self-efficacy in promoting the employment outcomes among individuals with severe mental illnesses.

Summary: Mental health and rehabilitation professionals represent an important factor that can either facilitate or hinder the recovery process of people with psychiatric disabilities. Practitioners can inspire hope and empower mental health consumers in their efforts to overcome the disabling effects of a mental illness or they can instill hopelessness, dependence, and helplessness. The Recovery Promoting Relationships Scale (RPRS) instrument focuses on identifying and reliably measuring the competencies of mental health providers that have a particular impact on the recovery process beyond the management of psychiatric symptoms.

Objective: This study identifies patterns and correlates of disclosure among professionals and managers with serious psychiatric conditions. Design: A national mail survey of such respondents was conducted. Results: A large proportion (87%) of study participants reported having disclosed their mental illness. About half of the disclosers reported unfavorable circumstances leading to disclosure while one third disclosed when they felt comfortable. Most frequently, respondents disclosed to supervisors; one third made their disability known when applying for the job. About half of the respondents had no regrets about disclosing. Multivariate analysis showed that correlates with the occurrence, timing, and choice of disclosure converge around constructs related to job confidence, empowerment, and recovery. We also describe those who chose not to disclose. Conclusion: Higher rates than previously reported and better experiences with disclosure were evident and may be related to this population's greater recovery as well as to occupational factors.