Sunday, 16 January 2005 - 8:00 AM

This presentation is part of: Beyond Mental Health Treatment: Research on Psychosocial Rehabilitation Services

Consumers' Perceptions of Psychosocial Rehabilitation Treatment Environments and Behavioral Coping: The Role of Self-Efficacy

3. Consumers' Perceptions of Psychosocial Rehabilitation Treatment Environments and Behavioral Coping: The Role of Self-Efficacy.

Purpose: According to the stress and coping model, stresses/resources are closely related to self-efficacy, which has an influence on behavioral outcomes. In addition to economic hardship and psychiatric symptoms, the treatment environment can be either a stressor or a resource. This study examined the relationships among treatment environment, self-efficacy, and behavioral coping among psychiatric service consumers served by psychosocial rehabilitation (PSR) agencies.

Methods: The sample consists of 351 consumers served by 25 PSR agencies in southeast Michigan - supported education programs, consumer-run drop-in centers, and clubhouses. The stress-coping model was tested using Structural Equation Modeling in AMOS 4. Final stress/resource variables included income, psychiatric symptoms, and treatment environment perceptions. Self-efficacy was hypothesized to mediate the relationship between stress/resource variables and behavioral coping. Behavioral coping was examined with a behavioral withdrawal measure.

Results: Measurement models (for symptoms, perceptions of agency environment, self-efficacy, and behavioral coping) presented acceptable fit indices. The structural model fit the data well – IFI=0.98, SRMR=0.06, RMSEA=0.06. Controlling for symptoms and income, consumers with more positive perceptions of the treatment environment presented greater self-efficacy (B=.16, p<.05). Further, those with greater self-efficacy presented lower levels of behavioral withdrawal (B=-.41, p<.00). Although perceptions of the environment had no direct effects on behavior, significant indirect effects were found through self-efficacy (B=-07, p<.05), indicating consumers who perceived the environment more negatively tended to present lower self-efficacy and greater behavioral withdrawal.

Implications: The findings of the current study suggest that treatment environment could be a stressor or resource, influencing consumers’ self-efficacy and behavioral coping. Based on our measure of treatment environment, results suggest that rehabilitation is more likely to be successful when the PSR program offers: (1) higher levels of consumer involvement, (2) clearer rules, (3) a clean environment, (4) more support, and (5) more practically oriented services.

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