Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Sells, D. Articles by Rowe, M. Search for Related Content PubMed Citation Articles by Sells, D. Articles by Rowe, M. Chronically Mentally Ill Patients Case Management Quality of Care, Practice Guidelines Staff Issues, Staffing Related Article

Beyond Generic Support: Incidence and Impact of Invalidation in Peer Services for Clients With Severe Mental Illness

The authors are affiliated with the Department of Psychiatry, Yale University School of Medicine, 319 Peck St., Building 1, New Haven, CT 06513 (e-mail: david.sells{at}yale.edu). Dr. Black is also affiliated with the Department of Veterans Affairs Connecticut Healthcare System, West Haven.

OBJECTIVE: This study explored experiences of validation and invalidation among clients with severe mental illness in treatment with either peer providers or traditional providers. Associations between six- and 12-month outcomes and validating and invalidating provider communications were also examined. METHODS: A total of 137 adults with severe mental illness were randomly assigned to either peer-based or traditional intensive case management. At six and 12 months participants completed self-report questionnaires on their quality of life, obstacles to recovery, and perceived invalidating and validating qualities (positive regard, empathy, and unconditional acceptance) of relationships with their providers. RESULTS: Mixed analysis of variance showed that communications from and interactions with providers were perceived to be more validating than invalidating by clients in treatment with peer providers than by those in treatment with traditional providers. Regression analyses showed an association at six months, but not at 12 months, between favorable outcomes and the experience of invalidation from peer providers; invalidation from peer providers was linked to improved quality of life and fewer obstacles to recovery, an association that was not found for clients who experienced invalidation from traditional providers. CONCLUSIONS: Peer providers, who reveal their experiences of mental illness to their clients, were perceived to be more validating, and their invalidating communications were linked with favorable short-term outcomes. Both peer and traditional providers sometimes express disapproval of clients' attitudes, values, or behaviors—a form of invalidation. This study found that early in the course of treatment peer providers may be effective in fostering progress by challenging clients' attitudes, values, or behaviors.

Related Article:

November 2008: This Month's Highlights
Psychiatr Serv 2008 59: 1241. [Full Text] [PDF]

This article has been cited by other articles:

				C. West Powerful Choices: Peer Support and Individualized Medication Self-Determination Schizophr Bull, June 10, 2009; (2009) sbp053v1. [Abstract] [Full Text] [PDF]

Get information about faster international access.

Privacy Policy

Copyright © 2008 American Psychiatric Association. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us