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Tijdschrift voor Psychiatrie 58 (2016) 3, 179 - 189

New research

Working effectively towards rehabilitation goals: long-term outcome of a randomised controlled trial of the Boston psychiatric rehabilitation approach

J.T. van Busschbach, W. Swildens, H. Michon, H. Kroon, M. Koeter†, D. Wiersma, J. van Os

background In the Netherlands the Boston psychiatric rehabilitation approach (bpr) is one of the most widely implemented rehabilitation methods. So far, little research has been done on the efficacy of this approach.
aim To investigate the effect of bpr on the attainment of personal rehabilitation goals, social functioning and empowerment and on care requirements and quality of life in persons with severe mental illness (smi) in the Netherlands.
method In a multicentre randomised controlled trial (rct: Clinical trial registration number: isrctn73683215) patients with smi were randomly assigned to bpr (n = 80) or ‘care as usual’ (cau; n = 76). The primary outcome was the attainment of the rehabilitation goal as formulated by the patient. The secondary outcomes were a change in the work situation and in the degree of independent living, in care requirements (Camberwell Assessment of Needs), in empowerment (Personal Empowerment Scale) and in the quality of life (who-qol). The effects were tested at 12 and 24 months.
results The degree of goal attainment was substantially higher in bpr at both 12 months (adjusted risk difference: 16%; 95%ci, 2 to 31; nnt = 7) and 24 months (adjusted risk difference: 21%, 95%ci, 4% to 38%; nnt = 5). The approach was also more effective in the area of societal participation (bpr: 21% adjusted increase, cau: 0% adjusted increase; nnt = 5), but not in the other secondary outcome measures.
conclusion The results suggest that bpr is effective in supporting patients with smi to reach self-formulated rehabilitation goals and in enhancing their societal participation.

keywords goal attainment, psychosocial rehabilitation, psychiatric rehabilitation, severe mental illness, societal participation, vocational rehabilitation