title: Client Views of Engagement in the RAISE Connection Program for Early Psychosis Recovery.
abstract: OBJECTIVE
  This study assessed factors that facilitated or impeded clients' engagement in services offered by the Recovery After an Initial Schizophrenia Episode (RAISE) Connection Program for youths and young adults experiencing early psychosis. It was part of the larger RAISE Implementation and Engagement Study.
  
  
  METHODS
  Thematic qualitative analyses of data from in-person, semistructured interviews with 32 clients were used to examine experiences of program services, staff practices, clients' engagement behaviors, and related factors, such as expectations, family involvement, illness, and setting. Eighteen clients were well engaged with services, and 14 were not. Thirteen were interviewed early in their program involvement (two to nine months after enrollment) and 18 others later (12 to 24 months after enrollment).
  
  
  RESULTS
  Four domains of factors influenced engagement: individualized care, program attributes, family member engagement, and personal attributes. A central factor was the program's focus on clients' life goals. For many interviewees, engagement hinged substantially on receiving what could be considered nonclinical services, such as supported education and employment. Other key factors were individualized services and staff interactions that were respectful, warm, and flexible; engagement of family members; and a focus on shared decision making.
  
  
  CONCLUSIONS
  The findings help explain the Connection Program's effectiveness regarding client engagement and deepen understanding of treatment engagement for youths and young adults experiencing early psychosis. The individualized, flexible, recovery-focused, and assertive model of services and client-staff interaction, incorporating shared decision making and a focus on client life goals, should be implemented and sustained in services for this population.
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Alicia
authors: A
authors: Lucksted
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Susan M
authors: SM
authors: Essock
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Jennifer
authors: J
authors: Stevenson
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Sapna J
authors: SJ
authors: Mendon
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Ilana R
authors: IR
authors: Nossel
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Howard H
authors: HH
authors: Goldman
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Amy B
authors: AB
authors: Goldstein
authors: Dr. Lucksted, Ms. Stevenson, and Dr. Goldman are with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore (e-mail: aluckste@psych.umaryland.edu ). Dr. Essock, Ms. Mendon, Dr. Nossel, and Dr. Dixon are with the New York State Psychiatric Institute, New York City. Dr. Essock, Dr. Nossel, and Dr. Dixon are also with the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York City. Dr. Goldstein is with the Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. This article is part of a special section on RAISE and other early intervention services. Marcela Horvitz-Lennon, M.D., M.P.H., served as guest editor of the special section. Some of the data reported here were included as part of a presentation at the annual meeting of the American Psychiatric Association, New York City, May 3-7, 2014.
authors: Lisa B
authors: LB
authors: Dixon
mesh_terms: D000328:Adult; D015142:Baltimore; D003657:Decision Making; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services; D009519:New York City; D010358:Patient Participation; D011369:Professional-Patient Relations; D015397:Program Evaluation; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D055815:Young Adult