This study is designed to assess the impact of Client Support and Representation Services (CSR) provided to mentally disabled clients. CSR services include providing information to clients and their families; meeting regularly with them to determine needs for assistance; mediating and negotiating with other staff and providers; serving as the client's representative in all actions pursued; and monitoring service provider activity around changes resulting from negotiations. Services will be offered in both a community and an inpatient setting to permit assessment with different mixes of problems and clients. Using experimental and quasi-experimental designs the study will assess the impact of CSR services on client outcomes such as self-concept, relationships with the environment and with significant others, mental status, etc. Specific designs are proposed for both the community setting (Santa Clara County, California) and the inpatient setting (Vermont State Hospital). CSR services will be provided in the experimental condition. In one control condition no new services will be provided. In a second control condition clients will receive friendly """"""""greetings"""""""" on a schedule identical to that of the experimental subjects in order to examine the alternative explanation that differences may result solely from friendly attention and not from the substance of CSR services. Data will be collected on the characteristics of the intervention, client characteristics, mental health services received, and outcomes. A number of possible process explanations for the results of the intervention will also be examined. Although there have been numerous arguments raised both in support of CSR-type services and in opposition, there have been no experimental assessments of such services. It is this absence of empirical data that the present study is designed to address. Realistic dissemination and utilization activities will be undertaken to make the findings of this project more accessible to researchers and clinicians.
| Freddolino, P P; Moxley, D P (1992) Refining an advocacy model for homeless people coping with psychiatric disabilities. Community Ment Health J 28:337-52 |
| Freddolino, P P; Moxley, D P; Fleishman, J A (1989) An advocacy model for people with long-term psychiatric disabilities. Hosp Community Psychiatry 40:1169-74 |
