The National Institute of Mental Health, the President's Commission on Mental Health, the Institute of Medicine, and the Surgeon General's Report on Mental Health unanimously urge all services to be effective, equitable, consumer oriented, and for the goal of services to not be limited to symptom reduction but focused on promoting recovery and empowerment. The proposed study will examine the relationship and explore the causal ordering between consumer working alliance, hope, and psychosocial functioning outcomes of individuals with schizophrenia participating in community-based psychosocial rehabilitation services using a mixed methods sequential explanatory design; collection and analysis of quantitative data followed by the collection and analysis of qualitative data, which are subsequently integrated and interpreted collectively. 100 individuals diagnosed with schizophrenia randomly selected and interviewed using the Working Alliance Inventory, Herth Hope Index, and the Role Functioning Scale. After the quantitative data are collected and analyzed, five individuals who score high (top 1/3) and five individuals who score low (bottom 1/3) on the Working Alliance Inventory will be purposefully sampled for subsequent open-ended interviews to explore factors that contributed to their high and low evaluations and further investigate the other results from the quantitative data. In the final stage, the quantitative and qualitative data will be compared side-by-side. Understanding the critical treatment process factors will lead to improved treatment models as well as better outcomes and enhanced quality of lives for individuals with schizophrenia. ? ? ?
