Treatment plans in psychiatric community housing programs: do they reflect rehabilitation principles?

This study examined the extent to which treatment plans of service users of community housing programs measure up to rehabilitation principles according to the Choose-Get-Keep model of psychiatric rehabilitation. The study evaluates whether these plans correspond with service-user and key-worker perspectives on unmet needs for care.

A representative sample of key workers and service users of 16 Dutch Regional Institutes for Residential Care (RIRCs) participated in a cross-sectional survey. Sociodemographic and clinical data and an assessment of needs for care of 240 service users were collected. In addition, we received an anonymous copy of each participant's most recent written treatment plan. First, we developed a method to measure adherence to rehabilitation principles of written treatment plans, based on the Choose-Get-Keep model of psychiatric rehabilitation. Next, treatment plans were screened on the degree of adherence, expressed in a score from 0 to 10 for overall quality, and correlated with needs for care.

RIRCs mostly seem to succeed in sufficiently integrating rehabilitation principles in their treatment plans. Adherence to rehabilitation principles was neither associated with the service-user perspective nor with the key worker perspective on needs for care.

Rehabilitation principles are rather well documented in the majority of written treatment plans, although apparently without substantial consequences for needs for care among the service users. Further research is needed to validate our method and to investigate not only the adherence to rehabilitation principles in written treatment plans, but also in the actual care provision itself.