CLINICAL HANDBOOK OF SCHIZOPHRENIA

CHAPTER 14ASSESSMENT OFPSYCHOSOCIAL FUNCTIONINGTANIA LECOMTEMARC CORBIÈRECATHERINE BRIANDPsychosocial functioning assessments for individuals with severe mental illness havegreatly evolved over the past two decades. Initially, their sole purpose was to determinean individual’s readiness to return to the community after years of institutionalization,and the level of assistance needed to stay there. Assessments were later used by mentalhealth professionals to determine whether their clients needed rehabilitation and howthey fared in different treatment programs. With psychiatric rehabilitation moving towardthe recovery model—which focuses on clients’ strengths, self-determination, growthpotential, and personal choices, and promotes full partnership with clinicians regardingservices offered—psychosocial functioning assessments have become more a collaborativeprocess between mental health professionals and clients. As such, social functioning measuresare used by clients to self-monitor their progress, and by mental health professionalsto guide them toward the appropriate programs or interventions. Large-scalepsychosocial functioning assessments may also be conducted by health management organizationsor other external funding agencies to determine the overall effectiveness ofspecific rehabilitation programs. Psychosocial functioning assessments are, of course, alsoused in the context of efficacy and effectiveness studies of specific rehabilitation treatmentsor programs. No longer considered the domain of psychometricians or psychologists,psychosocial functioning assessments are now an integral part of clinical practice inpsychiatric rehabilitation.Psychosocial functioning has been defined in different ways and may cover a largearray of behaviors. Typically, psychosocial functioning includes everything needed to livesuccessfully in today’s society, namely, having the necessary independent living skills(cooking, cleaning, hygiene, etc.), engaging in positive relationships (social skills), studyingor having a job, taking care of one’s health and mental health, as well as avoidingproblematic community behaviors (violence, substance abuse, etc.). For people with children,being a good parent and caregiver is also an important aspect of social functioning.135