CLINICAL HANDBOOK OF SCHIZOPHRENIA

14. Assessment of Psychosocial Functioning 141The instrument has 17 items. The measure was developed by mental health professionalsto assess individuals with severe and persistent mental illness. The higher the score, themore autonomous the person is considered. The MCAS allows us to assess different functioningdomains over time and is fairly brief to fill out, but it only considers the clinician’sinput. Therefore, it can be useful for research, management, or program evaluations, butit is less useful clinically than measures that include more than one perspective, includingthe client’s.Client Assessment of Strengths, Interests, and GoalsThe Client Assessment of Strengths, Interests, and Goals—Self-Report and InformantVersions (CASIG-SR and CASIG-I; Wallace, Lecomte, Wilde, & Liberman, 2001) is acomprehensive assessment of functioning that addresses most psychiatric rehabilitationtreatment domains, namely, community living skills, cognitive skills, medication practices(compliance and side effects), quality of life and treatment, symptoms, consumer rights,and unacceptable community behaviors. Each scale ends with a goal question pertainingto that domain. The assessment also elicits goals in five broad areas (Residence, Financial,Relationships, Religion/Spirituality, and Physical and Mental Health) with openendedquestions. The CASIG assesses multiple outcomes relevant to clients and cliniciansthat focus on strengths and skills. It is capable of assessing changes over time (can be readministeredevery 3 months) and includes multiple perspectives of family members, clinicians,and clients. The CASIG is ideal for treatment planning and assessing change overtime in goals and skills. It is, however, considered time-consuming to administer.Camberwell Assessment of NeedThe Camberwell Assessment of Need (CAN; Phelan et al., 1995) measures level of difficultyand level of assistance needed in 22 areas of functioning, including housing, food,cleaning, hygiene, daily activities, physical health, psychotic symptoms, treatment orillness information, psychological distress, personal security, social security, security ofothers, alcohol, drugs, social relationships, emotional relationships, sexual life, care ofchildren, education, financial tasks use of the telephone, and use of public transportation.The client and his or her clinician independently rate both the client’s difficulty in functioningand the assistance provided to the respondent in each of the 22 areas (essentiallyone question per area). These two ratings are combined to yield one of three possible responsesper area; (1) no difficulties, (2) no important difficulties, thanks to someone’s intervention,or (3) important difficulties. This questionnaire covers many basic functioningareas in a general way (problem or no problem), rather than in depth. It does, however,cover more domains than most instruments, offers the advantage of two versions (clinicianand client), and can be used at multiple time points.DOMAIN-SPECIFIC ASSESSMENTSOF PSYCHOSOCIAL FUNCTIONINGIndependent Living SkillsIndependent Living Skills SurveyThe Independent Living Skills Survey (ILSS; Wallace, Liberman, Tauber, & Wallace, 2000)measures basic functional living skills in the past 30 days in the following areas: appearance/