CLINICAL HANDBOOK OF SCHIZOPHRENIA

14. Assessment of Psychosocial Functioning 143or not employment is competitive, number of hours worked per week, wages earned,number of weeks the person has had the job, and whether the job provides benefits, suchas medical insurance.Barriers to Employment and Coping Efficacy ScaleThe Barriers to Employment and Coping Efficacy Scale (BECES; Corbière, Mercier, &Lesage, 2004) assesses 43 potential barriers to work integration mentioned by peoplewith mental illness seeking a job, along with perceived self-efficacy in overcoming thebarriers. For each barrier, participants are first asked to what extent “in their current situation,could this item represent a barrier to employment?” Participants are also asked toevaluate the extent to which they feel able to overcome this barrier. People can perceivebarriers to employment, yet feel able to overcome them. When clients encounter difficultiesin overcoming barriers, their job coach or counselor can intervene by guiding themtoward solutions or strategies.Work Behavior InventoryThe Work Behavior Inventory (WBI; Bryson, Bell, Lysaker, & Zito, 1997) is a 36-item assessmentthat measures work performance with the following five subscales: WorkHabits, Work Quality, Personal Presentation, Cooperativeness, and Social Skills. TheWBI is very useful for job coaches or vocational rehabilitation specialists who wish to offerprecise and useful support to their clients who are working. This measure is not appropriatefor settings in which the clients do not wish to disclose to their employer thatthey have a severe mental illness diagnosis, because the assessment needs to be completedby the employer.KEY POINTS• Psychosocial functioning assessments are an important aspect of treatment planning andoutcomes evaluation.• When choosing the right measure, clinicians should consider multiple factors, including thepurpose of the assessment, its psychometric properties, with whom it was validated, andthe length of administration.• Psychosocial functioning assessments can be grouped into three larger categories: globalmeasures, comprehensive measures, and domain-specific measures.• Global measures of psychosocial functioning often give one general score, include symptomsas well as functioning, and are mostly for large-scale health services or administrativestudies rather than for specific clinical use.• Comprehensive measures of psychosocial functioning assess multiple aspects of psychosocialfunctioning in a more detailed manner and are quite relevant clinically.• Domain-specific assessments cover in depth a single aspect of psychosocial functioning,such as independent living skills, social competence, or vocational functioning, and can bevery useful clinically for those with specific goals or needs in those domains.REFERENCES AND RECOMMENDED READINGSAmerican Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4thed.). Washington, DC: Author.Barker, S., & Barron, N. (1997). Multnomah Community Ability Scale: User’s manual. Portland, OR:Network Behavioral Health Care.