Improving Representative Payeeship for People With Psychiatric Disabilities and Their Families
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Purpose
Representative payees, mostly family members, manage Social Security Administration funds of more than one million people with psychiatric disabilities. Although studies show payeeship can be used coercively, foster dependency, reduce work incentives, lead to family conflict and even violence, there has been little systematic research on how to lower these significant barriers to community integration.
The investigators' long term goal is to promote recovery among adults with psychiatric disabilities who have payees by reducing downsides associated with what has been called "the nation's largest guardianship system." The investigators' objective in the current application is to evaluate a pilot-tested, stakeholder-informed intervention that is grounded in principles of psychiatric rehabilitation and encourages consumers with psychiatric disabilities and their family members to collaborate within the representative payee arrangement.
| Condition | Intervention |
|---|---|
|
Schizophrenia Bipolar Disorder Major Depressive Disorder |
Behavioral: Steps for Achieving Financial Empowerment (SAFE) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Outcomes Assessor) Primary Purpose: Health Services Research |
| Official Title: | Improving Representative Payeeship for People With Psychiatric Disabilities and Their Families |
- employment [ Time Frame: six months ] [ Designated as safety issue: No ]
- empowerment [ Time Frame: six months ] [ Designated as safety issue: No ]
- family support [ Time Frame: six months ] [ Designated as safety issue: No ]
| Enrollment: | 303 |
| Study Start Date: | May 2008 |
| Study Completion Date: | April 2011 |
| Primary Completion Date: | April 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
Subjects will be offered the Steps for Achieving Financial Empowerment (SAFE) which helps facilitate a cooperative consumer-payee relationship, increase accurate knowledge about representative payeeship, promote collaborative money management and effective budgeting, and prepare mutually developed plans for carrying out the payeeship in the future.
|
Behavioral: Steps for Achieving Financial Empowerment (SAFE)
The SAFE is a brief, 5-component intervention that aims to facilitate a cooperative consumer-payee relationship, increase accurate knowledge about representative payeeship, promote collaborative money management and effective budgeting, and prepare mutually developed plans for carrying out the payeeship in the future.
|
|
No Intervention: 2
Representative payeeship as usual
|
Detailed Description:
To do this, we will test the Steps for Achieving Financial Empowerment (SAFE) intervention by randomly assigning N=200 consumer-family payee dyads into one of two groups: (a) the SAFE intervention (n=100); or (b) a "usual care" control (n=100). The SAFE is a brief, 5 component educational intervention that aims to facilitate a cooperative consumer-payee relationship, increase accurate knowledge about representative payeeship, promote collaborative money management and effective budgeting, and prepare mutually developed plans for carrying out the payeeship in the future.
We will interview people with psychiatric disabilities and their family payees at baseline and six-months. This study aims to examine the effects of the SAFE intervention on community participation, employment, and family support of adults with psychiatric disabilities who have family representative payees. Our central hypothesis, based on strong preliminary data, is that the SAFE will benefit consumers by enhancing autonomy, boosting motivation to work, and reducing family conflict.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
For disability recipients:
- Meets DSM-IV criteria for schizophrenia, schizoaffective disorder, bipolar disorder, or depressive disorder with psychotic features;
- age 18-65;
- Has a family member (parent or sibling) as a representative payee.
For payees:
- Has family member (child or sibling) with schizophrenia, schizoaffective disorder, bipolar disorder, or depressive disorder with psychotic features; and
- Is the family member's representative payee.
Exclusion Criteria:
- None.
Contacts and Locations| United States, North Carolina | |
| UNC-Chapel Hill | |
| Chapel Hill, North Carolina, United States, 27599 | |
| Principal Investigator: | Eric B Elbogen, Ph.D. | UNC-Chapel Hill |
More Information
Publications:
| Responsible Party: | Eric Elbogen, UNC-Chapel Hill |
| ClinicalTrials.gov Identifier: | NCT00924976 History of Changes |
| Other Study ID Numbers: | H133G070058 |
| Study First Received: | June 17, 2009 |
| Last Updated: | May 10, 2011 |
| Health Authority: | United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Bipolar Disorder Depressive Disorder Depression Schizophrenia Depressive Disorder, Major |
Affective Disorders, Psychotic Mood Disorders Mental Disorders Behavioral Symptoms Schizophrenia and Disorders with Psychotic Features |
ClinicalTrials.gov processed this record on May 22, 2013