CBR delivery
schizophrenia, familial and social difficulties•
RECRUITMENT
The CBR intervention will be delivered by group at community health centers. Two CBR workers will be attached to each sub-district and have one group of 10–20 people with schizophrenia. CBR delivery will commence immediately after recruitment into the trial. A total of 18 group intervention sessions will be implemented within the following 12 months, and each group intervention session will last 90–120 min. The intervention is delivered in two phases (Table The content and process of the phase specific delivery of the intervention has been manualized. CBR workers will be closely supervised at each site by psychiatrists who will work as designated intervention coordinators. They will coordinate the overall delivery of the intervention and assure the quality and fidelity of the intervention at the site. The treating psychiatrists will provide clinical leadership for the community care teams and ongoing supervision to maintain safety and quality standards.In total, we anticipate that each participant in the intervention arm will receive a maximum of 18 group-based rehabilitation sessions during the 12 months of the intervention. In evaluating the intervention, a minimum adequate number of 12 sessions attended over 12 months was set according to priori definitions.
CRISC community-based rehabilitation (CBR) intervention outline• developing a positive therapeutic alliance• needs assessment• improving knowledge of illness• improving medication adherence• addressing familial and social difficulties• understanding schizophrenia• psychoeducation• adherence management• physical health promotion• life skill training• social skill training• symptoms management• warm-up exercises (15 min)• introduction & ice-breaking activity (20 min, for the first session)• sharing experience of past two weeks (30 min)• Module activity (30–40 min)• question and discussion (20 min)• assignment for next two weeks (10 min)Phase 2(stabilizing)• addressing the unmet or partially met needs from the first phase• reinforcing knowledge of illness• reinforcing medication adherence• improving self-care skills• improving social interactions within and outside of the family• Generating a rehabilitation and relapse prevention plan• psychoeducation• adherence management• physical health promotion• life skill training• social skill training• symptoms management• personal rehabilitation planning• prepare for termination• warm-up exercises (15 min)• sharing experience of past two weeks (30 min)• Module activity (30–40 min)• question and discussion (20 min)• making rehabilitation plan (20 min)• assignment for next two weeks (10 min)• CBR summary & energetic participants awards (20 min, for the last session)