A protocol to develop and study the effectiveness and implementation of social skills training that improves supported housing retention for persons with serious mental illness

doi:10.1016/j.conctc.2019.100344

. 2019 Mar 9:14:100344.

doi: 10.1016/j.conctc.2019.100344. eCollection 2019 Jun.

A protocol to develop and study the effectiveness and implementation of social skills training that improves supported housing retention for persons with serious mental illness

Sonya Gabrielian^{1

2

3}, Alison B Hamilton^{1

2

3}, Lillian Gelberg^{3

4

5}, Gerhard Hellemann^{1

2}, Ella R Koosis^{1

3}, Axeline Johnson⁶, Alexander S Young^{1

2

3}

Affiliations

¹ VA Greater Los Angeles, Mental Illness Research, Education, and Clinical Center, 11301 Wilshire Blvd., Bldg 210A, Los Angeles, CA, 90073, USA.
² UCLA David Geffen School of Medicine, Department of Psychiatry, 760 Westwood Plaza, Los Angeles, CA, 90095, USA.
³ VA Greater Los Angeles, HSR&D Center of Innovation, 11301 Wilshire Blvd., Bldg 206, Los Angeles, CA, 90073, USA.
⁴ UCLA David Geffen School of Medicine, Department of Family Medicine, 10880 Wilshire Blvd., Ste. 1800, Los Angeles, CA, 90024, USA.
⁵ UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles E. Young Dr. South, 16-035 Center for Health Sciences, Los Angeles, CA, 90095, USA.
⁶ University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Suite 200, Philadelphia, PA, 19104, USA.

PMID: 30923776
PMCID: PMC6421356
DOI: 10.1016/j.conctc.2019.100344

Free PMC article

A protocol to develop and study the effectiveness and implementation of social skills training that improves supported housing retention for persons with serious mental illness

Sonya Gabrielian et al. Contemp Clin Trials Commun. 2019.

Free PMC article

. 2019 Mar 9:14:100344.

doi: 10.1016/j.conctc.2019.100344. eCollection 2019 Jun.

Authors

Sonya Gabrielian^{1

2

3}, Alison B Hamilton^{1

2

3}, Lillian Gelberg^{3

4

5}, Gerhard Hellemann^{1

2}, Ella R Koosis^{1

3}, Axeline Johnson⁶, Alexander S Young^{1

2

3}

Affiliations

¹ VA Greater Los Angeles, Mental Illness Research, Education, and Clinical Center, 11301 Wilshire Blvd., Bldg 210A, Los Angeles, CA, 90073, USA.
² UCLA David Geffen School of Medicine, Department of Psychiatry, 760 Westwood Plaza, Los Angeles, CA, 90095, USA.
³ VA Greater Los Angeles, HSR&D Center of Innovation, 11301 Wilshire Blvd., Bldg 206, Los Angeles, CA, 90073, USA.
⁴ UCLA David Geffen School of Medicine, Department of Family Medicine, 10880 Wilshire Blvd., Ste. 1800, Los Angeles, CA, 90024, USA.
⁵ UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles E. Young Dr. South, 16-035 Center for Health Sciences, Los Angeles, CA, 90095, USA.
⁶ University of Pennsylvania, Department of Psychiatry, 3535 Market Street, Suite 200, Philadelphia, PA, 19104, USA.

PMID: 30923776
PMCID: PMC6421356
DOI: 10.1016/j.conctc.2019.100344

Erratum in

Erratum regarding missing Declaration of Competing Interest statements in previously published articles.
[No authors listed] [No authors listed] Contemp Clin Trials Commun. 2020 Dec 10;20:100690. doi: 10.1016/j.conctc.2020.100690. eCollection 2020 Dec. Contemp Clin Trials Commun. 2020. PMID: 33392414 Free PMC article.

Abstract

Introduction: Supported housing-which offers permanent, community-based housing and supportive services-effectively addresses homelessness. Yet, many persons with serious mental illness (SMI) struggle to retain housing in these programs. Social skills-which facilitate social interactions and instrumental tasks-predict premature exits from supported housing. Though social skills training effectively improves social skills and functioning for persons with SMI, this intervention is essentially absent from supported housing initiatives.

Methods: This study will use literature review, key informant interviews and an expert panel to adapt social skills training for supported housing, aiming to improve housing retention among SMI persons in these programs. In the Department of Housing and Urban Development-VA Supported Housing program (HUD-VASH) at VA Greater Los Angeles, we will conduct an effectiveness-implementation hybrid type I trial of the adapted intervention. Baseline and 6-month assessments (measuring social skills, mental health status, healthcare utilization, social networks, money management, and housing outcomes) will be conducted with intervention participants (n = 30) and a usual care control group (n = 20). We will use the generalized linear mixed model (GLMM) to compare change over 6 months between groups, capturing the intervention's effectiveness on factors strongly associated with housing retention. Qualitative data and surveys with staff, leadership, and participants will gather data on factors relevant to the intervention's future implementation in routine care.

Discussion: Few effective psychosocial interventions for persons with SMI have been adapted or studied in supported housing initiatives. To our knowledge, this is the first study to adapt and study the effectiveness and implementation of social skills training in supported housing programs.

Keywords: Homelessness; Hybrid trial; Serious mental illness; Supported housing; Veterans.

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Figures

**Fig 1**
Behavioral model for vulnerable populations¹⁸, adapted for this study protocol.

**Fig. 2**
Anticipated structure of the intervention.

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Cited by

Stakeholder perspectives on sustainment of Housing First in a VA permanent supportive housing program.
Fletcher EH, Gabrielian S, Flynn AWP, Greenberg JM, Hovsepian S, Oberman RS, Young AS. Fletcher EH, et al. Health Serv Res. 2022 Apr;57(2):374-384. doi: 10.1111/1475-6773.13904. Epub 2022 Mar 3. Health Serv Res. 2022. PMID: 35238030 Free PMC article.

References

1. Tsemberis S., Gulcur L., Nakae M. Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. Am. J. Public Health. 2004;94:651–656. - PMC - PubMed
1. Greenwood R.M., Schaefer-McDaniel N.J., Winkel G., Tsemberis S.J. Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. Am. J. Community Psychol. 2005;36:223–238. - PubMed
1. Kertesz S.G., Austin E.L., Holmes S.K., DeRussy A.J., Van Deusen Lukas C., Pollio D.E. Housing first on a large scale: fidelity strengths and challenges in the VA's HUD-VASH program. Psychol. Serv. 2017;14:118–128. - PubMed
1. O'Connell M., Kasprow W., Rosenheck R.A. National dissemination of supported housing in the VA: model adherence versus model modification. Psychiatr. Rehabil. J. 2010;33:308–319. - PubMed
1. Gabrielian S., Burns A.V., Nanda N., Hellemann G., Kane V., Young A.S. Factors associated with premature exits from supported housing. Psychiatr. Serv. 2015 appips201400311. - PMC - PubMed

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IK2 HX002089/HX/HSRD VA/United States

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[1] Tsemberis S., Gulcur L., Nakae M. Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. Am. J. Public Health. 2004;94:651–656. - PMC - PubMed

[2] Tsemberis S., Gulcur L., Nakae M. Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. Am. J. Public Health. 2004;94:651–656. - PMC - PubMed

[3] Greenwood R.M., Schaefer-McDaniel N.J., Winkel G., Tsemberis S.J. Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. Am. J. Community Psychol. 2005;36:223–238. - PubMed

[4] Greenwood R.M., Schaefer-McDaniel N.J., Winkel G., Tsemberis S.J. Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. Am. J. Community Psychol. 2005;36:223–238. - PubMed

[5] Kertesz S.G., Austin E.L., Holmes S.K., DeRussy A.J., Van Deusen Lukas C., Pollio D.E. Housing first on a large scale: fidelity strengths and challenges in the VA's HUD-VASH program. Psychol. Serv. 2017;14:118–128. - PubMed

[6] Kertesz S.G., Austin E.L., Holmes S.K., DeRussy A.J., Van Deusen Lukas C., Pollio D.E. Housing first on a large scale: fidelity strengths and challenges in the VA's HUD-VASH program. Psychol. Serv. 2017;14:118–128. - PubMed

[7] O'Connell M., Kasprow W., Rosenheck R.A. National dissemination of supported housing in the VA: model adherence versus model modification. Psychiatr. Rehabil. J. 2010;33:308–319. - PubMed

[8] O'Connell M., Kasprow W., Rosenheck R.A. National dissemination of supported housing in the VA: model adherence versus model modification. Psychiatr. Rehabil. J. 2010;33:308–319. - PubMed

[9] Gabrielian S., Burns A.V., Nanda N., Hellemann G., Kane V., Young A.S. Factors associated with premature exits from supported housing. Psychiatr. Serv. 2015 appips201400311. - PMC - PubMed

[10] Gabrielian S., Burns A.V., Nanda N., Hellemann G., Kane V., Young A.S. Factors associated with premature exits from supported housing. Psychiatr. Serv. 2015 appips201400311. - PMC - PubMed

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A protocol to develop and study the effectiveness and implementation of social skills training that improves supported housing retention for persons with serious mental illness

Affiliations

A protocol to develop and study the effectiveness and implementation of social skills training that improves supported housing retention for persons with serious mental illness

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