Project GREAT Educates Clinicians, Empowers Patients

This is exacerbated by the paternalistic perspective that continues to be taught by the traditional model "So shifting this attitude and getting providers to see their patients as capable and helping them instill hope is not at all intuitive or easy," he said.

"What we’re finding, though, is that the more contact providers have with the consumer, and particularly the CPS, the more they are able to see and appreciate a more promising outlook: that recovery is possible and that people can reclaim their lives, so this constant exposure is very valuable."

Although the model, which is being implemented at the Medical College of Georgia and its affiliated hospital as well as at a traditional mental health public hospital in Atlanta, is still new enough to preclude comprehensive outcome studies in the scientific domain, "our program evaluation materials suggest we’re on the right track," Dr. Mabe said. "The scores for the questions on our patient satisfaction measures that are most relevant to Project GREAT, including, ‘Does my doctor understand me? Does my doctor give a good explanation of the treatment options? Am I allowed to be an active participant in the decision-making process?’ have risen from the mid-80% range prior to 2007 to the 95% and higher range since 2007."

Further, in an assessment of the Project GREAT curriculum’s effectiveness for instilling knowledge about recovery and promoting recovery-based attitudes among psychiatrists and psychologists, investigators showed that the recovery principles were effectively taught and that when patients and CPS shared their recovery stories, provider attitudes "shifted toward recovery," Dr. Mabe said (Community Ment. Health J. 2009;45:239-45).

Project GREAT continues to be a work in progress. "Right now, we are piloting a new seminar on shared decision making in psychiatry and looking at the impact on attitudes in practice," Dr. Mabe said. Looking 5-10 years out, "our hope is that by then, there will be a solid skill base in faculty and students where they are really integrating the holistic perspective into their practice by considering life purpose and meaning rather than just symptoms," he said.

"Also, we hope collaboration and shared decision-making are established, valued clinical skills."

Dr. Mabe disclosed having no financial conflicts of interest.