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Instilling hope to enhance self-determination and service engagement in people with serious mental illnesses


Investigators: Mark Salzer, Ph.D. and Petra Kottsieper, Ph.D.

The goal of this project is to develop a new intervention to convey empowering and hope-inspiring messages to persons with serious mental illnesses and to study the extent to which the intervention can increase service participation.

Being diagnosed with a serious mental illness can result in hopelessness and demoralization, which might manifest in a perceived lack of meaning in daily activities, diminished attribution of value to life, discouragement about goals or low awareness of personally significant goals, disconnection from social meanings, suffering in the past without perceived significance, and pessimism about the future. Research has indicated that service users have a desire for professionals to incorporate explicit discussions of hope and/or the active fostering of hope into helping relationships. Empowering relationships that facilitate self-determination have also been linked to improved service participation and service outcomes.  Recent calls have been made to investigate interventions aimed at enhancing the provider’s capacity to promote the person’s sense of empowerment, self-determination, and hope, and assess the extent to which they ultimately increase service participation and treatment outcomes.


This research project will be carried out in two main phases. Phase 1. Hope and Empowerment Instillation Training (HEIT) Manual Development. A manual to assist providers in instilling hope and empowerment will be developed using a process and approach that promotes empathy and strengthens the skills of providers in the context of the therapeutic relationship.  Consistent with our CBPR efforts, this manual will be developed in conjunction with a team of consumers and providers in workgroup meetings and grounded in the literature on hope and empowerment. Phase 2. Randomized Clinical Trial of HEIT. This study will aim to recruit 60 individuals with serious mental illnesses in the greater Philadelphia area. The study will use a between-groups longitudinal randomized design. Participants will be randomly assigned to one of two groups: Hope and empowerment inspiring intervention as an adjunct to typical provider interactions and approaches (Experimental condition) versus typical provider relationship and approaches alone (Control condition).