581864
research-article2015
ISP0010.1177/0020764015581864International Journal of Social PsychiatryWang et al.
Letter to the Editor
Vocational rehabilitation improves insight
and social functioning of people with
schizophrenia
Wei Wang1, Guofu Zhang1, Man CM Tsui2 and Da Li1
The findings of the study (Erol, Delibas, Bora, & Mete,
2014) published recently in this Journal reveal that insight
has a significant impact on social functioning of people
with schizophrenia. So, how can the insight be fostered?
Vocational rehabilitation is a crucial means. In addition to
the traditional framework of recovery emphasizing profes-
sional knowledge (such as medicine, nursing, occupational
therapy, social work) in schizophrenia, lived-experience
knowledge formed by the rehabilitants has started emerg-
ing (Onken, Dumont, Ridgway, Dornan, & Ralph, 2002).
In fact, encompassing this lived-experience knowledge
base is important not only for widening the scope of knowl-
edge in recovery but also striking a balance among its
constructs held by the professionals and the rehabilitants in
relation to the interventions. In lived-experience under-
standing of recovery, maintenance of roles and responsi-
bilities of rehabilitants is emphasized (Glover, 2007). It is
perfectly in line with the philosophy and goal of vocational
rehabilitation in which the rehabilitants are empowered to
resume their worker roles and hence take up the associated
responsibilities. For instance, Tsang et al. (2013) state that
the social functioning of persons with schizophrenia can be
enhanced when they can secure some form of employment
through vocational rehabilitation interventions that they
are not only able to gain a livelihood but also make some
contribution to the income of the family which to some
extent relieves part of the immense burdens of caregivers.
Avolition is a negative symptom commonly observed in
people with schizophrenia that they are not motivated to
initiate or sustain their engagement in the tasks required
in their roles (American Psychiatric Association, 2000).
Through vocational rehabilitation programs, the rehabili-
tants are encouraged and supported by their care workers
to resume and maintain their worker roles by overcoming
hurdles regarding job seeking and maintenance. By review-
ing their progress, they become aware how much they have
stepped along their personal recovery journey towards
taking up the worker roles. Besides, active reflection of
own experiences (no matters positive or negative) can
contribute to the creation of wisdom of what works and
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International Journal of
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2015, Vol. 61(5) 515­
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DOI: 10.1177/0020764015581864
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what does not work in the recovery process (Glover, 2007).
It in turn helps them better develop their insight on how to
sharpen their strategies in order to fulfill their worker roles
and hence improve their social functioning.
In short, vocational rehabilitation is a crucial key to
enhancing social functioning of persons with schizophrenia
through fostering their insight on worker roles fulfillment.
Mental health professionals should explore the feasibility
of incorporating this rehabilitation into their clinical
practices to maximize the rehabilitants’ social functioning.
References
American Psychiatric Association. (2000). Diagnostic and sta-
tistical manual of mental disorders (DSM-IV TR) (4th ed.).
Washington, DC: Author.
Erol, A., Delibas, H., Bora, O., & Mete, L. (2014). The impact of
insight on social functioning in patients with schizophrenia.
International Journal of Social Psychiatry. Advance online
publication. doi:10.1177/0020764014548287
Glover, H. (2007). Lived experience perspectives. In R. King,
C. Lloyd & T. Meehan (Eds.), Handbook of psychoso-
cial rehabilitation (pp. 28–42). Oxford, UK: Blackwell
Publishing Ltd.
Onken, S., Dumont, J., Ridgway, P., Dornan, D., & Ralph, R.
(2002). Mental health recovery: What helps and what hinders?
New York, NY: NASMHPD Office of Technical Assistance.
Tsang, H. W. H., Li, D., Tsui, M. C. M., Chung, R. C. K.,
Wong, A. H. H., Li, S. M., . . . Yiu, M. G. (2013). The per-
ceived rehabilitation needs of people with schizophrenia in
Hong Kong: Perspectives from consumers and caregivers.
Administration and Policy for Mental Health and Mental
Health Services Research, 40, 179–189.
1Wuxi Mental Health Center, Wuxi Tongren International
Rehabilitation Hospital, Nanjing Medical University, Nanjing, China
2Department of Rehabilitation Sciences, The Hong Kong Polytechnic
University, Hong Kong
Corresponding author:
Da Li, Wuxi Mental Health Center, Wuxi Tongren International
Rehabilitation Hospital, Nanjing Medical University, Qian Rong Lu,
Binhu District, Wuxi City, Jiangsu, Nanjing 214000, China.
Email: 13358119052@163.com