정신질환자를 위한 심리·사회적 회복프로그램 개발 = Development of a psychological recovery program for individuals with mental illness

다국어 초록 (Multilingual Abstract)

The purpose of this study was to develop and evaluate a recovery-oriented psychosocial recovery program for individuals with mental illness residing long-term in psychiatric rehabilitation facilities. The program was theoretically grounded in the CHIME framework—Connectedness, Hope and optimism, Identity, Meaning in life, and Empowerment—and integrated cognitive-behavioral therapy (CBT) techniques as change strategies. Psychosocial recovery was operationally defined as a composite construct comprising psychological recovery, measured by the Korean version of the Mental Health Recovery Measure (MHRM-K), and social recovery, measured by the Multidimensional Scale of Perceived Social Support (MSPSS).
The program was systematically developed through needs assessment, theoretical review, goal setting, CHIME-based content construction with CBT strategies, expert validation, pilot implementation, and revision. The finalized intervention consisted of ten 90-minute group counseling sessions, progressing stepwise from emotional stabilization and self-understanding to relationship recovery, reconstruction of life meaning, and empowerment.
A non-equivalent control group mixed-model design was employed. Thirty-six adults with schizophrenia, bipolar disorder, or major depressive disorder from three psychiatric rehabilitation facilities were assigned at the facility level to an experimental group (CHIME×CBT integrated program), a comparison group (restructured existing recovery program), or a control group (routine daily activities). Data were collected at three time points (pretest, posttest, and follow-up). Quantitative data were analyzed using analysis of covariance (ANCOVA) with pretest scores as covariates, and qualitative data from facilitator logs, session evaluations, and participant reflection reports were analyzed using content analysis.
The results indicated that the experimental group showed significantly greater improvements in psychological recovery at both posttest (F = 50.09, p < .001) and follow-up (F = 53.36, p < .001) compared to the comparison and control groups. Social recovery, reflected in perceived social support, was also significantly higher at posttest (F = 30.37, p < .001) and follow-up (F = 52.51, p < .001). Qualitative findings further supported the quantitative results, revealing changes consistent with the CHIME recovery processes, including increased self-acceptance, enhanced hope and self-efficacy, strengthened connectedness, reconstruction of life meaning, and empowerment.
In conclusion, the CHIME×CBT psychosocial recovery program is a systematic and evidence-based, person-centered intervention that simultaneously enhances psychological and social recovery among individuals with mental illness in long-term residential settings. The findings suggest that this program provides a practical framework for activating both internal strengths and external social resources and has strong potential for standardization and application within psychiatric rehabilitation and community mental health services in Korea.

목차 (Table of Contents)

• (Abstract) ⅵ
• Ⅰ. 서론 1
• 1. 연구의 필요성과 목적 1
• 2. 연구문제 6
• 3. 용어의 정의 7
• Ⅱ. 이론적 배경 10
• 1. 정신질환자 10
• 2. 회복의 개념과 구성요소 13
• 3. 심리적 회복 및 사회적 회복 18
• 4. 회복프로그램에 관한 선행연구 32
• Ⅲ. 프로그램의 개발과정 및 구성결과 39
• 1. 프로그램 개발모형 39
• 2. 프로그램 평가모형 46
• 3. 프로그램 개발과정 49
• 4. 프로그램 구성결과 99
• Ⅳ. 프로그램의 평가방법 및 평가절차 102
• 1. 프로그램 평가방법 102
• 2. 프로그램 평가결과 113
• Ⅴ. 논의 및 결론 141
• 1. 논의 141
• 2. 결론 및 제언 153
• 참고문헌 157
• 부 록 174