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Zomer L, van der Meer L, van Weeghel J, Widdershoven G, Voskes Y. From Model to Practice: A Qualitative Study on Factors Influencing the Implementation of the Active Recovery Triad (ART) Model in Long-Term Mental Health Care. J Clin Med 2024; 13:3488. [PMID: 38930017 PMCID: PMC11205107 DOI: 10.3390/jcm13123488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/17/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024] Open
Abstract
Background: The Active Recovery Triad (ART) model provides a framework for recovery-oriented care in the long-term mental health setting. The aim of this study is to gain insight into factors influencing the implementation process of the ART model. Methods: Focus groups were conducted with fourteen multidisciplinary teams that were in the process of implementing the ART model. Data were thematically analyzed. Results: Three phases of implementation were identified. In the first phase, getting started, support from both the top of the organization and the care workers, sufficient information to care workers, service users, and significant others, and creating momentum were considered crucial factors. In the second phase, during implementation, a stable team with a good team spirit, leadership and ambassadors, prioritizing goals, sufficient tools and training, and overcoming structural limitations in large organizations were seen as important factors. In the third phase, striving for sustainability, dealing with setbacks, maintaining attention to the ART model, and exchange with other teams and organizations were mentioned as core factors. Conclusions: The findings may support teams in making the shift from traditional care approaches towards recovery-oriented care in long-term mental health care.
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Affiliation(s)
- Lieke Zomer
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, 1081 HV Amsterdam, The Netherlands
- Altrecht GGZ, 3705 WC Zeist, The Netherlands
| | - Lisette van der Meer
- Department of Clinical & Developmental Neuropsychology, University of Groningen, 9712 TS Groningen, The Netherlands
- Department of Rehabilitation, Lentis Psychiatric Institute, 9470 AC Zuidlaren, The Netherlands
| | - Jaap van Weeghel
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, 5037 DB Tilburg, The Netherlands
| | - Guy Widdershoven
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, 1081 HV Amsterdam, The Netherlands
| | - Yolande Voskes
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, 1081 HV Amsterdam, The Netherlands
- Tranzo Scientific Center for Care and Wellbeing, Tilburg University, 5037 DB Tilburg, The Netherlands
- Impact Care Group, GGz Breburg, 5017 JD Tilburg, The Netherlands
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2
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Kivistö M, Martin M, Hautala S, Soronen K. Facilitators and Challenges of Integrating Experts by Experience Activity in Mental Health Services: Experiences from Finland. Community Ment Health J 2023; 59:540-551. [PMID: 36344706 PMCID: PMC9981489 DOI: 10.1007/s10597-022-01039-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/06/2022] [Indexed: 11/09/2022]
Abstract
This qualitative study examines the facilitators and challenges of integrating Experts by Experience (EbyE) activity in mental health services in the public sector from the perspective of mental health professionals and trained EbyE. The research data consist of four focus group interviews conducted in one hospital district in Finland. In the hospital district, EbyE activity is an established working model in mental health services. The professional focus groups had 9, and the EbyE focus groups had 13 participants. The data were analysed using abductive content analysis. The experiences of professionals and EbyE emphasised the successful integration of EbyE activity. The identified facilitators of integration included an organisational culture that values EbyE activity, facilitating operating structures, and extensive implementation and utilization of EbyE activities. Despite successful integration, certain challenges were described with regard to actors and practices. The findings indicate that the hospital district has overcome many of the obstacles to the integration identified in previous studies. The findings highlight the role of effectively implemented, organised EbyE activity.
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Affiliation(s)
- Mari Kivistö
- Faculty of Social Sciences, University of Lapland, Rovaniemi, Finland.
| | - Marjatta Martin
- Faculty of Social Sciences, University of Lapland, Rovaniemi, Finland
| | - Sanna Hautala
- Faculty of Social Sciences, University of Lapland, Rovaniemi, Finland
| | - Kari Soronen
- Faculty of Social Sciences, University of Lapland, Rovaniemi, Finland
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3
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Ibrahim N, Ghallab E, Ng F, Eweida R, Slade M. Perspectives on mental health recovery from Egyptian mental health professionals: A qualitative study. J Psychiatr Ment Health Nurs 2022; 29:484-492. [PMID: 33740825 DOI: 10.1111/jpm.12754] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Personal recovery concept is dominant in mental health systems when service user involvement is emphasized; however, service user involvement in mental health research and practice does not exist in Egypt. Definitions of recovery from high-income and English-speaking countries should be carefully adapted to other settings. Nurses providing mental health care in Egypt generally do not have specialized mental health nursing qualifications. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Both cultural and contextual uniqueness of Egypt as a Middle Eastern, low-middle-income country were clear in the findings of this paper. There are differences in the definition of family and service user engagement in the current study and in high-income countries. Seeking faith healers as a barrier to mental health recovery is culturally unique. Functional recovery prevails as a model in Egypt as there is limited service user involvement. Nursing values and code of ethics are consistent with enablers of mental health recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Changing the pre-registration nursing education to prepare specialized graduates in mental health nursing. Training of mental health professionals on recovery approaches which involve service users is needed in Egypt. Mental health nurses in Egypt can use the current findings to implement national campaigns to raise public awareness of mental health problems. ABSTRACT: Introduction Recovery-oriented mental health practice is an emerging approach that aims to empower individuals to define their goals and take responsibility for their own recovery. However, mental health practice in Egypt is still custodial. Aim To explore perspectives of Egyptian mental health professionals on recovery. Method Semi-structured interviews were conducted with 15 mental health professionals identified through snowball sampling. Results The current study identified that functional recovery outweighed other definitions. Four facilitators of mental health recovery were identified: therapeutic relationship; family engagement; cultural sensitivity; and professionals' self-awareness. Six barriers to recovery were found, comprising mental health stigma and lack of awareness, seeking traditional healers, shortage of psychiatrists, cost of treatment, lack of training and effective rehabilitation programs. Discussion The concept of functional recovery predominates among nurses and other mental health professionals, which may be due to limited training and the historical lack of service user involvement in Egypt. Lack of support from family and society, inadequate training MHPs and perceived system inefficiencies are also major impeding factors for recovery. Implications for Practice There is a need for nurses to be involved in designing intervention programs targeting the general public and to support increased involvement of people with mental health issues.
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Affiliation(s)
- Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Eman Ghallab
- Nursing Education Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Rasha Eweida
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
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4
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Sreeram A, Cross W, Townsin L. Effect of recovery-based interventions on recovery knowledge and attitudes of mental health professionals, regarding recovery-oriented practice: A quantitative narrative review. Int J Ment Health Nurs 2021; 30:1057-1069. [PMID: 34109703 DOI: 10.1111/inm.12897] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/06/2021] [Accepted: 05/18/2021] [Indexed: 12/01/2022]
Abstract
Mental health recovery is an enabling process encouraging consumers to live a productive life, notwithstanding the presence of debilitating symptoms of illness. The recovery model has been integrated into all areas of mental health. However, literature shows that mental health professionals are not equipped to provide recovery-oriented care to consumers. Researchers have recommended recovery-based interventions to develop knowledge, attitudes, and skills to promote recovery-oriented practice in mental health, yet there is a paucity of research regarding the effect of recovery-oriented interventions on the knowledge and attitudes of mental health professionals to improve recovery-oriented practice. Therefore, the purpose of the current review is to understand the effectiveness of interventions on recovery knowledge and attitudes of mental health professionals regarding recovery-oriented practice. The papers were identified through the Population Intervention Comparison and Outcome strategy. The heterogeneity of the selected papers led to a narrative review instead of a systematic review with meta-analysis. The analysis suggested that recovery-based interventions are effective in enhancing the recovery knowledge and attitudes of mental health professionals. Recovery-based interventions have the potential to reduce the use of physical restraints and improve work satisfaction among mental health professionals. The limitations of the studies were the heterogeneity of the selected populations and the absence of strong methodologies to assess the effect of the interventions. Therefore, future investigations should be focused on the effect of interventions on a homogeneous group using randomized controlled trials.
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Affiliation(s)
- Anju Sreeram
- Federation University, Berwick, Victoria, Australia
| | - Wendy Cross
- School of Nursing and Healthcare Professions, Federation University, Berwick, Victoria, Australia
| | - Louise Townsin
- Federation University, Berwick, Victoria, Australia.,Torrens University, Adelaide, South Australia, Australia
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5
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Petros R, Solomon P. How Adults With Serious Mental Illness Learn and Use Wellness Recovery Action Plan's Recovery Framework. QUALITATIVE HEALTH RESEARCH 2021; 31:631-642. [PMID: 33292068 PMCID: PMC9648532 DOI: 10.1177/1049732320975729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This study was conducted to investigate how adults with serious mental illness learn and utilize an illness self-management framework for pursuing recovery through a program called Wellness Recovery Action Plan (WRAP). The researchers employed an interpretive descriptive methodology with thematic analysis. Data were collected from three focus groups (n = 26) and in-depth interviews with follow-up member checks with 10 participants (n = 20 interviews). Findings aligned with main constructs of self-determination theory (SDT) to explain how an autonomy-supportive environment created opportunities for participants to build competency, implementing personalized recovery strategies that are socially endorsed by peers, resulting in internalized motivation for continued application of WRAP's framework. SDT appears to explain mechanisms of change for WRAP. Recommendations for mental health organizations include broadly ensuring autonomy-supportive environments and services that maximize opportunities to build competence in recovery strategies in collaboration with peers. Future research may utilize SDT as the theoretical basis for investigating self-management programs.
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Affiliation(s)
- Ryan Petros
- University of Washington, Seattle, Washington, USA
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McCaffrey T, Higgins P, Morrison H, Nelligan S, Clancy A, Cheung PS, Moloney S. Exploring the role and impact of visual art groups with multiple stakeholders in recovery-oriented mental health services. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2020.101748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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7
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Dun C, Swan J, Hitch D, Vlachou V. Occupational therapy driver assessments with mental health consumers: A mixed‐methods study. Aust Occup Ther J 2020; 67:330-340. [DOI: 10.1111/1440-1630.12652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Carolyn Dun
- Northern Area Mental Health Service NorthWestern Mental Health Preston Vic. Australia
| | - Jodie Swan
- North West Area Mental Health Service NorthWestern Mental Health Coburg Vic. Australia
| | - Danielle Hitch
- North West Area Mental Health Service NorthWestern Mental Health Coburg Vic. Australia
- Deakin University Geelong Vic. Australia
| | - Voula Vlachou
- Northern Area Mental Health Service NorthWestern Mental Health Preston Vic. Australia
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8
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The perspectives of a service user academic and a psychiatric trainee on engagement in supervision. Ir J Psychol Med 2020; 37:141-145. [PMID: 32106895 DOI: 10.1017/ipm.2020.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper describes the perspectives of a service user academic and a psychiatric trainee in response to their engagement in service user supervision, now offered as part of our psychological medicine education, as a feature of an innovative service user-led, recovery and human rights focused, contact-based education programme. The supervision, being deliberately focused on exploring and addressing responsiveness to the traditionally underprivileged service user's perspective, and hence vastly different to clinical supervision, was acknowledged by the trainee as being of distinct value, translating into changes in practice, particularly in terms of addressing power imbalances, enhancing communication with patients, supporting recovery and enabling supported decision-making. The main barrier to implementation of such changes was identified as being the lack of support of senior clinicians. The active support and enablement of trainees who want to share and apply new perspectives, models and approaches being advocated, including through current training, would likely be of benefit to all.
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9
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Arblaster K, Mackenzie L, Gill K, Willis K, Matthews L. Capabilities for recovery-oriented practice in mental health occupational therapy: A thematic analysis of lived experience perspectives. Br J Occup Ther 2019. [DOI: 10.1177/0308022619866129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Karen Arblaster
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
- Nepean Blue Mountains Local Health District, Sydney, Australia
| | | | | | - Karen Willis
- Allied Health Research, Royal Melbourne Hospital, La Trobe University, Melbourne, Australia
| | - Lynda Matthews
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
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10
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Farkas M, Coe S. From Residential Care to Supportive Housing for People With Psychiatric Disabilities: Past, Present, and Future. Front Psychiatry 2019; 10:862. [PMID: 31849724 PMCID: PMC6893903 DOI: 10.3389/fpsyt.2019.00862] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/04/2019] [Indexed: 11/24/2022] Open
Abstract
For centuries, treatment and accommodation for people with significant mental health conditions in many countries, including the United States, have been viewed as necessarily inseparable elements, first in asylums and then, with deinstitutionalization, in community care models. The advent of psychiatric rehabilitation and later, recovery, helped to shift the paradigm of mental health services and the role of housing, to one focused on promoting the ability of individuals to achieve not only a life located in the community, but one that reflects a meaningful life as part of a community. In this context, supportive housing emerged as a model based on integrated, permanent, affordable housing, selected by the person, with flexible supports that are functionally separate, but available as needed and wanted. This model of housing has been predominant in American mental health services for over 20 years, and evidence now exists for its outcomes in terms of housing stability, symptom reduction, and psychosocial variables. Current challenges, both at the societal and the individual level, confront the sustainability of supportive housing, with some efforts being made by housing groups to address these challenges. This article reviews the evolution of supportive housing and its basic tenets, identifying the challenges and some efforts to address them. In addition, the article discusses the current social and economic climate, which appears to be shaping opposing trends, and makes a call to action, to mitigate the possible risks to the future of this value-based housing approach.
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Affiliation(s)
- Marianne Farkas
- Center for Psychiatric Rehabilitation, Sargent College, Boston University, Boston, MA, United States
| | - Steve Coe
- Community Access, New York, NY, United States
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11
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Wolstencroft KE, Deane FP, Jones CL, Zimmermann A, Cox M. Consumer and staff perspectives of the implementation frequency and value of recovery and wellbeing oriented practices. Int J Ment Health Syst 2018; 12:60. [PMID: 30377442 PMCID: PMC6195683 DOI: 10.1186/s13033-018-0244-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background Despite advances in our understanding of what mental health systems and services can do to enhance recovery and wellbeing outcomes for people seeking support, there is limited evidence demonstrating that this body of work has translated successfully into mental health service practice. The Collaborative Recovery Model (CRM) is a practice framework that has been designed to support application of recovery and wellbeing oriented principles and practices within mental health service delivery. The aims of this study were to assess consumer and staff perceptions of implementation frequency during service engagement and the value of this approach for assisting recovery within a setting where the CRM approach had been adopted. Methods The setting was a large Australian community managed mental health organisation. The study involved a cross-sectional analysis of consumer (n = 116) and staff practitioner (n = 62) perspectives. A series of paired sample t-tests assessed for differences between consumer and staff perceptions of the: (i) importance of key practice elements for assisting recovery, and the (ii) frequency that key practice elements are utilised during engagement sessions. Spearman's r correlational analysis explored associations between importance, frequency and helpfulness of sessions. Results Key practice elements of the model were applied during service interactions at a high level and perceived by the majority of consumers and staff participants as being important or very important for assisting recovery. Significant moderate correlations were found between the extent that practice elements were valued and the level at which they were applied. Higher levels of implementation of CRM practices were associated with higher ratings of perceived session helpfulness. The strongest association was between 'encouragement to set tasks to complete between support visits' and perceived helpfulness. Conclusions Consumer and staff responses revealed that the key practice elements of the CRM were frequently implemented during service engagement interactions and were seen as valuable for assisting recovery. The level of agreement between raters suggests firstly, that the key practice elements were apparent and able to be rated as occurring, and secondly that the CRM approach is seen as responsive to consumer needs. The results have implications for translating recovery and wellbeing oriented knowledge into mental health service practice.
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Affiliation(s)
| | - Frank P Deane
- 2Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Wollongong, NSW Australia
| | - Cara L Jones
- 3School of Psychology, University of Wollongong, Wollongong, NSW Australia
| | | | - Merrilee Cox
- Mental Health Association of Central Australia, Alice Springs, NT Australia
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12
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Taking a Gamble for High Rewards? Management Perspectives on the Value of Mental Health Peer Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040746. [PMID: 29652822 PMCID: PMC5923788 DOI: 10.3390/ijerph15040746] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/05/2018] [Accepted: 04/11/2018] [Indexed: 11/18/2022]
Abstract
Mental health peer work is attracting growing interest and provides a potentially impactful method of service user involvement in mental health design and delivery, contributing to mental health reform. The need to effectively support this emerging workforce is consequently increasing. This study aimed to better understand the views of management in relation to peer work and specifically explores the value of peer work from the perspective of management. This qualitative research employed grounded theory methods. There were 29 participants in total, employed in both peer designated and non-peer designated management roles, in not for profit and public health organisations in Queensland, Australia. The value of peer work as described by participants is found to be partially dependent on practical supports and strategies from the organisation. There were high benefits for all facets of the organisation when effective recruitment and ongoing support for peer workers was prioritised and a higher perception of limitations when they were not. Due to some parallels, it may be useful to explore the potential for peer work to be conceptually and/or practically considered as a form of diversity and inclusion employment.
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13
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Salamonson Y, Ramjan LM, Villarosa AR, Marjadi B. Does clinical placement in a community alcohol and other drugs rehabilitation centre influence students' career intention? Int J Ment Health Nurs 2018. [PMID: 28646523 DOI: 10.1111/inm.12366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Due to an ageing workforce, there is a growing need for greater numbers of nurses to work in areas, such as mental health and alcohol and other drugs (AOD) rehabilitation. These practitioners need to approach their work as 'recovery-oriented practitioners'. Positive experiences and preceptorship during clinical placement in AOD rehabilitation settings might influence students' later career choices and address some of the workforce shortage issues. The aim of the present concurrent, mixed-methods study was to explore students' perceptions of their clinical placement experience in a community-based AOD rehabilitation setting, and to examine attitude, career intention, and satisfaction with the placement. Fifty-eight students completed pre-post-test surveys, with closed and open-ended questions, which included standardized measures. A small sample of survey respondents also agreed to participate in a semistructured interview. The quantitative results revealed two predictors for higher intention to pursue a career in AOD: (i) a high satisfaction with their clinical placement (β = 0.29, P = 0.008); and (ii) a high baseline attitude to recovery-oriented practice (β = 0.28, P = 0.013). The qualitative findings identified five factors influencing placement experience: (i) educational factors; (ii) students' background factors; (iii) placement factors; (iv) client factors; and (v) staff factors. A model that synthesizes the quantitative and qualitative findings was also developed. In conclusion, clinical placement in a community-based AOD rehabilitation centre improved students' intention to work in that setting.
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Affiliation(s)
- Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia.,Centre for Applied Nursing Research, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Lucie M Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia.,Centre for Applied Nursing Research, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Amy R Villarosa
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia.,Centre for Applied Nursing Research, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia.,COHORTE Research Group, Sydney, New South Wales, Australia
| | - Brahm Marjadi
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
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14
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Grice T, Alcock K, Scior K. Mental health disclosure amongst clinical psychologists in training: Perfectionism and pragmatism. Clin Psychol Psychother 2018; 25:721-729. [PMID: 29582510 DOI: 10.1002/cpp.2192] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 01/20/2018] [Accepted: 02/20/2018] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study investigated the incidence of lived experience of mental health problems amongst UK-based trainee clinical psychologists and factors associated with anticipated disclosure for trainees both with and without lived experience. METHODS A web-based survey comprising the Multidimensional Perfectionism Scale, an adapted version of the Perceived Devaluation and Discrimination Scale, and questions about lived experience and anticipated likelihood of disclosure. RESULTS The survey was completed by 348 trainees across 19 UK training institutions. Sixty-seven percent reported lived experience of a mental health problem. For these trainees, there was no difference in anticipated likelihood of disclosing to different recipient types after controlling for maladaptive perfectionism. However, across all participants, anticipated disclosure was associated with maladaptive perfectionism, temporal proximity, anticipated stigma (past), and recipient type. Anticipated stigma (present) was not associated with anticipated disclosure. CONCLUSIONS Results support an approach to communicating about mental health disclosure that incorporates responsibility, interdependency, and transparency. Suggestions for further research are discussed.
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Affiliation(s)
- Tom Grice
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Kat Alcock
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Katrina Scior
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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15
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Abstract
SummaryWe consider key facets of the concept of mental health recovery and how they are reflected in other concepts that run through the emerging focus on public mental healthcare. We widen the scene to portray the niche into which recovery fits and show how it and recent research indicate why psychiatrists should use the social sciences more widely to complement neuroscience.
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16
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Abstract
SummaryThe principles of recovery have been supported by UK mental health policy
and have been incorporated into policy in several countries worldwide. In
this article we examine the ideas, principles and definitions of recovery
and their origins. Personal recovery is contrasted with clinical recovery
and the nature and development of the recovery movement is outlined. The
principal factors influencing personal recovery are hope, control and
opportunity. In an accompanying article we discuss the implications of these
principles for training and practice.
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17
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Mengshoel AM, Grape HE. Rethinking physiotherapy for patients with fibromyalgia - lessons learnt from qualitative studies. PHYSICAL THERAPY REVIEWS 2017. [DOI: 10.1080/10833196.2017.1377975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anne Marit Mengshoel
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hedda Eik Grape
- Department of Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
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18
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Gammon D, Strand M, Eng LS, Børøsund E, Varsi C, Ruland C. Shifting Practices Toward Recovery-Oriented Care Through an E-Recovery Portal in Community Mental Health Care: A Mixed-Methods Exploratory Study. J Med Internet Res 2017; 19:e145. [PMID: 28465277 PMCID: PMC5434256 DOI: 10.2196/jmir.7524] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/06/2017] [Accepted: 04/17/2017] [Indexed: 11/14/2022] Open
Abstract
Background Mental health care is shifting from a primary focus on symptom reduction toward personal recovery-oriented care, especially for persons with long-term mental health care needs. Web-based portals may facilitate this shift, but little is known about how such tools are used or the role they may play in personal recovery. Objective The aim was to illustrate uses and experiences with the secure e-recovery portal “ReConnect” as an adjunct to ongoing community mental health care and explore its potential role in shifting practices toward recovery. Methods ReConnect was introduced into two Norwegian mental health care communities and used for 6 months. The aim was to support personal recovery and collaboration between service users and health care providers. Among inclusion criteria for participation were long-term care needs and at least one provider willing to interact with service users through ReConnect. The portal was designed to support ongoing collaboration as each service user-provider dyad/team found appropriate and consisted of (1) a toolbox of resources for articulating and working with recovery processes, such as status/goals/activities relative to life domains (eg, employment, social network, health), medications, network map, and exercises (eg, sleep hygiene, mindfulness); (2) messaging with providers who had partial access to toolbox content; and (3) a peer support forum. Quantitative data (ie, system log, questionnaires) were analyzed using descriptive statistics. Qualitative data (eg, focus groups, forum postings) are presented relative to four recovery-oriented practice domains: personally defined recovery, promoting citizenship, working relationships, and organizational commitment. Results Fifty-six participants (29 service users and 27 providers) made up 29 service user-provider dyads. Service users reported having 11 different mental health diagnoses, with a median 2 (range 1-7) diagnoses each. The 27 providers represented nine different professional backgrounds. The forum was the most frequently used module with 1870 visits and 542 postings. Service users’ control over toolbox resources (eg, defining and working toward personal goals), coupled with peer support, activated service users in their personal recovery processes and in community engagement. Some providers (30%, 8/27) did not interact with service users through ReConnect. Dyads that used the portal resources did so in highly diverse ways, and participants reported needing more than 6 months to discover and adapt optimal uses relative to their individual and collaborative needs. Conclusions Regardless of providers’ portal use, service users’ control over toolbox resources, coupled with peer support, offered an empowering common frame of reference that represented a shift toward recovery-oriented practices within communities. Although service users’ autonomous use of the portal can eventually influence providers in the direction of recovery practices, a fundamental shift is unlikely without broader organizational commitments aligned with recovery principles (eg, quantified goals for service user involvement in care plans).
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Affiliation(s)
- Deede Gammon
- Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Monica Strand
- Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway.,Department of Psychiatry Blakstad, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Asker, Norway.,University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Lillian Sofie Eng
- Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway
| | - Elin Børøsund
- Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway
| | - Cecilie Varsi
- Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway
| | - Cornelia Ruland
- Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway.,University of Oslo, Faculty of Medicine, Oslo, Norway
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Competing priorities: staff perspectives on supporting recovery. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 42:429-38. [PMID: 25134949 DOI: 10.1007/s10488-014-0585-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Recovery has come to mean living a life beyond mental illness, and recovery orientation is policy in many countries. The aims of this study were to investigate what staff say they do to support recovery and to identify what they perceive as barriers and facilitators associated with providing recovery-oriented support. Data collection included ten focus groups with multidisciplinary clinicians (n = 34) and team leaders (n = 31), and individual interviews with clinicians (n = 18), team leaders (n = 6) and senior managers (n = 8). The identified core category was Competing Priorities, with staff identifying conflicting system priorities that influence how recovery-oriented practice is implemented. Three sub-categories were: Health Process Priorities, Business Priorities, and Staff Role Perception. Efforts to transform services towards a recovery orientation require a whole-systems approach.
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Huet V, Holttum S. Art therapists with experience of mental distress: Implications for art therapy training and practice. INTERNATIONAL JOURNAL OF ART THERAPY 2016. [DOI: 10.1080/17454832.2016.1219755] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Gaffey K, Evans DS, Walsh F. Knowledge and attitudes of Irish Mental Health Professionals to the concept of recovery from mental illness - five years later. J Psychiatr Ment Health Nurs 2016; 23:387-98. [PMID: 27440748 DOI: 10.1111/jpm.12325] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 11/27/2022]
Abstract
UNLABELLED WHAT IS KNOWN ABOUT THE SUBJECT?: The Advancing Recovery in Ireland (ARI) project (Health Service Executive, 2012) promotes recovery-orientated services. A previous study of Irish mental health practitioners (Cleary & Dowling ) identified the need to improve knowledge and attitudes towards recovery. To facilitate implementation of ARI and monitor progress, this study provided a 'benchmark' of current knowledge and attitudes to recovery. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: The study provides important baseline information on recovery knowledge and attitudes which can be used to assess the impact of the ARI Project. It also provides valuable information that can be compared to recovery approaches employed in other countries. Despite the increased emphasis on recovery in Ireland, knowledge and attitudes of health care practitioners towards recovery remain relatively unchanged between 2007 and 2013. Working in dual settings, being a non-nurse, and training was associated with better RKI scores. Training appears to be the strongest factor in predicting better recovery knowledge. The findings suggest that knowledge levels and attitude changes following education may not be sustained over time and ongoing training may be required. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is considerable scope to improve recovery knowledge. Key recommendations include the need for more recovery training, evaluate whether training translates into clinical practice, using 'Recovery Champions', introducing peer support workers and developing local policies and protocols to support recovery practice. ABSTRACT Introduction A study of Irish mental health practitioners (Cleary & Dowling ) identified the need to improve knowledge and attitudes towards recovery. This led to the Advancing Recovery in Ireland Project (ARI) which promoted recovery-orientated services and a need to 'benchmark' progress. There is little evidence regarding the types of educational interventions that maintain positive recovery knowledge and attitudes in providers. Aim The study assessed current knowledge and attitudes to recovery. Methods The methodology of Cleary & Dowling () was replicated. A survey was administered to practitioners (n = 337) using the adapted Recovery Knowledge Inventory (RKI) (Cleary & Dowling ). Results No significant differences were found in recovery scores compared to Cleary & Dowling () or by level of experience. Working in dual settings, being a non-nurse, and training was associated with better recovery scores. Significantly more respondents had received training in recovery (40% versus 23%) compared to Cleary & Dowling (). Training appears to be the strongest factor predicting better recovery knowledge. Conclusions There is considerable scope to improve recovery knowledge. Key recommendations include the need for more recovery training, using 'Recovery Champions', introducing peer support workers and developing local policies and protocols to support recovery working.
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Affiliation(s)
- K Gaffey
- Galway/Roscommon Mental Health Services, Ballinasloe, County Galway, Ireland
| | - D S Evans
- Department of Public Health, Health Executive Service West, Merlin Park Regional Hospital, Galway, Ireland
| | - F Walsh
- St Brigids Hospital, Ballinasloe, County Galway, Ireland
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Sowers W, Primm A, Cohen D, Pettis J, Thompson K. Transforming Psychiatry: A Curriculum on Recovery-Oriented Care. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:461-467. [PMID: 26586616 DOI: 10.1007/s40596-015-0445-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 10/13/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Wesley Sowers
- Western Psychiatric Institute and Clinic, Pittsburgh, PA, USA
| | | | - Deborah Cohen
- American Psychiatric Association, Arlington, VA, USA.
| | | | - Ken Thompson
- Pennsylvania Psychiatric Leadership Council, Philadelphia, PA, USA
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Holley J, Chambers M, Gillard S. The impact of risk management practice upon the implementation of recovery-oriented care in community mental health services: a qualitative investigation. J Ment Health 2015; 25:315-322. [PMID: 26698325 DOI: 10.3109/09638237.2015.1124402] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Recovery-oriented care has become guiding principle for mental health policies and practice in the UK and elsewhere. However, a pre-existing culture of risk management practice may impact upon the provision of recovery-oriented mental health services. AIMS To explore how risk management practice impacts upon the implementation of recovery-oriented care within community mental health services. METHOD Semi-structured interviews using vignettes were conducted with eight mental health worker and service user dyads. Grounded theory techniques were used to develop explanatory themes. RESULTS Four themes arose: (1) recovery and positive risk taking; (2) competing frameworks of practice; (3) a hybrid of risk and recovery; (4) real-life recovery in the context of risk. DISCUSSION In abstract responses to the vignettes, mental health workers described how they would use a positive-risk taking approach in support of recovery. In practice, this was restricted by a risk-averse culture embedded within services. Mental health workers set conditions with which service users complied to gain some responsibility for recovery. CONCLUSION A lack of strategic guidance at policy level and lack of support and guidance at practice level may result in resistance to implementing ROC in the context of RMP. Recommendations are made for policy, training and future research.
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Affiliation(s)
- Jessica Holley
- a Department of Mental Health , Social Work and Integrative Medicine, Middlesex University , TG69 Ground Floor Town Hall, Hendon Campus, The Burroughs, London , UK
| | - Mary Chambers
- b Department of Mental Health Nursing , Faculty of Health, Social Care and Education, Kingston University and St. George's University of London , Cranmer Terrace , London , UK , and
| | - Steven Gillard
- c Department of Social & Community Mental Health , Population Health Research Institute, St George's, University of London , London , UK
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Pinfold V, Sweet D, Porter I, Quinn C, Byng R, Griffiths C, Billsborough J, Enki DG, Chandler R, Webber M, Larsen J, Carpenter J, Huxley P. Improving community health networks for people with severe mental illness: a case study investigation. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03050] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
IntroductionPolicy drivers in mental health to address personal recovery, stigma and poor physical health indicate that new service solutions are required. This study aimed to understand how connections to people, places and activities were utilised by individuals with severe mental illness (SMI) to benefit health and wellbeing.MethodsA five-module mixed-methods design was undertaken in two study sites. Data were collected from 150 network-mapping interviews and 41 in-depth follow-up interviews with people with SMI; in-depth interviews with 30 organisation stakeholders and 12 organisation leaders; and 44 telephone interviews with practitioners. We undertook a three-stage synthesis process including independent lived experience feedback, and a patient and public involvement team participated in tool design, data collection, analysis and write-up.ResultsThree personal network types were found in our study using the community health network approach: diverse and active; family and stable; formal and sparse. Controlled for other factors we found only four variables significantly associated with which network type a participant had: living alone or not; housing status; formal education; long-term sickness or disability. Diagnosis was not a factor. These variables are challenging to address but they do point to potential for network change. The qualitative interviews with people with SMI provided further understanding of connection-building and resource utilisation. We explored individual agency across each network type, and identified recognition of the importance and value of social support and active connection management alongside the risks of isolation, even for those most affected by mental illness. We identified tensions in personal networks, be that relationships with practitioners or families, dealing with the impact of stigma, or frustrations of not being in employment, which all impact on network resources and well-being. The value of connectedness within personal networks of people, place and activity for supporting recovery was evident in shaping identity, providing meaning to life and sense of belonging, gaining access to new resources, structuring routines and helping individuals ‘move on’ in their recovery journey.Health-care practitioners recognised that social factors were important in recovery but reported system-level barriers (workload, administrative bureaucracy, limited contact time with clients) in addressing these issues fully. Even practitioners working in third-sector services whose remit involved increasing clients’ social connection faced restrictions due to being evaluated by outcome criteria that limited holistic recovery-focused practices. Service providers were keen to promote recovery-focused approaches. We found contrasts between recovery ideology within mental health policy and recovery practice on the ground. In particular, the social aspects of supporting people with SMI are often underprioritised in the health-care system. In a demanding and changing context, strategic multiagency working was seen as crucial but we found few examples of embedded multisector organisation partnerships.ConclusionWhile our exploratory study has limitations, findings suggest potential for people with SMI to be supported to become more active managers of their personal networks to support well-being regardless of current network type. The health and social care system does not currently deliver multiagency integrated solutions to support SMI and social recovery.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
| | | | - Ian Porter
- Primary Care Group, Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, UK
| | - Cath Quinn
- Primary Care Group, Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, UK
| | - Richard Byng
- Primary Care Group, Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, UK
| | | | | | - Doyo Gragn Enki
- Primary Care Group, Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, UK
| | - Ruth Chandler
- Sussex Partnership NHS Foundation Trust, West Sussex, UK
| | - Martin Webber
- International Centre for Mental Health Social Research, University of York, York, UK
| | | | - John Carpenter
- Department of Social Work and Applied Social Sciences, University of Bristol, Bristol, UK
| | - Peter Huxley
- Centre for Social Work and Social Care Research, University of Swansea, Swansea, UK
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Tse S, Davidson L, Chung KF, Yu CH, Ng KL, Tsoi E. Logistic regression analysis of psychosocial correlates associated with recovery from schizophrenia in a Chinese community. Int J Soc Psychiatry 2015; 61:50-7. [PMID: 24869851 DOI: 10.1177/0020764014535756] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS More mental health services are adopting the recovery paradigm. This study adds to prior research by (a) using measures of stages of recovery and elements of recovery that were designed and validated in a non-Western, Chinese culture and (b) testing which demographic factors predict advanced recovery and whether placing importance on certain elements predicts advanced recovery. METHOD We examined recovery and factors associated with recovery among 75 Hong Kong adults who were diagnosed with schizophrenia and assessed to be in clinical remission. Data were collected on socio-demographic factors, recovery stages and elements associated with recovery. Logistic regression analysis was used to identify variables that could best predict stages of recovery. Receiver operating characteristic curves were used to detect the classification accuracy of the model (i.e. rates of correct classification of stages of recovery). RESULTS Logistic regression results indicated that stages of recovery could be distinguished with reasonable accuracy for Stage 3 ('living with disability', classification accuracy = 75.45%) and Stage 4 ('living beyond disability', classification accuracy = 75.50%). However, there was no sufficient information to predict Combined Stages 1 and 2 ('overwhelmed by disability' and 'struggling with disability'). It was found that having a meaningful role and age were the most important differentiators of recovery stage. CONCLUSION Preliminary findings suggest that adopting salient life roles personally is important to recovery and that this component should be incorporated into mental health services.
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Affiliation(s)
- Samson Tse
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong
| | - Larry Davidson
- Program for Recovery and Community Health, Department of Psychiatry, School of Medicine, Institution for Social and Policy Studies, Yale University, New Haven, CT, USA
| | - Ka-Fai Chung
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Chong Ho Yu
- Department of Psychology, Azusa Pacific University, Azusa, CA, USA
| | - King Lam Ng
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong
| | - Emily Tsoi
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong
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Ness O, Borg M, Semb R, Karlsson B. "Walking alongside:" collaborative practices in mental health and substance use care. Int J Ment Health Syst 2014; 8:55. [PMID: 25540670 PMCID: PMC4276107 DOI: 10.1186/1752-4458-8-55] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 12/07/2014] [Indexed: 11/12/2022] Open
Abstract
Background Although the importance of collaboration is well established as a principle in research and in theory, what it actually means for practitioners to collaborate in practice, to be partners in a collaborative relationship, has thus far been given less attention. The aim of this study was to identify key characteristics of the ways in which mental health practitioners collaborate with service users and their families in practice. Methods This was a qualitative action research study, with a cooperative inquiry approach that used multi-staged focus group discussions with ten mental health care and social work practitioners in community mental health and substance use care. Thematic analysis was applied to identify common characteristics. Results We identified three major themes related to practitioners’ experiences of collaborative practices: (1) walking alongside through negotiated dialogues, (2) maintaining human relationships, and (3) maneuvering relationships and services. Conclusions It appears that even with the rich knowledgebase that has developed on the merits of collaborative relationships, it continues to be challenging for practitioners to reorient their practice accordingly. The findings of this study indicate that the practitioners focus on two types of processes as characterizing collaborative practice: one focusing on conversations among practitioners and service users and their families and the other focusing on management and control among health care providers, service sectors, and service users (i.e., inter/intra-system collaboration).
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Affiliation(s)
- Ottar Ness
- Centre for Mental Health and Substance Abuse, Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 7053, 3007 Drammen, Norway
| | - Marit Borg
- Centre for Mental Health and Substance Abuse, Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 7053, 3007 Drammen, Norway
| | - Randi Semb
- Centre for Mental Health and Substance Abuse, Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 7053, 3007 Drammen, Norway
| | - Bengt Karlsson
- Centre for Mental Health and Substance Abuse, Faculty of Health Sciences, Buskerud and Vestfold University College, P.O. Box 7053, 3007 Drammen, Norway
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Ness O, Borg M, Davidson L. Facilitators and barriers in dual recovery: a literature review of first-person perspectives. ADVANCES IN DUAL DIAGNOSIS 2014. [DOI: 10.1108/add-02-2014-0007] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The co-occurrence of mental health and substance use problems is prevalent, and has been problematic both in terms of its complexity for the person and of the challenges it poses to health care practitioners. Recovery in co-occurring mental health and substance use problems is viewed as with multiple challenges embedded in it. As most of the existing literature on recovery tends to treat recovery in mental health and substance use problems separately, it is critical to assess the nature of our current understanding of what has been described as “complex” or “dual” recovery. The purpose of this paper is to identify and discuss what persons with co-occurring mental health and substance use problems describe as facilitators and barriers in their recovery process as revealed in the literature.
Design/methodology/approach
– The method used for this study was a small-scale review of the literature gleaned from a wider general view. Searches were conducted in CINAHL, Psych info, Medline, Embase, SweMed+, and NORART.
Findings
– Three overarching themes were identified as facilitators of dual recovery: first, meaningful everyday life; second, focus on strengths and future orientation; and third, re-establishing a social life and supportive relationships. Two overarching themes were identified as barriers to dual recovery: first, lack of tailored help and second, complex systems and uncoordinated services.
Originality/value
– The recovery literature mostly focuses on recovery in mental health and substance use problems separately, with less attention being paid in the first-person literature to what helps and what hinders dual recovery.
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