A user-developed, user run recovery programme for people with severe mental illness: A randomised control trial

Boevink, Wilma; Kroon, Hans; Vugt, Maaike van; Delespaul, Philippe; Os, Jim van

doi:10.1080/17522439.2016.1172335

Cited by 51 publications

(47 citation statements)

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“…Discriminant validity was examined using the Quality of Life questionnaire, the Mental Health Index, the CAPE total score and the CAN total number of met and unmet needs, hypothesizing that Pearson correlations between NEL and these scales would be low to moderate. Reproducibility and responsiveness were analysed in sample 2 as described in detail in an earlier report [15]. A multilevel random regression analysis, adjusted for location, was conducted using the XTREG routine in STATA, in order to take into account clustering of observations (level 1) within persons (level 2).…”

Section: Discussionmentioning

confidence: 99%

“…Sample characteristics of the 163 participants have been described in detail elsewhere [15]. The mean age was 43.9 (years, SD = 11.4), 52% was male, 91% was born in the Netherlands.…”

Section: Sample 2: Respondent Characteristicsmentioning

confidence: 99%

“…The NEL had been collected at year 1 and year 2, allowing an analysis of the effect of TREE on NEL outcomes in those who started with TREE after year 1 [15]. The RCT examined, over a two-year period, the impact of a user-developed and user-run recovery program (Toward Recovery, Empowerment and Experiential Expertise -TREE) on outcomes in individuals with severe mental illness, as add-on to care as usual.…”

Section: Sample 2: Rct Samplementioning

confidence: 99%

“…A randomised wait-list controlled design of TREE (n = 80), added to care as usual (CAU; consisting of professional case management), versus CAU only (n = 83), was implemented in patients with severe mental illness. Follow-up was at 12 and at 24 months after inclusion [15]. The data pertaining to the RCT sample were used to examine NEL reproducibility (comparing repeated measures of NEL after the start of the intervention in the RCT) and responsiveness (change in NEL after treatment).…”

Section: Sample 2: Rct Samplementioning

confidence: 99%

“…In addition to sample 1, data from a recently published randomised controlled trial with data collected at baseline and two follow-up points (one year and two years), were used to examine the NEL [15]. The sample was divided in a group of "early starters"…”

Section: Sample 2: Rct Samplementioning

confidence: 99%

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Empowerment according to Persons with Severe Mental Illness: Development of the Netherlands Empowerment List and Its Psychometric Properties

Boevink¹,

Kroon²,

Delespaul³

et al. 2017

OJPsych

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Objectives. It is unclear whether and to what extent purportedly empowering practices in mental health care, like rehabilitation programs, recovery-supporting mental health care environments and peer-run services, contribute to the process of empowerment. Several American empowerment questionnaires have been developed in recent years, facilitating the measurement of empowerment outcomes. Given likely major transatlantic cultural differences in a value-sensitive concept such as empowerment, this article describes the development of the Netherlands Empowerment List (NEL) and its psychometric properties. Methods. Patients in Dutch mental health services provided meaning to the empowerment concept from which the NEL was derived. Based on 531 completed questionnaires, analyses in agreement with COSMIN criteria examined aspects of internal consistency, content validity, structural validity, convergent validity, discriminant validity, reproducibility and responsiveness of the NEL. Results. The NEL is a 40-item self-report questionnaire with six subscales: Social support, Professional help, Connectedness, Confidence and purpose, Self-management and Caring community. Internal consistency (Cronbach's alpha = 0.94), aspects of validity, reproducibility (intraclass correlation = 0.79) and responsiveness were good. Correlation with existing scales was the highest for the Mental Health Confidence Scale (r = 0.78) and the lowest for the Boston Empowerment Scale (r = 0.61). Conclusion. The NEL appears to be a suitable instrument to capture the dimension of empowerment in European mental health settings.

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Section: Discussionmentioning

confidence: 99%

“…Sample characteristics of the 163 participants have been described in detail elsewhere [15]. The mean age was 43.9 (years, SD = 11.4), 52% was male, 91% was born in the Netherlands.…”

Section: Sample 2: Respondent Characteristicsmentioning

confidence: 99%

Section: Sample 2: Rct Samplementioning

confidence: 99%

Section: Sample 2: Rct Samplementioning

confidence: 99%

Section: Sample 2: Rct Samplementioning

confidence: 99%

See 3 more Smart Citations

Empowerment according to Persons with Severe Mental Illness: Development of the Netherlands Empowerment List and Its Psychometric Properties

Boevink¹,

Kroon²,

Delespaul³

et al. 2017

OJPsych

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Effectiveness of Resource Groups for Improving Empowerment, Quality of Life, and Functioning of People With Severe Mental Illness

et al. 2021

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IMPORTANCEAlthough the importance of recovery-oriented care for people with severe mental illness (SMI) is widely acknowledged, essential elements such as personalization and involvement of significant others are not adequately implemented in practice.OBJECTIVE To determine whether using resource groups (RGs) within flexible assertive community treatment (FACT) has favorable effects on empowerment and recovery-related outcomes in people with SMI. DESIGN, SETTING, AND PARTICIPANTSThis assessor-blind, multisite randomized clinical trial was conducted from September 1, 2017, to September 30, 2020, with follow-up at 9 and 18 months. A total of 158 participants aged 18 to 65 years meeting the criteria for SMI were randomly allocated to FACT plus RG vs FACT as usual (1:1) in 20 FACT teams throughout the Netherlands. Data were analyzed from September 1, 2020, to January 31, 2021. The study was prespecified in the trial protocol and data from the intent-to-treat population were analyzed. INTERVENTIONSIn the FACT plus RG condition, patients chose members from their informal and formal networks to form an RG that meets quarterly to discuss self-formulated recovery goals. The RG was integrated into the multidisciplinary support provided by the FACT team. In the FACT as-usual condition, empowerment (defined as overcoming powerlessness and gaining control of one's life) and involvement of significant others was also part of the provided care, but without the structure of the RG. MAIN OUTCOMES AND MEASURESThe primary outcome was self-reported empowerment, measured with the Netherlands Empowerment List.RESULTS A total of 158 participants with SMI (median age, 38 [median absolute deviation, 13] years; 93 men [58.9%]) were randomized to FACT plus RG (n = 80) or FACT as usual (n = 78) care. Intention-to-treat analyses showed that randomization to the RG condition was associated with a clinically significant increase in empowerment (Cohen d, 0.54; 95% CI, 0.21-0.86) and improved outcomes with small to medium effect sizes in terms of quality of life (Cohen d, 0.25; 95% CI, −0.07 to 0.56), personal recovery (Cohen d, 0.38; 95% CI, 0.06-0.69), quality of social contact (Cohen d, 0.24; 95% CI, −0.07 to 0.56), disability (Cohen d, 0.29; 95% CI, −0.03 to 0.60), general functioning (Cohen d, 0.30; 95% CI, −0.01 to 0.62), and social functioning (Cohen d, 0.28; 95% CI, −0.04 to 0.59). No differences between conditions were found regarding psychopathological symptoms, attachment, frequency of social contact, and employment. Compared with FACT as usual, participants who stayed with the assigned treatment in the RG condition were more satisfied with treatment at 9 (Cohen d = 0.45; t 135 = −2.62; P = .009) and 18 (Cohen d = 0.41; t 116 = −2.22; P = .02) months.CONCLUSIONS AND RELEVANCE These findings show that working with RGs improves empowerment and other mental health outcomes in people with SMI who receive community-based mental health services. This method of network-oriented care empowers people with SMI within their own environment.

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Peer delivered services in mental health care in 2018: infancy or adolescence?

Farkas

Boevink

2018

World Psychiatry

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A second possibility is that antipsychotics have a normalizing effect on reward processing. Studies examining the neural response to rewarding stimuli in schizophrenia suggest that second generation antipsychotics are associated with intact response to reward outcomes in the ventral striatum 7 . Since individuals with schizotypy and youth at clinical high risk for psychosis are much less likely to be prescribed antipsychotics, the apparent paradox may reflect medication effects that become evident with more severe pathology.Third, schizophrenia is associated with more severe cognitive impairment and poorer insight into clinical symptomatology than schizotypy or clinical high risk states. It is possible that impaired cognition and insight are paradoxically protective, causing schizophrenia patients to have less awareness of hedonic deficits that may actually exist. Those with schizotypy and clinical high risk youth may be better able to accurately report their hedonic state because of higher cognitive function and insight.Fourth, environmental and stress effects may have a greater impact on youth at clinical high risk for psychosis and those with schizotypy. Schizophrenia is associated with impoverished quality of life, which for many patients reflects an environment and daily routine with restricted social, cognitive and affective demands. For individuals with schizotypy and clinical high risk youth, environments and daily routines are generally more complex and stressful. It is possible that this stress attenuates reward system responsivity. Supporting this, individuals with schizotypy seem to enjoy solitary activities, yet report activities with others as being taxing, stressful and unenjoyable 8 . Animal models and studies on humans support the notion of a "stress-induced anhedonia" 9 ; however, thisphenomenon has yet to be directly investigated in the schizophrenia spectrum. The schizophrenia spectrum anhedonia paradox harkens back to the seminal writings of P. Meehl 10 , who proposed that anhedonia is one of several polygenic potentiators that comprise the endophenotype for schizotaxia. Meehl distinguished between primary and secondary anhedonia. Primary anhedonia refers to one's hedonic capacity. This capacity is polygenically determined and dependent on neurotransmitter function and neural circuitry responsible for reward responsivity. Capacity varies on a continuous dimension, but may be taxonic at the extreme end. It seems that only a small proportion of schizophrenia patients would fall at the extreme end of the continuum, whereas substantially more individuals with schizotypy and clinical high risk youth would display primary anhedonia. Primary anhedonia may be a risk factor for the development of many forms of psychopathology, with schizophrenia being a less common outcome than others. Meehl also proposed the existence of "secondary anhedonia", which is measured via verbal report (through clinical interview or questionnaire) of one's hedonic response. He proposed that such reports are influenced b...

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A user-developed, user run recovery programme for people with severe mental illness: A randomised control trial

Cited by 51 publications

References 24 publications

Empowerment according to Persons with Severe Mental Illness: Development of the Netherlands Empowerment List and Its Psychometric Properties

Empowerment according to Persons with Severe Mental Illness: Development of the Netherlands Empowerment List and Its Psychometric Properties

Effectiveness of Resource Groups for Improving Empowerment, Quality of Life, and Functioning of People With Severe Mental Illness

Peer delivered services in mental health care in 2018: infancy or adolescence?

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