Training professionals in a recovery‐oriented methodology: a mixed method evaluation

Abstract

Background Several studies have reported difficulties concerning the implementation of recovery‐oriented interventions. In this study, the effect of training in the Comprehensive Approach to Rehabilitation (CARe) on daily practice was evaluated. Additionally, we aimed to acquire insight into the experiences with the implementation process involving professionals, management and trainers. Methods Fourteen teams for sheltered and supported housing in the Netherlands participated in this study. As part of a cluster‐randomised controlled trial (RCT) design, eight teams received training in the CARe methodology. Model fidelity (using the CARe fidelity audit) and professionals’ knowledge of recovery (using the Recovery Knowledge Inventory) were measured for all teams until 20 months after the start. Afterwards, an evaluation meeting with participating stakeholders was organised in which barriers and facilitators of the implementation of the CARe methodology were inventoried. Results Ten months after the training, the intervention teams scored higher than the control teams on the fidelity subscales: ‘recovery’, ‘strengths orientation’ and ‘amount of training and coaching’. Twenty months after the training, only the effect of ‘amount of coaching and training’ remained. Additionally, ‘methodological working’ clearly differed between the groups after 20 months in favour of the intervention teams. In all teams, model fidelity was moderate at both measurements. The knowledge of recovery of the trained teams was slightly and significantly higher at 10 and 20 months after training. Although professionals were positive about recovery and strength‐oriented working, they experienced several organisational and societal barriers. Conclusion Training in the CARe methodology improved the fidelity and knowledge of recovery among professionals. However, the differences were small, and fidelity decreased over time. More in‐depth knowledge is needed on which barriers professionals experience in practice so that tailored training and implementation strategies can be developed. Furthermore, more attention is needed for professional development and the translation of theory into practice.

Recovery‐oriented care: mental health workers’ attitudes towards recovery from mental illness

“…In addition, while some studies have neglected to report the psychometric findings of their instruments (18,22,23), others have reported only Cronbach's α scores for the four subscales, without examining the factor structure (15,17,24). Hence, reported results regarding the four presumed dimensions may be unreliable.…”

Quality of Life of People with Severe Mental Health Problems: Testing an Interactive Model

“…In addition, treatment may focus on equipping patients with the abilities necessary to overcome the deficits they perceive, for example by offering tips for managing their finances. Alternatively, treatment may focus on helping patients find new goals that are more in line with their opportunities [50]. Overall, the results of this study imply that treatment of people with severe mental health problems should include all facets of life in its attempt to improve the QoL of patients.…”

Resident and staff perceptions of an activity- and recovery-based intervention in supported housing for people with severe mental illness – a longitudinal pilot study

“…Previous research has found such training successful. The effect levelled out somewhat over time [34], indicating that such training should be part of continuous staff education. A third alternative could be to apply the principle of place-then-train, used in work rehabilitation according to the Individual Placement and Support model [35].…”