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Longer length of stay (LOS) in residential alcohol and other drug treatment has been associated with more favourable outcomes, but the optimal duration has yet to be determined for reliable change indices. Optimal durations are likely to be a function of participant and problem characteristics. The purpose of this paper is to determine whether LOS in a residential therapeutic community for alcohol and other drug treatment community independently predicts reliable change across a range of psychological recovery and well-being measures.

In total, 380 clients from Australian Salvation Army residential alcohol and other drug treatment facilities were assessed at intake and three months post-discharge using the Addiction Severity Index 5th ed., The Depression, Anxiety and Stress Scale, The Recovery Assessment Scale, the Mental Health Continuum-Short Form and The Life Engagement Test.

The findings confirm LOS as an independent predictor of reliable change on measures of well-being and client perceived assessment of recovery. The mean LOS that differentiated reliable change from no improvement was 37.37 days.

The finding of LOS as a predictor of reliable change and the identification of an estimated time requirement may be useful for residential drug treatment providers in modifying treatment durations.

Traditionally, facilities professionals are responsible for maintaining business operations after a disaster by safeguarding people and the physical infrastructure. While most organisations equate disaster preparedness to business continuity, the aftermath of 9/11 brought forth some startling realisations about business survival and business crisis. Boeing, a global company that was affected in a number of unexpected ways, embarked on an approach that separated, yet integrated the Disaster Preparedness Community with the Business Community. The result was a Business Continuity Model that fostered further development of robust Business Continuity Plans to serve employees, customers, stakeholders and community. Facilities professionals, equipped with an understanding of today’s business crisis and the Business Continuity Model, can serve as a partner to their Business Continuity Representative to educate, develop and execute a Business Continuity Plan that ensures business continuance through any unforeseen event.

The purpose of this paper is to review the perceptions of risk from the viewpoint of the psychiatrist, in the context of the expectations of patients, staff and society.

The paper is a reflection on clinical practice and narrative review of the literature.

There are significant problems in the prediction of risk, to do with the difficulty in attempting to predict any low prevalence outcome. Additional complications relate to societal expectations and the legal frameworks within which mental health is practiced. The evidence related to poor outcomes, such as suicide is very complex, occasionally appears contradictory, and caution is required in application. The paradigm of recovery provides a way forward in the assessment and management of risk that moves away from any pretence of future prediction and aims to engage with service users and their families in a supportive and complimentary way.

Use of a recovery framework, with a focus on need, as opposed to risk, would appear to benefit patients, carers and those delivering service.

This viewpoint enables a broader gestalt of the literature in the context of day-to-day clinical practice. This prevents the limitation of only examining the (largely) epidemiological literature, or just commenting on one clinician’s practice. It provides for a conceptualization of a way to move forward in the consideration of risk.

This paper aims to examine how neighborhood characteristics (income, population composition) and individual building attributes (ownership) affect the recovery period of single-family housing and determine their correlations with property abandonment and changes in residential land use after natural disaster.

This empirical study focuses on Valley Fire, one of the California’s most destructive wildfires in 2015, and uses assessor, community, demographic and sales data to measure recovery of a panel of single-family houses located in Lake County in California between 2012 and 2020. Several regression and correlation models will be developed to test different hypotheses.

This study found that: Recovery period is longer than what expected in most existing literature; ownership status significantly affects recovery period; income level is not a significant factor for shortening the recovery period; and minorities may need more assistance for constant recovery. Findings of this research will help identify at risk communities to avoid uneven housing recovery and lower the rate of property abandonment.

Housing recovery is key to revitalizing communities following major natural disasters. The sociodemographic characteristics of each neighborhood have significant impact on the duration of recovery and possible property abandonment. Understanding how home and neighborhood characteristics affect recovery will help planners prevent long-lasting adverse effects of natural disasters.

In this chapter, we review empirical research evidence on the relationship between stressors and catecholamines (i.e., adrenaline and noradrenaline) and cortisol. With respect to acute stressors, both laboratory and field research have shown that the exposure to stressors leads to an increase in catecholamine and cortisol levels. With respect to more chronic stressors, research evidence is less consistent. Chronic mental workload was found to be related to elevated adrenaline levels. With respect to cortisol responses the interaction between workload and other variables seems to play a role. Empirical studies suggest that chronic stressors affect the responsivity to acute stressors. Research showed that after the exposure to stressors catecholamine and cortisol recovery is delayed.

The service‐dominant logic describes customer‐actualized value as being idiosyncratic, experiential, contextual, and meaning laden. Since positive word‐of‐mouth (WOM) is an expression of customer‐actualized value, the paper postulate that WOM is not only related to a holistic set of assessments of the service experience but also to the idiosyncratic nature of the individual customer. In particular, do socially oriented individuals have a greater propensity to engage in positive WOM? The purpose of this paper is to test hypotheses that socially oriented personality traits, and personal values as well as a set of dimensions of the total service experience, are antecedents of positive WOM. The context studied is a surgical operation involving considerable personal meaning and implication in the whole service process.

A cohort of 500 surgical patients are studied prior to, three‐days after and one‐month post‐surgery. Independent variables include the socially oriented personality traits of agreeableness and extraversion, social‐ vs self‐oriented personal values, as well as dimensions of the total service experience assessed by information adequacy, pain and discomfort, patient‐to‐patient interaction, patient‐to‐personnel interaction, and recovery outcomes. The dependent variable is the strength of positive WOM intentions.

The sociability of surgery patients as measured by both their personality traits and socially oriented values is significantly related to the strength of positive WOM intentions. Self‐oriented values are not associated with positive WOM intentions. Also, to varying degrees, all dimensions of the total service experience are associated with positive WOM intentions.

The paper is the first to illustrate that, in a given service context, the antecedents of customer loyalty may be complex, not only dependent on customer assessments of their interactions and experiences throughout the service process, but also relative to their dispositional characteristics such as sociability. The consistency of the results for positive WOM assessed at three‐days and one‐month post‐surgery adds to the robustness of the findings. This paper makes a significant contribution to the service‐dominant logic and the concept of value co‐creation.

Recovery is a central component of UK substance misuse policy, however, relatively little is known about the views and meanings of recovery by those experiencing it. The purpose of this paper is to explore these factors, and understand how service user experiences align to current understandings of “recovery capital”.

This paper draws on qualitative interviews with 32 individuals from six UK recovery communities, including those commissioned by a statutory service (n=8) and a peer-led recovery community (n=24).

Meanings of recovery differed between people in abstinence-based communities and those not; however, all had consistent views on their own recovery outcomes and the benefits they believed recovery brought. All viewed recovery as a process; a continuous journey with no end-point. Internal motivation, peer support, social networks and daily structure were integral to supporting individuals achieve and maintain recovery. Key benefits of recovery reflected recovery capital and included positive relationships, sense of belonging, increased self-worth and confidence, employment and education.

This research shows that recovery experiences and outcomes are not centred entirely on the individual but are wider, more holistic. Maintaining recovery involves being connected to themselves and to the wider environment: family, friends, peers and society. Although the recovery capital model has many elements that were discussed by the participants of this research, the discourse they used does not align with the model. To validly measure and quantify recovery outcomes, individuals need to identify with the measures themselves.

From policy and commissioning perspectives, these findings suggest benefits of recovery that were viewed by participants as indicators of success: demonstrate elements which support recovery; and highlight key social value outcomes which people attribute to recovery.

These “softer”, qualitative benefits should be considered by policy-makers, commissioners, statutory and non-statutory services in order to evidence outcomes. However, it should also be recognised that a temporally static approach to assessing recovery may be in contradiction to the meaning and perspectives held by those in recovery communities who conceptualise it as a long term and ongoing process.

This paper adds to understandings of experiences and meanings of recovery, with a particular focus on the measurement of outcomes and their meanings, and the role of abstention and continued drug use within the recovery process.

The purpose of this paper is to explore whether the current forensic mental health inpatient population within a medium secure unit is more or less complex (i.e. clinical and risk presentations) than former years using the Health of the Nation Outcome Scale (HoNOS) secure. Additionally, the use of the HoNOS secure as a service-wide measure is discussed in terms of its usefulness. Clinical implications and recommendations are offered for the continued use of the HoNOS secure in services more widely.

A retrospective case review of completed HoNOS secure assessments for 130 patients over three time intervals 2012, 2015 and 2018 was used. A multivariate analysis was performed on the data using SPSS version 25.

The findings revealed that contrary to clinical opinion, inpatients’ clinical and risk presentations had not changed significantly overtime.

The study shows the benefits of using the HoNOS secure at a service-wide level to explore and understand similarities and differences in inpatient admissions over time. It also highlights the usefulness of the HoNOS secure for considering different ward characteristics and the needs of patients residing in these environments.

Although much research exists surrounding the individual use of the HoNOS secure in relation to outcomes, there is limited research focusing on use of the HoNOS secure at the service level. The paper therefore provides evidence of the utility and value of the HoNOS secure as a service-level outcome measure.

This paper aims to describe a review and overview of the issue of developing guidance on implementing recovery and supporting organisational change, focused specifically on seeking to clarify the many different contributions that “lived experience” could make to training and workforce development.

The particular focus of our workshop was to clarify the key issues in workforce development, training for a recovery‐focused service and the contribution of “lived experience”. A particular outcome was to emphasise the benefits of collaborative co‐working between people who use services and practitioners at all levels.

A key element of our learning has been in valuing collaborative co‐working and the synergism of personal experience, professional training, research and evaluation.

The paper draws out what lessons have been learned already and sketches guidance for future practice and service development.

The purpose of this paper is to identify what key factors multi-disciplinary teams (MDT) deem as most important when making the decision to move service users from one level of security (including low, medium and high secure services) to another. The researchers used the findings from this study to further develop a tool; the assessment for level of security tool (ALS), which aims to structure and streamline this decision-making process.

Data from 18 interviews (MDT staff) were analysed using the Delphi technique (Dalkey and Helmer, 1963). This revealed a range of factors discussed when considering service users moves. Participants were asked to rate these factors in accordance with the Delphi which resulted in the removal of certain less important factors based on their scores. The researchers then compared these factors of relevance with a checklist of 16 items previously proposed by a consultant psychiatrist within the trust. This comparison allowed the researchers to highlight any similarities and differences present.

Findings from staff interviews revealed a range of 20 clinical factors perceived as essential to this process including procedural, relational and physical security aspects. However, variations were evident between the MDT priorities (20 items) and the originally proposed list. This emphasised the need for a tool which facilitates a holistic and streamlined approach.

The findings from this research have resulted in the development of the ALS tool comprising of 18 key factors.

It is envisaged the development of the ALS tool will not only facilitate and structure the decision-making process but also ensure a person-centred approach. This is because the ALS allows for a holistic approach based on an array of factors deemed important to that particular service user. Furthermore, the ALS tool contributes towards the paucity of published structured professional judgement tools needed to make such decisions.