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Article
Publication date: 14 March 2016

Virginia C Williams, Frank P. Deane, Lindsay G Oades, Trevor P Crowe, Joseph Ciarrochi and Retta Andresen

The purpose of this paper is to review the role of values within contemporary mental health recovery services, outlining the rationale and approach for a specific…

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Abstract

Purpose

The purpose of this paper is to review the role of values within contemporary mental health recovery services, outlining the rationale and approach for a specific values-focused staff intervention to promote autonomously motivated uptake of recovery-oriented practices.

Design/methodology/approach

Recent advances in understanding of the enduring gap between ideological and applied acceptance of personal recovery within mental health services are outlined, with particular focus on the limited utility of training programmes as a means to promoting implementation. Frequently, mental health service organisations have adopted recovery policies in a primarily “top-down” fashion standing in contrast to the high autonomy approaches espoused for service users. Drawing from the extensive research related to Self-Determination Theory (SDT), a complementary focus on “bottom-up” approaches that enable service-delivery staff to develop a sense of autonomy for changed work practices in order to increase implementation is indicated.

Findings

Application of values-focused interventions for mental health recovery staff parallel to the approaches acknowledged as effective for service participants are likely to be effective in promoting implementation of newly trained recovery-oriented practices.

Research limitations/implications

The paper is conceptual in nature and therefore reflects the priorities and views of the authors but the paper draws together well-established literature to develop a novel approach to a highly relevant issue.

Practical implications

Training transfer and implementation of evidence-based practice are issues with broad relevance and the explication of additional methods to promote employee uptake of new practices is a key priority for organisations and policy makers.

Social implications

Significant social implications include furthering the discussion and insight to the development of effective delivery of mental health services to individuals accessing service.

Originality/value

A novel aspect of this paper is the provision of a theoretical rationale for the application of SDT as a framework for understanding the continuing challenge of recovery operationalisation, which despite the conceptual good-fit, currently stands as an association not well exploited. Moreover, this paper proposes values-clarification and coaching as a specific and reproducible approach to enhancing recovery-oriented service provision.

Details

The Journal of Mental Health Training, Education and Practice, vol. 11 no. 1
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 13 July 2012

Emily Handley, Olivia Southwell and Julie Steel

Given the increased prevalence of mental health problems amongst people with intellectual disabilities, it seems pertinent to consider how the recovery approach could…

1025

Abstract

Purpose

Given the increased prevalence of mental health problems amongst people with intellectual disabilities, it seems pertinent to consider how the recovery approach could potentially benefit practice within mental health services for people with intellectual disabilities. This paper seeks to explore the similarities between recovery principles and existing approaches in services for people with intellectual disabilities; it also aims to reflect on the potential barriers to the explicit uptake of the “recovery” approach in this context.

Design/methodology/approach

The presence and implementation of “recovery” approaches within mental health services for people with intellectual disabilities are reviewed. This is achieved through an examination of existing practices that could be described as recovery oriented, along with reflections on how these relate to the recovery approach. Questions are raised regarding whether practices can be regarded as “recovery oriented”, without first consulting service users.

Findings

Further consideration is needed about the extent to which mental health services for people with intellectual disabilities are recovery oriented and how recovery would be defined amongst people with intellectual disabilities.

Research limitations/implications

It is suggested that further research using qualitative methodology is conducted, to enable the voice of service users to be heard.

Originality/value

The paper is one of the first to explore the relevance of the recovery approach to people with intellectual disabilities. Given the increasing emphasis on recovery approaches within mainstream services, it seems vital to give consideration to the potential for its meaningful application to people with intellectual disabilities and mental health problems.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 6 no. 4
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 2 November 2015

Karen Arblaster, Lynette Mackenzie and Karen Willis

The purpose of this paper is to evaluate how mental health service user involvement in health professional education adds value to student learning about recovery-oriented

Abstract

Purpose

The purpose of this paper is to evaluate how mental health service user involvement in health professional education adds value to student learning about recovery-oriented practice and to determine the quality and suitability of instruments used in studies to evaluate this involvement in terms of their: relationship to recovery-oriented practice; and psychometric properties.

Design/methodology/approach

Studies of service user involvement were reviewed to identify their research objectives. These were mapped against an Australian recovery-oriented practice capability framework together with the constructs measured by instruments used in these studies. Psychometric properties for each instrument were evaluated using the COSMIN checklist.

Findings

While research objectives are not stated in terms of recovery-oriented practice, they do relate to some elements of a recovery-oriented practice framework. No instrument measures outcomes against all recovery-oriented practice domains. The AQ has the strongest evidence for its psychometric properties. The most commonly used instrument measures only stigma and has poorly validated psychometric properties.

Originality/value

This paper demonstrates that the “value add” of service user involvement in health professional education has been poorly defined and measured to date. Learning from lived experience is central to a recovery-orientation and is an expectation of health professional education programmes. Defining objectives for service user involvement in terms of recovery-oriented practice and developing an instrument which measures student learning against these objectives are important areas for ongoing research supporting improved approaches to supporting people’s recovery.

Details

The Journal of Mental Health Training, Education and Practice, vol. 10 no. 5
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 24 June 2019

Stacey L. Barrenger, Victoria Stanhope and Emma Miller

The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and…

Abstract

Purpose

The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for bridging this gap.

Design/methodology/approach

This viewpoint is a brief review of literature on peer support services and gaps in outcome measurement towards building an evidence base for recovery-oriented services.

Findings

Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary support. One approach is to identify the theoretical underpinnings of peer support services and the corresponding change mechanisms in models that would make these recovery-oriented outcomes mediators or process outcomes. A better starting point is to consider which outcomes are valued by the people who use services and develop an evaluation approach according to those stated goals. User driven measurement approaches and more participatory types of research can improve both the quality and impact of health and mental health services.

Originality/value

This viewpoint provides a brief review of peer support services and the challenges of outcome measurement in establishing an evidence base and recommends user driven measurement as a starting point in evaluation of recovery-oriented services.

Details

Journal of Public Mental Health, vol. 18 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 16 August 2021

Rosalind Lau and Anastasia Hutchinson

Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to…

Abstract

Purpose

Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision.

Design/methodology/approach

This scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings.

Findings

Three key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3.

Research limitations/implications

This review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts.

Practical implications

On hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity.

Social implications

Service users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care.

Originality/value

This is the first review to systematically synthesis consumers perspectives on the extent to which service providers are achieving the goal of implementing recovery-orientated practice into their service provision. Despite important policy changes, the findings of this review demonstrate that more work is needed to truly operationalise and translate these principles into practice.

Details

Mental Health Review Journal, vol. 26 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 14 August 2017

Geraldine Vacher

The purpose of this paper is to provide an account of Central and North West London NHS Foundation Trust Mental Health Rehabilitation Services’ experience of utilising…

Abstract

Purpose

The purpose of this paper is to provide an account of Central and North West London NHS Foundation Trust Mental Health Rehabilitation Services’ experience of utilising Team Recovery Implementation Plan (TRIP) as a framework to embed recovery-focused practice. The paper explores the challenges to creating recovery-focused services in inpatient settings and sets out how using TRIP has enabled frontline staff to work in partnership with people who use services and coproduce changes in practice and service development.

Design/methodology/approach

The paper draws on the process of utilising TRIP as a methodology to embed recovery-focused practice.

Findings

The account finds that using TRIP as a framework to embed recovery-focused practice supports frontline staff to work in partnership with people who use services and share responsibility for delivering recovery-oriented services, measure progress and drive change.

Originality/value

The paper provides an informative account of implementing TRIP as a framework to embed recovery-focused practice in mental health rehabilitation services. It explores the challenges faced by services in creating recovery-focused services and sets out how the TRIP has been used by teams as a methodology for coproducing, co-delivering and co-reviewing action plans. The paper gives practical examples of keeping the TRIP process alive and identifies several changes to practice and service developments achieved since TRIP’s implementation.

Details

Mental Health and Social Inclusion, vol. 21 no. 4
Type: Research Article
ISSN: 2042-8308

Keywords

Article
Publication date: 16 September 2013

Hans Oh, Douglas Noordsy and Glenn Roberts

– To galvanize practical discussion about how to modify psychiatry residency programs to instill the recovery paradigm into students who will become psychiatrists.

Abstract

Purpose

To galvanize practical discussion about how to modify psychiatry residency programs to instill the recovery paradigm into students who will become psychiatrists.

Design/methodology/approach

A review of relevant literature is undertaken.

Findings

Eight suggestions are offered to help residency programs initiate conversations about recovery.

Originality/value

There has been little, if any, discussion about how psychiatry residency programs must change in terms of curriculum and pedagogy.

Details

The Journal of Mental Health Training, Education and Practice, vol. 8 no. 3
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 8 May 2017

Fiona Donald, Cameron Duff, Katherine Lawrence, Jillian Broadbear and Sathya Rao

Recovery is an important concept within mental healthcare policy. There is a growing expectation that clinicians adopt approaches that align with the recovery principles…

Abstract

Purpose

Recovery is an important concept within mental healthcare policy. There is a growing expectation that clinicians adopt approaches that align with the recovery principles, despite significant disagreements about what recovery-oriented interventions might look like in practice. It is also unclear how recovery may be relevant to personality disorder. This paper aims to discuss these issues.

Design/methodology/approach

In total, 16 clinicians were interviewed at two mental health services in Melbourne, Australia. These clinicians had specialist training and experience in the treatment of borderline personality disorder (BPD) and provided insight regarding the meaning and relevance of the recovery paradigm in the context of BPD. Thematic analysis within a grounded theory approach was used to understand key themes identified from the interview data.

Findings

Thematic analysis suggested that clinicians understand recovery in three distinct ways: as moving towards a satisfying and meaningful life, as different ways of relating to oneself and as remission of symptoms and improved psychosocial functioning. Clinicians also identified ways in which recovery-related interventions in current use were problematic for individuals diagnosed with BPD. Different approaches that may better support recovery were discussed. This study suggests that practices supporting recovery in BPD may need to be tailored to individuals with BPD, with a focus on cultivating agency while acknowledging the creative nature of recovery.

Originality/value

Clinicians are in a strong position to observe recovery. Their insights suggest key refinements that will enhance the ways in which recovery in BPD is conceptualized and can be promoted.

Details

The Journal of Mental Health Training, Education and Practice, vol. 12 no. 3
Type: Research Article
ISSN: 1755-6228

Keywords

Open Access
Article
Publication date: 4 September 2017

Chris Lloyd, Philip Lee Williams, Gabrielle Vilic and Samson Tse

Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains…

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Abstract

Purpose

Initiated by the service user movement, recovery-oriented practices are one of the keystones of modern mental health care. Over the past two decades, substantial gains have been made with introducing recovery-oriented practice in many areas of mental health practice, but there remain areas where progress is delayed, notably, the psychiatric inpatient environment. The peer support workforce can play a pivotal role in progressing recovery-oriented practices. The purpose of this paper is to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

Design/methodology/approach

The authors reviewed current literature and considered practical approaches to building a peer workforce in collaboration with occupational therapists.

Findings

It is suggested that the peer support workforce should be consciously enhanced in the inpatient setting to support culture change as a matter of priority. Occupational therapists working on inpatient units should play a key role in promoting and supporting the growth in the peer support workforce. Doing so will enrich the Occupational Therapy profession as well as improving service user outcomes.

Originality/value

This paper seeks to provide a pragmatic consideration of how occupational therapists can influence mental health systems to work proactively with a peer workforce.

Details

Irish Journal of Occupational Therapy, vol. 45 no. 2
Type: Research Article
ISSN: 2398-8819

Keywords

Article
Publication date: 11 September 2017

Larry Davidson, Janis Tondora, Anthony J. Pavlo and Victoria Stanhope

The purpose of this paper is to consider the role of shared decision making (SDM) as one component of recovery-oriented care.

Abstract

Purpose

The purpose of this paper is to consider the role of shared decision making (SDM) as one component of recovery-oriented care.

Design/methodology/approach

This paper is conceptual and reviews the literature relevant to recovery-oriented care, person-centered recovery planning (PCRP), and SDM.

Findings

To the degree to which SDM offers tools for sharing useful information about treatment options with service users and family members or other loved ones, it can be considered a valuable addition to the recovery-oriented armamentarium. It is important to emphasize, though, that recovery-oriented practice has a broader focus on the person’s overall life in the community and is not limited to formal treatments or other professionally delivered interventions. Within the more holistic context of recovery, SDM regarding such interventions is only one tool among many, which needs to be integrated within an overall PCRP process. More emphasis is given within the recovery-oriented care to activating and equipping persons for exercising self-care and for pursuing a life they have reason to value, and the nature of the relationships required to promote such processes will be identified. In describing the nature of these relationships, it will become evident that decision making is only one of many processes that need to be shared between persons in recovery and those who accept responsibility for promoting and supporting that person’s recovery.

Originality/value

By viewing SDM within the context of recovery, this paper provides a framework that can assist in the implementation of SDM in routine mental health care.

Details

Mental Health Review Journal, vol. 22 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

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