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Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Policy is increasingly focused on implementing a recovery-orientation within mental health services, yet the subjective experience of individuals receiving a pro-recovery intervention is under-studied. The aim of this study was to explore the service user experience of receiving a complex, pro-recovery intervention (REFOCUS), which aimed to encourage the use of recovery-supporting tools and support recovery-promoting relationships.

Methods

Interviews (n = 24) and two focus groups (n = 13) were conducted as part of a process evaluation and included a purposive sample of service users who received the complex, pro-recovery intervention within the REFOCUS randomised controlled trial (ISRCTN02507940). Thematic analysis was used to analyse the data.

Results

Participants reported that the intervention supported the development of an open and collaborative relationship with staff, with new conversations around values, strengths and goals. This was experienced as hope-inspiring and empowering. However, others described how the recovery tools were used without context, meaning participants were unclear of their purpose and did not see their benefit. During the interviews, some individuals struggled to report any new tasks or conversations occurring during the intervention.

Conclusion

Recovery-supporting tools can support the development of a recovery-promoting relationship, which can contribute to positive outcomes for individuals. The tools should be used in a collaborative and flexible manner. Information exchanged around values, strengths and goals should be used in care-planning. As some service users struggled to report their experience of the intervention, alternative evaluation approaches need to be considered if the service user experience is to be fully captured.

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Acknowledgments

This article presents independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research (PGfAR) Programme (Grant Reference Number RP-PG-0707-10040), and in relation to the NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry King’s College London. The project will be published in full in the NIHR PGfAR journal. The views expressed in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the PGfAR programme or the Department of Health. Further information available at researchintorecovery.com/refocus

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Authors and Affiliations

  1. Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, UK

    Genevieve Wallace, Mary Leamy, Faye Bacon, Clair Le Boutillier, Monika Janosik & Julie Williams

  2. Wolfson Institute of Preventive Medicine, Queen Mary University of London, Newham Centre for Mental Health, London, E13 8SP, UK

    Victoria Bird

  3. 2gether NHS Foundation Trust, Gloucestershire, UK

    Rob MacPherson

  4. Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK

    Mike Slade

Authors
  1. Genevieve Wallace
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  2. Victoria Bird
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  3. Mary Leamy
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  4. Faye Bacon
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  5. Clair Le Boutillier
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  6. Monika Janosik
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  7. Rob MacPherson
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  8. Julie Williams
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  9. Mike Slade
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Corresponding author

Correspondence to Victoria Bird.

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Additional information

G. Wallace and V. Bird are joint first authors.

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Wallace, G., Bird, V., Leamy, M. et al. Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention. Soc Psychiatry Psychiatr Epidemiol 51, 1275–1284 (2016). https://doi.org/10.1007/s00127-016-1257-9

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  • DOI: https://doi.org/10.1007/s00127-016-1257-9

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