Drawing from the previously presented life-history narratives of ­participants in consumer-run organizations (CROs), this chapter seeks to provide general insights into the recovery process. I also consider implications for practice that are based on insights from the role framework and the holistic consideration of all studies presented in the book. The strengths and weaknesses of the qualitative and quantitative methods used to develop and test the role framework are also discussed. Many weaknesses of the qualitative studies are addressed by the quantitative studies and vice versa. However, numerous limitations of the research remain and this chapter presents future research directions that can further improve our understanding of how people benefit from CROs. Finally, the book concludes with some consideration of how the role framework informs future directions for the treatment and prevention of mental health problems.


Mental Health Problem Leadership Role Skill Development Identity Transformation Severe Mental Health Problem 
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  1. Bandura, A. (1997). Self-efficacy: The exercise of control. New York: Freeman.Google Scholar
  2. Borkman, T. J. (1999). Understanding self-help/mutual aid: Experiential learning in the commons. New Brunswick, NJ: Rutgers University Press.Google Scholar
  3. Callero, P. L. (1992). The meaning of self-in-role: a modified measure of role identity. Social Forces, 71, 485–501.Google Scholar
  4. Chavis, D. M., & Wandersman, A. (1990). Sense of community in the urban environment: a catalyst for participation and community development. American Journal of Community Psychology, 18, 55–81.CrossRefGoogle Scholar
  5. Chiu, M. Y. L., Ho, W. W. N., Lo, W. T. L., & Yiu, M. G. C. (2010). Operationalization of the SAMHSA model of recovery: a quality of life perspective. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 19(1), 1–13. doi: 10.1007/s11136-009-9555-2.CrossRefGoogle Scholar
  6. Greenfield, T. K., Stoneking, B. C., Humphreys, K., Sundby, E., & Bond, J. (2008). A randomized trial of a mental health consumer-managed alternative to civil commitment for acute psychiatric crisis. American Journal of Community Psychology, 42(1–2), 135–144. doi: 10.1007/s10464-008-9180-1.PubMedCrossRefGoogle Scholar
  7. Hinyard, L. J., & Kreuter, M. W. (2007). Using narrative communication as a tool for health behavior change: a conceptual, theoretical, and empirical overview. Health Education and Behavior, 34, 777–792.PubMedCrossRefGoogle Scholar
  8. Holter, M. C., & Mowbray, C. T. (2005). Consumer-run drop-in centers: program operations and costs. Psychiatric Rehabilitation Journal, 28, 323–331.PubMedCrossRefGoogle Scholar
  9. Isaacson, W. (2009). How to save your newspaper. Time, 16, 30–33.Google Scholar
  10. Kaufmann, C. L., Ward-Colasante, C., & Farmer, J. (1993). Development and evaluation of drop-in centers operated by mental health consumers. Hospital and Community Psychiatry, 44, 675–678.PubMedGoogle Scholar
  11. Knowles, E. S., & Linn, J. (Eds.). (2004). Resistance and persuasion. Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  12. Kreuter, M. W., Green, M. C., Capella, J. N., Slater, M. D., Wise, M. E., Storey, D., et al. (2007). Narrative communication in cancer prevention and control: a framework to guide research and application. Annals of Behavioral Medicine, 33, 221–235.PubMedCrossRefGoogle Scholar
  13. Lincoln, Y. S., & Guba, E. G. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. Naturalistic Evaluation, 30, 73–84.Google Scholar
  14. Lowe, M. R., & Cautela, J. R. (1978). A self-report measure of social skill. Behavior Therapy, 9, 535–544.CrossRefGoogle Scholar
  15. Maton, K. I., & Salem, D. A. (1995). Organizational characteristics of empowering community settings: a multiple case study approach. American Journal of Community Psychology, 23, 631–656.PubMedCrossRefGoogle Scholar
  16. Meissen, G. J., Gleason, D. F., & Embree, M. G. (1991). An assessment of the needs of mutual-help groups. American Journal of Community Psychology, 19, 427–442.PubMedCrossRefGoogle Scholar
  17. Mowbray, C. T., Woodward, A. T., Holter, M. C., MacFarlane, P., & Bybee, D. (2009). Characteristics of users of consumer-run drop-in centers versus clubhouses. Journal of Behavioral Health Services and Research, 36(3), 361–371. doi: 10.1007/s11414-008-9112-8.PubMedCrossRefGoogle Scholar
  18. Nelson, G., Janzen, R., Ochocka, J., & Trainor, J. (2010). Participatory action research and evaluation with mental health self-help initiatives: a theoretical framework. In L. D. Brown & S. A. Wituk (Eds.), Mental health self-help: Consumer and family initiatives (pp. 39–60). New York: Springer.CrossRefGoogle Scholar
  19. Nelson, G., Ochocka, J., Griffin, K., & Lord, J. (1998). ‘Nothing about me, without me’: Participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors. American Journal of Community Psychology, 26(6), 881–912. doi: 10.1023/a:1022298129812.PubMedCrossRefGoogle Scholar
  20. Powell, T. J., Hill, E. M., Warner, L., Yeaton, W., & Silk, K. R. (2000). Encouraging people with mood disorders to attend a self-help group. Journal of Applied Social Psychology, 30, 2270–2288.CrossRefGoogle Scholar
  21. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.Google Scholar
  22. Salem, D., Reischl, T., & Randall, K. (2008). The effect of professional partnership on the development of a mutual-help organization. American Journal of Community Psychology, 42(1), 179–191. doi: 10.1007/s10464-008-9193-9.PubMedCrossRefGoogle Scholar
  23. Salzer, M. S. (2010). Certified peer specialists in the United States behavioral health system: an emerging workforce. In L. D. Brown & S. Wituk (Eds.), Mental health self-help: Consumer and family initiatives (pp. 169–191). Springer Science  +  Business Media: New York, NY US.CrossRefGoogle Scholar
  24. Segal, S. P., Silverman, C. J., & Temkin, T. L. (2010). Self-help and community mental health agency outcomes: a recovery- focused randomized controlled trial. Psychiatric Services, 61(9), 905–910. doi: 10.1176/ Scholar
  25. Siebert, D. C., & Siebert, C. F. (2005). The caregiver role identity scale: a validation study. Research on Social Work Practice, 15, 204–212.CrossRefGoogle Scholar
  26. Sisson, R. W., & Mallams, J. H. (1981). The use of systematic encouragement and community access procedures to increase attendance at alcoholic anonymous and al-anon meetings. The American Journal of Drug and Alcohol Abuse, 8, 371–376.PubMedCrossRefGoogle Scholar
  27. Solomon, P., & Draine, J. (1995). The efficacy of a consumer case management team: 2-year outcomes of a randomized trial. Journal of Mental Health Administration, 22(2), 135–146. doi: 10.1007/bf02518754.PubMedCrossRefGoogle Scholar
  28. Solomon, P., & Draine, J. (1996). Service delivery differences between consumer and nonconsumer case managers in mental health. Research on Social Work Practice, 6(2), 193–207. doi: 10.1177/104973159600600204.CrossRefGoogle Scholar
  29. Stryker, S., & Serpe, R. T. (1994). Identity salience and psychological centrality: Equivalent, overlapping, or complementary concepts? Social Psychology Quarterly, 57, 16–35.CrossRefGoogle Scholar
  30. Talbott, B. H., & Hallows, S. (2008). Leadership skills: developing a measure for college students. Intuition, 4, 12–18.Google Scholar
  31. Teague, G.B., Johnsen, M., Rogers, J.A., & Schell, B. (2005). Research on consumer-operated service programs: Effectiveness findings and policy implications of a large multi-site study. Retrieved March 10 2009, from
  32. Wituk, S. A., Shepherd, M. D., Warren, M., & Meissen, G. (2002). Factors contributing to the survival of self-help groups. American Journal of Community Psychology, 30, 349–366.PubMedCrossRefGoogle Scholar
  33. Wolf, R., & Grotta, G. L. (1985). Images: a question of readership [Article]. Newspaper Research Journal, 6(2), 30–36.Google Scholar
  34. Zimmerman, M. A., Reischl, T. M., Seidman, E., Rappaport, J., Toro, P. A., & Salem, D. A. (1991). Expansion strategies of a mutual help organization. American Journal of Community Psychology, 19, 251–278.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.University of Texas School of Public HealthEl PasoUSA

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