Research into Recovery and Wellbeing

A website about the work of the recovery research team at the Institute of Mental Health

The University of Nottingham

August 2016

Recovery Research Network eBULLETIN

August 2016


RRN Meetings

The next meeting of the Recovery Research Network will be held on Wednesday 16th November 2016 at the Sussex Education Centre, Hove, East Sussex. The twin-track theme for the meeting will ask:

‘Are clinical and personal recovery opposed?’


'Where is the social in clinical and personal recovery?’


Registration will be free and further details, including directions, will follow soon.


If you would like to present at a future meeting of the RRN please email either Shula Ramon or Tony Sparkes. Their contact details are:






RRN Membership Profile

Anyone who has an interest in recovery research can join the RRN, just fill in the online form available at:


Please note that if you join the Network, the details you supply will be circulated to other members of the Network as part of the monthly e-bulletin, but will not be put on our website and will not be shared with any other organisation. If you would like to leave the RRN and have your details removed from our database, please email



Conferences and Events

i) ISPS have announced their 2016 Residential Conference for Wednesday 7th – Thursday 8th September 2016, at the Peter Chalk Centre, Streatham Campus, University of Exeter.


Therapeutic Relationships: Challenges for Mental Health Services and those who use them.

For further information see:


With regard to the above conference, ISPS announce their First Call for Papers. For further information see:



ii) November 26th, London.  Fourth ISPS UK annual psychodynamics and psychosis conference:  Trauma and psychosis: perspectives on psychodynamics



iii) Making Real Change Happen.  The 20th International Congress of the ISPS will take place in the city of Liverpool, UK August 30th - September 3rd, 2017


Plenary Speakers will include: Alison Brabban, Jacqui Dillon, Grainne Fadden, Jim van Os Other speakers will include: Richard Bentall, Jim Geekie, Peter Kinderman, Eleanor Longden, Brian Martindale, John Read, Rai Waddingham

See more at:


Contact: or visit

Twitter: #isps2017uk



iv) Refocus on Recovery 2017 will be held in Nottingham from 18th to 20th September 2017.


The event will comprise expert workshops, an international conference and a Mad Celebration event. Conference themes will be Recovery for different groups, Re-situating mental health, Prevention of mental ill-health, Allocating resources.

See more at:



Papers and Publications

i) Macpherson, R., Pesola, F., Leamy, M., Bird, V., Le Boutillier, C., Williams, J. and Slade, M. (2016) The relationship between clinical and recovery dimensions of outcome in mental health. Schizophrenia Research. 175(1-3) 142-147.



Background: Little is known about the empirical relationship between clinical and personal recovery.

Aims: To examine whether there are separate constructs of clinical recovery and personal recovery dimensions of outcome, how they change over time and how they can be assessed.

Method: Standardised outcome measures were administered at baseline and one-year follow-up to participants in the REFOCUS Trial (ISRCTN02507940). An exploratory factor analysis was conducted and a confirmatory factor analysis assessed change across time.

Results: We identified three factors: patient-rated personal recovery, patient-rated clinical recovery and staff rated clinical recovery. Only the personal recovery factor improved after one year. HHI, CANSAS-P and HoNOS were the best measures for research and practice.

Conclusions: The identification of three rather than two factors was unexpected. Our findings support the value of concurrently assessing staff and patient perceptions of outcome. Only the personal recovery factor changed over time, this desynchrony between clinical and recovery outcomes providing empirical evidence that clinical recovery and personal recovery are not the same. We did not find evidence of a trade-off between clinical recovery and personal recovery outcomes. Optimal assessment based on our data would involve assessment of hope, social disability and patient-rated unmet need



ii) Hawkes, D., Hingley, D., Wood, S. and Blackhall, A. (2015) Evaluating the VERA framework for communication. Nursing Standard. 30(2) 44-48.



This article describes an evaluation of the use of the VERA (validation, emotion, reassurance, activity) framework for communication in a practice development unit at North Essex Partnership University NHS Foundation Trust. Staff of two older-adult inpatient wards in the Crystal Centre received training on the VERA framework and applied it to their practice. They found the VERA framework to be practical and user friendly, and to result in compassionate communication. Staff found that focusing on meaningful, creative interactions with service users and making a connection with these individuals is important.



iii) Carr, S. (2016) Position paper: are mainstream mental health services ready to progress transformative co-production? Bath. National Development Team for Inclusion.


‘This position paper is aimed at everyone with an interest in understanding the challenges for progressing co-production work in mental health services. It is particularly designed for those involved in mental health policy and development as well as service users and practitioners who want to engage with and understand transformative co-production in mental health’ (p3)



iv) Smith, G.P. and Williams T.M. (2016) From providing a service to being of service:

advances in person-centred care in mental health. Current Opinion in Psychiatry. 29(5) 292-297.




Purpose of review: This review explores the concept of person-centred care, giving particular attention to its application in mental health and its relationship to recovery. It then outlines a framework for understanding the variety of approaches that have been used to operationalize person-centred care, focusing particularly on shared decision-making and self-directed care, two practices that have significant implications for mental health internationally.

Recent findings: Despite growing recognition of person-centred care as an essential component of recovery-orientated practice, the levels of uptake of shared decision-making and self-directed care in mental health remain low. The most significant barrier appears to be the challenge presented to service providers by one of the key principles of person-centred care, namely empowerment.

Summary: Shared decision-making and self-directed support, two practices based upon the principles of person-centred care, have the potential for being effective tools for recovery. Full engagement of clinicians is crucial for their successful uptake into practice. More research is needed to address both outcomes and implementation.



v) Ng, F.Y.Y., Bourke, M.E., and Grenyer, B.F.S. (2016) Recovery from borderline personality disorder: a systematic review of the perspectives of consumers, clinicians, family and carers. Plos One 11(8) e0160515.

doi: 10.1371/journal.pone.0160515



Purpose: Longitudinal studies support that symptomatic remission from Borderline Personality Disorder (BPD) is common, but recovery from the disorder probably involves a broader set of changes in psychosocial function over and above symptom relief. A systematic review of literature on both symptomatic and personal recovery from BPD was conducted including the views of consumers, clinicians, family and carers. 

Materials and Methods: A PRISMA guided systematic search identified research examining the process of recovery from BPD. Longitudinal studies with a follow-up period of five or more years were included to avoid treatment effects.

Results: There were 19 studies, representing 11 unique cohorts (1,122 consumers) meeting the review criteria. There was a limited focus on personal recovery and the views of family and carers were absent from the literature. Rates of remission and recovery differ depending upon individual and methodological differences between studies. Data on symptomatic remission, recurrence and diagnosis retainment suggests that BPD is a stable condition, where symptomatic remission is possible and the likelihood of recurrence following a period of remission is low.

Conclusion: Symptomatic remission from BPD is common. However, recovery including capacities such as engaging in meaningful work was seldom described. Future research needs broader measures of recovery as a sub-syndromal experience, monitoring consumer engagement in meaningful vocation and relationships, with or without the limitations of BPD.



Other News

Shula Ramon and Tony Sparkes co-produce the RRN monthly ebulletin. Please email if there is anything you would like included in the next issue, as we are keen to receive and advertise more news, articles and website references. Information can be posted to either Shula or Tony at the following:




page updated 21 September 2016