Recovery Research Network (RRN)

Recovery Research Network eBULLETIN

June 2015

RRN Meetings

The next meeting of the RRN will be held on the 10^th of November and hosted by Anglia Ruskin University at its Cambridge Campus. The focus will be on Implementation Issues of Recovery Research Projects. Details of this event will be circulated later in the year.

If you would like to present at a future meeting of the RRN please email:

researchintorecovery@kcl.ac.uk

RRN Membership Profile

Updated membership profile attached. If you would like to update your entry please email your text to researchintorecovery@kcl.ac.uk. The Membership Profile will be circulated with each RRN monthly email, but not put on our web-site. New members can now join via the website: https://www.researchintorecovery.com/join

Conferences and Events

i) 11th ENMESH Conference, Málaga. 1-3 October 2015. More information at: http://www.enmeshmalaga2015.com

ii) The International Society for Psychological and Social Approaches to Psychosis (ISPS) will be hosting a conference entitled Walking Alongside?: Navigating the tensions and opportunities for collaboration between lived and professional experience of psychosis. The event is scheduled for Saturday 11^th July 2015 (10am – 4.30pm). A flyer and programme details are available at:

http://www.ispsuk.org/?ai1ec_event=walking-alongside

Papers and Publications

i) Fox, J. (2015) The Contribution of Experiential Wisdom to the Development of the Mental Health Professional Discourse. Schizophrenia Bulletin [Advanced Access: published June 21 2015].

DOI: 10.1093/schbul/sbv082

http://schizophreniabulletin.oxfordjournals.org/content/early/2015/06/21/schbul.sbv082.full.pdf+html

The writer gives a first person account of in which she explores the relationship between experiential wisdom and mental health professional discourse. Articulated from a number of positions, including that of a person with lived experience, the author concludes by emphasising that professionals’ response to experiential wisdom requires them to both acknowledge the diversity of mental distress and to eradicate the imbalance of power between professional knowledge and service user experience. The value of lived experience to professional education is a key aspect to this understanding.

ii) Le Boutillier, C., Chevalier, A., Lawrence, V., Leamy, M., Bird, V. J., Macpherson, R., Williams, J. and Slade, M. (2015) Staff Understanding of Recovery-orientated Mental Health Practice: a systematic review and narrative synthesis. Implementation Science. Vol.10(87), pp.1-14.

DOI 10.1186/s13012-015-0275-4

http://www.implementationscience.com/content/10/1/87

Background: Mental health policy is for staff to transform their practice towards a recovery orientation. Staff understanding of recovery-orientated practice will influence the implementation of this policy. The aim of this study was to conduct a systematic review and narrative synthesis of empirical studies identifying clinician and manager conceptualisations of recovery-orientated practice.

Methods: A systematic review of empirical primary research was conducted. Data sources were online databases (n = 8), journal table of contents (n = 5), internet, expert consultation (n = 13), reference lists of included studies and references to included studies. Narrative synthesis was used to integrate the findings.

Results: A total of 10,125 studies were screened, 245 full papers were retrieved, and 22 were included (participants, n = 1163). The following three conceptualisations of recovery-orientated practice were identified: clinical recovery, personal recovery and service-defined recovery. Service-defined recovery is a new conceptualisation which translates recovery into practice according to the goals and financial needs of the organisation.

Conclusions: Organisational priorities influence staff understanding of recovery support. This influence is leading to the emergence of an additional meaning of recovery. The impact of service-led approaches to operationalising recovery-orientated practice has not been evaluated.

iii) Le Boutillier, C., Slade, M., Lawrence, V., Bird, V. J., Chandler, R., Farkas, M., Harding, C., Larsen, J., Oades, L.G., Roberts, G., Shepherd, G., Thornicroft, G., Williams, J. and Leamy, M. (2015) Competing Priorities: Staff Perspectives on Supporting Recovery. Administration and Policy in Mental Health. Vol.42(4), pp.429-438.

DOI 10.1007/s10488-014-0585-x

Abstract: Recovery has come to mean living a life beyond mental illness, and recovery orientation is policy in many countries. The aims of this study were to investigate what staff say they do to support recovery and to identify what they perceive as barriers and facilitators associated with providing recovery-oriented support. Data collection included ten focus groups with multidisciplinary clinicians (n = 34) and team leaders (n = 31), and individual interviews with clinicians (n = 18), team leaders (n = 6) and senior managers (n = 8). The identified core category was Competing Priorities, with staff identifying conflicting system priorities that influence how recovery-oriented practice is implemented. Three sub-categories were: Health Process Priorities, Business Priorities, and Staff Role Perception. Efforts to transform services towards a recovery orientation require a whole-systems approach.

iv) Rose, D., Barnes, M., Crawford, M., Omeni, E., MacDonald, D. and Wilson, A. (2014) How do Managers and Leaders in the National Health Service and Social Care Respond to Service User Involvement in Mental Health Services in both its Traditional and Emergent Forms? The ENSUE Study. Health Services and Delivery Research. Vol.2(10).

DOI: 10.3310/hsdr02100

Background: This study set out to measure the extent and perceived impact of service user involvement (SUI) in mental health services and to explore different forms of SUI, both collective and individual. The focus was on service users’ (SUs’) interactions with managers and other key decision-makers in the UK NHS and social care. The theoretical frameworks used were organisational theory and new social movement theory.

Objectives: To explore the impact of service user involvement in mental health on shaping policy agendas and delivery specifically in terms of their impact on key decision-makers.

Design: A mixed-methods design was used.

Setting: The study took place in three NHS foundation trusts (FTs): two metropolitan and one rural.

Methods: The methods included surveys, interviews, ethnographies, case studies and focus groups.

Results: In the first phase of the study, which took the form of surveys, it was found that ‘ordinary’ SUs had a relatively high level of involvement in at least one service domain and that where they were involved they believed this had produced a positive impact on service development and delivery. Likewise a majority of front-line staff encouraged SUI and thought this had a positive impact although social workers were more likely to have directly participated in SUI initiatives than nurses. In the second phase of the study, which used qualitative methods, an ethnography of user-led organisations (ULOs) was conducted, which showed that ULOs were being forced to adapt in an organisational climate of change and complexity, and that decision-makers no longer claimed the high moral ground for working with ULOs, but expected them to work within a system of institutional behavioural norms. This posed many challenges for the ULOs. In phase 2 of the research we also examined the role of SU governors in NHS FTs. We posed the question of whether or not SU governors represented a shift away from more collective forms of organisation to a more individual form. It was found that SU governors, too, had to work within a system of norms deriving from the organisational structure and culture of the NHS, and this impacted on how far they were able to exercise influence. There was also evidence that user governors were beginning to organise collectively. In respect of individual forms of involvement we also attempted to run focus groups of people in receipt of personal budgets but concluded that, as yet, they are not embedded in mental health services.

Conclusions: It was concluded that SUs and managers are working in a climate of dynamic and complex organisational change, of which user involvement is an integral part, and that this has impacted on the nature of SUI as a new social movement. Managers need to attend to this in their interactions with SUs and their organisations.

v) van der Krieke, L., Bird, V., Leamy, M., Bacon, F., Dunn, R., Pesola, F., Janosik, M., Le Boutillier, C., Williams, J. and Mike Slade, M. (2015) The Feasibility of Implementing Recovery, Psychosocial and Pharmacological Interventions for Psychosis: comparison study. Implementation Science. Vol.10(73), pp.1-7.

DOI 10.1186/s13012-015-0262-9

http://www.implementationscience.com/content/10/1/73

Background: Clinical guidelines for the treatment of people experiencing psychosis have existed for over a decade, but implementation of recommended interventions is limited. Identifying influences on implementation may help to reduce this translational gap. The Structured Assessment of Feasibility (SAFE) measure is a standardised assessment of implementation blocks and enablers. The aim of this study was to characterise and compare the implementation blocks and enablers for recommended psychosis interventions.

Methods: SAFE was used to evaluate and compare three groups of interventions recommended in the 2014 NICE psychosis guideline: pharmacological (43 trials testing 5 interventions), psychosocial (65 trials testing 5 interventions), and recovery (19 trials testing 5 interventions). The 127 trial reports rated with SAFE were supplemented by published intervention manuals, research protocols, trial registrations and design papers. Differences in the number of blocks and enablers across the three interventions were tested statistically, and feasibility profiles were generated.

Results: There was no difference between psychosocial and recovery interventions in the number of blocks or enablers to implementation. Pharmacological interventions (a) had fewer blocks than both psychosocial interventions (χ2(3) = 133.77, p < 0.001) and recovery interventions (χ2(3) = 104.67, p < 0.001) and (b) did not differ in number of enablers from recovery interventions (χ2(3) = 0.74, p = 0.863) but had fewer enablers than psychosocial interventions (χ2(3) = 28.92, p < 0.001). Potential adverse events associated with the intervention tend to be a block for pharmacological interventions, whereas complexity of the intervention was the most consistent block for recovery and psychosocial interventions.

Conclusions: Feasibility profiles show that pharmacological interventions are relatively easy to implement but can sometimes involve risks. Psychosocial and recovery interventions are relatively complex but tend to be more flexible and more often manualised. SAFE ratings can contribute to tackling the current implementation challenges in mental health services, by providing a reporting guideline structure for researchers to maximise the potential for implementation and by informing prioritisation decisions by clinical guideline developers and service managers.

Other News

A call for information has been received from the ENRICH research project led by a team from St George’s, University of London. If any member(s) of the RRN are able to assist, that would be great. We include their full request below:

Dear Colleague,

We are working on a project called ENRICH which revolves around one-to-one peer support to improve people’s experiences of discharge, being led from St George’s, University of London. As part of the project we’re particularly interested in grey literature around one-to-one peer support in mental health, this might include research reports, peer worker job descriptions, service descriptions etc, that may or not have been formally published. If you’re aware of any type of grey literature about existing or new one-to-one peer support services/initiatives in any mental health context, then please feel free to attach documents or weblinks in an email to us (enrichpeerwork@sgul.ac.uk) or alternatively email us if you have any further questions. We would be grateful if you were able to send any information to enrichpeerwork@sgul.ac.uk by 18^th July 2015. Your time and support with this is greatly appreciated, best wishes,

The ENRICH team at St George’s, University of London

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:

Shula:              s.ramon@herts.ac.uk

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

Of course, material can still be posted to researchintorecovery@kcl.ac.uk

Recovery Research Network eBULLETIN

July 2015

RRN Meetings

The next meeting of the RRN will be held on the 10^th of November 2015 and hosted by Anglia Ruskin University at its Cambridge Campus. The focus will be on Implementation Issues of Recovery Research Projects. Confirmed speakers and titles are to include:

Further details will be distributed in the August ebulletin.

If you would like to present at a future meeting of the RRN please email:

researchintorecovery@kcl.ac.uk

RRN Membership Profile

Updated membership profile attached. If you would like to update your entry please email your text to researchintorecovery@kcl.ac.uk. The Membership Profile will be circulated with each RRN monthly email, but not put on our web-site. New members can now join via the website: https://www.researchintorecovery.com/join

Conferences and Events

i) 11th ENMESH Conference, Málaga. 1-3 October 2015. More information at: http://www.enmeshmalaga2015.com

ii) PCCS Books Conference:

POSITIVE ACTION FOR CHANGE IN MENTAL HEALTH SERVICES

17th November 2015, 10.00 am – 4.45 pm

Trent Vineyard Conference Centre, Easter Park, Lenton Lane, Nottingham, NG7 2PX

Conference description (taken from website): The case for demedicalising mental health services is well rehearsed. The research has been done, the conferences have been held and the intellectual argument all but won. Yet on a day-to-day basis, services continue to operate within the medicalised status quo. One of the aims of this conference will be to look at how we can implement realistic, practical changes in our mental health practice, education and lives, in order to continue the progression from rhetoric to reality.

For mental health service users / survivors, carers, professionals, students and everyone interested in critical debate in mental health care.

For further information see:

http://www.pccs-books.co.uk/products/ticket/pccs-books-conference#.VZ1rvYvHpGJJ

Papers and Publications

i) Shepherd, A., Sanders, C., Doyle, M. and Shaw, J. (2015) Personal recovery in personality disorder: Systematic review and meta-synthesis of qualitative methods studies. International Journal of Social Psychiatry. First published online, 16 June 2015:

DOI: 10.1177/0020764015589133

Abstract

Background and aims: Support of personal recovery represents the aim for many modern mental health services. There is a lack of conceptual clarity around the application of the term however and this is particularly problematic with regard to the personality disorder diagnoses. This study sought to review the existing qualitative methods literature in relation to the experience of personal recovery in personality disorder.

Methods: A systematic literature search was conducted. Identified studies were incorporated through meta-synthesis in order to develop higher order descriptive themes representative of the individual experience described within included studies.

Results: Three studies were identified and incorporated into the meta-synthesis. Three novel higher order themes were developed: Safety and containment as a prerequisite to recovery, social networks and autonomy in the recovery process and identity construction as a process of change.

Conclusion: Personal recovery in personality disorder is revealed as a complex process reflecting both personal and social experiences or desires. These findings have important implications for clinical practice – emphasising the need to work closely with individuals and to develop an understanding of both their social experience and networks. Further research, taking greater account of social context in the recovery process, is necessary.

ii) Shepherd, A., Doyle, M., Sanders, C. and Shaw, J. (2015) Personal recovery within forensic

settings – Systematic review and meta-synthesis of qualitative methods studies. Criminal Behaviour and Mental Health. First published online, 21 June 2015:

DOI: 10.1002/cbm.1966

Abstract

Background: Many mental health services now explicitly aim to support personal recovery. Are there special ethical and practical considerations for application of this model in forensic mental health services? Is there, for example, any conflict in this context between personal empowerment and risk management?

Aim: Our aim was to develop a model of the personal recovery processes for people

needing forensic mental health services.

Methods: A systematic literature review was conducted and meta-synthesis applied to data from relevant papers.

Results: Five studies were identified through the search process and combined through metasynthesis. Three key overarching themes were synthesised: safety and security as a necessary base for the recovery process, the dynamics of hope and social networks in supporting the recovery process and work on identity as a changing feature in the recovery process.

Conclusions: The themes identified provide for theoretically informed and testable developments in care that could enhance the quality of recovery and rehabilitation for offender patients through explicitly enhancing personal sense of safety, understanding the patient’s sense of personal identity and their social networks and transitioning between institutional and community support.

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:

Shula:              s.ramon@herts.ac.uk

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

Of course, material can still be posted to researchintorecovery@kcl.ac.uk

Recovery Research Network eBULLETIN

August 2015

RRN Meetings

The next meeting of the RRN will be held on the 10^th of November 2015 and hosted by Anglia Ruskin University and Cambridgeshire and Peterborough NHS Foundation Trust (CPFT). The focus will be on Implementation Issues of Recovery Research Projects.

Further information, including the programme and registration details can be found in the attachment circulated with this ebulletin.

If you would like to present at a future meeting of the RRN please email:

researchintorecovery@kcl.ac.uk

RRN Membership Profile

Updated membership profile attached. If you would like to update your entry please email your text to researchintorecovery@kcl.ac.uk. The Membership Profile will be circulated with each RRN monthly email, but not put on our web-site. New members can now join via the website: https://www.researchintorecovery.com/join

Conferences and Events

i)  Peer-Supported Open Dialogue – Creative Conversations in the Mobilising of Social Networks.  Friday 11^th September 2015. Organised by Kent and Medway NHS and Social Care Partnership Trust (KMPT), the conference aims to:

1)      Set the scene for the introduction of Peer-Supported Open Dialogue in KMPT, as a treatment approach for people experiencing acute psychological crises such as psychosis.

2)      Understand this movement in the context of the national and international development of Open Dialogue as an approach with a significant evidence base that sees families and wider support networks included in treatment from the first contact.

3)      Highlight the research evidence that has been created over the last two decades and describe the current situation in which various Trusts around the country, including KMPT, are being recruited to undertake a national RCT research programme starting in 2016.

4)      Think about how the philosophy of the Open Dialogue approach may influence the wider transformation of mental health services over time.

More information and registration form is freely available over the internet. For example see:

http://www.ispsuk.org/?ai1ec_event=peer-supported-open-dialogue-day-conference

ii) 11th ENMESH Conference, Málaga. 1-3 October 2015. More information at: http://www.enmeshmalaga2015.com

iii) PCCS Books Conference:

POSITIVE ACTION FOR CHANGE IN MENTAL HEALTH SERVICES

17th November 2015, 10.00 am – 4.45 pm

Trent Vineyard Conference Centre, Easter Park, Lenton Lane, Nottingham, NG7 2PX

Conference description (website): The case for demedicalising mental health services is well rehearsed. The research has been done, the conferences have been held and the intellectual argument all but won. Yet on a day-to-day basis, services continue to operate within the medicalised status quo. One of the aims of this conference will be to look at how we can implement realistic, practical changes in our mental health practice, education and lives, in order to continue the progression from rhetoric to reality.

For mental health service users / survivors, carers, professionals, students and everyone interested in critical debate in mental health care.

For further information see:

http://www.pccs-books.co.uk/products/ticket/pccs-books-conference#.VZ1rvYvHpGJJ

Papers and Publications

i) The second edition of ‘Enabling Recovery: the principles and practice of psychiatric rehabilitation’ has recently been published. The publishers introduce the second edition on their web-site with the following text:

‘How can people with severe mental health problems be supported in their personal recovery? This question lies at the heart of rehabilitation psychiatry, and perhaps of mental healthcare as a whole. Our understanding of recovery has evolved rapidly since the first edition of this core text was published in 2006 – so this book comprises 31 entirely revised or newly commissioned chapters, giving readers a comprehensive overview of contemporary practice within psychiatric rehabilitation services. It takes a practical approach, guiding the reader logically and systematically from conceptual foundations to clinical practice and service development. The final section of the book covers special topics including rehabilitation in specific disorders and international perspectives.’

Please see:

http://www.rcpsych.ac.uk/usefulresources/publications/books/rcpp/9781909726338.aspx

ii)  Morant, N., Kaminskiy, E. and Ramon, S. (2015) Shared Decision Making for Psychiatric Medication Management: beyond the micro-social.  Health Expectations. First published online, 10^th August 2015. DOI: 10.1111/hex.12392

Abstract

Background Mental health care has lagged behind other health-care domains in developing and applying shared decision making (SDM) for treatment decisions. This is despite compatibilities with ideals of modern mental health care such as self-management and recovery oriented practice, and growing policy-level interest. Psychiatric medication is a mainstay of mental health treatment, but there are known problems with prescribing practices, and service users report feeling uninvolved in medication decisions and concerned about adverse effects. SDM has potential to produce better tailoring of psychiatric medication to individuals’ needs.

Objectives This conceptual review argues that several aspects of mental health care that differ from other health-care contexts (e.g. forms of coercion, questions about service users’ insight and disempowerment) may impact on processes and possibilities for SDM. It is therefore problematic to uncritically import models of SDM developed in other health-care contexts. We argue that decision making for psychiatric medication is better understood in a broader way that moves beyond the micro-social focus of a medical consultation. Contextualizing specific medication-related consultations within longer term relationships, and broader service systems enables recognition of the multiple processes, actors and agendas that shape how psychiatric medication is prescribed, managed and used, and which may facilitate or impede SDM.

Conclusion A broad conceptualization of decision making for psychiatric medication that moves beyond the micro-social can account for why SDM in this domain remains a rarity. It has both conceptual and practical utility for evaluating research evidence, identifying future research priorities and highlighting fruitful ways of developing and implementing SDM in mental health care.

iii)  Slade, M. and Longden, E. (2015) The Empirical Evidence about Mental Health and Recovery: how likely, how long, what helps? Victoria: MI Fellowship

This report reviews empirical scientific knowledge relating to recovery. It identifies seven evidence-based messages: 1. Recovery is best judged by the person living with the experience; 2. Many people with mental health problems recover; 3. If a person no longer meets criteria for a mental illness, they are not ill; 4. Diagnosis is not a robust foundation; 5. Treatment is one route amongst many to recovery 6. Some people choose not to use mental health services; 7. The impact of mental health problems is mixed.

See:

https://www.researchintorecovery.com/files/2015%20Recovery%20and%20mental%20health.pdf

Alternatively:

http://www.mifellowship.org/sites/default/files/MIFellowship_Slade_Longden_Empirical%20evidence%20about%20mental%20illness_WEB_5_8_2015.pdf

Other News

i) Request for participants:

Shaping a vision for implementing Recovery in Hull: a Delphi Study

Humber NHS Foundation Trust along with local partners is in the initial stages of preparing to launch the ‘Hull and East Riding Recovery College’. We are looking to create a vision and/or a mission statement to guide and support us in our early days. To help us formulate this we have commissioned a research project and are aiming to recruit a panel of ‘experts’ in Recovery willing to share their thoughts to identify,

‘what factors best encapsulate the implementation of Recovery?’

Potential respondents will be drawn from college/service users, peer support workers, professionals working within Recovery services and academics. It is proposed to administer 3 rounds of questions with all contact being made by email. If you are willing to join our panel please contact haley.jackson@nhs.net for further details or to register your interest by the 14th September 2015. Your time and support with this is will be greatly appreciated. Thanks

Haley Jackson, Research Nurse, Humber NHS Foundation Trust

ii) 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:

Shula:              s.ramon@herts.ac.uk

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

Of course, material can still be posted to researchintorecovery@kcl.ac.uk

Recovery Research Network eBULLETIN

September 2015

RRN Meetings

The next meeting of the RRN will be held on the 10^th of November 2015 and hosted by Anglia Ruskin University and Cambridgeshire and Peterborough NHS Foundation Trust (CPFT). The focus will be on Implementation Issues of Recovery Research Projects.

Further information, including the programme and registration details can be found in the attachment circulated with this ebulletin.

If you would like to present at a future meeting of the RRN please email:

researchintorecovery@kcl.ac.uk

RRN Membership Profile

Updated membership profile attached. If you would like to update your entry please email your text to researchintorecovery@kcl.ac.uk. The Membership Profile will be circulated with each RRN monthly email, but not put on our web-site. New members can now join via the website: https://www.researchintorecovery.com/join

Conferences and Events

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

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

For further information see:

http://www.ispsuk.org/wp-content/uploads/2015/08/ISPS-UK-Residential-2016-Conference.pdf

ii) PROMISE Global are advertising their PROMISE Charter event on Friday 9^th October, 2015 at Umney Theatre, Robinson College, Grange Road, Cambridge, CB3 9AN.

Registration: http://promisecharter.peatix.com

Information: www.promise.global

iii) 11th ENMESH Conference, Málaga. 1-3 October 2015. More information at: http://www.enmeshmalaga2015.com

iv) PCCS Books Conference:

POSITIVE ACTION FOR CHANGE IN MENTAL HEALTH SERVICES

17th November 2015, 10.00 am – 4.45 pm

Trent Vineyard Conference Centre, Easter Park, Lenton Lane, Nottingham, NG7 2PX

Conference description (website): The case for demedicalising mental health services is well rehearsed. The research has been done, the conferences have been held and the intellectual argument all but won. Yet on a day-to-day basis, services continue to operate within the medicalised status quo. One of the aims of this conference will be to look at how we can implement realistic, practical changes in our mental health practice, education and lives, in order to continue the progression from rhetoric to reality.

For mental health service users / survivors, carers, professionals, students and everyone interested in critical debate in mental health care.

For further information see:

http://www.pccs-books.co.uk/products/ticket/pccs-books-conference#.VZ1rvYvHpGJJ

v) Improving the Normalization of Complex Interventions: Development of a Measure based on Normalization Process Theory (NoMAD). Launch Event

Date: 18 November 2015

Venue: Kings Fund 11-13 Cavendish Square London

Time: 10.00am-4.00pm

This event is aimed at clinicians, managers, policy makers and academic interested in improving the implementation and evaluation of complex interventions. The event will launch a new quantitative tool (NoMAD) based on Normalisation Process Theory (NPT).

Professor Robbie Foy, Professor of Primary Care at Leeds University & Implementation Science Deputy Editor-in-Chief, will be a plenary speaker.

The programme details are currently being finalised. There will be no cost for attendance but please be aware that places will be limited so if you would like to attend please email melissa.girling@ncl.ac.uk

vi) Community Psychology UK will be hosting a Community Psychology festival in Manchester on November 20 and 21st. All welcome. For further details please see:

http://communitypsychologyuk.ning.com/forum/topics/call-for-contributions-festival-of-community-psychology

Or, alternatively:

http://www.kc-jones.co.uk/community20155

Papers and Publications

i) Barbato, A., D’Avanzo, B., D’Anza, V., Montorfano, E., Savio, M. and Corbascio, C.G. (2014)

Involvement of Users and Relatives in Mental Health Service Evaluation

Journal of Nervous and Mental Disease Vol.202(6), pp.479-486.

DOI 10.1097/NMD.0000000000000148

Background: Although Italian mental health (MH) services are community based, user and relative participation in service evaluation lagged behind until lately. We here review three recent studies involving stakeholder participation in service evaluation.

Methodology: Two were quantitative studies, one on 204 users in an MH service in Pistoia (Central Italy) and the other on 2259 relatives, conducted with the National Union of Associations for Mental Health. The third (supported by The Centro per il Controllo delle Malattie, the ministerial Center for Disease Control) was a qualitative study in seven MH services, involving users, relatives, and professionals together, which collected interviews from 136 users, 119 relatives, and 79 professionals.

Findings: In the quantitative studies, positive evaluations outnumbered negative ones. The qualitative study explored negative aspects in greater depth. Common findings were insufficient information, under involvement of users-relatives in planning, no choice of clinician, psychiatrist domination, and limited helpfulness of interventions.

Conclusion: With stakeholder participation in service evaluation, the present medical framework will need reshaping.

ii) Moran, G.S., Baruch, Y., Azaiza, F. and Lachman, M. (2015) Why do Mental Health Consumers who Receive Rehabilitation Services, are not using them? A Qualitative Investigation of Users’ Perspectives in Israel. Community Mental Health Journal. First published online: 23^rd July 2015.

DOI 10.1007/s10597-015-9905-1

Background: A recovery-oriented approach to mental health involves creating person centred services and enhancing engagement in psychiatric rehabilitation. Israel’s Rehabilitation in the Community of Persons with Mental Disabilities Law is a progressive initiative that shifted the locus of psychiatric care to community care supporting individualized rehabilitation and recovery-oriented processes. Yet over a quarter of applicants do not implement their assigned rehabilitation plans and services.

Methodology: This qualitative study investigated reasons and experiences related to lack of utilization from applicants’ perspectives. Fifteen service users were interviewed face to face in semi-structured interviews analysed using Grounded theory approach.

Findings: Seven categories emerged: (1) Lack of knowledge and orientation; (2) Negative perceptions about rehabilitation services (3) Lack of active participation/shared decision making; (4) Not feeling heard by the committee; (5) Lack of congruence between participants’ goals and committee’s final decisions; (6) Lack of escorting professionals’ competencies; and (7) Family members’ influence.

Conclusion: The results are interpreted at the structural and human process levels. Suggestions are provided for augmenting systemic procedures and human interactions processes.

iii) Gillard, S., Turner, K., and Neffgen, M. (2015) Understanding Recovery in the Context of Lived Experience of Personality Disorders: A Collaborative, Qualitative Research Study. BMC Psychiatry Vol.15(183). [online] http://www.biomedcentral.com/1471-244X/15/183

DOI 10.1186/s12888-015-0572-0

Background: Concepts of recovery increasingly inform the development and delivery of mental health services internationally. In the UK recent policy advocates the application of recovery concepts to the treatment of personality disorders. However diagnosis and understanding of personality disorders remains contested, challenging any assumption that mainstream recovery thinking can be directly translated into personality disorders services.

Methods: In a qualitative interview-based study understandings of recovery were explored in extended, in-depth interviews with six people purposively sampled from a specialist personality disorders’ service in the UK. An interpretive, collaborative approach to research was adopted in which university-, clinical- and service user (consumer) researchers were jointly involved in carrying out interviews and analysing interview data.

Results: Findings suggested that recovery cannot be conceptualised separately from an understanding of the lived experience of personality disorders. This experience was characterised by a complexity of ambiguous, interrelating and conflicting feelings, thoughts and actions as individuals tried to cope with tensions between internally and externally experienced worlds. Our analysis was suggestive of a process of recovering or, for some, discovering a sense of self that can safely coexist in both worlds.

Conclusions: We conclude that key facilitators of recovery – positive personal relationships and wider social interaction – are also where the core vulnerabilities of individuals with lived experience of personality disorders can lie. There is a role for personality disorders services in providing a safe space in which to develop positive relationships. Through discursive practice within the research team understandings of recovery were co-produced that responded to the lived experience of personality disorders and were of applied relevance to practitioners.

Other News

i) A new web-site allowing online completion and scoring of the INSPIRE measure of recovery support has been developed. See: http://completeinspireonline.com/

For further information about INSPIRE see: https://www.researchintorecovery.com/inspire

ii) 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:

Shula:              s.ramon@herts.ac.uk

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

Of course, material can still be posted to researchintorecovery@kcl.ac.uk

Recovery Research Network eBULLETIN

October 2015

RRN Meetings

The next meeting of the RRN will be held on the 10^th of November 2015 and hosted by Anglia Ruskin University and Cambridgeshire and Peterborough NHS Foundation Trust (CPFT). The focus will be on Implementation Issues of Recovery Research Projects.

Thank you to the individuals and various institutions who have helped to contribute and co-ordinate the November meeting of the RRN. A warm welcome is extended to those who are new to the RRN.

If you would like to present at a future meeting of the RRN please email:

researchintorecovery@kcl.ac.uk

RRN Membership Profile

Updated membership profile attached. If you would like to update your entry please email your text to researchintorecovery@kcl.ac.uk. The Membership Profile will be circulated with each RRN monthly email, but not put on our web-site. New members can now join via the website: https://www.researchintorecovery.com/join

Conferences and Events

i) PCCS Books Conference:

POSITIVE ACTION FOR CHANGE IN MENTAL HEALTH SERVICES

17th November 2015, 10.00 am – 4.45 pm

Trent Vineyard Conference Centre, Easter Park, Lenton Lane, Nottingham, NG7 2PX

Conference description (website): The case for demedicalising mental health services is well rehearsed. The research has been done, the conferences have been held and the intellectual argument all but won. Yet on a day-to-day basis, services continue to operate within the medicalised status quo. One of the aims of this conference will be to look at how we can implement realistic, practical changes in our mental health practice, education and lives, in order to continue the progression from rhetoric to reality.

For mental health service users / survivors, carers, professionals, students and everyone interested in critical debate in mental health care.

For further information see:

http://www.pccs-books.co.uk/products/ticket/pccs-books-conference#.VZ1rvYvHpGJJ

ii) Improving the Normalization of Complex Interventions: Development of a Measure based on Normalization Process Theory (NoMAD). Launch Event

DATE: 18 November 2015

VENUE: Kings Fund 11-13 Cavendish Square London

TIME: 10.00am-4.00pm

This event is aimed at clinicians, managers, policy makers and academic interested in improving the implementation and evaluation of complex interventions. The event will launch a new quantitative tool (NoMAD) based on Normalisation Process Theory (NPT).

Professor Robbie Foy, Professor of Primary Care at Leeds University & Implementation Science Deputy Editor-in-Chief, will be a plenary speaker.

The programme details are currently being finalised. There will be no cost for attendance but please be aware that places will be limited so if you would like to attend please email melissa.girling@ncl.ac.uk

iii) Community Psychology UK will be hosting a Community Psychology festival in Manchester on November 20 and 21st. All welcome. For further details please see:

http://communitypsychologyuk.ning.com/forum/topics/call-for-contributions-festival-of-community-psychology

Or, alternatively:

http://www.kc-jones.co.uk/community20155

iv) Open Dialogue UK 2016 Conference – London – 2nd February, 2016.

Our 2016 conference, “Towards openness and democracy in mental health services – Open Dialogue and related approaches in the UK and internationally” will take place on 2nd February 2016 at Friends House in Euston, London. This conference brings together many of the leading developers of Open Dialogue internationally. Keynote speakers will be Jaakko Seikkula, one of the founders of the approach, and Volkmar Aderhold and Petra Hohn, who have been leading the development of the approach in Germany and also in the Parachute Project in NYC. We are delighted to also welcome three key members of the Parachute Project team from New York, as well as members of the Peer supported Open Dialogue project in the UK. As well as addressing the key themes of openness and democracy, the conference will provide a unique opportunity to get an overview of the current state of development relating to Open Dialogue nationally and internationally. There will also be a panel of leading clinicians/experts from a variety of backgrounds in the UK who will be reflecting on the presentations, including Peter Kinderman, Anne Cooke, James Davies, Sami Timimi, Sarah Carr, Jacqui Dillon, Julie Repper and Rachel Waddingham.

We have a range of price points for the conference, in the hope that everyone who wishes to attend will be able to, including group discounts and early bird rates:

•          Organisation Rate: £110, £125*

•          Organisation Group Rate**: £99, £112.50*

•          Independent Practitioner Rate: £75, £85*

•          Student/Carer Rate: £30, £35*

•          Service User/Benefits Rate: £20, £25*

•          * Early Bird (until 30 Nov 2015)

•          * Full Rate (from 1 Dec 2015)

•          ** Group rates for 5 or more people

Please note: Some free places are also available for those who would like to help us with promoting the event and on the day of the conference. Further details of this can be found on our website.

For further details of the conference and to book places please visit our website by clicking here: http://opendialogueapproach.co.uk/2016-conference/

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

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

For further information see:

http://www.ispsuk.org/wp-content/uploads/2015/08/ISPS-UK-Residential-2016-Conference.pdf

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

http://www.isps.org/images/Call_for_Papers_FINAL_1.pdf

vi) Making Real Change Happen.  The 20th International Congress of the ISPS will take place in the city of Liverpool, UK August 30 – September 3, 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: http://tinyurl.com/isps-change

Contact: isps@isps.org or visit www.isps2017uk.org

Twitter: #isps2017uk

Papers and Publications

i) Castillo, H. (2015) The Reality of Recovery in Personality Disorder. Jessica Kingsley Publishers. ISBN978-1849056052. Click to view the book and purchase details on Amazon

Background:  The book examines the process of recovery for people diagnosed with personality disorder.  This is related to the application of the new meaning of recovery from mental illness as explored by those with the diagnosis.   An earlier inquiry led by the author yielded a new understanding of the diagnosis of personality disorder as defined by service users, and contributed to a change in the national agenda when the Department of Health responded by providing new national guidance and funding for pilot projects throughout the country.  This resulted in The Haven, which provided the service context for a further study.

Methods:  The methodology selected supported an interpretive examination of inner and outer realities, in relation to subjective definitions of recovery, and what it means for someone with a personality disorder diagnosis to be engaged in a journey of recovery.   Qualitative methods, employing a participatory action research approach were used.  A central issue in participatory action research is power and its goal is democratic as well as collaborative.  It challenges inequality and establishes the right of people to actively participate in processes that affect their lives.  The number of participants involved in formal data collection was sixty clients and six carers and the study spanned five years.  Participants were involved at all stages of the study from question formulation, data collection, analysis and dissemination of findings. Ten service users participated as researchers in the study, across its various stages.

Results:  An examination of emerging themes, and the interplay between themes, has given insight into what participants consider to be the key steps to recovery for someone with a personality disorder diagnosis.  From this thematic analysis a map is proposed of the journey of recovery.  Findings offer contributions to knowledge in terms of the service model and propose a new construct regarding recovery in personality disorder.  This is defined as a journey of small steps highlighting recovering as a process, rather than recovery as a goal, leading to the emergence of the concept of Transitional Recovery.

Conclusions:  This in-depth account of a qualitative research study, and the empirical evaluation process, presents alternatives to the historically sequential path of rehabilitation and proposed recovery because it offers a new, socially inclusive way of working with people who have a personality disorder diagnosis.   Current socio-economic forces are in danger of eroding innovative progress achieved in recent years.  However, this book proposes answers in both economic and human terms.

(written by the author)

ii) Ljungqvist, I., Topor, A., Forsell, H., Svensson, I. and Davidson, L. (2015) Money and Mental illness: A Study of the Relationship Between Poverty and Serious Psychological Problems.  Community Mental Health Journal. First Published Online: October 2015. 

DOI:10.1007/s10597-015-9950-9

Background:  Several studies have indicated a co-occurrence between mental problems, a bad economy, and social isolation. Medical treatments focus on reducing the extent of psychiatric problems. Recent research, however, has highlighted the possible effects of social initiatives. The aim of this study was to examine the relation between severe mental illness, economic status, and social relations.

Method: A financial contribution per month was granted to 100 individuals with severe mental illnesses for a 9-month period. Assessments of the subjects were made before the start of the intervention and after 7 months’ duration. A comparison group including treatment as usual only was followed using the same instruments.

Findings:  Significant improvements were found for depression and anxiety, social networks, and sense of self. No differences in functional level were found.

Conclusion:  Social initiatives may have treatment and other beneficial effects and should be integrated into working contextually with persons with severe mental illnesses.

iii) Mills, C. (2015) The Psychiatrization of Poverty: Rethinking the Mental Health-Poverty Nexus.  Social and Personality Psychology Compass. Vol.9(5), pp.213-222.

Abstract:  The positive association between ‘mental illness’ and poverty is one of the most well established in psychiatric epidemiology. Yet, there is little conclusive evidence about the nature of this relationship. Generally, explanations revolve around the idea of a vicious cycle, where poverty may cause mental ill health, and mental ill health may lead to poverty. Problematically, much of the literature overlooks the historical, social, political, and cultural trajectories of constructions of both poverty and ‘mental illness’. Laudable attempts to explore the social determinants of mental health sometimes take recourse to using and reifying psychiatric diagnostic categories that individualize distress and work to psychiatrically reconfigure ‘symptoms’ of oppression, poverty, and inequality as ‘symptoms’ of ‘mental illness’. This raises the paradoxical issue that the very tools that are used to research the relationship between poverty and mental health may prevent recognition of the complexity of that relationship. Looking at the mental health–poverty nexus through a lens of psychiatrization (intersecting with medicalization, pathologization, and psychologization), this paper recognizes the need for radically different tools to trace the messiness of the multiple relationships between poverty and distress. It also implies radically different interventions into mental health and poverty that recognize the landscapes in which lived realities of poverty are embedded, the political economy of psychiatric diagnostic and prescribing practices, and ultimately to address the systemic causes of poverty and inequality.

Other News

Included below is a link to The Guardian’s October coverage of the planned pilot of the New York ‘Parachute’ programme in a number of NHS Trusts in England. See:

http://www.theguardian.com/society/2015/oct/20/parachute-therapy-psychosis-new-york-uk?CMP=share_btn_fb

The following link gives access to the Scottish Mental Welfare Commission’s recent (September 2015) publication: Human Rights in Mental Health Care in Scotland.

http://www.mwcscot.org.uk/media/240757/human_rights_in_mental_health_care_in_scotland.pdf

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:

Shula:             s.ramon@herts.ac.uk

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

Of course, material can still be posted to researchintorecovery@kcl.ac.uk

Recovery Research Network eBULLETIN

November 2015

RRN Meetings

Thank you to Anglia Ruskin University and Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) for hosting the Research into Recovery Network (RRN) meeting on the 10th October. Thank you to Anne, Mat and Shula for their organisational skill, and thank you to all those individuals and agencies who contributed to the event. A warm welcome is extended to those who are new to the RRN.

The theme for the meeting was based upon Implementation Issues of Recovery Research Projects. The authors have kindly made their presentations available, and these (along with the minutes of the 14th meeting of the RRN) can be accessed via the Research into Recovery Network (RRN) website using the link below.  The presentations sit within a broader archive of material previously presented at RRN meetings and please feel free to explore this resource.

https://www.researchintorecovery.com/rrn/meeting-presentation-archive

Dr. Steve Gillard and Dr. Vanessa Pinfold have kindly agreed to co-ordinate the next meeting of the RRN which will take place during April 2016, in London. A provisional theme of recovery and relationships has been suggested.  Further information will appear in the ebulletin in due course.

If you would like to present at a future meeting of the RRN please email:

researchintorecovery@kcl.ac.uk

RRN Membership Profile

Updated membership profile attached. If you would like to update your entry please email your text to researchintorecovery@kcl.ac.uk. The Membership Profile will be circulated with each RRN monthly email, but not put on our web-site. New members can now join via the website: https://www.researchintorecovery.com/join

Conferences and Events

i) Open Dialogue UK 2016 Conference – London – 2nd February, 2016.

Our 2016 conference, “Towards openness and democracy in mental health services – Open Dialogue and related approaches in the UK and internationally” will take place on 2nd February 2016 at Friends House in Euston, London. This conference brings together many of the leading developers of Open Dialogue internationally. Keynote speakers will be Jaakko Seikkula, one of the founders of the approach, and Volkmar Aderhold and Petra Hohn, who have been leading the development of the approach in Germany and also in the Parachute Project in NYC. We are delighted to also welcome three key members of the Parachute Project team from New York, as well as members of the Peer supported Open Dialogue project in the UK. As well as addressing the key themes of openness and democracy, the conference will provide a unique opportunity to get an overview of the current state of development relating to Open Dialogue nationally and internationally. There will also be a panel of leading clinicians/experts from a variety of backgrounds in the UK who will be reflecting on the presentations, including Peter Kinderman, Anne Cooke, James Davies, Sami Timimi, Sarah Carr, Jacqui Dillon, Julie Repper and Rachel Waddingham.

We have a range of price points for the conference, in the hope that everyone who wishes to attend will be able to, including group discounts and early bird rates:

•          Organisation Rate: £110, £125*

•          Organisation Group Rate**: £99, £112.50*

•          Independent Practitioner Rate: £75, £85*

•          Student/Carer Rate: £30, £35*

•          Service User/Benefits Rate: £20, £25*

•          * Early Bird (until 30 Nov 2015)

•          * Full Rate (from 1 Dec 2015)

•          ** Group rates for 5 or more people

Please note: Some free places are also available for those who would like to help us with promoting the event and on the day of the conference. Further details of this can be found on our website.

For further details of the conference and to book places please visit our website by clicking here: http://opendialogueapproach.co.uk/2016-conference/

ii) 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:

http://www.ispsuk.org/wp-content/uploads/2015/08/ISPS-UK-Residential-2016-Conference.pdf

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

http://www.isps.org/images/Call_for_Papers_FINAL_1.pdf

iii) Making Real Change Happen.  The 20th International Congress of the ISPS will take place in the city of Liverpool, UK August 30 – September 3, 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: http://tinyurl.com/isps-change

Contact: isps@isps.org or visit www.isps2017uk.org

Twitter: #isps2017uk

Papers and Publications

i) A recent publication, supported by Recovery Devon, entitled Living with Psychosis – Recovery and Wellbeing aims to help people with psychosis seeking a path of personal recovery.

To cite authors Elina Baker and Melanie Attwater:

‘In this book, We use the word ”psychosis” to describe experiences outside of shared reality, such as voices, visions and an awareness of other unusual occurrences, which someone may find distressing. Based on our work running groups to support people who have these kinds of experiences, this book brings together psychological ideas about and personal experience of recovery in relation to psychosis. Each chapter also contains a ‘section for reflection’, to give you the opportunity to think about how to use these ideas and experiences in your own recovery.

We hope that this book will enable other people struggling with psychosis, either personally or as a relative, friend or worker, to find ways of understanding and managing these experiences successfully. We also want to give a message of hope, to let people know that they are not alone and that recovery is possible.’

http://www.amazon.co.uk/dp/1783822317/ref=olp_product_details?_encoding=UTF8&me

http://chipmunkapublishing.co.uk/shop/index.php?main_page=product_info&products_id=2662

ISBN: 978-1-78382-231-7

ii) Webber, M., Reidy, H., Ansari, D., Stevens, M. and Morris, D. (2015) Enhancing Social Networks: A Qualitative Study of Health and Social Care Practice in UK Mental a Health Services. Health and Social Care in the Community. Vol.23(2), pp.180-189.

Abstract

People with severe mental health problems such as psychosis have access to less social capital, defined as resources within social networks, than members of the general population. However, a lack of theoretically and empirically informed models hampers the development of social interventions which seek to enhance an individual’s social networks. This paper reports the findings of a qualitative study, which used ethnographic field methods in six sites in England to investigate how workers helped people recovering from psychosis to enhance their social networks. This study drew upon practice wisdom and lived experience to provide data for intervention modelling. Data were collected from 73 practitioners and 51 people who used their services in two phases. Data were selected and coded using a grounded theory approach to depict the key themes that appeared to underpin the generation of social capital within networks. Findings are presented in four over-arching themes – worker skills, attitudes and roles; connecting people processes; role of the agency; and barriers to network development. The sub-themes which were identified included worker attitudes; person-centred approach; equality of worker–individual relationship; goal setting; creating new networks and relationships; engagement through activities; practical support; existing relationships; the individual taking responsibility; identifying and overcoming barriers; and moving on. Themes were consistent with recovery models used within mental health services and will provide the basis for the development of an intervention model to enhance individuals’ access to social capital within networks.

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:

Shula:              s.ramon@herts.ac.uk

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

Of course, material can still be posted to researchintorecovery@kcl.ac.uk

page updated 30 March 2016

Recovery Research Network eBULLETIN

December 2015

RRN Meetings

Dr. Steve Gillard and Dr. Vanessa Pinfold have kindly agreed to co-ordinate the next meeting of the RRN, which will take place during April 2016, in London. A provisional theme of recovery and relationships has been suggested.  Further information will appear in the ebulletin in due course.

If you would like to present at a future meeting of the RRN please email:

researchintorecovery@kcl.ac.uk

RRN Membership Profile

Updated membership profile attached. If you would like to update your entry please email your text to researchintorecovery@kcl.ac.uk. The Membership Profile will be circulated with each RRN monthly email, but not put on our web-site. New members can now join via the website: https://www.researchintorecovery.com/join

Conferences and Events

i) Open Dialogue UK 2016 Conference – London – 2nd February, 2016.

Our 2016 conference, “Towards openness and democracy in mental health services – Open Dialogue and related approaches in the UK and internationally” will take place on 2nd February 2016 at Friends House in Euston, London. This conference brings together many of the leading developers of Open Dialogue internationally. Keynote speakers will be Jaakko Seikkula, one of the founders of the approach, and Volkmar Aderhold and Petra Hohn, who have been leading the development of the approach in Germany and also in the Parachute Project in NYC. We are delighted to also welcome three key members of the Parachute Project team from New York, as well as members of the Peer supported Open Dialogue project in the UK. As well as addressing the key themes of openness and democracy, the conference will provide a unique opportunity to get an overview of the current state of development relating to Open Dialogue nationally and internationally. There will also be a panel of leading clinicians/experts from a variety of backgrounds in the UK who will be reflecting on the presentations, including Peter Kinderman, Anne Cooke, James Davies, Sami Timimi, Sarah Carr, Jacqui Dillon, Julie Repper and Rachel Waddingham.

We have a range of price points for the conference, in the hope that everyone who wishes to attend will be able to, including group discounts and early bird rates:

•          Organisation Rate: £110, £125*

•          Organisation Group Rate**: £99, £112.50*

•          Independent Practitioner Rate: £75, £85*

•          Student/Carer Rate: £30, £35*

•          Service User/Benefits Rate: £20, £25*

•          * Early Bird (until 30 Nov 2015)

•          * Full Rate (from 1 Dec 2015)

•          ** Group rates for 5 or more people

Please note: Some free places are also available for those who would like to help us with promoting the event and on the day of the conference. Further details of this can be found on our website.

For further details of the conference and to book places please visit our website by clicking here: http://opendialogueapproach.co.uk/2016-conference/

ii) 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:

http://www.ispsuk.org/wp-content/uploads/2015/08/ISPS-UK-Residential-2016-Conference.pdf

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

http://www.isps.org/images/Call_for_Papers_FINAL_1.pdf

iii) Making Real Change Happen.  The 20th International Congress of the ISPS will take place in the city of Liverpool, UK August 30 – September 3, 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: http://tinyurl.com/isps-change

Contact: isps@isps.org or visit www.isps2017uk.org

Twitter: #isps2017uk

Papers and Publications

i) Slade, M., Bird, V., Le Boutillier, C., Farkas, M., Grey, B., Larsen, J., Leamy, M., Oades, L. and Williams, J. (2015) Development of the REFOCUS intervention to increase mental health team support for personal recovery. The British Journal of Psychiatry.  Vol.207(6)., pp.544-550.

Abstract

Background: There is an emerging evidence base about best practice in supporting recovery. This is usually framed in relation to general principles, and specific pro-recovery interventions are lacking.

Aims: To develop a theoretically based and empirically defensible new pro-recovery manualised intervention – called the REFOCUS intervention.

Method: Seven systematic and two narrative reviews were undertaken. Identified evidence gaps were addressed in three qualitative studies. The findings were synthesised to produce the REFOCUS intervention, manual and model.

Results: The REFOCUS intervention comprises two components: recovery-promoting relationships and working practices. Approaches to supporting relationships comprise coaching skills training for staff, developing a shared team understanding of recovery, exploring staff values, a Partnership Project with people who use the service and raising patient expectations. Working practices comprise the following: understanding values and treatment preferences; assessing strengths; and supporting goal-striving. The REFOCUS model describes the causal pathway from the REFOCUS intervention to improved recovery.

Conclusions: The REFOCUS intervention is an empirically supported prorecovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940).

ii) Williams, J., Leamy, M., Pesola, F., Bird, V., Le Boutillier, C. and Slade, M. (2015) Psychometric evaluation of the Questionnaire about the Process of Recovery (QPR). The British Journal of Psychiatry. Vol.207(6), pp.551-555.

Abstract

Background: Supporting recovery is the aim of national mental health policy in many countries. However, only one measure of recovery has been developed in England: the Questionnaire about the Process of Recovery (QPR), which measures recovery from the perspective of adult mental health service users with a psychosis diagnosis.

Aims: To independently evaluate the psychometric properties of the 15- and 22-item versions of the QPR.

Method: Two samples were used: data-set 1 (n = 88) involved assessment of the QPR at baseline, 2 weeks and 3 months. Data-set 2 (n = 399; trial registration: ISRCTN02507940) involved assessment of the QPR at baseline and 1 year.

Results: For the 15-item version, internal consistency was 0.89, convergent validity was 0.73, test–retest reliability was 0.74 and sensitivity to change was 0.40. Confirmatory factor analysis showed the 15-item version offered a good fit. For the 22-item version, the interpersonal subscale was found to underperform and the intrapersonal subscale overlaps substantially with the 15-item version.

Conclusions: Both the 15-item and the intrapersonal subscale of the 22-item versions of the QPR demonstrated satisfactory psychometric properties. The 15-item version is slightly more robust and also less burdensome, so it can be recommended for use in research and clinical practice.

iii) Pesola, F., Williams, J., Bird, V., Freidl, M., Le Boutillier, C., Leamy, M., Macpherson, R. and Slade, M. (2015) Development and Evaluation of an Individualised Outcome Measure (IOM) for Randomised Controlled Trials in Mental Health. International Journal of Methods in Psychiatric Research. Vol.24(4)., pp.257-265.

Abstract

Pre-defined, researcher-selected outcomes are routinely used as the clinical end-point in randomized controlled trials (RCTs); however, individualized approaches may be an effective way to assess outcome in mental health research. The present study describes the development and evaluation of the Individualized Outcome Measure (IOM), which is a patient-specific outcome measure to be used for RCTs of complex interventions. IOM was developed using a narrative review, expert consultation and piloting with mental health service users (n = 20). The final version of IOM comprises two components: Goal Attainment (GA) and Personalized Primary Outcome (PPO). For GA, patients identify one relevant goal at baseline and rate its attainment at follow-up. For PPO, patients choose an outcome domain related to their goal from a pre-defined list at baseline, and complete a standardized questionnaire assessing the chosen outcome domain at baseline and follow-up. A feasibility study indicated that IOM had adequate completion (89%) and acceptability (96%) rates in a clinical sample (n = 84). IOM was then evaluated in a RCT (ISRCTN02507940). GA and PPO components were associated with each other and with the trial primary outcome. The use of the PPO component of IOM as the primary outcome could be considered in future RCTs.

iv) Slade, M. and Longden, E. (2015) Empirical evidence about recovery and mental health.  BMC Psychiatry.  15:285. Published 14th November 2015. DOI 10.1186/s12888-015-0678-4

Abstract

Background: Two discourses exist in mental health research and practice. The first focuses on the limitations associated with disability arising from mental disorder. The second focuses on the possibilities for living well with mental health problems.

Discussion: This article was prompted by a review to inform disability policy. We identify seven findings from this review: recovery is best judged by experts or using standardised assessment; few people with mental health problems recover; if a person no longer meets criteria for a mental illness, they are in remission; diagnosis is a robust basis for characterising groups and predicting need; treatment and other supports are important factors for improving outcome; the barriers to receiving effective treatment are availability, financing and client awareness; and the impact of mental illness, in particular schizophrenia, is entirely negative. We selectively review a wider range of evidence which challenge these findings, including the changing understanding of recovery, national mental health policies, systematic review methodology and uncertainty, epidemiological evidence about recovery rates, reasoning biased due to assumptions about mental illness being an illness like any other, the contested nature of schizophrenia, the social construction of diagnoses, alternative explanations for psychosis experiences including the role of trauma, diagnostic over-shadowing, stigma, the technological paradigm, the treatment gap, social determinants of mental ill-health, the prevalence of voice-hearing in the general population, and the sometimes positive impact of psychosis experience in relation to perspective and purpose.

Conclusion: We propose an alternative seven messages which are both empirically defensible and more helpful to mental health stakeholders: Recovery is best judged by the person living with the experience; Many people with mental health problems recover; If a person no longer meets criteria for a mental illness, they are not ill; Diagnosis is not a robust foundation; Treatment is one route among many to recovery; Some people choose not to use mental health services; and the impact of mental health problems is mixed.

v) Supported by Recovery Devon, entitled Living with Psychosis – Recovery and Wellbeing aims to help people with psychosis seeking a path of personal recovery.

To cite authors Elina Baker and Melanie Attwater:

‘In this book, We use the word ”psychosis” to describe experiences outside of shared reality, such as voices, visions and an awareness of other unusual occurrences, which someone may find distressing. Based on our work running groups to support people who have these kinds of experiences, this book brings together psychological ideas about and personal experience of recovery in relation to psychosis. Each chapter also contains a ‘section for reflection’, to give you the opportunity to think about how to use these ideas and experiences in your own recovery.

We hope that this book will enable other people struggling with psychosis, either personally or as a relative, friend or worker, to find ways of understanding and managing these experiences successfully. We also want to give a message of hope, to let people know that they are not alone and that recovery is possible.’

http://www.amazon.co.uk/dp/1783822317/ref=olp_product_details?_encoding=UTF8&me

http://chipmunkapublishing.co.uk/shop/index.php?main_page=product_info&products_id=2662

ISBN: 978-1-78382-231-7

Other News

The British Journal of Social Work (Volume 45 suppl. 1) published a special issue on Social Work and Recovery in December 2015. There will be more on this publication in the January 2016 edition of the RRN ebulletin.

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:

Shula:              s.ramon@herts.ac.uk

                        shula.ramon@anglia.ac.uk

Tony                a.sparkes@bradford.ac.uk

Of course, material can still be posted to researchintorecovery@kcl.ac.uk

page updated 30 March 2016