Development of the REFOCUS intervention to increase mental health team support for personal recovery
Mike Slade1, Victoria Bird2, Clair Le Boutillier2
1Mike Slade, PhD, Victoria Bird, BSc, Clair Le Boutillier, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Marianne Farkas, ScD, Center for Psychiatric Rehabilitation, Boston University, Boston, Massachusetts, USA; Barbara Grey, PhD, South London and Maudsley NHS Foundation Trust, London, UK; John Larsen, PhD, Rethink Mental Illness, London, UK; Mary Leamy, PhD, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK; Lindsay Oades, PhD, Centre for Health Initiatives, University of Wollongong, NSW, Australia; Julie Williams, MSc, Health Service and Population Research Department, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK mike.slade@kcl.ac.uk.
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 pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940).
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