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Perspectives on internal vs. external facilitation for implementing guidelines for recovery-oriented practice: a

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This study explored internal versus external facilitation for implementing recovery-oriented practices in mental health services. Participants found value in both approaches, highlighting the importance of facilitator skills in building relationships and fostering unity.

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Area of Science:

  • Mental Health Services Research
  • Implementation Science
  • Organizational Psychology

Background:

  • Collaboration between mental health organizations and researchers to implement Canada's Guidelines for Recovery-Oriented Practice.
  • Development of a multi-component implementation strategy including external facilitation and coaching.
  • Focus on participant perspectives regarding internal versus external facilitation within implementation teams.

Purpose of the Study:

  • To explore participant experiences and perceptions of internal versus external facilitation.
  • To understand the perceived benefits and drawbacks of each facilitation approach.
  • To identify key factors influencing the effectiveness of facilitation in recovery-oriented practice implementation.

Main Methods:

  • Forty semi-structured online interviews with 32 implementation team members and 8 external facilitators.
  • Inclusion of diverse participant roles: service users, providers, family members, managers, and knowledge users.
  • Exploration of experiences with external facilitation and hypothetical comparison to internal facilitation.

Main Results:

  • Thematic analysis revealed seven themes concerning facilitator position, power hierarchies, cultural shifts, context understanding, candour, relationships, and facilitator identity.
  • Participants valued different facilitator skills and attributes based on their role and the facilitation approach.
  • No definitive preference for internal or external facilitation emerged; both presented distinct advantages and disadvantages.

Conclusions:

  • Facilitator effectiveness hinges on rapport, ally development, and fostering unity, regardless of internal or external position.
  • A blended approach, integrating strengths of both internal and external facilitators, may optimize support for recovery-oriented practice implementation.
  • Understanding the nuances of insider knowledge versus outsider neutrality is crucial for effective facilitation.