Staff experiences of the REFOCUS intervention to support recovery in mental health: A qualitative study nested within a cluster randomised controlled trial

Eleanor Clarke, Mary Leamy, Victoria Bird, M. Janosik, Harriet Jordan, Clair Le Boutillier, Rob Macpherson, Genevieve Riley, Kevanne Sanger, Julie Williams, Mike Slade

Research output: Contribution to journalBook/Film/Article reviewpeer-review

Abstract


Background
The REFOCUS intervention was a whole team, complex intervention, designed to increase the recovery support offered by community based, mental health staff. The intervention consisted of two components: Recovery promoting relationships, which focused on how staff work with service users, and Recovery working practices, which focused on what activities and tasks staff and service users could do together.
Aim
We aimed to investigate the experiences of community mental health workers using the REFOCUS intervention to support personal recovery.
Method
In the context of the REFOCUS Trial (ISRCTN02507940), 28 semi-structured individual interviews and 4 staff focus groups, with 24 participants were conducted and thematically analysed.
Results
Staff valued coaching training and used coaching skills to have tough as well as empowering, motivational conversations with service users. They were positive about the resources within the ‘working practices’ intervention component. The whole team training and reflection sessions helped create team cultures, structures and processes which were conducive to supporting recovery practice.
Conclusions

We recommend the wider use of coaching skills, strengths-based assessments, and approaches to support clinicians to broaden their understanding of service users’ values, treatment preferences and to support striving towards personally-meaningful goals. Staff who used these working practices changed their beliefs about what their service users were capable of, and became more hopeful practitioners. A team-based approach to support recovery creates a learning environment in which staff can support and challenge one another, making sustained practice change more likely.
Original languageEnglish
JournalArchives of Psychiatry and Mental Health
Publication statusAccepted/In press - 25 Apr 2020

Keywords

  • Recovery, Complex interventions, Process evaluation, Psychosis, Cluster randomised controlled trial, Staff experiences, REFOCUS

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