Development of the REFOCUS intervention to increase mental health team support for personal recovery

Mike Slade; Victoria Bird; Clair Le Boutillier; Marianne Farkas; Barbara Grey; John Larsen; Mary Leamy; Lindsay Oades; Julie Williams

doi:10.1192/bjp.bp.114.155978

Development of the REFOCUS intervention to increase mental health team support for personal recovery

Br J Psychiatry. 2015 Dec;207(6):544-50. doi: 10.1192/bjp.bp.114.155978. Epub 2015 Oct 8.

Authors

Mike Slade¹, Victoria Bird², Clair Le Boutillier², Marianne Farkas², Barbara Grey², John Larsen², Mary Leamy², Lindsay Oades², Julie Williams²

Affiliations

¹ Mike 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 [email protected].
² Mike 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.

PMID: 26450586
DOI: 10.1192/bjp.bp.114.155978

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 pro-recovery intervention for use in mental health services. It will be evaluated in a multisite cluster randomised controlled trial (ISRCTN02507940).

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Government Programs / economics*
Humans
Mental Disorders / therapy*
Mental Health / legislation & jurisprudence*
Mental Health Services / standards*
Practice Guidelines as Topic
Qualitative Research
Randomized Controlled Trials as Topic
United Kingdom

Associated data

ISRCTN/ISRCTN02507940

Grants and funding

RP-PG-0707-10040/DH_/Department of Health/United Kingdom