Iancu Sorana C, Zweekhorst Marjolein B M, Veltman Dick J, van Balkom Anton J L M, Bunders Joske F G
Department of Innovation in the Health and Life Sciences, VU University Amsterdam, the Netherlands, and.
Disabil Rehabil. 2014;36(7):573-83. doi: 10.3109/09638288.2013.804595. Epub 2013 Jun 26.
Mental health services increasingly incorporate the vision of recovery. This qualitative study analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model.
Data were collected through semi-structured interviews with participants on care farms (n = 14), work (n = 7) and creative projects (n = 5).
The transition from past to current lives was described as a progressive, non-linear process, with different stages guided by different goals. Participants on creative projects lacked clear goals, presented less interest in peers and high need for emotional support. Participants on work projects aimed for occupational rehabilitation, but struggled with the patient culture of the peer community. Participants on care farms aimed for daytime occupations and closer contact with society. They experienced care farms as open, real-life work settings where they could exercise responsibility and connect with people.
Participants progressed towards recovery, as care farms, work- and creative projects empowered them to leave behind inactive, isolated or disorganized living. In day centres, users focused on self-reflection and personal development (creative projects) or on occupational performance (work projects), whereas on care farms, users fulfilled worker roles in a real-life, open community environment.
Organized as open communities in real-life settings, care farms facilitate the reflection on personal and social responsibility, and therefore have the potential to help users internalize worker identities and improve their motivation to progress towards recovery. Supervisors on care farms are regarded by users as close contacts within the social networks they develop on the service, a position that allows supervisors to actively engage and promote users' progress towards recovery. Elements of the farm environment (such as the "normal life", presence of family members and visitors, and nature) can serve as anchors for supporting the progress towards recovery.
心理健康服务越来越多地融入康复理念。这项定性研究分析并比较了职业前服务中的康复体验，以评估相对于阶段性康复模型，使用者在康复方面是否取得进展。
通过对参与护理农场项目（n = 14）、工作项目（n = 7）和创意项目（n = 5）的参与者进行半结构化访谈收集数据。
从过去生活到当前生活的转变被描述为一个渐进的、非线性的过程，不同阶段由不同目标引导。参与创意项目的参与者缺乏明确目标，对同伴的兴趣较低，对情感支持的需求较高。参与工作项目的参与者旨在实现职业康复，但在同伴社区的患者文化中挣扎。参与护理农场项目的参与者旨在从事日间职业并与社会有更密切的接触。他们将护理农场体验为开放的、现实生活中的工作场所，在那里他们可以承担责任并与人建立联系。
参与者在康复方面取得了进展，因为护理农场、工作和创意项目使他们能够摆脱无所事事、孤立或杂乱无章的生活。在日间中心，使用者专注于自我反思和个人发展（创意项目）或职业表现（工作项目），而在护理农场，使用者在现实生活的开放社区环境中扮演工人角色。
护理农场作为现实生活环境中的开放社区进行组织，有助于反思个人和社会责任，因此有可能帮助使用者内化工人身份并提高他们朝着康复前进的动力。护理农场的主管被使用者视为他们在服务中建立的社交网络中的密切联系人，这一地位使主管能够积极参与并促进使用者朝着康复前进。农场环境的元素（如“正常生活”、家庭成员和访客的存在以及自然）可以作为支持康复进展的支柱。
