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康复学院学生的作用机制和结果。

Mechanisms of Action and Outcomes for Students in Recovery Colleges.

机构信息

Ms. Toney, Prof. Pollock, and Prof. Slade are with the Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom. Mr. Elton and Ms. Munday are with the RECOLLECT Lived Experience Advisory Panel. Ms. Hamill is with the Leicestershire Partnership NHS Trust, Leicestershire, United Kingdom. Mr. Crowther and Dr. Meddings are with the Sussex Partnership, NHS Foundation Trust, Hove, United Kingdom. Ms. Taylor and Dr. Henderson are with the Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London. Dr. Henderson is also with the South London and Maudsley (SLaM) NHS Foundation Trust, London. Ms. Jennings is with the Department of Occupational Therapy, York St. John University, York, United Kingdom. Prof. Waring is with the Nottingham University Business School, University of Nottingham, Nottingham. Mr. Bates is with Peter Bates Associates Ltd., Nottingham.

出版信息

Psychiatr Serv. 2018 Dec 1;69(12):1222-1229. doi: 10.1176/appi.ps.201800283. Epub 2018 Sep 17.

Abstract

OBJECTIVE

Recovery colleges are widespread, with little empirical research on how they work and the outcomes they produce. This study aimed to coproduce a change model characterizing mechanisms of action (how they work) and outcomes (their impact) for mental health service users who attend recovery colleges.

METHODS

A systematized review identified all publications about recovery colleges. Inductive collaborative data analysis of 10 key publications by academic researchers and coresearchers with lived experience informed a theoretical framework for mechanisms of action and student outcomes, which was refined through deductive analysis of 34 further publications. A change model was coproduced and refined through stakeholder interviews (N=33).

RESULTS

Four mechanisms of action for recovery colleges were identified: empowering environment (safety, respect, and supporting choices), enabling different relationships (power, peers, and working together), facilitating personal growth (for example, coproduced learning, strengths, and celebrating success), and shifting the balance of power through coproduction and reducing power differentials. Outcomes were change in the student (for example, self-understanding and self-confidence) and changes in the student's life (for example, occupational, social, and service use). A coproduced change model mapping mechanisms of action to outcomes was created.

CONCLUSIONS

Key features differentiate recovery colleges from traditional services, including an empowering environment, enabling relationships, and growth orientation. Service users who lack confidence, those with whom services struggle to engage, those who will benefit from exposure to peer role models, and those lacking social capital may benefit most. As the first testable characterization of mechanisms and outcomes, the change model allows formal evaluation of recovery colleges.

摘要

目的

康复学院分布广泛,但关于它们的运作方式和产生的结果的实证研究却很少。本研究旨在为参加康复学院的心理健康服务使用者共同制定一个描述其作用机制(如何运作)和结果(其影响)的变化模型。

方法

系统综述确定了所有关于康复学院的出版物。通过对学术研究人员和具有亲身体验的核心研究人员的 10 篇关键出版物进行归纳性合作数据分析,为作用机制和学生结果提供了一个理论框架,该框架通过对 34 篇进一步出版物的演绎分析得到了进一步的完善。通过利益相关者访谈(N=33)共同制定和完善了一个变化模型。

结果

确定了康复学院的四个作用机制:赋权环境(安全、尊重和支持选择)、建立不同的关系(权力、同伴和共同合作)、促进个人成长(例如,共同学习、优势和庆祝成功)以及通过共同生产和减少权力差异来改变权力平衡。结果是学生的变化(例如,自我理解和自信)和学生生活的变化(例如,职业、社会和服务使用)。建立了一个将作用机制映射到结果的共同制定的变化模型。

结论

关键特征将康复学院与传统服务区分开来,包括赋权环境、建立关系和成长导向。缺乏信心的服务使用者、那些与服务机构难以接触的人、那些将从接触同伴榜样中受益的人以及那些缺乏社会资本的人可能受益最大。作为对机制和结果的首次可测试描述,该变化模型允许对康复学院进行正式评估。

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