Rapisarda Filippo, Briand Catherine, Vallée Catherine, Vachon Brigitte, Lefay Galaad
Département d'ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.
Centre d'études sur la réadaptation, le rétablissement et l'insertion sociale, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.
Front Psychiatry. 2025 May 27;16:1534349. doi: 10.3389/fpsyt.2025.1534349. eCollection 2025.
Recovery Colleges (RCs) are educational hubs offering free courses on mental health, well-being, and recovery through mutual and transformative learning. These co-learning spaces bring together individuals with diverse backgrounds-such as those with lived experience of mental illness, family members, and mental health practitioners-to collaboratively produce knowledge on mental health topics. Studies have shown RC participation leads to improvements in several psychosocial dimensions (e.g. mental health literacy, empowerment, well-being, reduced anxiety, stigma) and healthcare utilization. However, the methodological approach of averaging outcomes across all participants can mask important individual differences in experiences and outcomes, which is particularly significant given the heterogeneity of RC learners. In light of these limitations, this study aims to explore the heterogeneity of change among RC learners by identifying different trajectories of change and exploring their determinants.
The study adopts a quasi-experimental longitudinal design with repeated measures, utilizing data from 353 participants recruited from a French-language RC in Quebec, Canada. Data were collected at three time points: baseline (T0) prior to program participation, one-month post-program (T1), and three to four months post-program (T2). The study uses clustering techniques to identify distinct patterns of change across participants, focusing on key outcome measures such as well-being, anxiety, resilience, empowerment, and stigma.
The results identified three distinct clusters of change trajectories. The largest cluster (Cluster A) demonstrated moderate improvements in well-being, anxiety reduction, and slight increases in empowerment and resilience. Cluster B, characterized by participants with higher baseline well-being and lower stigma, showed improvements in empowerment and a slight reduction in stigma, often linked to participants with clinical backgrounds, such as healthcare practitioners. Cluster C, primarily composed of participants with clinical levels of anxiety and lower baseline empowerment, exhibited significant reductions in anxiety and increases in empowerment over time.
This study contributes to a more nuanced understanding of the diverse outcomes associated with RC participation and highlights the importance of tailoring RC programs to meet the heterogeneous needs of learners. It also reinforces the role of empowerment as a central mechanism of change within the RC model, suggesting that empowerment fosters not only personal growth but also improved well-being and reduced stigma.
康复学院(RCs)是教育中心,通过相互学习和变革性学习提供有关心理健康、幸福和康复的免费课程。这些共同学习空间汇聚了背景各异的个人,如患有精神疾病的人、家庭成员和心理健康从业者,共同生成有关心理健康主题的知识。研究表明,参与康复学院会在几个心理社会层面(如心理健康素养、赋权、幸福、焦虑减轻、耻辱感降低)以及医疗保健利用方面带来改善。然而,对所有参与者的结果进行平均的方法可能会掩盖经历和结果中重要的个体差异,鉴于康复学院学习者的异质性,这一点尤为重要。鉴于这些局限性,本研究旨在通过识别不同的变化轨迹并探索其决定因素,来探讨康复学院学习者变化的异质性。
本研究采用具有重复测量的准实验纵向设计,利用从加拿大魁北克的一所法语康复学院招募的353名参与者的数据。在三个时间点收集数据:项目参与前的基线(T0)、项目结束后一个月(T1)以及项目结束后三到四个月(T2)。该研究使用聚类技术来识别参与者中不同的变化模式,重点关注幸福、焦虑、恢复力、赋权和耻辱感等关键结果指标。
结果确定了三种不同的变化轨迹聚类。最大的聚类(A聚类)在幸福感、焦虑减轻方面有适度改善,赋权和恢复力略有增加。B聚类的特点是基线幸福感较高且耻辱感较低的参与者,在赋权方面有所改善,耻辱感略有降低,这通常与具有临床背景的参与者有关,如医疗保健从业者。C聚类主要由焦虑水平处于临床范围且基线赋权较低的参与者组成,随着时间的推移,焦虑显著降低,赋权增加。
本研究有助于更细致入微地理解与参与康复学院相关的多样结果,并强调根据学习者的异质需求调整康复学院项目 的重要性。它还强化了赋权作为康复学院模式中变革核心机制的作用,表明赋权不仅促进个人成长,还能改善幸福感并降低耻辱感。