Sjursæther Therese Ersvær, Øye Christine, Mellingen Sonja
Western Norway University of Applied Sciences, Faculty of Health and Social Science, Bergen, Norway.
Western Norway University of Applied Sciences, Faculty of Health and Social Science, Stord, Norway.
Front Psychiatry. 2025 Jun 23;16:1606180. doi: 10.3389/fpsyt.2025.1606180. eCollection 2025.
Recovery Colleges (RCs) for people with substance use and mental health challenges represent an innovation in mental health services, emphasising co-creation and adult learning. Students and course facilitators with diverse experiences engage in collaborative learning in these settings by sharing experiences, knowledge, and skills. This paper examines the social frameworks that facilitate or hinder sharing within RCs.
We conducted an ethnographic study in two distinct RC settings, using participatory observation and semi-structured interviews with facilitators, students, and leaders. We employed Goffman's frame analysis to understand the social framework in RC and how its organisational structures and physical premises influence sharing among students and facilitators.
Our results reveal layers of social frameworks that emphasise learning, recovery, strengths, equality, and open discussions about mental health. Organisational structures and physical premises significantly support or hinder these social frameworks. Clear communication, preparatory conversations, respect for boundaries, and neutral settings were identified as key aspects promoting sharing. Conversely, focus on diagnoses, top-down attitudes, inadequate preparations, excessive facilitator involvement, health-related settings, and overly exposed arrangements could inhibit sharing.
The organic interactions within RC courses create complexities in understanding the promoters and inhibitors of sharing within these social frameworks. What promotes sharing in one setting can inhibit sharing in another. We illustrated situations where disruptions to the frames either promoted active participation for some or inhibited sharing for those who felt overwhelmed. Recognising this complexity is crucial for facilitators in RCs to effectively frame sharing and achieve mutual learning among students.
为有物质使用和心理健康问题的人设立的康复学院（RCs）代表了心理健康服务的一项创新，强调共同创造和成人学习。有着不同经历的学生和课程促进者在这些环境中通过分享经验、知识和技能参与协作学习。本文探讨了促进或阻碍康复学院内部分享的社会框架。
我们在两个不同的康复学院环境中进行了一项人种志研究，采用参与观察以及对促进者、学生和领导者进行半结构化访谈的方法。我们运用戈夫曼的框架分析来理解康复学院的社会框架，以及其组织结构和物理环境如何影响学生和促进者之间的分享。
我们的结果揭示了强调学习、康复、优势、平等以及关于心理健康的开放讨论的社会框架层次。组织结构和物理环境显著支持或阻碍这些社会框架。清晰的沟通、准备性对话、对界限的尊重以及中立的环境被确定为促进分享的关键方面。相反，关注诊断、自上而下的态度、准备不足、促进者过度参与、与健康相关的环境以及过度暴露的安排可能会抑制分享。
康复学院课程中的有机互动在理解这些社会框架内分享的促进因素和抑制因素方面产生了复杂性。在一种环境中促进分享的因素在另一种环境中可能会抑制分享。我们举例说明了框架的干扰要么促进了一些人的积极参与，要么抑制了那些感到不堪重负的人的分享的情况。认识到这种复杂性对于康复学院的促进者有效地构建分享并在学生之间实现相互学习至关重要。
