Training professionals in a recovery-oriented methodology

A mixed method evaluation

N.A. Bitter*, D.P.K. Roeg, C. van Nieuwenhuizen, J. van Weeghel

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Several studies have reported difficulties concerning the implementation of recovery-oriented interventions. In this study, the effect of training in the Comprehensive Approach to Rehabilitation (CARe) on daily practice was evaluated. Additionally, we aimed to acquire insight into the experiences with the implementation process involving professionals, management and trainers.

Methods
Fourteen teams for sheltered and supported housing in the Netherlands participated in this study. As part of a cluster-randomised controlled trial (RCT) design, eight teams received training in the CARe methodology. Model fidelity (using the CARe fidelity audit) and professionals' knowledge of recovery (using the Recovery Knowledge Inventory) were measured for all teams until 20 months after the start. Afterwards, an evaluation meeting with participating stakeholders was organised in which barriers and facilitators of the implementation of the CARe methodology were inventoried.

Results
Ten months after the training, the intervention teams scored higher than the control teams on the fidelity subscales: 'recovery', 'strengths orientation' and 'amount of training and coaching'. Twenty months after the training, only the effect of 'amount of coaching and training' remained. Additionally, 'methodological working' clearly differed between the groups after 20 months in favour of the intervention teams. In all teams, model fidelity was moderate at both measurements. The knowledge of recovery of the trained teams was slightly and significantly higher at 10 and 20 months after training. Although professionals were positive about recovery and strength-oriented working, they experienced several organisational and societal barriers.

Conclusion
Training in the CARe methodology improved the fidelity and knowledge of recovery among professionals. However, the differences were small, and fidelity decreased over time. More in-depth knowledge is needed on which barriers professionals experience in practice so that tailored training and implementation strategies can be developed. Furthermore, more attention is needed for professional development and the translation of theory into practice.
Original languageEnglish
Pages (from-to)457-466
JournalScandinavian Journal of Caring Sciences
Volume33
Issue number2
DOIs
Publication statusPublished - 2019

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Netherlands
Equipment and Supplies
Mentoring

Keywords

  • CARE
  • CLUSTER
  • IMPLEMENTATION
  • IPS
  • KNOWLEDGE INVENTORY
  • PROGRAM
  • implementation
  • mental health care
  • model fidelity
  • recovery-oriented care
  • rehabilitation

Cite this

@article{f1dbba1393234407b0f00da9f1256571,
title = "Training professionals in a recovery-oriented methodology: A mixed method evaluation",
abstract = "BackgroundSeveral studies have reported difficulties concerning the implementation of recovery-oriented interventions. In this study, the effect of training in the Comprehensive Approach to Rehabilitation (CARe) on daily practice was evaluated. Additionally, we aimed to acquire insight into the experiences with the implementation process involving professionals, management and trainers.MethodsFourteen teams for sheltered and supported housing in the Netherlands participated in this study. As part of a cluster-randomised controlled trial (RCT) design, eight teams received training in the CARe methodology. Model fidelity (using the CARe fidelity audit) and professionals' knowledge of recovery (using the Recovery Knowledge Inventory) were measured for all teams until 20 months after the start. Afterwards, an evaluation meeting with participating stakeholders was organised in which barriers and facilitators of the implementation of the CARe methodology were inventoried.ResultsTen months after the training, the intervention teams scored higher than the control teams on the fidelity subscales: 'recovery', 'strengths orientation' and 'amount of training and coaching'. Twenty months after the training, only the effect of 'amount of coaching and training' remained. Additionally, 'methodological working' clearly differed between the groups after 20 months in favour of the intervention teams. In all teams, model fidelity was moderate at both measurements. The knowledge of recovery of the trained teams was slightly and significantly higher at 10 and 20 months after training. Although professionals were positive about recovery and strength-oriented working, they experienced several organisational and societal barriers.ConclusionTraining in the CARe methodology improved the fidelity and knowledge of recovery among professionals. However, the differences were small, and fidelity decreased over time. More in-depth knowledge is needed on which barriers professionals experience in practice so that tailored training and implementation strategies can be developed. Furthermore, more attention is needed for professional development and the translation of theory into practice.",
keywords = "CARE, CLUSTER, IMPLEMENTATION, IPS, KNOWLEDGE INVENTORY, PROGRAM, implementation, mental health care, model fidelity, recovery-oriented care, rehabilitation",
author = "N.A. Bitter and D.P.K. Roeg and {van Nieuwenhuizen}, C. and {van Weeghel}, J.",
year = "2019",
doi = "10.1111/scs.12644",
language = "English",
volume = "33",
pages = "457--466",
journal = "Scandinavian Journal of Caring Sciences",
issn = "0283-9318",
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}

Training professionals in a recovery-oriented methodology : A mixed method evaluation. / Bitter, N.A.; Roeg, D.P.K.; van Nieuwenhuizen, C.; van Weeghel, J.

In: Scandinavian Journal of Caring Sciences, Vol. 33, No. 2, 2019, p. 457-466.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Training professionals in a recovery-oriented methodology

T2 - A mixed method evaluation

AU - Bitter, N.A.

AU - Roeg, D.P.K.

AU - van Nieuwenhuizen, C.

AU - van Weeghel, J.

PY - 2019

Y1 - 2019

N2 - BackgroundSeveral studies have reported difficulties concerning the implementation of recovery-oriented interventions. In this study, the effect of training in the Comprehensive Approach to Rehabilitation (CARe) on daily practice was evaluated. Additionally, we aimed to acquire insight into the experiences with the implementation process involving professionals, management and trainers.MethodsFourteen teams for sheltered and supported housing in the Netherlands participated in this study. As part of a cluster-randomised controlled trial (RCT) design, eight teams received training in the CARe methodology. Model fidelity (using the CARe fidelity audit) and professionals' knowledge of recovery (using the Recovery Knowledge Inventory) were measured for all teams until 20 months after the start. Afterwards, an evaluation meeting with participating stakeholders was organised in which barriers and facilitators of the implementation of the CARe methodology were inventoried.ResultsTen months after the training, the intervention teams scored higher than the control teams on the fidelity subscales: 'recovery', 'strengths orientation' and 'amount of training and coaching'. Twenty months after the training, only the effect of 'amount of coaching and training' remained. Additionally, 'methodological working' clearly differed between the groups after 20 months in favour of the intervention teams. In all teams, model fidelity was moderate at both measurements. The knowledge of recovery of the trained teams was slightly and significantly higher at 10 and 20 months after training. Although professionals were positive about recovery and strength-oriented working, they experienced several organisational and societal barriers.ConclusionTraining in the CARe methodology improved the fidelity and knowledge of recovery among professionals. However, the differences were small, and fidelity decreased over time. More in-depth knowledge is needed on which barriers professionals experience in practice so that tailored training and implementation strategies can be developed. Furthermore, more attention is needed for professional development and the translation of theory into practice.

AB - BackgroundSeveral studies have reported difficulties concerning the implementation of recovery-oriented interventions. In this study, the effect of training in the Comprehensive Approach to Rehabilitation (CARe) on daily practice was evaluated. Additionally, we aimed to acquire insight into the experiences with the implementation process involving professionals, management and trainers.MethodsFourteen teams for sheltered and supported housing in the Netherlands participated in this study. As part of a cluster-randomised controlled trial (RCT) design, eight teams received training in the CARe methodology. Model fidelity (using the CARe fidelity audit) and professionals' knowledge of recovery (using the Recovery Knowledge Inventory) were measured for all teams until 20 months after the start. Afterwards, an evaluation meeting with participating stakeholders was organised in which barriers and facilitators of the implementation of the CARe methodology were inventoried.ResultsTen months after the training, the intervention teams scored higher than the control teams on the fidelity subscales: 'recovery', 'strengths orientation' and 'amount of training and coaching'. Twenty months after the training, only the effect of 'amount of coaching and training' remained. Additionally, 'methodological working' clearly differed between the groups after 20 months in favour of the intervention teams. In all teams, model fidelity was moderate at both measurements. The knowledge of recovery of the trained teams was slightly and significantly higher at 10 and 20 months after training. Although professionals were positive about recovery and strength-oriented working, they experienced several organisational and societal barriers.ConclusionTraining in the CARe methodology improved the fidelity and knowledge of recovery among professionals. However, the differences were small, and fidelity decreased over time. More in-depth knowledge is needed on which barriers professionals experience in practice so that tailored training and implementation strategies can be developed. Furthermore, more attention is needed for professional development and the translation of theory into practice.

KW - CARE

KW - CLUSTER

KW - IMPLEMENTATION

KW - IPS

KW - KNOWLEDGE INVENTORY

KW - PROGRAM

KW - implementation

KW - mental health care

KW - model fidelity

KW - recovery-oriented care

KW - rehabilitation

U2 - 10.1111/scs.12644

DO - 10.1111/scs.12644

M3 - Article

VL - 33

SP - 457

EP - 466

JO - Scandinavian Journal of Caring Sciences

JF - Scandinavian Journal of Caring Sciences

SN - 0283-9318

IS - 2

ER -