Psychological recovery in a step 4 service: a qualitative study exploring the views of service users and clinicians

Abstract

Background

Psychological recovery is typically measured in improving access to psychological therapies (IAPT) services as the reduction of symptoms on routine outcome measures (ROMs). However, conceptualisations of psychological recovery vary, and there are concerns that ROMs may not be suitable for measuring recovery from complex mental health difficulties.

Aim

To gain insight into psychological recovery and measurement in clinical practice.

Method

A qualitative study at a step-4 IAPT service in the North of England. Eight clinicians contributed to focus groups, and 10 service users were later interviewed individually.

Results

Factors that informed four congruent and interacting themes of recovery were identified among participants as an ongoing personal process, of intra-therapeutic and extra-therapeutic factors impacting on recovery in helpful and unhelpful ways, and the need for idiographic long-term recovery measures. The functional and long-term nature of recovery and the socio-economic context for recovery were considered particularly crucial.

Conclusions

The need for idiographic long-term recovery measures to support the ongoing process of recovery was reported in the majority of instances. Study findings mirrored existing recovery and outcome measurement literature, provided new evidence in relation to recovery from complex mental health difficulties, and made recommendations for future research and clinical practice.

Keywords:

• Recovery
• routine outcomes
• mental health
• qualitative
• service user experience
• outcome measurement

Disclosure statement

No potential conflict of interest was reported by the author(s).

Acknowledgements

The authors thank the participants of the study. The authors also thank Newcastle University, Michelle Reeves (Manager of the Step 4 Psychology Team), and NHS England for the support received. BW and RS conducted the study as part of their Doctorate in Clinical Psychology training.