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Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention

Wallace, Genevieve; Bird, Victoria; Leamy, Mary; Bacon, Faye; Le Boutillier, Clair; Janosik, Monika; Macpherson, Rob; Williams, Julie; Slade, Mike

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Genevieve Wallace

Victoria Bird

Mary Leamy

Faye Bacon

Clair Le Boutillier

Monika Janosik

Rob Macpherson

Julie Williams

Professor of Mental Health Recovery and Social Inclusion


Purpose: Policy is increasingly focused on implementing a recovery-orientation within mental health services, yet the subjective experience of individuals receiving a pro-recovery intervention is under-studied. The aim of this study was to explore the service user experience of receiving a complex, pro-recovery intervention (REFOCUS), which aimed to encourage the use of recovery-supporting tools and support recovery-promoting relationships.
Methods: Interviews (n=24) and two focus groups (n=13) were conducted as part of a process evaluation and included purposive sample of service users who received the complex, pro-recovery intervention within the REFOCUS randomised controlled trial (ISRCTN02507940). Thematic analysis was used to analyse the data.
Results: Participants reported that the intervention supported the development of an open and collaborative relationship with staff, with new conversations around values, strengths and goals. This was experienced as hope-inspiring and empowering. However, others described how the recovery tools were used without context, meaning participants were unclear of their purpose and did not see their benefit. During the interviews, some individuals struggled to report any new tasks or conversations occurring during the intervention.
Conclusion: Recovery-supporting tools can support the development of a recovery-promoting relationship, which can contribute to positive outcomes for individuals. The tools should be used, in a collaborative and flexible manner. Information exchanged around values, strengths and goals should be used in care-planning. As some service users struggled to report their experience of the intervention, alternative evaluation approaches need to be considered if the service user experience is to be fully captured.


Wallace, G., Bird, V., Leamy, M., Bacon, F., Le Boutillier, C., Janosik, M., …Slade, M. (in press). Service user experiences of REFOCUS: a process evaluation of a pro-recovery complex intervention. Social Psychiatry and Psychiatric Epidemiology, 51(9),

Journal Article Type Article
Acceptance Date Jun 3, 2016
Online Publication Date Jun 30, 2016
Deposit Date Jun 14, 2016
Publicly Available Date Jun 30, 2016
Journal Social Psychiatry and Psychiatric Epidemiology
Print ISSN 0933-7954
Electronic ISSN 0933-7954
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 51
Issue 9
Keywords Recovery, health service and population research, process evaluation, complex intervention
Public URL
Publisher URL
Additional Information The final publication is available at Springer via