Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings

James Roe; Susan Brown; Caroline Yeo; Stefan Rennick-Egglestone; Julie Repper; Fiona Ng; Joy Llewelyn-Beardsley; Ada Hui; Pim Cuijpers; Graham Thornicroft; David Manley; Kristian Pollock; Mike Slade

doi:10.3389/fpsyt.2020.589731

Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings

James Roe^*, Susan Brown, Caroline Yeo, Stefan Rennick-Egglestone, Julie Repper, Fiona Ng, Joy Llewelyn-Beardsley, Ada Hui, Pim Cuijpers, Graham Thornicroft, David Manley, Kristian Pollock, Mike Slade

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education. Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education. Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted. Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements). Conclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress. Trial Registration Number: Work in this paper has informed three clinical trials: ISRCTN11152837; ISRCTN63197153; ISRCTN76355273.

Original language	English
Article number	589731
Pages (from-to)	1-11
Number of pages	11
Journal	Frontiers in Psychiatry
Volume	11
Issue number	October
DOIs	https://doi.org/10.3389/fpsyt.2020.589731
Publication status	Published - 30 Oct 2020

Funding

Funding. This article is independent research jointly funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Programme Grants for Applied Research, Personal experience as a recovery resource in psychosis: Narrative Experiences Online (NEON) Programme, RP-PG-0615-20016) and by NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands (CLAHRC EM, NIHR200171), now recommissioned as NIHR Applied Research Collaboration (ARC) East Midlands. JRo received support from the NIHR CLAHRC EM. SB received support from Nottingham Biomedical Research Centre (BRC) and NIHR Mental Health Medtech Co-operative. GT received support from the National NIHR ARC South London at King's College London NHS Foundation Trust, and by the NIHR Asset Global Health Unit award. GT also receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). GT was supported by the UK Medical Research Council in relation the Emilia (MR/S001255/1) and Indigo Partnership (MR/R023697/1) awards. MS received support from the Center for Mental Health and Substance Abuse, University of South-Eastern Norway, and the NIHR Nottingham BRC. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Funders	Funder number
Australian Research Council
NIHR Mental Health Medtech Co-operative
NIHR Imperial Biomedical Research Centre
Nottingham Biomedical Research Centre
Universitetet i Sørøst-Norge
National Institute of Mental Health
National NIHR ARC
NIHR Nottingham BRC
King's College London NHS Foundation Trust
UK Research and Innovation
Medical Research Council	MR/S001255/1, MR/R023697/1
National Institute for Health Research	RP-PG-0615-20016, NIHR200171
National Institutes of Health	R01MH100470

Keywords

clinical practice
education and training
mental health
online resources
recovery narrative

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3389/fpsyt.2020.589731

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Roe, J., Brown, S., Yeo, C., Rennick-Egglestone, S., Repper, J., Ng, F., Llewelyn-Beardsley, J., Hui, A., Cuijpers, P., Thornicroft, G., Manley, D., Pollock, K., & Slade, M. (2020). Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings. Frontiers in Psychiatry, 11(October), 1-11. Article 589731. https://doi.org/10.3389/fpsyt.2020.589731

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abstract = "Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education. Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education. Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted. Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements). Conclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress. Trial Registration Number: Work in this paper has informed three clinical trials: ISRCTN11152837; ISRCTN63197153; ISRCTN76355273.",

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Roe, J, Brown, S, Yeo, C, Rennick-Egglestone, S, Repper, J, Ng, F, Llewelyn-Beardsley, J, Hui, A, Cuijpers, P, Thornicroft, G, Manley, D, Pollock, K & Slade, M 2020, 'Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings', Frontiers in Psychiatry, vol. 11, no. October, 589731, pp. 1-11. https://doi.org/10.3389/fpsyt.2020.589731

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T1 - Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings

AU - Roe, James

AU - Brown, Susan

AU - Yeo, Caroline

AU - Rennick-Egglestone, Stefan

AU - Repper, Julie

AU - Ng, Fiona

AU - Llewelyn-Beardsley, Joy

AU - Hui, Ada

AU - Cuijpers, Pim

AU - Thornicroft, Graham

AU - Manley, David

AU - Pollock, Kristian

AU - Slade, Mike

PY - 2020/10/30

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N2 - Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education. Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education. Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted. Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements). Conclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress. Trial Registration Number: Work in this paper has informed three clinical trials: ISRCTN11152837; ISRCTN63197153; ISRCTN76355273.

AB - Background: Recorded Recovery Narratives (RRNs) describing first-person lived experience accounts of recovery from mental health problems are becoming more available. Little is known about how RRNs can be used in clinical practice and clinical education. Aims: The aim of this paper is to enable implementation planning for RRN interventions by identifying determinants of uptake. The objective was to identify opportunities, barriers, and enablers to the uptake of RRN interventions in clinical practice and education. Method: Three phases of focus groups were conducted with multi-professional mental health clinicians. Phase 1 (4 groups, n = 25) investigated current and possible uses of RRNs, Phase 2 (2 groups, n = 15) investigated a specific intervention delivering recovery narratives. Phase 3 (2 groups, n = 12) investigated clinical education uses. Thematic analysis was conducted. Results: RRNs can reinforce the effectiveness of existing clinical practices, by reducing communication barriers and normalizing mental health problems. They can also extend clinical practice (increase hope and connection, help when stuck). Clinical considerations are the relationship with care pathways, choice of staff and stage of recovery. In educational use there were opportunities to access lived experience perspectives, train non-clinical staff and facilitate attitudinal change. Barriers and enablers related to design (ability to use online resources, accessibility of language, ability to individualize choice of narrative), risk (triggering content, staff skills to respond to negative effects), trust in online resource (evidence base, maintenance), and technology (cost of use, technology requirements). Conclusions: RRNs can both improve and extend existing clinical practice and be an important educational resource. RRNs can improve engagement and hope, and address internalized stigma. Beneficially incorporating RRNs into clinical practice and education may require new staff skills and improved technological resources in healthcare settings. Future work could focus on the use of peer support workers views on RRN use and how to avoid unnecessary and unhelpful distress. Trial Registration Number: Work in this paper has informed three clinical trials: ISRCTN11152837; ISRCTN63197153; ISRCTN76355273.

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KW - education and training

KW - mental health

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KW - recovery narrative

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Opportunities, Enablers, and Barriers to the Use of Recorded Recovery Narratives in Clinical Settings

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UN SDGs

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