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Background <p>While recovery orientation is national policy in many countries, evidence remains limited for the effectiveness at a service level. This paper describes the protocol for implementing a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France. The aim is to evaluate whether REFOCUS-RETAFORM plus usual care leads to improved outcomes for adolescent and adult mental health service users compared with usual care alone.</p> Methods <p>A two-step stepped wedge cluster randomised controlled trial will be conducted, with a nested qualitative sub-study exploring stakeholders’ views on changes in staff-user relationships and implementation influences. The REFOCUS-RETAFORM intervention is a training intervention for mental health staff, to develop recovery-promoting relationships and pro-recovery working practices. Clusters are services, which transition sequentially from control to intervention condition in a randomised order. Eight clusters are randomised to deliver REFOCUS-RETAFORM in year one and eight clusters in year two. Each cluster delivers REFOCUS-RETAFORM to two teams from their organisation (32 teams in total). Participants are a) service users aged 13–65&#xa0;years attending services implementing REFOCUS-RETAFORM, and b) staff receiving the intervention. The primary outcome is the Questionnaire about the Process of Recovery. Secondary outcomes include perceived stigma and coercion, self-stigma and wellbeing for service users, and recovery-orientation for staff. Data will be collected from 540 service users (180 at baseline, 180 at month 12, 180 at month 24) and 220 staff. We will use multilevel mixed-effects models, adjusting for secular trends and thematic analysis for the qualitative interview data.</p> Discussion <p>Findings will inform the continued transformation of French specialist mental health services toward a recovery orientation.</p> Trial registration <p>Clinical Trials NCT05824234, registered 21 April 2023.</p>

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Evaluation of a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France: stepped-wedge cluster randomised controlled trial protocol

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月14日

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  • Julien Dubreucq,
  • Nicolas Franck,
  • Julien Plasse,
  • Anne-Elisabeth Muller,
  • Marie-Cécile Bralet,
  • Céline Bera-Potelle,
  • Fabrice Berna,
  • Clara Blachère,
  • Alexandre Carpentier,
  • Isabelle Chereau,
  • Pauline Chillet,
  • Marine Dubreucq,
  • Isabelle Durand-Zaleski,
  • Marion Chirio-Espitalier,
  • Pauline Espi,
  • Pierre Fourneret,
  • Tristan Gabriel-Segard,
  • Axel Guioux,
  • Anne-Laure Grangé,
  • Amanda Green,
  • Errol Green,
  • Nathalie Guillard-Bouhet,
  • Priscille Gerardin,
  • Yves-Antoine Harscoet,
  • Yasser Khazaal,
  • Evelyne Lassere,
  • Alicia Le Bras,
  • Mary Leamy,
  • Guillaume Legrand,
  • Emilie Legros-Lafarge,
  • Pierre-Michel Llorca,
  • Nemat Jaafari,
  • Louis Mabille,
  • David Masson,
  • Catherine Massoubre,
  • Aurore Moisset,
  • Noushig Nahabedian,
  • Clélia Quiles,
  • David Reydellet,
  • Antoine Simon,
  • Aude Sibert,
  • Rémi Tresse,
  • Aurélie Tinland,
  • Graham Meadows,
  • Mike Slade,
  • Luc Vigneault,
  • Philippe Maugiron,
  • Charles Bonsack,
  • Marie-Jeanne Richard,
  • Camille Niard,
  • Jean-François Pelletier,
  • Mary Leamy,
  • Pauline Le Neir,
  • Mathilde Vavasseur,
  • Emmanuelle Douriez,
  • Jean Maxime Cobac,
  • Anthony Compain,
  • Elisabeth Barraud,
  • Julie Jadeau,
  • Hélène Videau,
  • Carole Wangermez,
  • Hélène Thomas,
  • Fabienne Boumeriche,
  • Sandrine Guglielmetti,
  • Estelle Mexique,
  • Maha Zahaf,
  • Vincent Belloncle,
  • Émilie Voirin,
  • Audrey Martinez,
  • Charlotte Burdel,
  • Karine Larpent,
  • Gérald Chambas,
  • Julie Cartier,
  • Laure Tournebize,
  • Emmanuelle Castano,
  • Jennifer Fernandes,
  • Olivier Blanc,
  • Myriam Mennetrier,
  • Ludovic Ducher,
  • Yann Boulon,
  • Olivier Martin,
  • Céline Garcher,
  • Christelle Thauvin-Fabregue,
  • Alexandra Koubichkine,
  • Fabrice Saulière,
  • Martina Traykova,
  • Sarah Barrière,
  • Jean-Christophe Duval,
  • Anais Saillard,
  • Charlotte Mullet,
  • Julien Jupille,
  • Gaelle Challet. Mike Slade

摘要

Background

While recovery orientation is national policy in many countries, evidence remains limited for the effectiveness at a service level. This paper describes the protocol for implementing a pro-recovery training intervention (REFOCUS-RETAFORM) in specialist mental health services across France. The aim is to evaluate whether REFOCUS-RETAFORM plus usual care leads to improved outcomes for adolescent and adult mental health service users compared with usual care alone.

Methods

A two-step stepped wedge cluster randomised controlled trial will be conducted, with a nested qualitative sub-study exploring stakeholders’ views on changes in staff-user relationships and implementation influences. The REFOCUS-RETAFORM intervention is a training intervention for mental health staff, to develop recovery-promoting relationships and pro-recovery working practices. Clusters are services, which transition sequentially from control to intervention condition in a randomised order. Eight clusters are randomised to deliver REFOCUS-RETAFORM in year one and eight clusters in year two. Each cluster delivers REFOCUS-RETAFORM to two teams from their organisation (32 teams in total). Participants are a) service users aged 13–65 years attending services implementing REFOCUS-RETAFORM, and b) staff receiving the intervention. The primary outcome is the Questionnaire about the Process of Recovery. Secondary outcomes include perceived stigma and coercion, self-stigma and wellbeing for service users, and recovery-orientation for staff. Data will be collected from 540 service users (180 at baseline, 180 at month 12, 180 at month 24) and 220 staff. We will use multilevel mixed-effects models, adjusting for secular trends and thematic analysis for the qualitative interview data.

Discussion

Findings will inform the continued transformation of French specialist mental health services toward a recovery orientation.

Trial registration

Clinical Trials NCT05824234, registered 21 April 2023.