Personal Recovery Research Articles

The Association Between Change in Symptom Severity and Personal Recovery in Patients With Severe Mental Illness

Abstract This study examined the relationship between change in symptom severity and personal recovery in patients with severe mental illness (SMI). Forty-nine outpatients at Mentrum/Arkin, Amsterdam, the Netherlands, were assessed at baseline and 3 years later, using the Brief Psychiatric Rating Scale and the Mental Health Recovery Measure. Correlation coefficients and linear regression analyses were used. Further, the impact of severity of symptoms at baseline on change in personal recovery was evaluated. Results show that change in symptom severity explained 31.8% of the variance of change in personal recovery. Change in depression/anxiety explained 27.3% of the variance of change in personal recovery. Higher affective symptom severity at baseline significantly predicted positive change in personal recovery. In conclusion, besides change in symptom severity, other potential determinants of personal recovery should be addressed in treatment of patients with SMI, for example, self-esteem and social functioning. Treatment of depression/anxiety symptoms may increase personal recovery.

Reasons for disengagement in first-episode psychosis - perspectives from service users and their caregivers.

The efforts of early psychosis intervention programmes can be impeded by difficulties in maintaining the engagement of service users. As disengagement is often an autonomous decision made by service users, the main aim of this study was to gain insight into the reasons for service user disengagement through qualitative interviews with the service users themselves, and caregivers as proxies or secondary informants. Participants recruited for the study were enrolled in the Early Psychosis Intervention Programme in Singapore for at least a year, aged 21 and above, able to communicate in English, and had disengaged for at least three months. The recruitment and interview processes were conducted independently for service user and caregiver participants. Potential participants were invited to a face-to-face semi-structured interview over video call or in-person. Each interview spanned one to two hours, and comprised five phases - icebreaker, exploration of the participant's experience with EPIP before deciding to disengage, discussion of reasons for disengagement, exploration of the post-disengagement experience, and feedback and suggestions for EPIP. Recruitment aimed to conclude after 10-15 participants were interviewed for both service user and caregiver groups, with the expectation that data sufficiency would be reached with no new themes being generated. Ultimately, 12 service user and 12 caregiver participants were recruited. There were six pairs of service user and caregiver dyads, where the caregivers interviewed were caring for service users also enrolled in the study. Valuable qualitative insights were gathered, including the type of disengagement, medication compliance during disengagement, the decision-making process behind disengaging, and circumstances surrounding re-engagement. A total of five categories each with subthemes were identified from the reasons for service user disengagement - individual factors, stigma, progression, treatment factors, and external factors. There is a need to narrow down urgent areas of attention, aligning the study themes with established risk factors so that feasible solutions can be developed and appropriate care models can be adopted, to minimise adverse outcomes related to disengagement. It is important to keep an open mind to understand what personal recovery means to the individual service user, so that treatment goals can be better harmonised.

Psychometric Evaluation of the Dutch version of the Substance Use Recovery Evaluator (SURE-NL).

Introduction Patient-Reported Outcome Measures (PROMs) are an important source of information that allow for a patient-centered assessment. Outcome measurement of substance use disorder (SUD) treatment traditionally focuses on drug use and deficits in functioning, overlooking other aspects of the personal and dynamic process of recovery. The Substance Use Recovery Evaluator (SURE) is a PROM developed with service user input to monitor the recovery journey and assess treatment outcomes in people with SUD. The objective of this study was to examine the validity and reliability of the Dutch translation of the SURE, the SURE-NL, for measuring indicators of recovery in Dutch-speaking patients with SUD. Methods The original SURE questionnaire was translated from English to Dutch using forward-backward translation. A total of N=171 participants were recruited as part of a naturalistic multicenter study in inpatient (N=149) and outpatient (N=22) SUD treatment centers. We examined the factorial structure, reliability, and concurrent and discriminant validity of the SURE-NL. Results The original 5-factor structure of the SURE showed acceptable fit for the SURE-NL, and internal consistencies of the subscales ranged from .61 to .76 and internal consistency of the total score was .83. Concurrent validity was confirmed through positive correlations of the SURE-NL total and subscale scores with the WHOQoL-BREF subscales, but correlations varied depending on subscale and treatment setting, with higher correlations for the outpatient compared to the inpatient subgroup. Discriminant validity was confirmed through low, mostly non-significant correlations between the SURE-NL and the DASS-21. Conclusions Although the SURE was originally designed for outpatient settings, our findings in a predominantly inpatient sample indicate that the SURE-NL is suitable for assessing personal recovery and recovery capital in Dutch-speaking Belgian patients with SUD. However, subscales should be used and interpreted with caution. Further research is needed with larger Dutch-speaking outpatient samples and the development of a tailored SURE for inpatient settings should be considered.

Proposal for a socially constitutive process of personal recovery in psychiatry

SUMMARY This article discusses the importance of personal recovery in psychiatry and proposes a new socially constitutive process. The author, an expert by experience, emphasises that recovery is not only an individual endeavour but also an intersubjective one. Moreover, social relationships and external factors such as community, family, health service culture and social norms influence the recovery process. The socially constitutive process posits that support from professionals and family members is crucial, significantly reducing the burden of responsibility carried by individuals with mental illness.

Intelligent rehabilitation assistant: Application of deep learning methods in sports injury recovery

In recent years, sports injury rehabilitation has developed into a specialized field that has forced the combination of an orthopedic surgeon, sports physiotherapist, and sports physician. Determining the appropriate time for an injured athlete to resume practice or competition is regarded as sports rehabilitation. Discovering the best solutions to avoid injuries, maximize recovery, and enhance performance is crucial for sports activities. The study introduced an intelligent rehabilitation assistant (IRA) that leverages advanced deep learning (DL) methods to enhance sports injury recovery. In this study, the IRA incorporates redefined prairie dog optimized bidirectional long-short-term memory (RPDO-Bi-LSTM) to enhance accuracy, predicting sports injury recovery. The study collected data on the state of rehabilitation, physiological parameters, and general health using wearable sensors and movement patterns. The data was preprocessed using a median filter to remove noise from sensor data. Region-based segmentation using segmented images from preprocessed data. Convolutional neural networks (CNN) using extracted features from obtained data. The IRA provides personalized recovery plans and real-time feedback. The framework consists of the components, suggested models to create quality scores for motions, measurements to quantify motion performance, and scoring of performance measurement elements into numerical quality scores. The proposed method is implemented using Python software. RPDO-Bi-LSTM presentation is evaluated by various metrics, such as accuracy 94.2% recall 98.2%, precision 96.5%, and specificity 95.2%, f1 score 95.6%, he planned technique attained good performance and improved the accuracy of sports injury recovery.

Do Health Workers Believe that Personal Recovery is Possible? An Evaluation of the Recovery Attitudes Questionnaire

Do Health Workers Believe that Personal Recovery is Possible? An Evaluation of the Recovery Attitudes Questionnaire

Factors Influencing the Personal Recovery in Outpatients With Schizophrenia

Objectives: This study aims to quantitatively investigate factors influencing personal recovery in patients with schizophrenia.Methods: This study included 168 outpatients treated for schizophrenia. Patients’ sociodemographic factors (sex, age, education, and marital status), clinical factors (duration of illness, number of hospitalizations, and dose of drug), symptoms, behavior and symptoms, physical and mental health, family attitude, social support, attitude toward drug therapy, insight, self-esteem, hopelessness, and self-stigma were analyzed. The analysis included these 17 factors as explanatory variables for personal recovery to perform regression analysis.Results: Backward elimination was used to select variables, and multiple regression analysis was performed. The five factors (symptoms, self-esteem, insight, physical, and mental health, and social support) accounted for 75.8% of the variance in patients’ perceived willingness for personal recovery.Conclusion: Personal recovery in schizophrenic patients is very important because it means subjective satisfaction and quality of life in society. In this study, social support was the most important variable in predicting personal recovery. These results imply that not only symptoms but also various factors including social support should be emphasized when establishing a recovery strategy for schizophrenic patients.

A systematic review and meta-ethnography exploring personal perspectives of recovery among those with lived experience of non-suicidal self-injury.

Non-suicidal self-injury (NSSI) is a significant public health concern. Research and treatment interventions largely focus on stopping self-injury. People who self-injure do not necessarily equate recovery to cessation. Qualitative accounts allow greater understanding of personal recovery narratives. This study aimed to synthesise personal conceptualisations of NSSI recovery. Participants had lived experience of NSSI and discussed their recovery. Papers not written in English or had a quantitative design were excluded. Four databases (PsycInfo, CINAHL, Medline and Web of Science) were systematically searched. The quality of each paper was assessed using the CASP quality assessment tool. Data were synthesised using a meta-ethnographic approach. Thirteen studies comprising 159 participants were included. Three overarching themes were developed. While ceasing NSSI was an important aspect of recovery for some, recovery was typically viewed more holistically, encompassing developments within the self and relationships. Recovery was regarded an ongoing non-linear journey. The personal and multifaceted nature of the recovery process emerged through a line of argument synthesis. This was the first qualitative synthesis of personal conceptualisations of NSSI recovery. The findings highlighted the personal and multifaceted nature of NSSI recovery and supported person-centred models of self-injury recovery. Clinical implications include the importance of expanding self-injury recovery beyond cessation within research and clinical practice, and for collaborative and person-centred approaches to be embraced when supporting those who self-injure.

Choice Matters: The Moderating Effect of Choice on the Relationship Between Mental Health Personal Recovery and Symptomatology

PurposeLimited research examines how choice surrounding treatment impacts mental health recovery among young adults with serious mental illness (SMI) who are navigating symptom management, complex mental health systems, and developmental expectations of increased independence. This study examines whether perceived choice related to mental health treatment impacts the relationship between symptomatology and personal recovery among Black, Latino/e, and multiracial young adults with SMI. MethodsSurveys were conducted with 121 young adults with SMI attending a community-based personal recovery-oriented program. Data included covariates (demographics and social support), psychiatric symptomatology, personal recovery, and choice. Ordinary least squares regressions tested whether choice predicts symptomatology and personal recovery, and whether choice moderates the relationship between symptomatology and personal recovery. ResultsMost participants were Black, Latino/e, or multiracial (96%) and male (67%) with an SMI diagnosis receiving services through Medicaid. Holding demographics and social support constant, a strong sense of choice was positively associated with personal recovery, (χ2 (7, N = 112) = 17.5, p = .01), but not symptomatology (χ2 (7, N = 112) = 12.5, p = .09). Furthermore, perceived choice moderated the relationship between symptomatology and personal recovery (β = −0.48, 95% CI [-0.79, −0.17], p = .012), where the association between symptomatology and personal recovery ceased to exist at lower levels of perceived choice in treatment. DiscussionThis study suggests perceived choice can influence the relationship between symptomatology and personal recovery among Black, Latino/e, and multiracial young adults with SMI. Implications for clinical practice include further evidence for enhancing shared decision-making and transition-focused care for young adults of color.

Effects of an online program about intimate and romantic relationships for people with mental disorders (AIRIKI): a study protocol for a randomized controlled trial

BackgroundThe concept of recovery has become internationally widespread. To promote personal recovery of individuals with mental disorders, it is important that they live life on their own terms. Many people with mental disorders wish to build intimate relationships and marry. However, people with mental disorders face obstacles in building such relationships and communicating with their partners. The program AIRIKI, which means “power to love,” was developed to help people with mental disorders gain confidence in building intimate relationships. The AIRIKI pilot study with one-group pre post test showed positive effects on self-esteem, hope, and communication. Therefore, the purpose of the proposed randomized controlled trial (RCT) is to determine the effects of the videoconferencing program on self-esteem, hope, and self-confidence in communication among un-married people with mental disorders.MethodsThe proposed randomized controlled trial has two arms (intervention group and control group). After baseline questionnaire assessment, participants will be allocated randomly. Within two months of allocation, the intervention group will participate in videoconferences about intimate relationships and marriage with 2–5 participants and 3 facilitators, which will last 3 h, for two days. Three facilitators will support participants in each session. The intervention group will complete a questionnaire for outcome assessment at termination and one month after the program. The control group will complete the outcome questionnaire at one month after baseline and two months after baseline. The questionnaire will include the Rosenberg Self-Esteem Scale (RSES), Herth Hope Index (HHI), and Self-confidence in Communication Scale (SCS). Control group members can participate in a videoconference program, which will be held separately from the intervention group, after completing their outcome assessments.DiscussionThis trial is the first randomized controlled trial of which we are aware to test the effects of an online program for un-married people with mental disorders to consider and discuss their romantic relationship and marriage. The results will provide information on the effectiveness of an online program for people with mental disorders to imagine their romantic relationships and marriages.Trial registrationThis trial has been registered with the UNIN Clinical Trials Registry (UMIN000052027; 2023/08/28).

‘It’s like someone is holding your hand, an invisible hand’: A grounded theory study of participation and personal recovery in Flexible Assertive Community Treatment

Background Participation in everyday life and personal recovery is often adversely affected for individuals with complex mental health needs. Flexible Assertive Community Treatment (FACT) is a recovery-oriented service targeting participation in everyday life and personal recovery and is thus important to understand from the perspectives of service users. Aim To explore how service users experience the care and support they receive from FACT as facilitating processes of participation in everyday life and in their personal recovery process. Materials and Methods A constructivist Grounded Theory approach was employed, involving 14 in-depth interviews conducted from January to November 2023 with FACT service users (9 women, 5 men; 23-55 years) within the Swedish adult general Mental Health Services. Results The process of Building genuine relationships between participants and FACT team members enabled Doing as a way of recovering. This was facilitated by how FACT was organised, promoting continuity and flexibility in care and support. Conclusions and significance This study contributes to a greater understanding of how genuine relationships between FACT service users and team members provide opportunities for participation and doing as a means for personal recovery. The results underscore the significance of incorporating an occupational therapy perspective into recovery-oriented services.

Recovery and Its Correlates Following Intervention in Depression

Abstract Background: Recovery connotes the act of regaining or returning to a normal or usual state of health. When it comes to recovery in depression, recovery is usually defined as sustained remission. The process of recovery from depression is influenced by a wide variety of factors such as internalized stigma and self-esteem. Objectives: The objectives of the study were to find out the longitudinal effectiveness of intervention on the process of recovery, self-esteem, and internalized stigma in depression. Sample and Design: A longitudinal and comparative research design was employed in the study. Consecutive sampling was employed to recruit 30 participants fulfilling inclusion and exclusion criteria. They were distributed into two groups – Group 1 (pharmacological treatment) and Group 2 (pharmacological treatment along with psychotherapeutic treatment). Results and Conclusion: Results indicate that patients provided with combined treatment showed a significant increase in clinical and personal recovery. There was a significant improvement in “Connecting and Belonging” subdomains of personal recovery. No significant differences were observed for internalized stigma and self-esteem.

Barriers and facilitators to recovery among college students without access to a collegiate recovery program

Background Undergraduate students pursuing substance use recovery face multiple barriers, including widespread substance use on campus, stigma, and limited support. A small number of campuses have collegiate recovery programs to support students. Most students in recovery lack access to such programming, and little research has explored their experiences. Methods This study, framed by the recovery capital perspective, utilized thematic analysis to illuminate students’ experiences in recovery without a collegiate recovery program on a Midwestern US campus. Seventeen students participated in semi-structured interviews. We sought to understand the barriers to recovery these students faced and how students overcame them. Results Barriers exemplified limited or negative recovery capital. Students described substance use and mental health challenges, being overwhelmed with responsibilities, feeling isolated, and negative twelve-step group experiences. Students gained personal recovery capital by mobilizing personal strengths, coping, and self-care strategies. To build family/social capital, they engaged various supports (e.g. mutual aid or activist groups). Community capital was limited to campus counseling services or supportive professors. Notably, not all students chose abstinence. Conclusion This study augments the literature about how students in recovery overcome barriers without a collegiate recovery program. Universities should offer services to accommodate the range of recovery preferences and experiences.

'My Journey': A Qualitative Study of Recovery From the Perspective of Individuals With Chronic Mental Illness.

Due to the humanistic paradigm shift in recent years, mental health recovery has been approached through personal recovery beyond the limits of the biomedical perspective, emphasising the subjective perception and uniqueness of the individual. Therefore, approaching recovery perceptions from patients' perspectives has gained importance. This study aimed to examine in depth the recovery perceptions of individuals with chronic mental illness. It is a qualitative study conducted using a phenomenological design. The study group consisted of 12 patients who had been undergoing treatment for mental illness for at least 1 year and were selected by purposive sampling method. Data were collected face-to-face using a semi-structured interview form and analysed using the content analysis technique. The content analysis revealed three main themes and seven sub-themes. The themes were journey (a meaningful life, optimal functioning, new identity), journey ticket (resilience, support systems) and stones on the road (traditional perspective, barriers). In conclusion, the study results revealed that individuals in the recovery process required support and counselling to make sense of the process and adapt their identity. Employment should be used more effectively in the recovery process of individuals with chronic mental illness. Recovery can only be achieved by breaking away from the traditional perspective of healing and combating the perception of society towards patients. Accordingly, psychiatric nurses should provide effective guidance and counselling to show that individuals can create and live a meaningful life alongside their illnesses.

Psychometric Validation of the Purpose in Life Test-Short Form (PIL-SF) in Individuals Diagnosed with Severe Mental Illness.

Meaning in Life (MiL) represents a key variable in mental health models of personal recovery. There is a need for straightforward and concise instruments to assess this construct quantitatively in individuals diagnosed with severe mental illness (SMI). The aim of the present study was to test the psychometric properties of the Purpose in Life Test-Short Form (PIL-SF), a brief self-report measuring the presence of MiL, in a sample of individuals with SMI. The participants were 41 adults (21 women, 51.8% and 20 men, 48.2%) aged 18 to 65 years (M = 50.05; SD = 10.73) with a diagnosis of SMI (schizophrenia, 61%; bipolar disorder, 26.8%; borderline personality disorder, 7.3%; and major depression, 4.9%) and clinically stable. The PIL-SF, Satisfaction with Life Scale (SWLS), Oxford Happiness Questionnaire-6 Item (OHQ-6), Engagement in Meaningful Activities Survey (EMAS), and Seeking of Noetic Goals-8 Item (SONG-8) were used. Descriptive analysis, estimation of the internal consistency, and Confirmatory Factor Analysis of the PIL-SF were conducted. Furthermore, correlations between the PIL-SF, SWLS, OHQ-6, EMAS, and SONG-8 were calculated. The PIL-SF showed acceptable internal consistency (ω = 0.81) and an excellent fit as a unidimensional scale (CFI = 1.000, TLI = 1.070, RMSEA = 0.000, SRMR = 0.021), confirming its factorial structure. Regarding construct validity, correlations between the PIL-SF and the SWLS (ρ = 0.54, p < 0.001), the OHQ-6 (ρ = 0.52, p < 0.001), and EMAS (ρ = 0.44, p < 0.005) were positive and significant, whereas the correlations between the PIL-SF and the SONG-8NfM (ρ = -0.35, p < 0.025) were negative and significant. The Spanish version of the PIL-SF appears to be a reliable and valid instrument to measure the presence of MiL in adults with SMI.

A Mixed Methods Study of Ethnic Identity and Mental Health Recovery Processes in Minoritized Young Adults.

Ethnic identity development is associated with positive mental health in young adults from ethnic minority groups. How a sense of belonging and attachment to one's ethnic culture is related to personal mental health recovery remains unexplained. This study examines the experiences of ethnic minority young adults in the U.S. to understand the aspects of culture and identity development that are relevant to their recovery processes. Young adults who were living with chronic mental disorders were recruited from four rehabilitation programs. Interviews produced quantitative and qualitative data. An explanatory sequential mixed methods design was used to integrate the qualitative findings from a sub-group of young adults (n = 44) with the results from the quantitative study. Directed content analysis was used to analyze the qualitative data, and the integrated data were analyzed in joint displays. The prominent themes characterizing ethnic identity development in personal recovery were (a) cultural history, traditions, and values; (b) mental illness stigma within the ethnic community; and (c) bias and discrimination in mental health services. Young adults with high ethnic identity development reported having more support from family, but they also described experiences with stigma and racism. The integrated results suggest that ethnic identity development promotes mental health recovery in minoritized young adults through social support and improved well-being and resilience. Experiences of intersectional stigma and structural racism associated with ethnic identity can interfere with self-determination and access to care among minoritized Hispanic/Latine, Black, and multiracial young adults in the U.S.

Taking what you get or Getting what you Need: A Qualitative Study on Experiences with Mental Health and Welfare Services in Long-Term Recovery in First-Episode Psychosis.

How people in long-term recovery (clinical and personal) in first-episode psychosis (schizophrenia and bipolar spectrum disorders) experience the mental health and welfare services they interact with is not frequently studied but has significant implications. We therefore aimed to explore which aspects of these services people with FEP evaluate as important for their long-term recovery. Twenty participants in clinical and/or personal recovery from two Norwegian long-term follow-up studies after FEP (TOP 10-year and TIPS 20-year) were sampled for this interview-based qualitative study. The research-team included service user experience. A deductive analysis based on personal accounts of recovery generated five service aspects. Few specific types of interventions were reported to promote recovery although medications, psychotherapy and employment support were mentioned. Participants valued services based in collaboration and that focused on their resources rather than limitations. The importance of long-term follow-up with a consistent aim was highlighted, as was the inclusion of caregivers and peers. Welfare services contributed to recovery by supporting basic needs and safety, but some experienced social exclusion when not participating in the labor market. This study is unique in exploring the role of services, including welfare, in long-term FEP recovery from service user perspectives. Participants evaluated that services played a more indirect role in long-term recovery by supporting their personal resources, although what they needed from services had frequently not been offered. Their expertise by experience contributes valuable knowledge. Better service coordination and consistent implementation of this knowledge are crucial to support recovery in FEP.

The Different Faces of Religion in Therapy: An Exploratory Qualitative Study of a Religion-Based Therapeutic Community for Addiction Recovery in Israel.

This article examines the impact of the integration of religion and psychological treatment in a religion-based therapeutic community for persons in recovery from addiction in Israel. Based on an exploratory qualitative study that includes participant observation in a Jewish forgiveness therapy training course and in-depth interviews with counselors working in the community, we identify three themes that characterize the therapeutic process. First, religion emerges as a challenge in therapy, one that should be addressed with sensitivity. Second, religion can be turned into a spiritual and cultural resource in the recovery process, with a cautious and sensitive approach. Third, religion can offer a remedial experience, without necessarily involving an intensification of faith. We offer principles that can help guide decisions regarding the integration of religion into therapy, with a focus on addiction treatment oriented to clients with a religious background.

‘Two sides of the one coin’: using reflection to examine co-production of human rights education within higher institutions in Ireland

ABSTRACT Encompassing human rights-based approaches within mental health service delivery is essential to supporting the recovery of service users, their family members/carers/supporters. This is being increasingly led by social workers due to their role in responding to psychosocial challenges. This is seen in today’s mental health services through their work in safeguarding service users and addressing familial concerns regarding all aspects of life. It is also evidenced in their openness to the concept of personal recovery—a movement aimed at defending and improving human rights for service users and their family members/carers/supporters through the recognition of international legislation. Recent debates within social work education have explored whether our critical and radical roots are declining or absent in practice. One argument for this has been the increasing pressures coming from neoliberal policies. This paper describes how both authors approached several co-produced sessions with social work students at an Irish university regarding mental health recovery and social work. The authors provide insight into this approach, including a description and exploration of a model of reflexivity used during this process which can be used by other educators, students, and practitioners [CS is an Assistant Professor of Social Work,MJN is a Consumer Academic].

Peer-led recovery groups for people with psychosis in South Africa (PRIZE): Results of a randomized controlled feasibility trial.

The aims of this feasibility trial were to assess the acceptability and feasibility of peer-led recovery groups for people with psychosis in a low-resource South African setting, to assess the feasibility of trial methods, and to determine key parameters in preparation for a definitive trial. The design was an individually randomised feasibility trial comparing recovery groups in addition to treatment as usual (TAU) with TAU alone. Ninety-two isiXhosa-speaking people with psychosis and forty-seven linked caregivers were recruited from primary care clinics and randomly allocated to trial arms in a 1:1 allocation ratio. TAU comprised anti-psychotic medication delivered in primary care. The intervention arm comprised six recovery groups including service users and caregivers. Two-hour recovery group sessions were delivered weekly in a 2-month auxiliary social worker (ASW)-led phase, then a 3-month peer-led phase. To explore acceptability and feasibility, a mixed methods process evaluation included 25 in-depth interviews and 2 focus group discussions at 5months with service users, caregivers and implementers, and quantitative data collection including attendance and facilitator competence. To explore potential effectiveness, quantitative outcome data (functioning, relapse, unmet needs, personal recovery, stigma, health service use, medication adherence and caregiver burden) were collected at baseline, 2months and 5months post randomisation. Trial registration: PACTR202202482587686. Qualitative interviews revealed that recovery groups were broadly acceptable with most participants finding groups to be an enjoyable opportunity for social interaction, and joint problem-solving. Peer facilitation was a positive experience; however a minority of participants did not value expertise by lived experience to the same degree as expertise of professional facilitators. Attendance was moderate in the ASW-led phase (participants attended 59% sessions on average) and decreased in the peer-led phase (41% on average). Participants desired a greater focus on productive activities and financial security. Recovery groups appeared to positively impact on relapse. Relapse occurred in 1 (2.2%) of 46 participants in the recovery group arm compared to 8 (17.4%) of 46 participants in the control arm (risk difference -0.15 [95% CI: -0.26; -0.05]). Recovery groups also impacted on the number of days in the last month totally unable to work (mean 1.4days recovery groups vs 7.7days control; adjusted mean difference -6.3 [95%CI: -12.2; -0.3]). There were no effects on other outcomes. Peer-led recovery groups for people with psychosis in South Africa are potentially acceptable, feasible and effective. A larger trial, incorporating amendments such as increased support for peer facilitators, is needed to demonstrate intervention effectiveness definitively.