Table 5 Summary of themes and sub-themes
1. Impacts of interventions | ||
Common impacts: Improved motivation level, better management of one’s emotion, mental symptoms and negative thoughts | ||
Different impacts: | SMCM group | Control group |
Domain of improvement- | Improvements in functional recovery e.g., finding paid employment, widening social circle, more contact with family members, and adopting a more planful approach to achieve one’s goals | General improvement |
Account of the impacts- | Vivid, detailed, rich accounts of how recovery goals were set and eventually achieved | Tended to be straightforward |
One’s own strengths- | Better adjusted to understand and accept one’s strengths, weaknesses and shortcomings | No similar comments were found |
2. Experience of the intervention | ||
2.1 Relationship between service user and case worker: Both SMCM and control group service users appraised the case workers as very helpful and approachable, having regular contact, caring like a family members. | ||
SMCM group | Control group | |
Context- | • Helping service users gain hope and a sense of satisfaction by supporting them to achieve their identified goals, showing a genuine appreciation of users’ strengths and a curiosity to explore their talents and skills | • Being person-centered in therapeutic relationship with service users, showing empathy and trust towards them |
Concerns- | • Once-a-fortnight contact between case worker and service user was too much for user and the potential to build dependence on case worker | • Did not mention any particular concerns |
2.2 Who would benefit from the interventions? Service users’ characteristics were important in determining whether they would benefit from the respective interventions. Both SMCM and control group service users needed to have some insight, willingness to engage in conversations about one’s own recovery process and have some social support. | ||
SMCM group | Control group | |
Service users need to have- | • Stable mental state (e.g., no severe depressive or hypomanic symptoms) • Adequate communication skills | • Good adherence to medications regime • A “normal life”, meaningful daytime engagement • Life skills • Trust in the case worker • Opportunity to make own decisions |
2.3 Specific tools used in the interventions: Control group participants did not mention any particular features of the interventions. SMCM workers commented about- • Found the personal recovery plan very helpful for both case workers and service users • The service users had mixed feelings about how the workers used the strengths assessment and personal recovery plan • The importance of taking part in group supervision where workers could learn from each other and find optimal solutions to the problems they face. Meanwhile, the group discussion was influenced by the worker’s understanding and perception of the user | ||