Brief Psychoeducation Program to Enhance Recovery Knowledge and Attitudes of Mental Health Service Providers and Users: Randomized Controlled Trials

  • Winnie W. S. MakEmail author
  • Randolph C. H. Chan
  • Sania S. W. Yau
Original Article


Recovery-oriented transformation of mental health service systems not only necessitates changes in mental health policies and practices, it also requires an adoption of recovery-oriented mindset, which includes knowledge and attitudes, among service providers. It is also important that service users are informed about the changes and can fully participate in the process. The present study developed and evaluated the efficacy of a recovery psychoeducation program in enhancing recovery-oriented knowledge and attitudes among mental health service providers and users in Hong Kong. In study 1, 111 service providers were randomly assigned to 2-day psychoeducation group or control group. Results showed that participants in psychoeducation group had significantly better recovery knowledge and more positive attitudes towards recovery after the intervention than the control counterparts. The effect of the recovery psychoeducation program on recovery attitudes was fully mediated by the improvement in recovery knowledge. In study 2, 93 people with mental illness were randomized into 2-week psychoeducation group or control group. Participants in the psychoeducation group had a significant improvement in the level of recovery-oriented knowledge immediately after the workshops, but the effect could not be sustained at follow-up. To transform into a recovery-oriented service system, having an effective program to orient service providers and users to recovery is essential. This study provided initial support to the use of a brief psychoeducational program for recovery-oriented knowledge enhancement. Given the short-term efficacy and feasibility of the interventions, service leaders and managers in different clinical and social service settings should consider implementing the programs as part of staff and users’ service orientation to build a recovery-supporting workforce and empower their service users early in the recovery process.


Mental health Personal recovery Brief psychoeducation Recovery knowledge Attitudes towards recovery 



We would like to thank Candice Ling-Powell, Ka Tsun Ting, Ellery Wu, and staff of New Life Psychiatric Rehabilitation Association for their assistance throughout the process of delivering of recovery psychoeducation program to service providers and users.


The authors did not receive any grant or funding support for this work.

Compliance with Ethical Standards

Conflict of interest

All authors have no conflicts of interest related to this study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10488_2018_905_MOESM1_ESM.docx (23 kb)
Supplementary material 1 (DOCX 22 KB)


  1. Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11–23.CrossRefGoogle Scholar
  2. Bedregal, L. E., O’connell, M., & Davidson, L. (2006). The recovery knowledge inventory: Assessment of mental health staff knowledge and attitudes about recovery. Psychiatric Rehabilitation Journal, 30(2), 96–103.CrossRefGoogle Scholar
  3. Borg, M., & Kristiansen, K. (2004). Recovery-oriented professionals: Helping relationships in mental health services. Journal of Mental Health, 13(5), 493–505.CrossRefGoogle Scholar
  4. Chang, B. H., Geller, J. L., & Biebel, K. (2018). Recovery services and outcomes in a state psychiatric hospital. Psychiatric Quarterly. Scholar
  5. Crowe, T. P., Deane, F. P., Oades, L. G., Caputi, P., & Morland, K. G. (2006). Effectiveness of a collaborative recovery training program in Australia in promoting positive views about recovery. Psychiatric Services, 57(10), 1497–1500.CrossRefGoogle Scholar
  6. Davidson, L., & Roe, D. (2007). Recovery from versus recovery in serious mental illness: One strategy for lessening confusion plaguing recovery. Journal of Mental Health, 16(4), 459–470.CrossRefGoogle Scholar
  7. Davidson, L., Tondora, J., O’connell, M. J., Kirk, T. Jr., Rockholz, P., & Evans, A. C. (2007). Creating a recovery-oriented system of behavioral health care: Moving from concept to reality. Psychiatric Rehabilitation Journal, 31(1), 23–31.CrossRefGoogle Scholar
  8. Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.Google Scholar
  9. Higgins, A., Callaghan, P., Devries, J., Keogh, B., Morrissey, J., Nash, M.,.. . Carter, T. (2012). Evaluation of mental health recovery and Wellness Recovery Action Planning education in Ireland: a mixed methods pre–postevaluation. Journal of Advanced Nursing, 68(11), 2418–2428.CrossRefGoogle Scholar
  10. Kazantzis, N., & Deane, F. P. (1999). Psychologists’ use of homework assignments in clinical practice. Professional Psychology: Research and Practice, 30(6), 581–585.CrossRefGoogle Scholar
  11. Kidd, S. A., George, L., O’connell, M., Sylvestre, J., Kirkpatrick, H., Browne, G., … Davidson, L. (2011). Recovery-oriented service provision and clinical outcomes in assertive community treatment. Psychiatric Rehabilitation Journal, 34(3), 194–201.CrossRefGoogle Scholar
  12. Krueger, C., & Tian, L. (2004). A comparison of the general linear mixed model and repeated measures ANOVA using a dataset with multiple missing data points. Biological Research for Nursing, 6(2), 151–157.CrossRefGoogle Scholar
  13. Lam, M. M., Pearson, V., Ng, R. M., Chiu, C. P., Law, C., & Chen, E. Y. (2011). What does recovery from psychosis mean? Perceptions of young first-episode patients. International Journal of Social Psychiatry, 57(6), 580–587.CrossRefGoogle Scholar
  14. Mak, W. W. S., Chan, R. C. H., Wong, S. Y. S., Lau, J. T. F., Tang, W. K., Tang, A. K. L., Chiang, T. P., Cheng, S. K. W., Chan, F., Cheung, F. M., Woo, J., & Lee, D. T. F. (2017). A cross-diagnostic investigation of the differential impact of experienced discrimination on personal and clinical recovery. Psychiatric Services, 68(2), 159–166.CrossRefGoogle Scholar
  15. Mak, W. W. S., Chan, R. C. H., & Yau, S. S. W. (2018). Development and validation of Attitudes towards Recovery Questionnaire across people in recovery, their family carers, and service providers in Hong Kong. Psychiatry Research, 267, 48–55.CrossRefGoogle Scholar
  16. Mak, W. W. S., Cheung, F. M. C., Wong, S. Y. S., Tang, W. K., Lau, J. T. F., Woo, J., & Lee, D. T. F. (2015). Stigma towards people with psychiatric disorders. Hong Kong Medical Journal, 21(Suppl 2), 9–12.Google Scholar
  17. Mak, W. W. S., Lam, B. Y. H., & Yau, S. S. W. (2010). Recovery knowledge and recovery-oriented services in Hong Kong. Psychiatric Services, 61(11), 1164.CrossRefGoogle Scholar
  18. Malinovsky, I., Lehrer, P., Silverstein, S. M., Shankman, S. A., O’brien, W., Samuelson, T., & Van Nostrand, G. (2013). An empirical evaluation of recovery transformation at a large community psychiatric rehabilitation organization. Psychological Services, 10(4), 428–441.CrossRefGoogle Scholar
  19. McGregor, J., Repper, J., & Brown, H. (2014). The college is so different from anything I have done”: A study of the characteristics of Nottingham Recovery College. The Journal of Mental Health Training, Education and Practice, 9(1), 3–15.CrossRefGoogle Scholar
  20. McGuire, W. J. (1981). Theoretical foundations of campaigns. In R. E. Rice & W. J. Paisley (Eds.), Public communication campaigns (pp. 41–70). Beverly Hills: Sage.Google Scholar
  21. Meehan, T., & Glover, H. (2009). Using the recovery knowledge inventory (RKI) to assess the effectiveness of a consumer-led recovery training program for service providers. Psychiatric Rehabilitation Journal, 32(3), 223–226.CrossRefGoogle Scholar
  22. Mental Health Commission of Canada. (2015). Guidelines for recovery-oriented practice. Ottawa, Canada: National Library of Canada. Retrived from
  23. Ng, R. M., Pearson, V., & Chen, E. Y. (2008a). What does recovery from schizophrenia mean? Perceptions of psychiatrists. International Journal of Culture and Mental Health, 1(1), 73–84.CrossRefGoogle Scholar
  24. Ng, R. M., Pearson, V., Lam, M., Law, C., Chiu, C. P., & Chen, E. Y. (2008b). What does recovery from schizophrenia mean? Perceptions of long-term patients. International Journal of Social Psychiatry, 54(2), 118–130.CrossRefGoogle Scholar
  25. Peebles, S. A., Mabe, P. A., Fenley, G., Buckley, P. F., Bruce, T. O., Narasimhan, M.,.. . Williams, E. (2009). Immersing practitioners in the recovery model: an educational program evaluation. Community Mental Health Journal, 45(4), 239–245.CrossRefGoogle Scholar
  26. Repper, J. (2000). Adjusting the focus of mental health nursing: Incorporating service users’ experiences of recovery. Journal of Mental Health, 9(6), 575–587.CrossRefGoogle Scholar
  27. Salgado, J. D., Deane, F. P., Crowe, T. P., & Oades, L. G. (2010). Hope and improvements in mental health service providers’ recovery attitudes following training. Journal of Mental Health, 19(3), 243–248.CrossRefGoogle Scholar
  28. Substance Abuse and Mental Health Services Administration. (2005). National consensus conference on mental health recovery and systems transformation. Rockville, MD: Department of Health and Human Services.Google Scholar
  29. Tsai, J., Salyers, M. P., & McGuire, A. B. (2011). A cross-sectional study of recovery training and staff attitudes in four community mental health centers. Psychiatric Rehabilitation Journal, 34(3), 186–193.CrossRefGoogle Scholar
  30. Tse, S., Siu, B. W. M., & Kan, A. (2013). Can recovery-oriented mental health services be created in Hong Kong? Struggles and strategies. Administration and Policy in Mental Health and Mental Health Services Research, 40(3), 155–158.CrossRefGoogle Scholar
  31. Tsoi, E., Lo, I., Chan, C., Siu, K., & Tse, S. (2014). How recovery oriented are mental health services in Hong Kong? Snapshots of service users’ perspectives. Asia Pacific Journal of Social Work and Development, 24(1–2), 82–93.CrossRefGoogle Scholar
  32. World Health Organization. (2011). Mental health atlas-2011 country profiles. Retrieved from

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Winnie W. S. Mak
    • 1
    Email author
  • Randolph C. H. Chan
    • 1
  • Sania S. W. Yau
    • 2
  1. 1.Department of PsychologyThe Chinese University of Hong KongShatinHong Kong
  2. 2.New Life Psychiatric Rehabilitation AssociationHong KongHong Kong

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