S70: SYMPOSIUM: Recovery-focused therapeutic approaches: Innovations in incorporating lived experience into recovery-focused therapeutic approaches.

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Authors: Neil Thomas, Indigo Daya, Bronte McLeod, Nev Jones, Jo-Anne Abbott, Janet Karagounis, Louisa Pearce, Rachel Brand, Steve Quinn, Anne Williams, Ellie Fossey, John Farhall, Fiona Foley, The ORBIT Project Team

Year: 2017

Event: 2017 TheMHS Conference

Subject: symposium, lived experience, recovery,

Type of resource: Conference Presentations and Papers

Abstract: People who experience persisting mental health problems frequently say that contact with peers with shared lived experience facilitated their own recovery. In this symposium, we bring together a series of research projects that examine innovative ways to incorporate lived experience into mental health service delivery. These extend from formal peer work programs to uses of digital technology to learn from others’ lived experience via peer videos and forums. Through this symposium we aim to illustrate varied ways of embedding lived experience within mental health practice. We also use examination of these different types of peer contact to consider, in depth, what the different elements of peer contact and interaction are that help to promote recovery.

Paper 1: Consumer experiences in a peer-facilitated education recovery program: A qualitative investigation of the peer contact mechanisms facilitating personal recovery outcomes
Bronte McLeod, Nev Jones, Jo-Anne Abbott and Neil Thomas
There is still a relative lack of knowledge regarding how contact with peers with lived experience of mental illness helps to challenge mental illness stereotypes and promote positive identity development. Qualitative methods were used to explore this with fourteen consumers following completion of the Wellways Australia MI Recovery peer-facilitated education program. This included individual semi-structured interviews, thematic analysis of interview transcripts and interviewer field diaries, and review of the findings by a lived experience advisory panel. Emergent themes pertaining to recognition, equal opportunity, unification through shared treatment and service experiences, and respect for diverse perspectives were seen to facilitate intrapersonal and interpersonal identity shifts. Enhanced understanding of the peer contact processes that facilitate subjectively meaningful and valued personal and social identities will contribute to improving the quality of peer-education recovery programs and the integration of experts by experience in traditional service delivery.

Paper 2: Voice Exchange: results of a pilot randomised controlled trial of one-to-one peer support integrating principles of the Hearing Voices Movement with Intentional Peer Support
Neil Thomas, Indigo Daya, Janet Karagounis, Louisa Pearce, Rachel Brand and Steve Quinn
We developed a one-to-one peer support program that used a combination of Intentional Peer Support and principles of working with voices from the Hearing Voices Movement (such as making sense of voices in relation to someone’s broader experience, and learning to develop a better relationship with them). We conducted a pilot randomised controlled trial, with 27 participants, comparing this intervention with a waiting list control group. We found that the peer support approach appeared feasible and acceptable to participants, and nearly all participants reported their experience of hearing voices was better following doing the peer support sessions. On outcome measures of the impact of voices and personal recovery, we saw improvements similar in magnitude to those observed in trials of formal psychotherapies for voices.

Paper 3: Being inspired that recovery is possible: Consumers’ views on engaging with video-based lived experience through a recovery-oriented website
Anne Williams, Ellie Fossey, John Farhall, Fiona Foley and Neil Thomas
Websites offer an innovative way to make the lived experience of consumers available to others. The Self-Management and Recovery Technology (SMART) research program developed an evidence-based website that includes videos of people with lived experience of mental illness discussing their recovery. These videos can be watched on a tablet device alongside a mental health worker, or independently. Thirty-one consumers with experience of psychosis who used the site participated in individual semi-structured interviews. Data analysis used constructivist grounded theory methodology. Participants engaged with lived experience through watching the videos and reflecting on their own experience in discussion with a mental health worker. Benefits of seeing others talking about their lived experience online included ‘knowing I’m not alone’, ‘being inspired’ and ‘believing recovery is possible’. In conclusion, the experience of engaging with lived experience through online videos was powerful for participants, and demonstrates strong potential to support consumers’ recovery.

Paper 4: Development of an online guided self-help intervention for bipolar disorder: the Online Recovery-focused Bipolar Individual Tool (ORBIT)
Kathryn Fletcher, Greg Murray, Fiona Foley, Neil Thomas and the ORBIT Project Team
The Online Recovery-focused Bipolar Individual Tool (ORBIT) project is an NHMRC-funded research program conducted by Swinburne University in conjunction with an international team. ORBIT comprises two low-intensity guided self-help interventions that aim to improve quality of life (QoL) in bipolar disorder. An international randomised controlled trial will test their comparative effectiveness later this year. Published pilot data suggested the first iteration of ORBIT was feasible, safe and effective in improving QoL. A central focus of the second iteration—ORBIT 2.0, currently in development—is the use of peer-to-peer learning via videos of consumers with lived experience of bipolar disorder. This drives the core content of the intervention. In addition, the program facilitates connection between different users via commenting functions, and a consumer-moderated forum. In this presentation, we discuss the content development phase of ORBIT 2.0: key design principles, challenges and learnings.

Learning Objectives
Learning Objective 1: People in the audience will gain an understanding of different ways in which lived experience can be incorporated into therapeutic approaches, both by peer workers and by non-peer mental health practitioners. They will also learn more about what the consumer experience is of contact with peers, and some of the therapeutic processes involved.

Learning Objective 2: The projects highlight a range of different ways of embedding lived experience into mental health service delivery, with a focus on promoting personal recovery among people with experiences of persisting mental health problems.

Thomas, N., Farhall, J., Foley, F., Leitan, N., Villagonzalo, K. A., Ladd, E., ... Kyrios, M. (2016). Promoting personal recovery in people with persisting psychotic disorders: Development and pilot study of a novel digital intervention. Frontiers in Psychiatry, 7, e196 doi:10.3389/fpsyt.2016.00196
Dent-Pearce, L., Daya, I., Karagounis, J., & Thomas, N. (2015). Integrating peer work with a specific therapeutic target: Experiences from the Voice Exchange program. In K. Kellehear, A. Lane, M. Cassaniti, B. Tooth, C. Chapman, S. Robertson ... R. Astbury (Eds.), Proceedings of the 24th TheMHS Mental Health Services Conference 2014 (“What we share makes us strong”). Balmain: Australia: TheMHS.

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