The resource group method in severe mental illness: study protocol for a randomized controlled trial and a qualitative multiple case study

Cathelijn D Tjaden; Cornelis L Mulder; Jaap van Weeghel; Philippe Delespaul; Rene Keet; Stynke Castelein; Jenny Boumans; Eva Leeman; Ulf Malm; Hans Kroon

doi:10.1186/s13033-019-0270-2

The resource group method in severe mental illness: study protocol for a randomized controlled trial and a qualitative multiple case study

Int J Ment Health Syst. 2019 Mar 22:13:15. doi: 10.1186/s13033-019-0270-2. eCollection 2019.

Authors

Cathelijn D Tjaden^{1

2}, Cornelis L Mulder^{3

4}, Jaap van Weeghel^{2

5}, Philippe Delespaul^{6

7}, Rene Keet⁸, Stynke Castelein^{9

10

11}, Jenny Boumans^{1

2}, Eva Leeman⁴, Ulf Malm¹², Hans Kroon^{1

2}

Affiliations

¹ 1Department of Reintegration and Community Care, Trimbos Institute, Utrecht, The Netherlands.
² 4Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands.
³ 2Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands.
⁴ 3Antes, Parnassia Psychiatric Institute, Rotterdam, The Netherlands.
⁵ Phrenos Centre of Expertise, Utrecht, The Netherlands.
⁶ 6School of Mental Health and NeuroSciences, Maastricht University, Maastricht, The Netherlands.
⁷ Mondriaan Mental Health Trust, Maastricht/Heerlen, The Netherlands.
⁸ 8Department of Community Mental Health, GGZ Noord-Holland-Noord, Heiloo, The Netherlands.
⁹ 9Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands.
¹⁰ 10Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands.
¹¹ 11Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
¹² 12Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Abstract

Background: The resource group method provides a structure to facilitate patients' empowerment and recovery processes, and to systematically engage significant others in treatment and care. A patient chooses members of a resource group (RG) that will work together on fulfilling patients' recovery plan. By adopting shared decision-making processes and stimulating collaboration of different support systems, a broad and continuous support of patients' chosen goals and wishes is preserved and problem solving and communication skills of the RG members are addressed.

Objective: The objectives of this study are (1) to establish the effectiveness of the RG method in increasing empowerment in patients with severe mental illnesses (SMI) in the Netherlands; (2) to investigate the cost-effectiveness and cost utility of the RG method; and (3) to qualitatively explore its dynamics and processes.

Methods/design: This multisite randomized controlled trial will compare the effects of the RG-method integrated in Flexible Assertive Community Treatment (FACT) (90 patients) with those of standard FACT (90 patients). Baseline assessments and 9-month and 18-month follow-up assessments will be conducted in face-to-face home visits. The primary outcome measure, empowerment, will be assessed using the Netherlands Empowerment List (NEL). The secondary outcomes will be quality of life (MANSA); personal, community and clinical recovery (I.ROC); general, social and community functioning (WHODAS 2.0); general psychopathological signs and symptoms (BSI-18); and societal costs (TiC-P). An economic evaluation of the cost-effectiveness and cost utility of the RG method will also be conducted. A qualitative multiple case-study will be added to collect patients', RG members' and professionals' perspectives by in-depth interviews, observations and focus groups.

Discussion: This trial will be the first to study the effects of the RG method on empowerment in patients with SMI. By combining clinical-effectiveness data with an economic evaluation and in-depth qualitative information from primary stakeholders, it will provide a detailed overview of the RG method as a mean of improving care for patients with SMI.Trial registration The study has been registered in the Dutch Trial Register, identifier: NTR6737, September 2017.

Keywords: (Flexible) Assertive Community Treatment; Care structure; Community mental health; Empowerment; Family; Family intervention; RACT; Recovery; Resource group; Severe mental illness.