Background
Theoretical approach
Method
Phase 1
Sample
Qualitative guides
Focus group questions
Procedure
Coding and interpretation
Phase 2
Measures
Demographics, housing, vocational, and service use history (DHHS)
Visual analogue scales (VAS)
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Sense of connection and belonging: Please mark on a scale of 0–100 the extent you feel a sense of belonging and social connectedness at Progress Place where you can fully be yourself.
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Dignity and self-worth: Please mark on a scale of 0–100 the extent you feel that you have value and worth as a person in society regardless of your mental health status.
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Skills acquired: Please mark on a scale of 0–100 the extent you feel that you have gained knowledge and skills at Progress Place that you can use in a volunteer or paid work experiences.
Procedure
Statistical analysis
Results
Phase 1
Context
You know, somebody comes in and is at a certain stage of their emotional well-being… the friendships that they build, the activities that they participate in. You know, progress that is done slowly. And I think Progress Place allows for that growth… Not everybody who walks in the door would be qualified, for example, to participate in the employment program. I think it might take a while. So, I think there are different phases that they can get to and then, you know, get wings and fly off… So yes, I think that Progress Place does allow for, for a reasonably large spectrum of where you’re at with mental illness.-Focus group 3.
Mechanisms and outcomes of recovery
Restorative Demi-regularity
Like, I remember at one point, like going into a shopping center or going to do little things was really hard, like I, I’d hear things, I’d see things and it was hard… But now I can go places alone, I can do everything on my own. And, like I can depend on me and like, I don’t feel weird anywhere. Now I tell myself, [name] don’t worry, sometimes these things happen, it’s only in your head, you know? Like, you just go out there and you do what you have to do and you feel great after accomplishing everything… And it took me a while to feel that confidence, but I’m getting there. - Focus group 1.
We use language like membership which is a, conveys a sense of belonging. And we set up our work so that there is a mutual, reciprocal need for each other. That, and that it is accepting of basically anybody who wants to be a member. Because we have that kind of community, sense of belonging… I say that we help people with correcting Maslow’s hierarchy of needs in our life. Where, they may have their safety and their security, but their sense of community and belonging has been reversed… So, we try to correct…we can create this intentional community where people do have a sense of belonging and being needed and being wanted and expected. And therefore, they regain their esteem so that they can go out and venture out and achieve. - Focus group 4.
The participant discussed the mechanisms: acceptance, sense of respect and non-judgment (M1) by stating that anyone can become a member and they will be accepted into the Progress Place community. Secondly, the participant stated that Progress Place promotes relationship to others and reduced isolation (M5); and a sense of connection and belonging (M6). This participant also stated that individuals regain their dignity and self-worth (M2) as well as independence and self-efficacy (M4) in achieving their goals. These mechanisms all engender the development of feeling better and at peace (O1).
Reaffirming Demi-regularity
At Progress Place you don’t look at a person as a case, you don’t look at a person as their illness. We don’t, we look at a person as a person. We deal with [them] as a person and that’s what [member’s name] says, you know that relationships are very important for us. And that’s one thing I think is very important, at Progress Place… You don’t look at a diagnosis, you look at a person. You know. And you build a relationship, and you know the person by what they are and then, you know, working together. - Focus group 4.You choose what’s right for you. And I think when people make choices, you know look, like when things are, say going well and they are making choices, they’re taking on responsibilities and they’re reminding themselves on a, like on a daily basis that I’m strong enough that I can take on doing tours. And I’m strong enough that I can, you know, answer the switchboard. Or, you know I’m not as fragile as I may have been when I was ill. Like, this is, I’m on the recovery side or it’s reinforcing of that on a daily basis. And it moves people away from like, like you, like someone mentioned that they have a voice. That I have choices. That I’m not in patienthood, I’m moving into personhood. - Focus group 4.
It’s a community of people that are, share a common, a common struggle in dealing with mental illness, mental health issues, and do collective work and individual support. They’re able to regain as [other participant] said, their confidence. They can regain aspects of their life to get back to, you know, living a full life, making a, making contributions to society, which drives everybody. But, they do have, the common theme they all have an experience with mental illness and that’s the common thread. But, after that it becomes just a group of people trying to help each other. - Focus group.
Re-engaging Demi-regularity
I like to become very independent and know how to do everything, but if there’s something I don’t know how to do, there’s a lot, the staff here, four of them are here, and they very much, they’ll help you out and get you on the straight and narrow as well as if something’s broken down, “Help! Help! Help!” you know [laughs]… But at the same time, I like to feel independent doing my work and not always having to ask all the time. I like to get to know what I’m doing and do it well and not having to ask for help every single minute of the day. - Focus group 4.Everyone and anyone who struggles or has a mental health issue can benefit very much from coming here. Very much because there’s just so much you can do here and you, you get, you feel a lot of hope seeing, seeing yourself work and ah, like work, complete tasks and be successful. And it always builds on your confidence level and your self-esteem eventually gets higher because you know that you’re acquiring more and more every day when you’re doing new things, learning new skills or practicing the skills you already have. - Focus group 5.
Phase 2
VAS Measurea | M | SD | 95% Confidence Interval | Response Range | |
---|---|---|---|---|---|
Mechanism | Acceptance, equality, and non-judgment | 80.1 | 20.7 | [76.83, 83.34] | 0–100 |
Dignity and self-worth | 77.3 | 21.5 | [73.88, 80.65] | 1–100 | |
Reduced experience of stigma | 83 | 20.1 | [79.78, 86.15] | 10–100 | |
Independence and self-efficacy | 81 | 19.8 | [77.79, 84.04] | 8–100 | |
Relationship to others and reduced isolation | 74 | 23.8 | [70.02, 77.63] | 0–100 | |
Sense of connection and belonging | 79 | 21.9 | [75.20, 82.24] | 0–100 | |
Outcome | |||||
Feeling better and at peace | 74 | 23 | [70.31, 77.55] | 0–100 | |
Personhood | 83 | 18.9 | [80.00, 85.93] | 0–100 | |
Skills Acquired | 75 | 23.6 | [71.53, 79.05] | 0–100 |
Outcome | Mechanism | B | SE | Tolerance | VIF |
---|---|---|---|---|---|
Feeling better and at peace | |||||
Acceptance | .070 | .095 | .569 | 1.758 | |
Dignity | .353 | .090 | .530 | 1.886 | |
Reduced stigma | −.103 | .102 | .471 | 2.123 | |
Efficacy | .288 | .095 | .554 | 1.806 | |
Isolation | −.004 | .079 | .570 | 1.753 | |
Belonging | .273 | .103 | .401 | 2.495 | |
Personhood | |||||
Acceptance | .230 | .073 | .649 | 1.540 | |
Dignity | .089 | .073 | .593 | 1.686 | |
Reduced stigma | .099 | .086 | .498 | 2.010 | |
Isolation | .040 | .067 | .588 | 1.700 | |
Belonging | .289 | .085 | .430 | 2.325 | |
Skills acquired | |||||
Dignity | .266 | .094 | .695 | 1.438 | |
Efficacy | .448 | .102 | .695 | 1.438 |
Sample
Restorative Demi-regularity
Variable | B | Std. Error | Beta | t | R2 | R2 Change | |
---|---|---|---|---|---|---|---|
Model 1 | (Constant) | 64.499 | 15.962 | 4.041 | .061 | .061 | |
Gender | −3.505 | 3.539 | −.089 | −.990 | |||
Education | 2.503 | 1.767 | .126 | 1.416 | |||
Age | −.314 | .178 | −.172 | −1.765 | |||
Length | 1.720 | 1.160 | .145 | 1.482 | |||
Frequency | 3.338 | 2.517 | .119 | 1.326 | |||
Model 2 | (Constant) | 2.386 | 14.287 | .167 | .516 | .456*** | |
Gender | −4.240 | 2.659 | −.107 | − 1.594 | |||
Education | 1.263 | 1.371 | .064 | .921 | |||
Age | −.108 | .135 | −.059 | −.800 | |||
Length | .222 | .906 | .019 | .244 | |||
Frequency | 1.745 | 1.885 | .062 | .926 | |||
Acceptance | .114 | .098 | .103 | 1.160 | |||
Dignity*** | .364 | .091 | .348 | 4.006 | |||
Stigma | −.147 | .120 | −.134 | −1.223 | |||
Efficacy* | .225 | .097 | .197 | 2.316 | |||
Belonging** | .330 | .117 | .311 | 2.819 | |||
Isolation | .004 | .079 | .004 | .049 |
Reaffirming Demi-regularity
Variable | B | Std. Error | Beta | t | R2 | R2 Change | |
---|---|---|---|---|---|---|---|
Model 1 | (Constant) | 104.701 | 13.608 | 7.694 | .064 | .064 | |
Gender | −1.469 | 3.021 | −.043 | −.486 | |||
Education | .811 | 1.507 | .048 | .539 | |||
Age* | −.365 | .152 | −.233 | −2.406 | |||
Length | .010 | .986 | .001 | .010 | |||
Frequency | −1.597 | 2.152 | −.066 | −.742 | |||
Model 2 | (Constant) | 41.801 | 12.000 | 3.483 | .511 | .448*** | |
Gender | −2.386 | 2.268 | −.071 | −1.052 | |||
Education | .282 | 1.157 | .017 | .244 | |||
Age | −.243 | .115 | −.155 | −2.116 | |||
Length | −.216 | .768 | −.021 | −.282 | |||
Frequency | −1.434 | 1.614 | −.060 | −.888 | |||
Accept*** | .266 | .074 | .294 | 3.606 | |||
Dignity | .109 | .075 | .122 | 1.462 | |||
Stigma | .064 | .101 | .068 | .634 | |||
Belonging** | .304 | .097 | .334 | 3.142 | |||
Isolation | .027 | .067 | .034 | .409 |
Re-engaging Demi-regularity
Variable | B | Std. Error | Beta | t | R2 | R2 Change | |
---|---|---|---|---|---|---|---|
Model 1 | (Constant) | 69.456 | 16.584 | 4.188 | .049 | .049 | |
Gender | −1.125 | 3.733 | −.027 | −.301 | |||
Education | 1.829 | 1.852 | .087 | .987 | |||
Age | −.403 | .187 | −.208 | −2.156 | |||
Length | 1.619 | 1.215 | .129 | 1.332 | |||
Frequency | 3.274 | 2.580 | .113 | 1.269 | |||
Model 2 | (Constant) | 22.503 | 16.131 | 1.395 | .290 | .242*** | |
Gender | −.884 | 3.254 | −.021 | −.272 | |||
Education | −.156 | 1.641 | −.007 | −.095 | |||
Age | −.186 | .166 | −.096 | −1.120 | |||
Length | .574 | 1.072 | .046 | .536 | |||
Frequency | 2.020 | 2.257 | .070 | .895 | |||
Dignity* | .203 | .101 | .182 | 2.000 | |||
Efficacy*** | .472 | .111 | .386 | 4.231 |