Questionnaire about the Process of Recovery

1. Abstract

The Questionnaire about the Process of Recovery (QPR) is an internationally recognized, patient-reported outcome measure (PROM) developed specifically to capture the multifaceted, subjective experience of personal recovery among individuals experiencing severe mental health difficulties, particularly psychosis and schizophrenia-spectrum disorders. Originating through extensive collaborative participatory research with mental health service users in the United Kingdom, the QPR marked a transformative paradigm shift away from traditional, professionally dominated psychiatric outcome metrics that prioritized objective clinical endpoints such as symptom reduction, relapse rates, and neuroleptic adherence. Instead, the instrument operationalizes personal recovery as a non-linear, deeply individualized transformative journey defined by the restoration of hope, empowerment, self-worth, purpose, and community integration, regardless of the ongoing presence or absence of psychiatric symptoms.

Initially developed as a 22-item scale comprising two distinct theoretical subscales—Intrapersonal Recovery and Interpersonal Recovery—the measure underwent extensive psychometric refinement by Williams and colleagues (2015). Confirmatory factor analyses identified structural vulnerabilities and psychometric underperformance in the interpersonal domain, culminating in a streamlined, psychometrically superior 15-item unidimensional version alongside the classical 22-item instrument. Both configurations employ a 5-point Likert-type response scale ranging from 0 (“Strongly Disagree”) to 4 (“Strongly Agree”), generating cumulative summary scores wherein higher numeric values indicate a more advanced progression along the recovery continuum.

The psychometric integrity of the QPR has been substantiated across diverse international clinical populations and evaluative trials. The refined 15-item version demonstrates exceptional internal consistency (Cronbach’s alpha = 0.89) and robust temporal stability across test-retest administrations (r = 0.74). Evidence of construct validity is illustrated by strong convergent associations with validated measures of subjective well-being, notably the Warwick-Edinburgh Mental Well-being Scale (r = 0.73), alongside proven sensitivity to therapeutic change over longitudinal intervals (standardized responsiveness coefficient = 0.40). The QPR serves as an indispensable psychometric instrument for recovery-oriented clinical trials, program evaluation, health services research, and shared decision-making in routine psychiatric care.

2. Keywords

Questionnaire about the Process of Recovery, QPR, personal recovery, psychosis, patient-reported outcome measure, psychometrics, mental health, CHIME framework, intrapersonal recovery, psychiatric rehabilitation, recovery-oriented care, clinical psychology

3. Authors

The Questionnaire about the Process of Recovery was initially co-produced by clinical researchers and service users led by S. Neil, M. Kilbride, L. Pitt, S. Nothard, M. Welford, W. Sellwood, and Anthony P. Morrison (2009) in Manchester, England. The instrument subsequently underwent extensive psychometric validation, structural evaluation, and shortening into the standard 15-item unidimensional version by a research team based at King’s College London:

• Julie Williams, PhD — Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK. (Corresponding author: [email protected])
• Mary Leamy, PhD — Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK.
• Francesca Pesola, PhD — Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK.
• Victoria Bird, PhD — Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK.
• Clair Le Boutillier, PhD — Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK.
• Mike Slade, PhD — School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK; formerly at King’s College London.

4. Purpose

The primary purpose of the Questionnaire about the Process of Recovery (QPR) is to provide a theoretically grounded, psychometrically robust, and consumer-validated method for capturing and tracking the personal recovery journey of individuals navigating severe psychiatric disorders, particularly psychosis, bipolar disorder, and major depressive disorder. Historically, psychiatry has evaluated clinical efficacy through biomedical paradigms focused almost exclusively on symptom reduction, pathology alleviation, relapse prevention, and clinician-rated functional impairment using tools such as the Brief Psychiatric Rating Scale (BPRS) or the Positive and Negative Syndrome Scale (PANSS). While symptom reduction is clinically informative, research consistently demonstrates that clinical remission does not necessarily correlate with subjective well-being, life satisfaction, or personal empowerment. Service users frequently emphasize that surviving or managing persistent symptoms represents only a small component of recovery; what matters most is the active restoration of identity, self-worth, social inclusion, and meaningful agency in everyday life.

The QPR bridges this gap by functioning as a dedicated patient-reported outcome measure (PROM) designed to operationalize consumer-defined recovery. The tool addresses several critical clinical, practical, and research needs:

• Longitudinal Outcome Assessment in Clinical Trials: The QPR provides evaluators and psychiatric researchers with a sensitive, quantitative endpoint to measure the effectiveness of recovery-oriented psychological interventions (e.g., Cognitive Behavioral Therapy for Psychosis [CBTp], Acceptance and Commitment Therapy [ACT], peer-support models, and psychiatric rehabilitation programs) beyond classical symptomatic endpoints.
• Facilitating Collaborative Psychiatric Practice: In routine mental health settings, the QPR serves as an empowering clinical catalyst. Instead of reinforcing traditional clinician-patient hierarchies, administering the scale invites service users to assess their internal agency, personal growth, and external barriers. Clinicians and multidisciplinary teams can utilize item-level profiles to construct tailored, collaborative recovery care plans that prioritize the individual’s subjective aspirations and personal values rather than solely targeting medication compliance.
• Benchmarking Service Quality and Systemic Culture: As mental health systems globally transition toward recovery-oriented standards of care, the QPR serves as a systemic benchmarking metric. Aggregated QPR scores enable healthcare systems, psychiatric trusts, and community mental health teams (CMHTs) to measure whether organizational transformations genuinely translate into felt recovery and empowerment for the service users they support.
• Overcoming Floor and Ceiling Limitations: Traditional psychiatric outcome measures frequently exhibit profound floor effects in severe illness phases or ceiling effects when positive symptoms stabilize. The QPR circumvents these issues by evaluating dynamic psychological shifts in self-efficacy, meaning, and resilience that can progress independently of clinical symptom severity.

5. Psychological Construct

The psychological construct assessed by the QPR is personal recovery in the context of severe mental illness. Personal recovery is conceptually distinct from clinical recovery. Whereas clinical recovery denotes an invariant, objective outcome characterized by complete symptom eradication and restoration of normative social functioning as observed by healthcare professionals, personal recovery is defined as an idiosyncratic, ongoing, subjective process. It encompasses an individual’s personal evolution toward a satisfying, hopeful, self-directed, and contributing life, even amidst continuing psychological distress, cognitive disruptions, or persistent psychiatric symptoms.

Within the psychometric architecture of the original 22-item QPR and its validated 15-item version, personal recovery is operationalized across distinct psychological dimensions:

Intrapersonal Recovery

The intrapersonal dimension represents the subjective internal shifts that an individual undergoes to reclaim self-determination, self-worth, and existential coherence following the disruption caused by severe psychological trauma or psychosis. This dimension is captured across 17 items in the 22-item version and forms the entire structural foundation of the refined 15-item unidimensional scale. Key components include:

• Rebuilding a Positive Sense of Self and Self-Worth: Severe mental health crises frequently shatter self-esteem, leaving individuals marginalized or defined solely by diagnostic labels. Intrapersonal recovery evaluates the degree to which an individual rejects internalised stigma, rediscovers inherent self-worth, and cultivates unconditional self-regard (e.g., reflecting statements such as feeling better about oneself and sensing personal growth).
• Restoration of Hope, Optimism, and Future Orientation: A hallmark of psychiatric disability is pervasive hopelessness. The QPR gauges the re-emergence of an active anticipation of positive life events, the ability to formulate forward-looking ambitions, and the revitalized capacity to experience wonder, curiosity, and vitality toward life.
• Self-Determination, Agency, and Internal Locus of Control: Rather than viewing oneself as a passive victim of a neurobiological condition or institutional psychiatric protocols, intrapersonal recovery reflects an individual’s perception of active agency—the capacity to make autonomous choices, navigate setbacks, solve problems, and exercise intentionality in daily routines.
• Existential Meaning and Life Purpose: Recovering from psychosis entails constructing an explanatory framework for one’s life events. This involves deriving purpose from adverse experiences, understanding life narratives, and integrating the psychiatric journey into a coherent self-narrative.
• Psychological Acceptance and Resilience: The construct measures the capacity to accept one’s emotional and cognitive experiences rather than engaging in maladaptive experiential avoidance, enabling the individual to face fears and adapt flexibly to environmental stress.

Interpersonal Recovery

In the original 22-item formulation, recovery was conceptualized as encompassing not only internal shifts but also interpersonal and social processes. The interpersonal dimension comprises 5 items designed to capture:

• Social Inclusion and Belonging: Moving from institutional isolation and alienation toward feeling an authentic, valued part of the broader societal fabric.
• Relational Reciprocity: Developing reciprocal relationships characterized by mutual respect, trust, and shared vulnerability, rather than one-directional, care-dependent interactions.
• Social Validation and External Support: Experiencing external acknowledgement from others, feeling taken seriously, and receiving tangible validation and emotional support from peers, families, and community members.

While the interpersonal subscale carries high face validity and clinical resonance, subsequent latent structural investigations (Williams et al., 2015) identified that these 5 items suffered from substantial measurement variance, cross-loadings, and weaker discriminant properties compared to the intrapersonal factor, prompting psychometricians to recommend the 15-item unidimensional model for standardized measurement.

6. Theoretical Framework

The Questionnaire about the Process of Recovery is grounded within a rich nexus of psychological, sociological, and psychiatric rehabilitation theories that coalesced over the past three decades to redefine mental healthcare.

Anthony’s Foundational Recovery Paradigm

The foundational bedrock of the QPR is derived from William Anthony’s (1993) landmark conceptualization of recovery in psychiatric rehabilitation. Anthony defined recovery as “a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness.” Anthony posited that mental health recovery represents a multidimensional process analogous to adjusting to a chronic physical disability or profound life catastrophe. Rather than equating recovery with medical cure, Anthony asserted that individuals can thrive psychologically by cultivating new meaning and purpose beyond the boundaries of illness.

The CHIME Conceptual Framework

The contemporary validation and refinement of the QPR are theoretically anchored in the CHIME framework, established via a comprehensive systematic review and narrative synthesis by Leamy, Bird, Le Boutillier, Williams, and Slade (2011). The CHIME framework synthesized hundreds of qualitative and quantitative studies examining consumer experiences of recovery into five core, cross-cutting processes:

• C — Connectedness: Fostering supportive interpersonal relationships, peer support networks, and active inclusion in community life.
• H — Hope and Optimism about the Future: Sustaining belief in the possibility of positive transformation, cultivating motivation, and generating realistic future aspirations.
• I — Identity: Overcoming the dehumanizing, stigmatizing identity of the “chronic mental patient” to construct a multifaceted, positive, and valued self-identity.
• M — Meaning in Life: Engaging in meaningful social, creative, vocational, or spiritual activities, reconstructing personal narrative coherence, and comprehending the significance of past mental health adversity.
• E — Empowerment: Taking personal responsibility, exercising self-direction, regaining control over daily choices, and cultivating psychological self-efficacy.

The QPR directly operationalizes these CHIME domains. Items capturing agency, control, and overcoming obstacles directly mirror Empowerment; statements regarding future goals and optimism reflect Hope; items addressing self-worth and personal growth reflect Identity; statements regarding purpose and understanding adversity map onto Meaning; and the interpersonal items directly reflect Connectedness.

Psychological Empowerment and Self-Determination Theory

The theoretical architecture of the QPR is also heavily influenced by Patrick Corrigan’s (1999) models of psychological empowerment in mental illness, as well as Self-Determination Theory (SDT) developed by Edward Deci and Richard Ryan. SDT posits that human flourishing and intrinsic motivation require the fulfillment of three basic psychological needs: autonomy (experiencing oneself as the author of one’s actions), competence (feeling effective in interacting with the environment), and relatedness (feeling connected and significant to others). The QPR systematically reflects these basic psychological needs, tracking how severe psychological distress initially impairs them, and how recovery entails their active reclamation.

7. Validity

The validity of the Questionnaire about the Process of Recovery has been established through multi-stage psychometric evaluations involving large-scale observational cohorts and registered randomized controlled trials in mental health services.

Construct and Structural Validity

During the initial validation by Neil et al. (2009), exploratory factor analysis supported a 22-item structure divided into intrapersonal and interpersonal domains. However, rigorous psychometric re-evaluation conducted by Williams et al. (2015) using two independent datasets provided critical insights into structural validity:

• Dataset 1: Comprised 88 adult service users diagnosed with psychosis assessed at baseline, two-week follow-up, and three-month follow-up to assess structural replication, test-retest reliability, and preliminary convergent validity.
• Dataset 2: Comprised 399 adult participants recruited from the large-scale REFOCUS cluster randomized controlled trial (Slade et al., 2011) across community-based mental health teams, assessed at baseline and one-year follow-up.

Confirmatory factor analysis demonstrated that the hypothesized 22-item two-factor model exhibited poor fit and significant cross-loadings, with several interpersonal items displaying weak factor determinacy. By removing seven psychometrically unstable items, the researchers established a 15-item unidimensional scale. The 15-item single-factor model exhibited superior model fit indices across independent samples, demonstrating that personal recovery functions psychometrically as a cohesive, dominant intrapersonal construct.

Convergent and Concurrent Validity

The convergent validity of the QPR has been substantiated through robust correlations with theoretically aligned psychological and well-being constructs:

• Mental Well-Being: The 15-item QPR demonstrated a robust, statistically significant positive correlation of r = 0.73 (p < 0.001) with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). This finding verifies that as personal recovery advances, subjective psychological flourishing and affective well-being concurrently improve.
• Staff Support for Recovery: Significant positive correlations were documented between QPR scores and service-user ratings of therapeutic recovery support as measured by the INSPIRE measure (Williams et al., 2015), validating that environments fostering recovery-oriented practice actively elevate QPR scores.
• Self-Efficacy and Hope: Additional validation studies (e.g., Law et al., 2014) reported moderate-to-strong positive associations between the QPR and established measures of generalized hope (Herth Hope Index) and self-esteem (Rosenberg Self-Esteem Scale), confirming concurrent alignment with core psychological recovery dimensions.

Discriminant Validity

Discriminant validity has been demonstrated by examining the relationship between the QPR and traditional psychiatric symptom indices. In multiple studies (Neil et al., 2009; Williams et al., 2015), QPR total scores demonstrated only weak-to-moderate inverse correlations with clinician-rated psychiatric symptom measures such as the PANSS total score (typically ranging between r = -0.20 and r = -0.35). This modest correlation confirms that the QPR does not simply measure the absence of psychotic symptoms; rather, it assesses a distinct psychological construct of personal recovery that varies independently of acute psychopathology.

Sensitivity to Change (Responsiveness)

A vital metric for any clinical trial outcome tool is longitudinal responsiveness. Williams et al. (2015) evaluated the sensitivity to change of the 15-item QPR over a one-year interval in Dataset 2. The scale yielded a standardized sensitivity to change coefficient of 0.40. This indicates a moderate and clinically meaningful capacity to capture therapeutic progression over time, confirming that the QPR is sensitive to dynamic rehabilitative shifts rather than measuring a static personality trait.

8. Reliability

The reliability of the Questionnaire about the Process of Recovery has been rigorously tested across parameters of internal consistency, temporal stability, and measurement precision.

Internal Consistency

Internal consistency evaluates the extent to which the items within a psychometric instrument consistently evaluate the same latent construct. In the comprehensive re-evaluation by Williams et al. (2015), the refined 15-item QPR demonstrated high internal consistency, yielding a Cronbach’s alpha of 0.89. This reflects excellent scale coherence without falling into the excessive redundancy range (α > 0.95) that can indicate item duplication. In the original 22-item version (Neil et al., 2009; Law et al., 2014), Cronbach’s alpha coefficients were similarly robust:

• Total 22-Item Scale: α = 0.92 to 0.94
• Intrapersonal Subscale (17 items): α = 0.91 to 0.93
• Interpersonal Subscale (5 items): α = 0.72 to 0.77

The comparatively lower internal consistency of the interpersonal subscale provided empirical support for the structural refinement leading to the 15-item unidimensional scale.

Test-Retest Reliability (Temporal Stability)

Temporal stability was evaluated by administering the instrument to stable clinical outpatients across a two-week testing window (Dataset 1, n = 88). In the absence of targeted therapeutic interventions or acute psychiatric crises, the 15-item QPR yielded an intraclass correlation coefficient / test-retest correlation of r = 0.74 (p < 0.001). This demonstrates solid temporal reliability, confirming that the instrument yields stable, reproducible measurements while retaining sufficient flexibility to reflect authentic longitudinal change.

Measurement Error and Scale Precision

Evaluation of the standard error of measurement (SEM) across cohorts indicates low error margins across the score distribution. Scale items exhibit broad coverage along the latent trait continuum, ensuring acceptable measurement precision across diverse severity levels of psychiatric recovery.

9. Factor Analysis

The factorial structure of the QPR has been the subject of extensive psychometric investigation, shifting from early exploratory models to modern structural equation modeling and confirmatory factor analysis (CFA).

Exploratory Factor Analysis (EFA)

In the foundational work by Neil et al. (2009), an exploratory factor analysis using principal axis factoring with oblimin rotation was conducted on an initial pool of candidate items generated from qualitative service-user focus groups. This initial analysis extracted a two-factor solution accounting for substantial variance, resulting in the 22-item QPR composed of:

• Factor 1 (Intrapersonal Recovery): Comprising 17 items reflecting personal hope, self-management, meaning, and personal agency.
• Factor 2 (Interpersonal Recovery): Comprising 5 items assessing social inclusion, belonging, and perceived support.

Confirmatory Factor Analysis (CFA)

Williams et al. (2015) subjected the QPR to rigorous CFA using Mplus software on a large clinical sample of 399 service users experiencing psychosis (Dataset 2). Structural equation modeling was utilized to compare competing latent representations:

1. The original 22-item two-factor correlated model.
2. A 22-item unidimensional single-factor model.
3. A streamlined 15-item unidimensional single-factor model.

The confirmatory factor analyses revealed that the original 22-item two-factor model did not achieve acceptable goodness-of-fit benchmarks. Inspection of modification indices and factor loadings revealed that the Interpersonal subscale underperformed; items 3, 5, 16, 20, and 21 exhibited substantial cross-loadings and high residual covariance with other items, while item 14 demonstrated ambiguous loading between constructs. Furthermore, the correlation between the intrapersonal and interpersonal latent factors was exceptionally high (r > 0.85), suggesting that the two dimensions did not possess sufficient discriminant validity to justify distinct subscales.

The 15-Item Unidimensional Model

Through systematic item-reduction procedures based on factor loadings, conceptual clarity, and item-total correlations, a refined 15-item unidimensional model was tested. The CFA results showed that the 15-item single-factor model achieved a good fit to the data across standard goodness-of-fit parameters:

• Comparative Fit Index (CFI): ≥ 0.95, indicating acceptable structural specification.
• Tucker-Lewis Index (TLI): ≥ 0.94, confirming robust fit against the null baseline.
• Root Mean Square Error of Approximation (RMSEA): ≤ 0.06 (90% CI [0.048, 0.071]), confirming minimal residual approximation error.
• Standardized Root Mean Square Residual (SRMR): ≤ 0.05, indicating low variance-covariance residuals.

All standardized factor loadings on the single latent “Personal Recovery” factor in the 15-item version were robust, ranging from 0.58 to 0.81 (p < 0.001). The 15 items of this shortened scale substantially overlap with the original intrapersonal items, demonstrating that intrapersonal recovery represents the primary empirical engine of consumer-reported recovery.

10. Instrument / Measurement Tool

• Test Name: Questionnaire about the Process of Recovery (QPR)
• Alternative Names: QPR-22 (original full-length version), QPR-15 (shortened psychometric version)
• Test Type: Patient-Reported Outcome Measure (PROM); standardized psychological self-report questionnaire
• Target Population: Adult mental health service users (≥ 18 years) diagnosed with severe mental health difficulties, including psychosis, schizophrenia, schizoaffective disorder, and major affective disorders
• Administration Format: Self-administered (paper-and-pencil or secure electronic web-based portal); may be administered as a structured clinician/researcher interview if cognitive or literacy impairments exist
• Completion Time: Approximately 5 to 10 minutes for the 22-item version; 3 to 5 minutes for the 15-item version
• Item Count: 22 items (classical version) or 15 items (refined standard version)
• Response Scale: 15 or 22 items, Likert-type scale scored across 5 response levels:
  • 0 = Strongly Disagree
  • 1 = Disagree
  • 2 = Neither Agree nor Disagree
  • 3 = Agree
  • 4 = Strongly Agree
• Scoring Rules:
  • Total score is calculated via the direct summation of individual item ratings; higher cumulative scores indicate greater progression along the personal recovery continuum.
  • 22-Item Version: Theoretical score range is 0 to 88. Can be computed as an overall recovery score or divided into:
    • Intrapersonal Recovery Subscale: Items 1, 2, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 17, 18, 19, and 22 (Score range: 0 to 68).
    • Interpersonal Recovery Subscale: Items 3, 5, 16, 20, and 21 (Score range: 0 to 20).
  • 15-Item Version: Theoretical score range is 0 to 60, treated strictly as a unidimensional total score (comprising the best-performing intrapersonal items).
  • Missing Data Protocol: If fewer than 10% of items are missing, mean-item substitution based on completed scale items may be applied; protocols with >10% missing items should be excluded from formal psychometric aggregation.

11. Permissions & Fee and Test Year

The Questionnaire about the Process of Recovery was initially developed and published in 2009 by Neil and colleagues, with the definitive psychometric validation and refinement of the 15-item scale published in 2015 by Williams and colleagues in The British Journal of Psychiatry. In accordance with the principles of the recovery movement and collaborative participatory research, the QPR is made available as an open-access, royalty-free measurement tool for non-commercial research, public health services, and academic investigations. No user fees are levied for routine clinical implementation within publicly funded healthcare services (such as the UK National Health Service [NHS]).

Researchers and clinical administrators wishing to reproduce, integrate the QPR into digital electronic health records (EHR), or translate the instrument into languages other than English are advised to contact the corresponding author, Dr. Julie Williams ([email protected]), or the senior co-author, Professor Mike Slade, to obtain administrative permissions, register prospective translations, and ensure adherence to standardized validation methodologies.

12. References

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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. https://doi.org/10.1037/h0095655

Burgess, P., Pirkis, J., Coombs, T., & Rosen, A. (2011). Assessing the value of existing recovery measures for routine use in Australian mental health services. Australian & New Zealand Journal of Psychiatry, 45(4), 267–280. https://doi.org/10.3109/00048674.2010.549996

Corrigan, P. W. (1999). Recovery as a psychological construct. Community Mental Health Journal, 35(3), 231–239. https://doi.org/10.1023/A:1018741302682

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Law, H., Neil, S. T., Dunn, G., & Morrison, A. P. (2014). Psychometric properties of the Questionnaire about the Process of Recovery (QPR). Schizophrenia Research, 156(2–3), 184–189. https://doi.org/10.1016/j.schres.2014.04.011

Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445–452. https://doi.org/10.1192/bjp.bp.110.083733

Neil, S. T., Kilbride, M., Pitt, L., Nothard, S., Welford, M., Sellwood, W., & Morrison, A. P. (2009). The questionnaire about the process of recovery (QPR): A measurement tool developed in collaboration with service users. Psychosis, 1(2), 145–155. https://doi.org/10.1080/17522430902913450

Reininghaus, U., & Priebe, S. (2012). Measuring patient-reported outcomes in psychosis: Conceptual and methodological review. The British Journal of Psychiatry, 201(4), 262–267. https://doi.org/10.1192/bjp.bp.111.107615

Sklar, M., Groessl, E. J., O’Connell, M., Davidson, L., & Aarons, G. A. (2013). Instruments for measuring mental health recovery: A systematic review. Clinical Psychology Review, 33(8), 1082–1095. https://doi.org/10.1016/j.cpr.2013.08.002

Slade, M., Bird, V., Le Boutillier, C., Williams, J., McCrone, P., & Leamy, M. (2011). REFOCUS Trial: Protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams. BMC Psychiatry, 11, Article 185. https://doi.org/10.1186/1471-244X-11-185

Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., Parkinson, J., Secker, J., & Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5, Article 63. https://doi.org/10.1186/1477-7525-5-63

Williams, J., Leamy, M., Bird, V., Le Boutillier, C., Norton, S., Pesola, F., & Slade, M. (2015). Development and evaluation of the INSPIRE measure of staff support for personal recovery. Social Psychiatry and Psychiatric Epidemiology, 50(5), 777–786. https://doi.org/10.1007/s00127-014-0983-0

Williams, J., Leamy, M., Pesola, F., Bird, V., Le Boutillier, C., & Slade, M. (2015). Questionnaire about the Process of Recovery (QPR): Psychometric properties of the 15-item version. The British Journal of Psychiatry, 207(2), 177–178. https://doi.org/10.1192/bjp.bp.114.161695

13. Items of the Scale