The New Freedom Commission (2003), World Health Organization Report (2001), and Surgeon General (1999), highlight the need for evidence-based practice (EBP) in mental health. Concurrently, recovery orientations have received increased emphasis, guiding the policies and practices in many state mental health systems. Some researchers argue that existing EBP research is deficient within a recovery philosophy and mission while others acknowledge EBP as supporting recovery. To address this argument Family Psychoeducation (FPE) and Interpersonal Psychotherapy (IPT) are considered. Both EBP's have been identified by the New Freedom Commission (2003) as effective, state of the art treatments for serious mental illnesses (SMI). This study addresses two questions: are FPE and IPT supportive of 1) user identified recovery facilitating factors, and 2) user identified recovery hindering factors?

Method:

Through a national research project to develop performance indicators for recovery for SMI, both recovery facilitating and recovery hindering factors have been identified and grouped under an ecologically based paradigm for mental health recovery (Onken et al, 2004). Using this framework, this paper presents the fundamental mechanisms of Family Psychoeducation and Interpersonal Psychotherapy and compares these to client identified factors that hinder or facilitate recovery. For each factor the core mechanisms, goals, and techniques of FPE and IPT were assessed to determine whether they support the facilitating or hindering factor. Because some factors contained multiple components, mechanisms supporting at least one factor component were judged ‘supporting'. This process was applied independently to facilitating and hindering factors.

Results:

Results by factor groups, both recovery facilitating and hindering, are reported and compared for IPT and FPE. For user identified recovery facilitating factors, IPT is judged to support 64 of 89 factors (72%), and 3 of 86 recovery hindering factors (3%). FPE is judged to support of 71 of 89 user identified recovery facilitating factors (80%) and no recovery hindering factors (0%). For both interventions, certain identified recovery facilitating factors appear to require broader system level interventions related to basic human needs such as housing, transportation, income assistance, and telephone accessibility.

Implications for Practice and Policy:

Current mental health policy calls for both EBP and a recovery orientation. While using practices supported by research evidence may be the best choice for many clients, these practices may not be sufficient to fully support a recovery orientation. The findings in this exploratory study strongly support the recovery oriented features of both IPT and FPE.

However, as many recovery facilitating factors can not be addressed by mental health treatment, case management, advocacy and support of client self-advocacy may be important practice considerations.

Future policy should support EBP's that are congruent both with recovery facilitating and incorporate recovery supporting mental health systems. Our findings indicate that IPT & FPE alone may not fully support a recovery orientation because some facilitating factors call for changes at broader system levels.