Adaptation and validity evidence of REE (Recovery Enhancing Environment)A system for assessing recovery in the assisstance of people suffering from a severe mental disorder

Abstract

The personal recovery model, defined as the person's ability to build a satisfying life despite possible symptoms of the disease, is a growing perspective in the care of people with severe mental disorder (SMI). Through a review, a lack of unicity in the concept has been observed, as well as a scarce of instruments adapted to our environment. Therefore, this thesis presents the adaptation and psychometric validation of the Spanish REE measure (Recovery Enhancing Environment, Ridgway & Press, 2004). An instrument that allows the evaluation of both, the individual recovery process and how mental health services promote this recovery model. For this purpose, a sample of 312 representative users of the Mental Health Network of Biscay stratified by sex, age and care centre have participated. Analyses have been carried out to prove its internal and concurrent validity, as well as the unidimensionality of the four subscales of the instrument; those offer the possibility of being used independently. Likewise, the factorial structure of the measure has been checked based on most used conceptual model CHIME, in which the bifactorial structure has obtained adequate indexes. After proving that the Spanish REE is an adequate measure for its use, two useful methodologies are presented for clinicians, which would allow them to know easily the evolution of individuals in their process and the possible organizational change. Finally, it has been observed that this perspective of recovery is negatively related to the traditional perspective of clinical recovery, a relationship that is mediated by self-stigma. In conclusion, the REE is an adequate instrument for assessing the recovery model and the adaptation of care resources to it.