Effectiveness of the Comprehenisve Approach to Rehabilitation methodology? A randomized controlled trial

People with severe mental illnesses (SMI) often have a small social network, a
lack of resources and a small amount of social roles. Although they do have the
same goals in life as other citizens, it is more difficult for them to realize
those goals. Rehabilitation methods support people to choose, achieve and
maintain desirable social roles (Michon & Van Weeghel, 2010). A well-known and
often applied rehabilitation method in The Netherlands is the Comprehensive
Approach to Rehabilitation (CARe) methodology (Dutch acronym: SRH). The overall
goal of the CARe methodology is to improve the client*s quality of life (Wilken
& Den Hollander, 1999). This is done by supporting the client in realizing
goals and wishes, handling his vulnerability and improving the quality of the
client*s social environment. Last years, the methodology has been influenced by
new scientific insights and societal movements. Especially the recovery
movement, the strengths model and the presence approach are important
influences (Den Hollander & Wilken, 2011). In this study this updated form of
CARe is called *CARe 2.0*. Until now, no effect studies have been done yet on
the effectiveness of the CARe methodology.

This study aims to investigate the effectiveness of the CARe methodology in
terms of rehabilitation, participation, empowerment, hope and confidence,
fullfilled needs for care and quality of life.
The central research question is: *Does the support of clients by use of the
CARe methodology lead to more recovery compared with clients who receive care
as usual?*

This study has the design of a Randomized Controlled Trial (RCT). Randomization
will take place on team level. Only teams that work with *CARe 1.0* on a low
level of fidelity will be included. In the teams in the intervention group CARe
2.0 will be implemented by training the team members and implementation
support. The teams in the control group maintain their practice. There are
three moments of measurement: at the start, after the randomization (T=0), 12
months after training (T=1) and 18 months after training (T=2).

Providing of care following the CARe Methodology as described in the book 'Zo
worden clienten burgers' (Den Hollander & Wilken, 2011) and the currently
offered 'SRH (CARe) basiseduction' of the RINO-groep.

Concerning the providing of care by the social workers:
No risks.

Concerning the study:
Three times filling in a questionaire (1-1,5 hour).