Effects of IMR: a randomized controlled trial 121 For all outcome measures, Table 3 shows the estimated marginal means (95% CI) from the LMM analyses. The results, including reported effect sizes (Cohen’s d), concern the differences between the experimental and control condition (IMR vs. CAU) at different time points. Post-treatment, all measures showed improvement in favor of IMR except for the IS and the ASI (Table 3). At follow-up, this improvement continued not only within the client version of the IMR scale, but also within the MHRM and SERS-SF personal recovery scales; those two scales demonstrated small and moderate effect-sizes, respectively. Both the experimental and control group showed statistically significant improvement over time with respect to overall illness management, as measured using the clinician version of the IMR scale, as well as with respect to social support, clinical and functional recovery, and reduced self-stigma (Table 2). After adjusting for hospitalization a year prior to T1, the treatment condition was not found to be a statistically significant predictor for hospitalization within the year following T2 (odds ratio (OR) = 1.22, 95% CI = 0.44, 3.42, p = 0.71). Regarding total days of hospitalization one year before and after treatment, there were no statistically significant between-group differences as measured by difference scores (IMR group, M = −7.72, SD = 51.19 vs. the control group, M = −4.46, SD = 44.23; U =3,928.50, p = 0.50). Impact of Fidelity Fidelity assessments via the IMR fidelity scale were conducted in 15 IMR groups, which enrolled 68 study participants who had attended ≥ 10 IMR sessions. This yielded a mean fidelity score of 3.94 (SD = 0.29). Eight groups (n = 39, 57%) had scores of _4 (range 4.00–4.54), which indicated high (54) or good (31) fidelity. Seven groups (n = 29, 43%) had scores <4 and >3 (range 3.46–3.92), which indicated moderate (54) or fair (31) fidelity. Lower fidelity scores were partly because roleplaying, a key element of cognitive-behavioral techniques and coping skills training, was practiced at a low rate within the evaluated interventions. Assessment of the impact of fidelity on the results of the client version of the IMR scale as well as SERS-SF scores revealed no effects on overall IMR scale scores (F (4, 271) = 1.42, p = 0.23); however, we did observe a statistically significant overall interaction effect for group and time with respect to self-esteem (F (4, 237) = 3.11, p = 0.02). Examination of the fixed coefficients for the client version of the IMR scale revealed that there were no statistically significant differences in improvement between the
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