Chapter 2 50 Completers were very positive about IMR. Most of all, they wanted to achieve the following: to obtain knowledge (13 respondents); to increase insight (13 respondents); the contact with fellow patients (peer-contact) (9 respondents); to work on personal goals (8 respondents); and to learn coping skills (also named 8x). All IMR-trainers were positive about IMR; some said that they saw changes in individual clients. They appreciated the content of the training, adding, for example, that it was very structured and “nice and fun to give.” Trainers appreciated the recovery vision of IMR. Some thought that participants learn most by practicing social skills such as assertiveness. They appreciate it if there is a lot of interaction in the group and if role-play and exercises can be done according to the topics of the modules. They thought that peer contact helps and that participants are motivated to meet each other. Some trainers observed that participants adopted coping mechanisms from each other. Most trainers said that, as safety in the group is an important condition for people to open up, they preferred to have a “closed group,” i.e., no rolling admissions. Effectiveness Completers showed a significant improvement on the IMR Scale clinician version (N=36); and also on the RMQ (N=31). Completers did not show a significant improvement on the IMR Scale client version (N=33), see Table 3. TABLE 3 Effectiveness of IMR completers (one group pre- and post-measurement; paired sample t-test) N M (SD) pre M (SD) post t Df p d 95% CI IMR-scale client version 33 3.47 (0.39) 3.66 (0.50) 1.93 32 .06 0.41 (-0.08, 0.90) IMR-scale clinician version 36 3.21 (0.44) 3.59 (0.48) 4.73 35 <.001 0.84 (0.36, 1.32) RMQ 31 12.23 (5.61) 14.94 (4.84) 3.19 30 .003 0.52 (0.01, 1.02) B. Secondary feasibility outcomes Fidelity The mean (SD) total fidelity score of the six groups was 4.0 (.20), which meets the stated objective of ≥ 4.0. The median (IQR) was 3.9 (.35). Three groups had overall good fidelity, with total scores on the IMR Fidelity Scale (49) of 4.0, 4.2 and 4.2. But three groups had moderate fidelity, all with total scores of 3.8. Eight items with scores ranging from 4.2 to 5.0 reflected good implementation: “Number of People in a Session or Group,” “Program Length,” “Comprehensiveness of the Curriculum,” “Provision of Educational Handouts,” “IMR Goal Setting,” “Motivation-Based Strategies,” “Educational Techniques” and “Cognitive-Behavioral Techniques”. Four aspects were implemented poorly in all groups:
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