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Effectiveness of recovery colleges: a nonrandomised clinical trial across two years using propensity score matching
van Wezel, Marloes MC Smits, Robin LA Muusse, Christien Wijnen, Ben FM van de Mheen, Dike Slade, Mike Henderson, Claire Kroon, Hans
van Wezel, Marloes MC
Smits, Robin LA
Muusse, Christien
Wijnen, Ben FM
van de Mheen, Dike
Slade, Mike
Henderson, Claire
Kroon, Hans
Abstract
BackgroundRecovery colleges (RCs) facilitate peer-supported communities where people with lived experience of mental disruption learn collaboratively, aiming to foster empowerment and personal recovery. While existing (qualitative) research relates RC attendance to positive outcomes, high-quality multi-college quantitative studies evaluating RC effectiveness are scarce.AimsWe examine the extent to which RC attendance impacts empowerment (primary outcome) and other recovery-related outcomes.MethodIn this nonrandomised clinical trial (May 2022 to January 2025), RC partakers from four Dutch RCs were compared with controls over 2 years, in annual data collections. Linear mixed model analyses were conducted to investigate interactions between group and time. Exploratory analyses investigated distinguishing characteristics of RC partakers. This study was embedded in a larger project and was pre-registered (clinicaltrials.gov: #NCT05620212). Academic and experiential researchers collaborated in the design, recruitment, and analysis.ResultsThe sample comprised 91 RC partakers and 182 matched controls. RC partakers faced severe or persistent mental health challenges and attended RCs in multiple capacities (e.g., student and visitor/volunteer). Outcomes were mostly stable over time and did not differ between groups. Hence, no group-specific changes over time were found, as shown by interaction terms that were not statistically significant (e.g., empowerment: 0.02, -0.08-0.13, -0.001, -0.11-0.11).ConclusionsDespite promising qualitative evidence of RC effectiveness, our study found no differences between RC partakers and matched controls in quantitative recovery-related outcomes over time. Factors of influence may be possible pre-study effects, unmeasured confounding, or limitations in how standardised questionnaires capture recovery experiences. Methodologically, the findings raise questions about the operationalisation of effectiveness in the context of personal recovery and flexible, co-created practices such as RCs. Importantly, while this study could not establish effectiveness, this does not automatically imply that RC attendance cannot contribute to recovery.
Study evaluating if recovery colleges have effects on recovery by comparing survey scores of people who do vs. do not attend them across two yearsPlain Language Summary At recovery colleges, people who experience mental disruption can work on recovery. Partakers share experiences and learn from each other in self-help workshops , social meeting places, and/or as (voluntary) employee. Recovery colleges aim to support recovery. However, high-quality evaluations are lacking. Therefore this study examines whether attending a recovery college has effects on recovery. 273 individuals experiencing mental disruption participated. We compared 91 people who took part in a recovery college (recovery college partakers) with 182 people who did not. For a fair comparison, we matched each recovery college partaker with two participants who did not attend, but were similar on key characteristics, such as age or diagnoses. Participants (both recovery college partakers and people who did not take part in a recovery college) completed surveys about their mental health and recovery at the study start, and one and two years later. All participants reported similar empowerment, quality of life, mental health, loneliness, and self-stigma. Scores were similar across groups and also stable over time. Based on personal stories, other studies describe benefits of recovery college attendance such as feeling more confident and socially supported. Our survey study did not find effects, which could mean that there is no measurable effect of recovery college attendance. It could also be that effects have already occurred before the study: recovery college partakers already attended the recovery college before the study started. Some suggest that surveys where people score their experiences on a scale do not fully capture what people go through. Importantly, while the study did not find measurable effects, this does not rule out that people can benefit from attending a recovery college. We advise collaboration with lived experience researchers.
CONTEXTE:: Les collèges de rétablissement (CR) favorisent la création de communautés soutenues par les pairs, au sein desquelles des personnes ayant vécu des troubles mentaux apprennent de manière collaborative, dans le but de favoriser l’autonomisation et le rétablissement personnel. Bien que les recherches (qualitatives) existantes établissent un lien entre la fréquentation des CR et les résultats positifs, les études quantitatives multicollégiales de grande qualité évaluant l’efficacité des CR sont rares.
OBJECTIFS:: Nous examinons dans quelle mesure la fréquentation des CR influe sur l’autonomisation (résultat principal) et d’autres résultats liés au rétablissement.
MÉTHODE:: Au cours de cet essai clinique sans répartition aléatoire (de mai 2022 à janvier 2025), les participants aux CR issus de quatre CR néerlandais ont été comparés à un groupe témoin sur une période de deux ans, dans le cadre de collectes de données annuelles. Des analyses en modèle linéaire mixte ont été effectuées pour étudier l’interaction entre le groupe et le temps. Des analyses exploratoires ont examiné les caractéristiques distinctives des participants aux CR. Cette étude s’inscrivait dans un projet plus vaste et a fait l’objet d’un enregistrement préalable (clinicaltrials.gov : #NCT05620212). Les chercheurs universitaires et issus de la pratique ont collaboré à la conception, au recrutement et à l’analyse.
RÉSULTATS:: L’échantillon comprenait 91 participants aux CR et 182 témoins appariés. Les participants aux CR étaient confrontés à des problèmes de santé mentale graves ou persistants et fréquentaient les CR à divers titres (par exemple, en tant qu’étudiants et visiteurs/bénévoles). Les résultats sont restés globalement stables au fil du temps et ne différaient pas entre les groupes. Par conséquent, aucun changement propre à un groupe n’a été observé au fil du temps, comme le montrent les termes d’interaction qui n’étaient pas statistiquement significatifs (p. ex., l’autonomisation : =0,02, =-0,08 – 0,13, =-0,001, =-0,11 – 0,11).
CONCLUSIONS:: Malgré des preuves qualitatives prometteuses de l’efficacité des CR, notre étude n’a révélé aucune différence entre les participants aux CR et les témoins appariés en ce qui concerne les résultats quantitatifs liés au rétablissement au fil du temps. Les facteurs d’influence peuvent être des effets possibles avant l’étude, des facteurs de confusion non mesurés ou des limites dans la manière dont les questionnaires standardisés rendent compte des expériences de rétablissement. Sur le plan méthodologique, ces résultats soulèvent des questions sur l’opérationnalisation de l’efficacité dans le contexte du rétablissement personnel et des pratiques flexibles et co-créées comme les CR. Il est important de noter que, bien que cette étude n’ait pas pu établir d’efficacité , cela n’implique pas automatiquement que la participation aux CR ne puisse pas contribuer de manière au rétablissement.
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2026-05-14
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van Wezel MMC, Smits RLA, Muusse C, Wijnen BFM, van de Mheen D, Slade M, Henderson C, Kroon H. Effectiveness of Recovery Colleges: A Nonrandomised Clinical Trial Across Two Years Using Propensity Score Matching: Efficacité des collèges de rétablissement: essai clinique non randomisé sur deux ans utilisant l'appariement par score de propension. Can J Psychiatry. 2026 May 14:7067437261449914. doi: 10.1177/07067437261449914. Epub ahead of print.