Self-Identified Stage of Recovery
The Self-Identified Stage of Recovery (originally named the Stage of Recovery Measure) is a brief, two-part measure of recovery. Part A of the Self-identified Stage of Recovery (SISR-A) consists of five statements (each statement consisting of two sentences) that reflect the five stages of recovery. Respondents select the statement that best reflects their current experience of recovery. For example, a respondent may chose the statement ‘I don’t think people can recover from mental illness. I feel my life is out of control, and there is nothing I can do to help myself’ reflecting the Moratorium stage.
Part B of the SISR (SISR-B) consists of four statements reflecting the four processes of recovery: Hope, Responsibility, Identity and Meaning. Respondents rate each statement on a six-point scale from 1¼‘Strongly disagree’ to 6¼‘Strongly agree’. For instance, the process of Meaning is reflected in the statement ‘The things I do in my life are meaningful and valuable’. A respondent would rate the extent to which he or she agrees or disagrees with this statement.
There is some evidence that the psychometric properties of the SISR are sound. Chiba, Kawakami, Miyamoto, and Andresen (2010) have developed a Japanese version of the SISR. They evaluated the psychometric properties of this version of the SISR using a sample of 223 participants with long-term mental illness drawn from both community and inpatient settings. Chiba et al. (2010) reported acceptable levels of internal consistency (Cronbach alpha coefficient greater than 0.70) for the total score of the SISR-B in both the community and inpatient samples. Further, Chiba et al. (2010) also tested the temporal stability for the SISR-A and the SISR-B, and found some evidence that these measures were stable over time. The reported statistics were modest, but acceptable, prompting the need for further research around the stability of the measure over time.
Chiba et al. (2010) also examined the concurrent validity of the SISR-A and SISR-B. Total scores for the SISR-A and SISR-B were significantly correlated with the RAS, the Japanese version of the Herth Hope Index (Hirano et al., 2007; as cited in Chiba et al., 2010), the Japanese versions of theEmpowermentScale(YamadaandSuzuki, 2007; as cited in Chiba et al., 2010) and the Resilience Scale (Oshio et al, 2002; as cited in Chiba et al., 2010). These findings provide support for the validity of the SISR-A and SISR-B. We compared the relationship between the SISR and two other measures of recovery, the Recovery Assessment Scale (RAS: Corrigan et al., 1999b) and the Mental Health Recovery Measure (MHRM; Young and Ensing, 1999; Ralph, Kidder and Phillips, 2000) in a sample of adults with a diagnosis of a psychiatric disorder and high support needs (Andresen, Caputi and Oades, 2010). We found high correlations between the SISR-B and the MHRM and RAS, and lower correlations between the SISR-A and the other recovery measures. We then compared the SISRA and the individual SISR-B items of Hope, Identity, Meaning and Responsibility to the subscales of the RAS and MHRM, and found low to moderate correlations. The findings not only provided further support for the validity of these measures, but they highlighted that the SISR-A, being a stage measure, is assessing unique aspects of recovery not assessed by contunuous recovery measures.
We also looked at whether the RAS and MHRM scores differed across stages assessed by the SISR-A (Andresen, Caputi and Oades, 2010). One would anticipate lower scores on the RAS and MHRM in the Moratorium stage than at later stages, and highest scores in the Growth stage. Standardized total scores for the RAS and MHRM differed significantly across stages, and as anticipated, scores increased steadily across the stages of recovery. Significant differences were also observed in some of the subscales of the RAS (Personal confidence and hope, Goal success orientation and Not dominated by symptoms) and all subscales of the MHRM except Overcoming stuckness. These findings provide useful insight into what might be important in recovery, and demonstrate the theoretical utility of the SISR. For example, we found that scores on Reliance on others and Willingness to ask for help (subscales of the RAS) were higher at Moratorium than at Awareness. Given the conceptual association between these two subscales, this result suggests that, while asking for help is important in recovery, it may not be sufficient for higher levels of recovery (Andresen, Caputi and Oades, 2010, p. 315).
Notably, we also found evidence that recovery measures such as the RAS,MHRM and SISR assess aspects of recovery that are not detected by traditional clinical measures (Andresen, Caputi and Oades, 2010). We examined the relationship between four clinical measures, the Health of the Nation Outcome Scales (Wing et al., 1998), the Life Skills Profile-16 (Rosen, Hadzi-Pavlovic and Parker, 1989), the Global Assessment of Functioning (American Psychiatric Association, 1994) and the Kessler-10 (Andrews and Slade, 2001), and the RAS, MHRM, SISR-A and SISR-B. There was little relationship between recovery and clinical measures. Only the Kessler-10 was found to be correlated with the recovery measures. These findings support the position held by consumers that traditional approaches to outcome measurement overlook things that are important to them in their recovery process.
The Self-Identified Stage of Recovery (originally named the Stage of Recovery Measure) is a brief, two-part measure of recovery. Part A of the Self-identified Stage of Recovery (SISR-A) consists of five statements (each statement consisting of two sentences) that reflect the five stages of recovery. Respondents select the statement that best reflects their current experience of recovery. For example, a respondent may chose the statement ‘I don’t think people can recover from mental illness. I feel my life is out of control, and there is nothing I can do to help myself’ reflecting the Moratorium stage.
Part B of the SISR (SISR-B) consists of four statements reflecting the four processes of recovery: Hope, Responsibility, Identity and Meaning. Respondents rate each statement on a six-point scale from 1¼‘Strongly disagree’ to 6¼‘Strongly agree’. For instance, the process of Meaning is reflected in the statement ‘The things I do in my life are meaningful and valuable’. A respondent would rate the extent to which he or she agrees or disagrees with this statement.
There is some evidence that the psychometric properties of the SISR are sound. Chiba, Kawakami, Miyamoto, and Andresen (2010) have developed a Japanese version of the SISR. They evaluated the psychometric properties of this version of the SISR using a sample of 223 participants with long-term mental illness drawn from both community and inpatient settings. Chiba et al. (2010) reported acceptable levels of internal consistency (Cronbach alpha coefficient greater than 0.70) for the total score of the SISR-B in both the community and inpatient samples. Further, Chiba et al. (2010) also tested the temporal stability for the SISR-A and the SISR-B, and found some evidence that these measures were stable over time. The reported statistics were modest, but acceptable, prompting the need for further research around the stability of the measure over time.
Chiba et al. (2010) also examined the concurrent validity of the SISR-A and SISR-B. Total scores for the SISR-A and SISR-B were significantly correlated with the RAS, the Japanese version of the Herth Hope Index (Hirano et al., 2007; as cited in Chiba et al., 2010), the Japanese versions of theEmpowermentScale(YamadaandSuzuki, 2007; as cited in Chiba et al., 2010) and the Resilience Scale (Oshio et al, 2002; as cited in Chiba et al., 2010). These findings provide support for the validity of the SISR-A and SISR-B. We compared the relationship between the SISR and two other measures of recovery, the Recovery Assessment Scale (RAS: Corrigan et al., 1999b) and the Mental Health Recovery Measure (MHRM; Young and Ensing, 1999; Ralph, Kidder and Phillips, 2000) in a sample of adults with a diagnosis of a psychiatric disorder and high support needs (Andresen, Caputi and Oades, 2010). We found high correlations between the SISR-B and the MHRM and RAS, and lower correlations between the SISR-A and the other recovery measures. We then compared the SISRA and the individual SISR-B items of Hope, Identity, Meaning and Responsibility to the subscales of the RAS and MHRM, and found low to moderate correlations. The findings not only provided further support for the validity of these measures, but they highlighted that the SISR-A, being a stage measure, is assessing unique aspects of recovery not assessed by contunuous recovery measures.
We also looked at whether the RAS and MHRM scores differed across stages assessed by the SISR-A (Andresen, Caputi and Oades, 2010). One would anticipate lower scores on the RAS and MHRM in the Moratorium stage than at later stages, and highest scores in the Growth stage. Standardized total scores for the RAS and MHRM differed significantly across stages, and as anticipated, scores increased steadily across the stages of recovery. Significant differences were also observed in some of the subscales of the RAS (Personal confidence and hope, Goal success orientation and Not dominated by symptoms) and all subscales of the MHRM except Overcoming stuckness. These findings provide useful insight into what might be important in recovery, and demonstrate the theoretical utility of the SISR. For example, we found that scores on Reliance on others and Willingness to ask for help (subscales of the RAS) were higher at Moratorium than at Awareness. Given the conceptual association between these two subscales, this result suggests that, while asking for help is important in recovery, it may not be sufficient for higher levels of recovery (Andresen, Caputi and Oades, 2010, p. 315).
Notably, we also found evidence that recovery measures such as the RAS,MHRM and SISR assess aspects of recovery that are not detected by traditional clinical measures (Andresen, Caputi and Oades, 2010). We examined the relationship between four clinical measures, the Health of the Nation Outcome Scales (Wing et al., 1998), the Life Skills Profile-16 (Rosen, Hadzi-Pavlovic and Parker, 1989), the Global Assessment of Functioning (American Psychiatric Association, 1994) and the Kessler-10 (Andrews and Slade, 2001), and the RAS, MHRM, SISR-A and SISR-B. There was little relationship between recovery and clinical measures. Only the Kessler-10 was found to be correlated with the recovery measures. These findings support the position held by consumers that traditional approaches to outcome measurement overlook things that are important to them in their recovery process.
