Fidelity to the Structural and Clinical Aspects of the Illness Management and Recovery Program in an Institutional Setting: A 6-Year Study

Illness Management and Recovery (IMR) was implemented and assessed for fidelity in 4 state psychiatric hospitals over a 6-year period. Differences in the assessment of the structural and clinical elements of the practice were evaluated. The scores for the structural aspects of the program started and remained “fully implemented” throughout the 6 years of observation. The scores for the clinical elements of the program started in the “not implemented” range and were only “partially implemented” throughout the 6 years. Three recommendations to improve clinical fidelity scores are (a) composing IMR groups of consumers considering homogeneity of current functioning, (b) identifying IMR facilitators who are motivated to provide the intervention to fidelity, and (c) using an audit and feedback approach (Ivers et al., 2014) with the IMR Treatment Integrity Scale (McGuire et al., 2015) to shape high-fidelity practice. The implications of the study’s findings, study limitations, and areas for future research are discussed.