What recovery-enabling services for psychosis should do: a multi-informant focus group study

Background Recovery-oriented care is widely promoted but remains difficult to realize in routine psychosis services, particularly in hospital-centered systems. The authors aimed to identify broadly supported service actions to embed recovery principles in daily practice in Flanders, Belgium.Methods Twelve focus groups were conducted in two waves with purposively sampled stakeholders: service users (n = 19), relatives (n = 20), bachelor-level staff (n = 20), and MSc/MD-level professionals (n = 18). Data were analyzed using reflexive thematic analysis by a four-researcher team.Results Analysis yielded 13 action points, emphasizing: (1) warm welcome and caring style; (2) dialogical practice; (3) small-scale, everyday living together; (4) centering the person’s trajectory and meaning of experiences; (5) continuity of relationships; (6) patience and pace-matching; (7) involving the social context while safeguarding confidentiality; (8) structural inclusion of peer experts; (9) co-creation and shared decision-making; (10) de-escalation and dialogical crisis work; (11) professional containment of anxiety through supervision and reflective team cultures; (12) shared responsibility rather than rigid procedure enforcement; and (13) community connection and warm handovers. Subgroups differed in emphasis, yet expressed broadly overlapping views.Discussion The actions form a practicable framework for recovery-supporting psychosis care and can inform training, service standards, quality improvement, and policy.