title: Are we there yet? The four-year impact of a VA fellowship program on the recovery orientation of rehabilitation programs.
abstract: OBJECTIVE
  This study represents the first program evaluation of the impact of a Psychosocial Rehabilitation (PSR) fellowship program within the Veterans Health Administration (VHA). Specifically, it examines the recovery orientation of five mental health rehabilitation programs at the Edith Nourse Rogers Memorial VA Medical Center (ENRM VAMC) in Bedford, MA by comparing program stakeholder rating of the "recovery orientation" between the initial data and the four-year follow-up during which the PSR fellowship was in operation. The goal of this fellowship program is to increase the VHA's fidelity to recovery-oriented best practice recommendations.
  
  
  METHODS
  Participants were mental health consumers and staff members within five key psychiatric rehabilitation programs at the ENRM VAMC. Perception of programs' recovery orientation was measured at the start of the fellowship (Time 1) and after the fellowship was in place for four years (Time 2).
  
  
  RESULTS
  Results demonstrate that across the entire sample of stakeholders, perceptions of recovery orientation significantly improved from Time 1 to Time 2. Results also reveal a significant overall increase in program recovery orientation over time in three out of the five rehabilitation programs, with years of fellow involvement in particular programs significantly and positively correlating with increases in ratings of program recovery-orientation gains.
  
  
  CONCLUSIONS
  Implications for using fellowships as agents of program change, and specifically, recovery-oriented change, are discussed.
authors.affiliation: Edith Nourse Rogers Memorial VA Medical Center, Bedford, MA 01730, USA. Jennifer.Kymalainen@va.gov
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Kymalainen
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Henze
authors.forename: Melissa
authors.initials: M
authors.lastname: Deluca
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Mitton
authors.forename: Heather M
authors.initials: HM
authors.lastname: Walton
authors.forename: Patricia
authors.initials: P
authors.lastname: Duffy
authors.forename: Chivi
authors.initials: C
authors.lastname: Kapungu
authors.forename: Trudy
authors.initials: T
authors.lastname: Lefebvre
authors.forename: William H
authors.initials: WH
authors.lastname: Alexander
authors.forename: Jerry
authors.initials: J
authors.lastname: Pinsky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003258:Consumer Behavior; D005257:Fellowships and Scholarships; D005260:Female; D006302:Health Services Research; D006801:Humans; D007318:Inservice Training; D008297:Male; D008404:Massachusetts; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team; D012050:Rehabilitation, Vocational; D012917:Social Adjustment; D019966:Substance-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*