title: Effectiveness of the Comprehensive Approach to Rehabilitation (CARe) methodology: design of a cluster randomized controlled trial.
abstract: BACKGROUND
  There is an increasing amount of evidence for the effectiveness of rehabilitation interventions for people with severe mental illness (SMI). In the Netherlands, a rehabilitation methodology that is well known and often applied is the Comprehensive Approach to Rehabilitation (CARe) methodology. The overall goal of the CARe methodology is to improve the client's quality of life by supporting the client in realizing his/her goals and wishes, handling his/her vulnerability and improving the quality of his/her social environment. The methodology is strongly influenced by the concept of 'personal recovery' and the 'strengths case management model'. No controlled effect studies have been conducted hitherto regarding the CARe methodology.
  
  
  METHODS
  This study is a two-armed cluster randomized controlled trial (RCT) that will be executed in teams from three organizations for sheltered and supported housing, which provide services to people with long-term severe mental illness. Teams in the intervention group will receive the multiple-day CARe methodology training from a specialized institute and start working according the CARe Methodology guideline. Teams in the control group will continue working in their usual way. Standardized questionnaires will be completed at baseline (T0), and 10 (T1) and 20 months (T2) post baseline. Primary outcomes are recovery, social functioning and quality of life. The model fidelity of the CARe methodology will be assessed at T1 and T2.
  
  
  CONCLUSIONS
  This study is the first controlled effect study on the CARe methodology and one of the few RCTs on a broad rehabilitation method or strength-based approach. This study is relevant because mental health care organizations have become increasingly interested in recovery and rehabilitation-oriented care.
  
  
  BACKGROUND
  The trial registration number is ISRCTN77355880 .
authors.affiliation: Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE, Tilburg, The Netherlands. n.a.bitter@tilburguniversity.edu.
authors.forename: Neis A
authors.initials: NA
authors.lastname: Bitter
authors.affiliation: Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE, Tilburg, The Netherlands. d.p.k.roeg@tilburguniversity.edu.|GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX, Eindhoven, The Netherlands. d.p.k.roeg@tilburguniversity.edu.
authors.forename: Diana P K
authors.initials: DP
authors.lastname: Roeg
authors.affiliation: Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE, Tilburg, The Netherlands. ch.vannieuwenhuizen@tilburguniversity.edu.|GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX, Eindhoven, The Netherlands. ch.vannieuwenhuizen@tilburguniversity.edu.
authors.forename: Chijs
authors.initials: C
authors.lastname: van Nieuwenhuizen
authors.affiliation: Tilburg University, Department of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, PO Box 90153, 5000 LE, Tilburg, The Netherlands. j.vanweeghel@tilburguniversity.edu.|Phrenos Centre of Expertise, PO Box 1203, 3500 BE, Utrecht, The Netherlands. j.vanweeghel@tilburguniversity.edu.|Parnassia Group, Dijk en Duin Mental Health Centre, PO Box 305, 1900 AH, Castricum, The Netherlands. j.vanweeghel@tilburguniversity.edu.
authors.forename: Jaap
authors.initials: J
authors.lastname: van Weeghel
mesh_terms: D000328:Adult; D019090:Case Management / Q000592:standards; D016000:Cluster Analysis; D003631:Day Care, Medical / Q000592:standards; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*; D009426:Netherlands; D011787:Quality of Health Care; D011788:Quality of Life; D012931:Social Environment; D011795:Surveys and Questionnaires; D016896:Treatment Outcome