Recovery Self-Assessment (RSA)

Abstract

The Recovery Self-Assessment (RSA) is a comprehensive, multi-perspective instrument designed to evaluate the degree to which mental health and addiction service agencies adhere to recovery-oriented principles. Developed by O’Connell and colleagues, the RSA and its revised version (RSA-R) provide critical feedback from various stakeholders, including Persons in Recovery (PIR), Family/Significant Others, Service Providers, and Administrators/Managers. The scale measures key dimensions of recovery practice, focusing on client choice, individualized services, community integration, and the proactive development of life goals beyond mere symptom management. The RSA is utilized by agencies undergoing system transformation to identify areas of practice strength and those requiring enhancement to align fully with consumer-driven models of care.

Keywords

Recovery, Mental illness, Addiction services, Recovery-oriented practice, Psychiatric rehabilitation, Consumer choice, Service evaluation, Recovery Self-Assessment, Organizational assessment.

Authors

M. O’Connell, J. Tondora, G. Croog, A. Evans, L. Davidson, S. Kidd, K. Stayner, J. Hawkins.

Purpose

The primary purpose of the Recovery Self-Assessment (RSA) is to quantify perceptions of the implementation fidelity of recovery-oriented practices within behavioral health organizations. By gathering data from multiple perspectives—the person receiving services, their family, the staff delivering services, and agency leadership—the instrument provides a holistic view of the organizational culture and operational practices.

The scale is a tool for organizational quality improvement, helping agencies move from rhetorical commitment to active, routine implementation of recovery principles. It identifies specific areas where services may fall short of supporting self-determination, community integration, and the achievement of personal life goals for individuals dealing with mental illness and addiction challenges.

Construct

The RSA measures the organizational and programmatic support for the philosophical tenets of recovery. The core construct assessed is the degree of alignment between agency operations and recovery-oriented care, which emphasizes client empowerment, individualized treatment planning, and hope. This construct is operationalized across several factors, including the provision of diverse treatment options, fostering client involvement in agency governance, supporting meaningful life goals (e.g., employment and education), and respecting client choice and cultural background.

Validity

The development of the RSA through multiple iterations and versions tailored for specific stakeholders (PIR, Provider, Family/Significant Other) suggests strong content and face validity, ensuring that the items are relevant to the experiences of each group. Further psychometric validation has been performed, notably on the brief version (RSA-B), utilizing advanced techniques like Rasch Measurement Theory to confirm the scale’s structural integrity and responsiveness to change.

Reliability

Internal consistency reliability has been reported for the subscales of the original RSA instrument. These reliability coefficients (Cronbach’s Alpha) indicate generally high to acceptable consistency across most of the measured domains, supporting the scale’s use in research and clinical settings.

The reported internal consistency values for the original RSA subscales are:

• Life Goals: alpha 0.90
• Involvement: alpha 0.87
• Diversity of Treatment Options: alpha 0.83
• Choice: alpha 0.76
• Individually-Tailored Services: alpha 0.076 (Note: This low value suggests potential structural issues in this specific factor of the 2003 version, which may have been addressed in the revised RSA-R.)

Factor Analysis

Factor analysis of the RSA consistently reveals five underlying dimensions crucial to assessing recovery-oriented practices. These factors organize the assessment items into conceptually distinct yet related areas of service delivery.

The five primary factors identified across the various RSA and RSA-R versions are: Life Goals (focusing on employment, education, and personal aspirations); Involvement (measuring client participation in agency planning, evaluation, and staff training); Diversity of Treatment Options (assessing the range of individualized, non-coercive treatment options available); Choice (evaluating client autonomy in selecting providers and services); and Individually-Tailored Services (measuring the extent to which services are customized to unique cultural, life, and community needs).

Instrument

Test Type: Multi-rater psychological scale assessing organizational fidelity to recovery principles.

Format: Multiple versions (32-40 items) utilizing a 5-point Likert scale (e.g., 1=Strongly Disagree to 5=Strongly Agree), often including options for ‘N/A’, ‘Doesn’t Apply’, or ‘Don’t Know’.

Language Available: English (Original documentation).

Population Group: Stakeholders within mental health and addiction services, including clients (Persons in Recovery), family members/advocates, service providers, and administrative staff.

Age Group: Adults receiving mental health or addiction services, and adult stakeholders involved in their care or the administration of services.

Population Details: Individuals diagnosed with mental illness and/or substance use disorders, and those supporting them.

Test Methodology: Self-administered organizational assessment tool designed to track system transformation and measure the congruence between service experiences/delivery and recovery-oriented principles.

Keywords

Empowerment, Self-determination, Likert scale, Consumer advocacy, Outcome measures, System fidelity, Treatment choice, Community integration, Cultural competency.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: [email protected]

Correspondence Address: Yale Program for Recovery and Community Health (PRCH) (Implied affiliation).

Permissions & Fee and Test Year

The original Recovery Self-Assessment (RSA) was initially developed in 2003, with revised versions (RSA-R) published in 2007, and a brief version validated in 2015. The instrument is often made available through academic research centers, specifically the Yale Program for Recovery and Community Health. Permissions for use should be sought directly from the primary authors or the affiliated institution. The instrument is typically utilized as an open-access tool for organizational evaluation and recovery transformation initiatives.

References

• Barbic, S. P., Kidd, S. A., Davidson, L., McKenzie, K., & O’Connell, M. J. (2015). Validation of the Brief Version of the Recovery Self-Assessment (RSA-B) Using Rasch Measurement Theory. Psychiatric Rehabilitation Journal. Jun 15.
• Connecticut Department of Mental Health and Addiction Services (undated). Recovery self-assessment. Executive Summary. New Haven, CT.
• Davidson, L., O’Connell, M., Sells, D., & Staeheli, M. (2003). Is there an outside to mental illness? In L. Davidson, Living outside mental illness. Qualitative studies of recovery in schizophrenia. (pp. 31-60). New York: New York University Press.
• O’Connell, M., Tondora, J., Croog, G., Evans, A., & Davidson, L. (2005). From rhetoric to routine: Assessing perceptions of recovery-oriented practices in a state mental health and addiction system. Psychiatric Rehabilitation Journal, 28(4), 378–386.

The instrument can be found at: http://hsrc.ucsd.edu/public/RSA_Report_May08_8-26-08.pdf (PDF Report) & http://medicine.yale.edu/psychiatry/prch/tools/rec_selfassessment.aspx & http://www.williamwhitepapers.com/pr/Philadelphia’s%20Person%20In%20Recovery%20Survey.pdf.

Additional factor information (PDF) is available here: http://medicine.yale.edu/psychiatry/prch/tools/RSA_Factors_File2_tcm800-204214_tcm800-284-32.pdf.

Items of the Recovery Self-Assessment (RSA)

Recovery Assessment: Person in Recovery Version (2003)

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable

1. Staff focus on helping me to build connections in my neighborhood and community.
2. This agency offers specific services and programs to address my unique culture‚ life experiences‚ interests‚ and needs.
3. I have access to all my treatment records.
4. This agency provides education to community employers about employing people with mental illness and/or addictions.
5. My service provider makes every effort to involve my significant others (spouses‚ friends‚ family members) and other sources of natural support (i.e.‚ clergy‚ neighbors‚ landlords) in the planning of my services‚ if this is my preference.
6. I can choose and change‚ if desired‚ the therapist‚ psychiatrist‚ or other service provider with whom I work.
7. Most of my services are provided in my natural environment (i.e.‚ home‚ community‚ workplace).
8. I am given the opportunity to discuss my sexual and spiritual needs and interests.
9. Staff of this agency regularly attend trainings on cultural competency.
10. Staff at this agency listen to and follow my choices and preferences.
11. Staff at this agency help to monitor the progress I am making towards my personal goals on a regular basis.
12. This agency provides structured educational activities to the community about mental illness and addictions.
13. Agency staff do not use threats‚ bribes‚ or other forms of coercion to influence my behavior or choices.
14. Staff at this agency encourage me to take risks and try new things.
15. I am/can be involved with facilitating staff trainings and education programs at this agency.
16. Staff are knowledgeable about special interest groups and activities in the community.
17. Groups‚ meetings‚ and other activities can be scheduled in the evenings or on weekends so as not to conflict with other recovery-oriented activities such as employment or school.
18. This agency actively attempts to link me with other persons in recovery who can serve as role models or mentors by making referrals to self-help‚ peer support‚ or consumer advocacy groups or programs.
19. I am able to chose from a variety of treatment options at this agency (i.e.‚ individual‚ group‚ peer support‚ holistic healing‚ alternative treatments‚ medical).
20. The achievement of my goals is formally acknowledged and celebrated by the agency.
21. I am/can be routinely involved in the evaluation of the agency’s programs‚ services‚ and service providers.
22. Staff use a language of recovery (i.e. hope‚ high expectations‚ respect) in everyday conversations.
23. Staff play a primary role in helping me to become involved in non-mental health/addiction related activities‚ such as church groups‚ special interest groups‚ and adult education.
24. If the agency cannot meet my needs‚ procedures are in place to refer me to other programs and services.
25. Staff actively assist me with the development of career and life goals that go beyond symptom management and stabilization.
26. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.
27. I am/can be a regular member of agency advisory boards and management meetings.
28. At this agency‚ participants who are doing well get as much attention as those who are having difficulties.
29. Staff routinely assist me in the pursuit of my educational and/or employment goals.
30. I am/can be involved with agency staff on the development and provision of new programs and services.
31. Agency staff actively help me become involved with activities that give back to my community (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
32. This agency provides formal opportunities for me‚ my family‚ service providers‚ and administrators to learn about recovery.
33. The role of agency staff is to assist me‚ and other people in recovery with fulfilling my individually-defined goals and aspirations.
34. Criteria for exiting or completing the agency were clearly defined and discussed with me upon entry to the agency.
35. The development of my leisure interests and hobbies is a primary focus of my services.
36. Agency staff believe that I can recover and make my own treatment and life choices.

Recovery Self-Assessment: Person in Recovery Version (2005)

1= Strongly Disagree‚ 2=Disagree‚ 3=Agree‚ 4= Strongly agree‚ 5= Doesn’t apply

1. I receive most of my services at home‚ workplace‚ or community (place of worship‚ recreation center).
2. Staff listen to and follow my choices and preferences.
3. Services meet my needs.
4. Services respect my life experiences and personal interests.
5. Services and staff respect my culture‚ ethnicity and race.
6. Staff help to link me with other persons in recovery who can help me.
7. Staff encourage me to talk about my needs and beliefs including spiritual‚ social and sexual‚ if I wish.
8. I can review my treatment records‚ if I wish.
9. I can be involved in the development of new programs for this agency‚ if I wish.
10. Staff help me to participate in special interest activities like adult education and church groups.
11. Staff help me to develop my career and life goals.
12. I can participate in reviewing my services and service provider(s).
13. Staff help to involve my significant others (spouses‚ friends‚ family members‚ etc) in the planning of my services‚ if I wish.
14. Staff help to involve other sources of support (clergy‚ neighbors‚ landlords‚ etc) in the planning of my services‚ if I wish.
15. Staff believe I can recover.
16. Staff believe I can make my own treatment and life choices.

Recovery Assessment: Person in Recovery Version (2007) RSA-R

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable‚ D/K= Don’t Know

1. Staff welcome me and help me feel comfortable in this program.
2. The physical space of this program (e.g.‚ the lobby‚ waiting rooms‚ etc.) feels inviting and dignified.
3. Staff encourage me to have hope and high expectations for myself and my recovery.
4. I can change my clinician or case manager if I want to.
5. I can easily access my treatment records if I want to.
6. Staff do not use threats‚ bribes‚ or other forms of pressure to get me to do what they want.
7. Staff believe that I can recover.
8. Staff believe that I have the ability to manage my own symptoms.
9. Staff believe that I can make my own life choices regarding things such as where to live‚ when to work‚ whom to be friends with‚ etc.
10. Staff listen to me and respect my decisions about my treatment and care.
11. Staff regularly ask me about my interests and the things I would like to do in the community.
12. Staff encourage me to take risks and try new things.
13. This program offers specific services that fit my unique culture and life experiences.
14. I am given opportunities to discuss my spiritual needs and interests when I wish.
15. I am given opportunities to discuss my sexual needs and interests when I wish.
16. Staff help me to develop and plan for life goals beyond managing symptoms or staying stable (e.g.‚ employment‚ education‚ physical fitness‚ connecting with family and friends‚ hobbies).
17. Staff help me to find jobs.
18. Staff help me to get involved in non-mental health/addiction related activities‚ such as church groups‚ adult education‚ sports‚ or hobbies.
19. Staff help me to include people who are important to me in my recovery/treatment planning (such as family‚ friends‚ clergy‚ or an employer).
20. Staff introduce me to people in recovery who can serve as role models or mentors.
21. Staff offer to help me connect with self-help‚ peer support‚ or consumer advocacy groups and programs.
22. Staff help me to find ways to give back to my community‚ (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
23. I am encouraged to help staff with the development of new groups‚ programs‚ or services.
24. I am encouraged to be involved in the evaluation of this program’s services and service providers.
25. I am encouraged to attend agency advisory boards and/or management meetings if I want.
26. Staff talk with me about what it would take to complete or exit this program.
27. Staff help me keep track of the progress I am making towards my personal goals.
28. Staff work hard to help me fulfill my personal goals.
29. I am/can be involved with staff trainings and education programs at this agency.
30. Staff listen‚ and respond‚ to my cultural experiences‚ interests‚ and concerns.
31. Staff are knowledgeable about special interest groups and activities in the community.
32. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.

Recovery Assessment: Family/Significant Other/Advocate Version (2003)

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable

1. Staff focus on helping people in recovery to build connections in their neighborhood and community.
2. This agency offers specific services and programs to address the unique culture‚ life experiences‚ interests‚ and needs of people in recovery.
3. People in recovery have access to all of their treatment records.
4. This agency provides education to community employers about employing people with mental illness and/or addictions.
5. Service providers at this agency make every effort to involve significant others (spouses‚ friends‚ family members) and other sources of natural support (i.e.‚ clergy‚ neighbors‚ landlords) in the planning of a person’s services‚ if this is his/her preference.
6. People in recovery can choose and change‚ if desired‚ the therapist‚ psychiatrist‚ or other service provider with whom they work.
7. Most services are provided in a person in recovery’s natural environment (i.e.‚ home‚ community‚ workplace).
8. People in recovery are given the opportunity to discuss sexual and spiritual needs and interests.
9. The staff of this agency regularly attend trainings on cultural competency.
10. Staff at this agency listen to and follow the choices and preferences expressed by people in recovery.
11. Staff at this agency help to monitor the progress made towards a person in recovery’s personal goals on a regular basis.
12. This agency provides structured educational activities to the community about mental illness and addictions.
13. Agency staff do not use threats‚ bribes‚ or other forms of coercion to influence the behavior or choices of people in recovery.
14. Staff at this agency encourage people in recovery to take risks and try new things.
15. People in recovery are/can be involved with facilitating staff trainings and education programs at this agency.
16. Staff are knowledgeable about special interest groups and activities in the community.
17. Groups‚ meetings‚ and other activities can be scheduled in the evenings or on weekends so as not to conflict with other recovery-oriented activities such as employment or school.
18. This agency actively attempts to link people in recovery with others in recovery who can serve as role models or mentors by making referrals to self-help‚ peer support‚ or consumer advocacy groups or programs.
19. People in recovery can chose from a variety of treatment options at this agency (i.e.‚ individual‚ group‚ peer support‚ holistic healing‚ alternative treatments‚ medical).
20. The achievement of a person in recovery’s goals is formally acknowledged and celebrated by the agency.
21. People in recovery are/can be routinely involved in the evaluation of the agency’s programs‚ services‚ and service providers.
22. Staff use a language of recovery (i.e. hope‚ high expectations‚ respect) in everyday conversations.
23. Staff play a primary role in helping people in recovery to become involved in non-mental health/addiction related activities‚ such as church groups‚ special interest groups‚ and adult education.
24. If the agency can not meet a person in recovery’s needs‚ procedures are in place to refer him/her to other programs and services.
25. Staff actively assist people in recovery with the development of career and life goals that go beyond symptom management and stabilization.
26. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.
27. People in recovery are/can be regular members of agency advisory boards and management meetings.
28. At this agency‚ participants who are doing well get as much attention as those who are having difficulties.
29. Staff routinely assist people in recovery with the pursuit of educational and/or employment goals.
30. People in recovery can work along side agency staff on the development and provision of new programs and services.
31. Agency staff actively help people become involved with activities that give back to their community (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
32. This agency provides formal opportunities for people in recovery‚ family and significant others‚ service providers‚ and administrators to learn about recovery.
33. The role of agency staff is to assist people in recovery with fulfilling their individually-defined goals and aspirations.
34. Criteria for exiting or completing the programs are clearly defined and discussed with people in recovery upon entry to the agency.
35. The development of a person in recovery’s leisure interests and hobbies is a primary focus of services.
36. Agency staff believe that people can recover and make their own treatment and life choices.

RSA-R Family Member/Significant Other Version (2007)

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable‚ D/K= Don’t Know

1. Staff make efforts to welcome my loved one and help him/her to feel comfortable in this program.
2. The physical space of this program (e.g.‚ the lobby‚ waiting rooms‚ etc.) feels inviting and dignified.
3. Staff encourage my loved one to have hope and high expectations for his/her recovery.
4. My loved one can change his/her clinician or case manager if he/she wants to.
5. My loved one can easily access his/her treatment records if he/she wishes.
6. Staff do not use threats‚ bribes‚ or other forms of pressure to influence the behavior of my loved one.
7. Staff believe that my loved one can recover.
8. Staff believe that my loved one has the ability to manage his/her own symptoms.
9. Staff believe that program participants can make their own life choices regarding things such as where to live‚ when to work‚ whom to be friends with‚ etc.
10. Staff listen to my loved one and respect his/her decisions about his/her treatment and care.
11. Staff regularly ask my loved one about his/her interests and the things he/she would like to do in the community.
12. Staff encourage my loved one to take risks and try new things.
13. This program offers specific services that fit the unique culture and life experiences of my loved one.
14. My loved one is given opportunities to discuss his or her spiritual needs and interests when he or she wishes.
15. My loved one is given opportunities to discuss his or her sexual needs and interests when he or she wishes.
16. Staff help my loved one to develop and plan for life goals beyond managing symptoms or staying stable (e.g.‚ employment‚ education‚ physicalfitness‚ connecting with family and friends‚ hobbies).
17. Staff assist my loved one with getting jobs.
18. Staff help my loved one to get involved in non-mental health related activities‚ such as church groups‚ adult education‚ sports‚ or hobbies.
19. Staff help my loved one to include people who are important to him/her in his/her recovery/treatment planning (such as family‚ friends‚ clergy‚ or an employer).
20. Staff introduce my loved one to others in recovery who can serve as role models or mentors.
21. Staff connect my loved one with self-help‚ peer support‚ or consumer advocacy groups and programs.
22. Staff help my loved one to find ways to give back to the community (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
23. My loved one is encouraged to help staff with the development of new groups‚ programs‚ or services.
24. Program participants are encouraged to be involved in the evaluation of this program’s services and service providers.
25. My loved one is encouraged to attend agency advisory boards and management meetings
26. Staff talk with my loved one about what it takes to complete or exit the program.
27. Staff help my loved one keep track of the progress he/she makes towards his/her personal goals.
28. Staff work hard to help my loved one fulfill his/her personal goals.
29. My loved one is or can be involved in facilitating staff trainings and education programs at this agency.
30. Staff listen‚ and respond‚ to my loved ones cultural experiences‚ interests‚ and concerns.
31. Staff are knowledgeable about special interest groups and activities in the community.
32. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.

*For family/sig oth only

33. Staff make efforts to welcome me and make me feel comfortable in this program.
34. Staff encourage me to have hope and high expectations for my loved one’s recovery.
35. Staff listen to me and respect my opinion about my loved one’s treatment and care.
36. Staff include me in my loved one’s recovery/ treatment planning.
37. I am encouraged to help staff with the development of new groups‚ programs‚ or services.
38. I am encouraged to be involved in the evaluation of this program’s services and service providers.
39. I am encouraged to attend agency advisory boards and management meetings‚ if I want.
40. I am/ can be involved in facilitating staff trainings and education programs at this agency

Recovery Self-Assessment: Provider Version (2003)

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable

1. Helping people build connections with their neighborhoods and communities is one of the primary activities in which staff at this agency are involved.
2. This agency offers specific services and programs for individuals with different cultures‚ life experiences‚ interests‚ and needs.
3. People in recovery have access to all their treatment records.
4. This agency provides education to community employers about employing people with mental illness and/or addictions.
5. Every effort is made to involve significant others (spouses‚ friends‚ family members) and other natural supports (i.e.‚ clergy‚ neighbors‚ landlords) in the planning of a person’s services‚ if so desired.
6. People in recovery can choose and change‚ if desired‚ the therapist‚ psychiatrist‚ or other service provider with whom they work.
7. Most services are provided in a person’s natural environment (i.e.‚ home‚ community‚ workplace).
8. People in recovery are given the opportunity to discuss their sexual and spiritual needs and interests.
9. All staff at this agency regularly attend trainings on cultural competency.
10. Staff at this agency listen to and follow the choices and preferences of participants.
11. Progress made towards goals (as defined by the person in recovery) is monitored on a regular basis.
12. This agency provides structured educational activities to the community about mental illness and addictions.
13. Agency staff do not use threats‚ bribes‚ or other forms of coercion to influence a person’s behavior or choices.
14. Staff and agency participants are encouraged to take risks and try new things.
15. Persons in recovery are involved with facilitating staff trainings and education programs at this agency.
16. Staff are knowledgeable about special interest groups and activities in the community.
17. Groups‚ meetings‚ and other activities can be scheduled in the evenings or on weekends so as not to conflict with other recovery-oriented activities such as employment or school.
18. This agency actively attempts to link people in recovery with other persons in recovery who can serve as role models or mentors by making referrals to self-help‚ peer support‚ or consumer advocacy groups or programs.
19. This agency provides a variety of treatment options (i.e.‚ individual‚ group‚ peer support‚ holistic healing‚ alternative treatments‚ medical) from which agency participants may choose.
20. The achievement of goals by people in recovery and staff are formally acknowledged and celebrated by the agency.
21. People in recovery are routinely involved in the evaluation of the agency’s programs‚ services‚ and service providers.
22. Staff use a language of recovery (i.e. hope‚ high expectations‚ respect) in everyday conversations.
23. Staff play a primary role in helping people in recovery become involved in non- mental health/addiction related activities‚ such as church groups‚ special interest groups‚ and adult education.
24. Procedures are in place to facilitate referrals to other programs and services if the agency cannot meet a person’s needs.
25. Staff actively assist people in recovery with the development of career and life goals that go beyond symptom management and stabilization.
26. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.
27. People in recovery are regular members of agency advisory boards and management meetings.
28. At this agency‚ participants who are doing well get as much attention as those who are having difficulties.
29. Staff routinely assist individuals in the pursuit of educational and/or employment goals.
30. People in recovery work along side agency staff on the development and provision of new programs and services.
31. Agency staff actively help people become involved with activities that give back to their communities (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
32. This agency provides formal opportunities for people in recovery‚ family members service providers‚ and administrators to learn about recovery.
33. The role of agency staff is to assist a person with fulfilling their individually-defined goals and aspirations.
34. Criteria for exiting or completing the agency are clearly defined and discussed with participants upon entry to the agency.
35. The development of a person’s leisure interests and hobbies is a primary focus of services.
36. Agency staff believe that people can recover and make their own treatment and life choices.

RSA-R Provider Version (2007)

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable‚ D/K= Don’t Know

1. Staff make a concerted effort to welcome people in recovery and help them to feel comfortable in this program.
2. This program/agency offers an inviting and dignified physical environment (e.g.‚ the lobby‚ waiting rooms‚ etc.).
3. Staff encourage program participants to have hope and high expectations for their recovery.
4. Program participants can change their clinician or case manager if they wish.
5. Program participants can easily access their treatment records if they wish.
6. Staff do not use threats‚ bribes‚ or other forms of pressure to influence the behavior of program participants.
7. Staff believe in the ability of program participants to recover.
8. Staff believe that program participants have the ability to manage their own symptoms.
9. Staff believe that program participants can make their own life choices regarding things such as where to live‚ when to work‚ whom to be friends with‚ etc.
10. Staff listen to and respect the decisions that program participants make about their treatment and care.
11. Staff regularly ask program participants about their interests and the things they would like to do in the community.
12. Staff encourage program participants to take risks and try new things.
13. This program offers specific services that fit each participant’s unique culture and life experiences.
14. Staff offer participants opportunities to discuss their spiritual needs and interests when they wish.
15. Staff offer participants opportunities to discuss their sexual needs and interests when they wish.
16. Staff help program participants to develop and plan for life goals beyond managing symptoms or staying stable (e.g.‚ employment‚ education‚ physical fitness‚ connecting with family and friends‚ hobbies).
17. Staff routinely assist program participants with getting jobs.
18. Staff actively help program participants to get involved in non-mental health/addiction related activities‚ such as church groups‚ adult education‚ sports‚ or hobbies.
19. Staff work hard to help program participants to include people who are important to them in their recovery/treatment planning (such as family‚ friends‚ clergy‚ or an employer).
20. Staff actively introduce program participants to persons in recovery who can serve as role models or mentors.
21. Staff actively connect program participants with self-help‚ peer support‚ or consumer advocacy groups and programs.
22. Staff actively help people find ways to give back to their community (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
23. People in recovery are encouraged to help staff with the development of new groups‚ programs‚ or services.
24. People in recovery are encouraged to be involved in the evaluation of this agency’s programs‚ services‚ and service providers.
25. People in recovery are encouraged to attend agency advisory boards and management meetings.
26. Staff talk with program participants about what it takes to complete or exit the program.
27. Progress made towards an individual’s own personal goals is tracked regularly.
28. The primary role of agency staff is to assist a person with fulfilling his/her own goals and aspirations.
29. Persons in recovery are involved with facilitating staff trainings and education at this program.
30. Staff at this program regularly attend trainings on cultural competency.
31. Staff are knowledgeable about special interest groups and activities in the community.
32. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.

Recovery Self-Assessment: CEO/ Agency Director Version (2003)

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable

1. Helping people build connections with their neighborhoods and communities is one of the primary activities in which staff at this agency are involved.
2. This agency offers specific services and programs for individuals with different cultures‚ life experiences‚ interests‚ and needs.
3. People in recovery have access to all their treatment records.
4. This agency provides education to community employers about employing people with mental illness and/or addictions.
5. Every effort is made to involve significant others (spouses‚ friends‚ family members) and other natural supports (i.e.‚ clergy‚ neighbors‚ landlords) in the planning of a person’s services‚ if so desired.
6. People in recovery can choose and change‚ if desired‚ the therapist‚ psychiatrist‚ or other service provider with whom they work.
7. Most services are provided in a person’s natural environment (i.e.‚ home‚ community‚ workplace).
8. People in recovery are given the opportunity to discuss their sexual and spiritual needs and interests.
9. All staff at this agency regularly attend trainings on cultural competency.
10. Staff at this agency listen to and follow the choices and preferences of participants.
11. Progress made towards goals (as defined by the person in recovery) is monitored on a regular basis.
12. This agency provides structured educational activities to the community about mental illness and addictions.
13. Agency staff do not use threats‚ bribes‚ or other forms of coercion to influence a person’s behavior or choices.
14. Staff and agency participants are encouraged to take risks and try new things.
15. Persons in recovery are involved with facilitating staff trainings and education programs at this agency.
16. Staff are knowledgeable about special interest groups and activities in the community.
17. Groups‚ meetings‚ and other activities can be scheduled in the evenings or on weekends so as not to conflict with other recovery-oriented activities such as employment or school.
18. This agency actively attempts to link people in recovery with other persons in recovery who can serve as role models or mentors by making referrals to self-help‚ peer support‚ or consumer advocacy groups or programs.
19. This agency provides a variety of treatment options (i.e.‚ individual‚ group‚ peer support‚ holistic healing‚ alternative treatments‚ medical) from which agency participants may choose.
20. The achievement of goals by people in recovery and staff are formally acknowledged and celebrated by the agency.
21. People in recovery are routinely involved in the evaluation of the agency’s programs‚ services‚ and service providers.
22. Staff use a language of recovery (i.e. hope‚ high expectations‚ respect) in everyday conversations.
23. Staff play a primary role in helping people in recovery become involved in non-mental health/addiction related activities‚ such as church groups‚ special interest groups‚ and adult education.
24. Procedures are in place to facilitate referrals to other programs and services if the agency cannot meet a person’s needs.
25. Staff actively assist people in recovery with the development of career and life goals that go beyond symptom management and stabilization.
26. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.
27. People in recovery are regular members of agency advisory boards and management meetings.
28. At this agency‚ participants who are doing well get as much attention as those who are having difficulties.
29. Staff routinely assist individuals in the pursuit of educational and/or employment goals.
30. People in recovery work along side agency staff on the development and provision of new programs and services.
31. Agency staff actively help people become involved with activities that give back to their communities (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
32. This agency provides formal opportunities for people in recovery‚ family members service providers‚ and administrators to learn about recovery.
33. The role of agency staff is to assist a person with fulfilling their individually-defined goals and aspirations.
34. Criteria for exiting or completing the agency are clearly defined and discussed with participants upon entry to the agency.
35. The development of a person’s leisure interests and hobbies is a primary focus of services.
36. Agency staff believe that people can recover and make their own treatment and life choices.

RSA-R Administrator/Manager Version (2007)

1= Strongly Disagree‚ 2‚ 3‚ 4‚ 5= Strongly Agree‚ N/A= Not Applicable‚ D/K= Don’t Know

1. Staff make a concerted effort to welcome people in recovery and help them to feel comfortable in this program.
2. This program/agency offers an inviting and dignified physical environment (e.g.‚ the lobby‚ waiting rooms‚ etc.).
3. Staff encourage program participants to have hope and high expectations for their recovery.
4. Program participants can change their clinician or case manager they wish.
5. Program participants can easily access their treatment records if they wish.
6. Staff do not use threats‚ bribes‚ or other forms of pressure to influence the behavior of program participants.
7. Staff believe in the ability of program participants to recover.
8. Staff believe that program participants have the ability to manage their own symptoms.
9. Staff believe that program participants can make their own life choices regarding things such as where to live‚ when to work‚ whom to be friends with‚ etc.
10. Staff listen to and respect the decisions that program participants make about their treatment and care.
11. Staff regularly ask program participants about their interests and the things they would like to do in the community.
12. Staff encourage program participants to take risks and try new things.
13. This program offers specific services that fit each participant’s unique culture and life experiences.
14. Staff offer participants opportunities to discuss their spiritual needs and interests when they wish.
15. Staff offer participants opportunities to discuss their sexual needs and interests when they wish.
16. Staff help program participants to develop and plan for life goals beyond managing symptoms or staying stable (e.g.‚ employment‚ education‚ physical fitness‚ connecting with family and friends‚ hobbies).
17. Staff routinely assist program participants with getting jobs.
18. Staff actively help program participants to get involved in non-mental health related activities‚ such as church groups‚ adult education‚ sports‚ or hobbies.
19. Staff work hard to help program participants to include people who are important to them in their recovery/treatment planning (such as family‚ friends‚ clergy‚ or an employer).
20. Staff actively introduce program participants to persons in recovery who can serve as role models or mentors.
21. Staff actively connect program participants with self-help‚ peer support‚ or consumer advocacy groups and programs.
22. Staff actively help people find ways to give back to their community (i.e.‚ volunteering‚ community services‚ neighborhood watch/cleanup).
23. People in recovery are encouraged to help staff with the development of new groups‚ programs‚ or services.
24. People in recovery are encouraged to be involved in the evaluation of this agency’s programs‚ services‚ and service providers.
25. People in recovery are encouraged to attend agency advisory boards and management meetings.
26. Staff talk with program participants about what it takes to complete or exit the program.
27. Progress made towards an individual’s own personal goals is tracked regularly.
28. The primary role of agency staff is to assist a person with fulfilling his/her own goals and aspirations.
29. Persons in recovery are involved with facilitating staff trainings and education at this program.
30. Staff at this program regularly attend trainings on cultural competency.
31. Staff are knowledgeable about special interest groups and activities in the community.
32. Agency staff are diverse in terms of culture‚ ethnicity‚ lifestyle‚ and interests.

Separate Section for Administrators Only

33. This agency provides formal opportunities for people in recovery‚ family members‚ service providers‚ and administrators to learn about recovery.
34. This agency provides structured educational activities to the community about mental illness and addictions.
35. This agency provides a variety of treatment options for program participants (e.g.‚ individual‚ group‚ peer support‚ medical‚ community –based‚ employment‚ skill building‚ employment‚ etc.).
36. Groups‚ meetings‚ and other activities are scheduled in the evenings or on weekends so as not to conflict with other recovery-oriented activities such as employment or school.

RSA-R‚ PIR brief version

1. Staff welcomes me and help me feel comfortable in this program.
2. The physical space of this program (e.g.‚ the lobby‚ waiting rooms‚ etc.) feels inviting and dignified.
3. Helping people build connections with their neighborhoods and communities is one of the primary activities in which staff at this agency are involved.
4. People in recovery have access to all their treatment records.
5. This agency actively attempts to link people in recovery with other persons in recovery who can serve as role models or mentors by making referrals to self-help‚ peer support‚ or consumer advocacy groups or programs.
6. Persons in recovery are involved with facilitating staff trainings and education at this program.
7. Staff actively assist people in recovery with the development of career and life goals that go beyond symptom management and stabilization.
8. This agency offers specific services and programs to address my unique culture‚ life experiences‚ interests‚ and needs.
9. Staff at this agency listen to and follow the choices and preferences expressed by people in recovery.
10. This agency actively attempts to link people in recovery with other persons in recovery who can serve as role models or mentors by making referrals to self-help‚ peer support‚ or consumer advocacy groups or programs.
11. People in recovery are regular members of agency advisory boards and management meetings.
12. Staff routinely assist individuals in the pursuit of educational and/or employment goals.
13. All staff at this agency regularly attend trainings on cultural competency.
14. Agency staff do not use threats‚ bribes‚ or other forms of coercion to influence my behavior or choices.
15. Criteria for exiting or completing the agency are clearly defined and discussed with participants upon entry to the agency.
16. People in recovery work along side agency staff on the development and provision of new programs and services.
17. The role of agency staff is to assist a person with fulfilling their individually-defined goals and aspirations.