Cross-cultural de-centring of Recovery College tools: a 20-country Delphi study
Abstract Recovery Colleges are expanding internationally (264 identified in 31 countries across six continents), yet key tools for defining and assessing them were developed in high-income Anglophone contexts. We conducted a two-round international Delphi study using a cross-cultural de-centring approach to examine the cross-cultural applicability of the RECOLLECT Change Model and RECOLLECT Fidelity Measure, and to develop versions that were more applicable across the participating settings and interoperable versions of these tools. In Round 1, 54 panellists from 20 countries rated item importance and cultural difficulty and provided free-text feedback, analysed using corpus-informed linguistic methods. Core principles were broadly endorsed, but ‘co-production’, ‘recovery’, ‘professionals’ and ‘shifting the balance of power’ were interpreted inconsistently, revealing embedded assumptions about equality, autonomy and open-ended participation. Round 1 findings informed wording refinements tested in Round 2 with 41 panellists from 15 countries. All 11 revised items reached consensus for understandability and cultural appropriateness, strengthening the tools while preserving core Recovery College values. By identifying and revising culturally embedded assumptions while preserving interoperability with the original tools, this study demonstrates a transferable approach to the cross-cultural adaptation of mental health tools.
Authors
- Mike Slade (ORCID: https://orcid.org/0000-0001-7020-3434)
- Ramona Hiltensperger (ORCID: https://orcid.org/0000-0003-2544-4188)
- Amy Ronaldson (ORCID: https://orcid.org/0000-0001-8369-9168)
- Dagmar Narusson (ORCID: https://orcid.org/0000-0001-6774-0060)
- Tesnime Jebara (ORCID: https://orcid.org/0000-0002-6848-8845)
- Jana Pluhaříková Pomajzlová
- Ulrika Bejerholm (ORCID: https://orcid.org/0000-0001-7505-6955)
- Claire Henderson (ORCID: https://orcid.org/0000-0002-6998-5659)
- José Alberto Orsi (ORCID: https://orcid.org/0000-0002-2905-6871)
- Vlasta Řezníková
- Yasuhiro Kotera (ORCID: https://orcid.org/0000-0002-0251-0085)
- Mário César Rezende Andrade (ORCID: https://orcid.org/0000-0003-2784-5209)
- Peter Bates (ORCID: https://orcid.org/0000-0002-0558-6907)
- Mariam Namasaba (ORCID: https://orcid.org/0000-0002-7941-3769)
- Sara Vilar-Lluch (ORCID: https://orcid.org/0000-0002-5495-9386)
- Vanessa C. Lawrence (ORCID: https://orcid.org/0000-0001-7852-2018)
- Vanessa Kellermann (ORCID: https://orcid.org/0009-0004-5969-3769)
- Simran Kaur Takhi (ORCID: https://orcid.org/0000-0003-3248-8912)
- Yuki Miyamoto (ORCID: https://orcid.org/0000-0002-2192-0469)
- Peanchanan Leah (ORCID: https://orcid.org/0009-0004-0745-8206)
- Agnieszka Kapka
Institutions
- University of Nottingham (GB)
- Federal University of São João del-Rei (BR)
- King's College London (GB)
- Lund University (SE)
- Universität Ulm (DE)
- Mahidol University (TH)
- Nord University (NO)
- Institute of Mental Health (GB)
- Ramathibodi Hospital (TH)
- College of Polytechnics Jihlava (CZ)
- University of Tartu (EE)
- The University of Tokyo (JP)
- Cardiff University (GB)
- Azerbaijan University (AZ)
- Universidade Federal de São Paulo (BR)
- The University of Osaka (JP)
Publication Details
- Journal
- npj Mental Health Research
- Published
- 2026-10-06
- DOI
- https://doi.org/10.1038/s44184-026-00250-1
- Primary Topic
- Mental Health and Patient Involvement
- Type
- article
- Field-Weighted Citation Impact
- 0.00