Designing recovery-oriented care: a qualitative study to inform service design at Kyrie Therapeutic Farm in Ireland.

Objectives: Recovery-oriented approaches are gaining increased attention in the mental health sector, including from the World Health Organization and the United Nations, for their potential to support people in recovering and building meaningful lives through strengths-based, person-centered principles. Kyrie Therapeutic Farm (KTF) is a new initiative in Ireland that seeks to develop recovery-oriented model of adult mental health care. The aim of this study was to explore the barriers and facilitators of recovery-oriented models of practice in a small number of therapeutic farm settings across the world in order to inform service design at KTF whilst also addressing a gap in research on this topic.

Methods: Three semi-structured focus-group interviews were conducted online via MS Teams with ten staff members in different roles and years of experience from three existing therapeutic community farms. reflexive thematic analysis was employed for data analysis.

Results: Four themes emerged that illustrate how therapeutic farm communities operate in general and specifically in relation to recovery: 1. common humanity, 2. freedom and responsibility, 3. interdependence and community living, and 4. learning organisations.

Conclusion: This study demonstrates the viability of recovery-oriented practices in community therapeutic farms, including KTF, thereby contributing to the broader trend toward more person-centered mental health services. The values inherent in the recovery-oriented approach - such as community, empowerment, and close, equitable, non-hierarchical relationships - act as facilitators. However, embedding these values in practice can generate tensions for staff which warrant attention. Implications for the integration into service design of KTF and further research are offered.