Recovery Assessment Scale –

Domains and Stages (RAS‐DS)

Manual
Version 3. 2019
ACKNOWLEDGEMENTS
Reaching the point that we are at today has involved a journey that started in 2005. There
have been numerous cycles of data collection, feedback and analysis, collaborative reflection,
development and testing. Initially, over 250 people living with mental illness, 50 mental
health support workers and 3 non‐government organisations (Richmond Fellowship
Queensland, Schizophrenia Fellowship of NSW [now called One Door Mental Health] and
Richmond PRA [now called Flourish Australia]) all generously volunteered their time and
expertise to develop and test the RAS‐DS. Since that time, data generously shared by over a
thousand consumers and close to a hundred mental health workers or clinicians have helped
us to continually test and refine the tool. Thank you!

We would like to particularly acknowledge the expertise and generosity of so many people
living with and recovering from mental illness who have engaged in various ways throughout
the development and ongoing testing of the RAS‐DS. The RAS‐DS is a measure of consumer or
service‐user defined recovery (not clinician or researcher defined recovery). Without your
honest and generous sharing of the expertise and knowledge each of you have gained through
your own personal journeys, this would be a much poorer, less valid measure. You have
played centre stage in the evaluation and refining of the RAS‐DS. Thank you for your
constructive criticisms as well as your positive feedback and suggestions!

Thank you to the organisations and mental health workers who have also, due to their
commitment to advancing recovery‐oriented practice in Australia, generously and
passionately engaged. Again, you have provided invaluable insights into the usefulness of the
RAS‐DS as well as how to enhance its practical usefulness further.

We look forward to working with you and many others on the continued evaluation and
development of the RAS‐DS and this manual.

Note: In Australia the term ‘consumer’ is commonly used to refer to people living with a
mental health diagnosis and using mental health services. It is therefore this term that we
have chosen to use throughout this manual. We understand that this is not a term that
everyone likes, and that other terms such as ‘service‐user’ and ‘survivor’ are preferred by
some and are more commonly used in other countries.

©2019 The University of Sydney Page 2

SUGGESTED CITATION:
Hancock, N., Scanlan, J.N., Bundy, A.C., & Honey, A. (2019). Recovery Assessment Scale –
Domains & Stages (RAS‐DS) Manual‐ Version 3. Sydney; University of Sydney.

©2019 The University of Sydney Page 3

CONTENTS
ACKNOWLEDGEMENTS.................................................................................................................................................... 2
SUGGESTED CITATION: .................................................................................................................................................... 3
CONTENTS ................................................................................................................................................................................... 4
SECTION 1: MEASURING RECOVERY – CAN WE DO IT AND WHY BOTHER
TRYING? ......................................................................................................................................................................................... 5
Enhanced understandings ................................................................................................................................................. 5
Enhanced collaborative, recovery‐oriented goal planning or personal recovery plans ................ 5
Measuring recovery outcomes at the individual and service/program level ....................................... 5
SECTION 2: INSTRUMENT DESCRIPTION ......................................................................................................... 7
SECTION 3: INSTRUMENT ADMINISTRATION & USE ........................................................................... 9
Completing the form ............................................................................................................................................................. 9
Conversations leading to shared understanding & personal recovery plans ....................................... 9
Repeated use of the RAS‐DS to see changes over time .................................................................................... 10
SECTION 4: SCORING....................................................................................................................................................... 11
Total recovery score .......................................................................................................................................................... 11
Scoring each recovery domain ..................................................................................................................................... 11
SECTION 5: INSTRUMENT DEVELOPMENT & RESULTS (USEFULNESS &
PSYCHOMETRIC PROPERTIES) ................................................................................................................................. 13
The journey of RAS‐DS development ........................................................................................................................ 13
A snapshot of results to date: ........................................................................................................................................ 14
a. Enhance understandings & facilitation of recovery‐oriented goal planning ..................................... 14
b. Measuring individual and service level outcomes (psychometric properties) ................................ 15
SECTION 6: OUR FUTURE PLANS/WHAT WE STILL NEED TO EXAMINE & DEVELOP
............................................................................................................................................................................................................. 16
Does the RAS‐DS measure the entire recovery construct? ........................................................................... 16
Is the RAS‐DS sensitive to change? ............................................................................................................................. 16
Examining the RATING SCALE structure with larger sets of data ............................................................. 16
Examining test‐retest reliability ................................................................................................................................. 16
Does the use of the ras‐ds lead to better therapeutic alliance and greater consumer choice
and control in their recovery planning? ................................................................................................................. 16
CONTACT INFORMATION ........................................................................................................................................ 17
REFERENCES ............................................................................................................................................................................. 18
APPENDIX 1: ............................................................................................................................................................................ 19
RECOVERY ASSESSMENT SCALE – DOMAINS & STAGES (RAS-DS) ............................................ 19

©2019 The University of Sydney Page 4

SECTION 1: MEASURING RECOVERY – CAN WE
DO IT AND WHY BOTHER TRYING?
There are three main reasons for mental health services to use a tool that enables consumers
or service users to think about and measure their own recovery progress:

1) enhanced understandings (both personally for the consumer and between consumer and
staff partnerships) that lead to

2) enhanced collaborative and recovery‐oriented goal planning or personal recovery plans

and

3) measuring individual and service outcomes with a focus on recovery rather than symptom
reduction for example.

ENHANCED UNDERSTANDINGS

A self‐report measure that enables exploration or enquiry into recovery related topics gives
people living with mental illness (consumers) a structured opportunity to reflect upon their
own recovery progress. The process of completing a self‐report measure of recovery can
facilitate consumers to develop greater recognition of the successes and achievement already
made in their personal recovery journey as well as identifying the areas that they see as
needing further work. When (and we suggest this is essential) consumers have the
opportunity to talk about their self‐ratings of recovery progress with their mental health
support worker or clinician, there is the opportunity to enhance the shared understanding.
Staff report having a better understanding of what consumers are feeling, experiencing and
prioritising in relation to their recovery. Equally, consumers feel that the staff person who
they are working with has a better understanding of them, their successes, feelings and needs.

ENHANCED COLLABORATIVE, RECOVERY‐ORIENTED GOAL PLANNING OR

PERSONAL RECOVERY PLANS

Conversations, in which the consumer and staff member explore the consumer’s self‐rating of
recovery, lead naturally towards recovery planning that focuses upon the priorities of the
consumer.

MEASURING RECOVERY OUTCOMES AT THE INDIVIDUAL AND

SERVICE/PROGRAM LEVEL

In Australia, the outcome measures selected for routine use across State mental health sectors
have a predominantly symptom/illness measurement focus. There is a repeated call
internationally to include recovery‐oriented outcome measurement in the suite of
instruments used, particularly with the growing understanding and embracing of the need for
systemic change that sees a shift from illness management approaches to recovery‐oriented
approaches.

There is an argument that perhaps only measures of recovery‐oriented practice (i.e.,

measures of service quality in relation to their recovery‐orientation) are needed. We would
argue that 1) we need to know that if recovery‐oriented practice is enhanced, it leads to

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enhanced individual recovery, 2) consumers have the right to reflect and report on their
personal perspectives of recovery progress (who other than the person themselves would
know how hopeful they feel for example?) and 3) inclusion of a structure that enables
consumers to actively participate in the ‘assessment’ process is a fundamental first step
towards self‐directed care (a cornerstone of recovery‐oriented practice).

©2019 The University of Sydney Page 6

SECTION 2: INSTRUMENT DESCRIPTION
The RAS‐DS has 38 items or statements for the consumer to rate. It is a Likert scale with 4
rating categories for consumers to select from: “untrue”; “a bit true”; “mostly true” and
“completely true”. See Figures 1 and 2 on the following page for examples of what the RAS‐DS
looks like. The complete RAS‐DS is provided in the appendices at the back.

The items have been divided into 4 recovery domains: Doing Things I Value; Looking
Forward; Mastering My Illness and Connecting and Belonging.

As you will see in Section 4 where we describe how to score the RAS‐DS, each domain can be
used and scored separately as well as collectively for a more holistic exploration. See Table 1
below for descriptions of the 4 domains and their relationship to stages of recovery.

Table 1: Four Domains of Recovery covered by the RAS‐DS

DOMAINS STAGES
Very Early Middle Later
Doing Unengaged, inactive or Doing things that are personally
Things I poverty of activity or valued and meaningful; sense of
Value role engagement; sick or contributing to others
patient role dominates

Looking Anguish; hopelessness; Awareness; In control of life; wellbeing;

Forward views self as “sick insight; action hopeful about the future; views
person” plan self as external to experience of
illness
Mastering Dominated by symptoms Control over, or management of,
My Illness any residual symptoms; minimal
interference with life

Connecting Few relationships; Larger social network; greater

and dependent; mostly diversity including peers, family
Belonging family and broader communities;
reciprocal in nature; personally
satisfying

Please note:

1. In the Doing Things I Value domain, there is an emphasis on doing things that are
PERSONALLY valued /meaningful rather than a focus on socially valued activities/roles

2. The Mastering My Illness domain differs to the medically oriented definition of clinical
recovery that focuses on the degree of symptom amelioration. In the RAS‐DS the focus is on
developing a sense of control over & management of symptoms and reducing their impact on
living.

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Figure 1: Excerpt from the RAS‐DS (part of page 1)

(see Appendix at the back of the manual for a complete copy of the RAS‐DS)

Figure 2: Excerpt from the RAS‐DS (part of page 2)

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SECTION 3: INSTRUMENT ADMINISTRATION &
USE

COMPLETING THE FORM

This is a self‐report measure. Therefore, it is critical that consumers who use the RAS‐DS are
providing their OWN self‐assessment freely and that their ratings are not influenced by
others.

However, this does not mean that some consumers might need or like to have assistance with
reading the items. We have made a lot of effort to ensure that the language of the RAS‐DS is as
accessible and user‐friendly as possible, but, for various reasons, some consumers might find
it hard to read and concentrate on all 38 statements at the same time as thinking about the
statements and rating their responses.

It is more than acceptable for staff or peers/peer workers to read the statements to the
consumer completing the RAS‐DS. In fact, administering self‐report instruments via interview
has been recommended by others (Corrigan et al, 1999). If each person has their own copy of
the RAS‐DS while this is being done, it will avoid the sense of “someone watching over me as I
do it”. To avoid any sense of being judged or the risk that consumers rate in the way that they
think others want them to, people present should not watch the scoring process or comment
on the consumers ratings until the process is completed. Consumers might ask what a
statement means, if this happens it would be best to say something like “The important thing
is what it means to you. It might mean different things to different people”. Try to avoid
rephrasing the statement if you can because that can change the meaning without you
realising it.

Please note: In some of the stages of our research, trained consumer researchers read the
instrument statements out to consumer participants as they completed the ratings. We
received only positive feedback about peers facilitating this process. We anticipate and hope
that much of the future work done using the RAS‐DS will include the peer‐workforce.

CONVERSATIONS LEADING TO SHARED UNDERSTANDING & PERSONAL

RECOVERY PLANS

The magic in the use of the RAS‐DS comes from its use as a conversation starter that leads
to deeper personal and shared understandings. In our studies to‐date, both consumers and
staff feedback demonstrate that:

 Doing the RAS‐DS helps almost all consumers to think about and reflect upon their
recovery journey (both achievements to‐date and areas to work on in the future)

 Staff frequently find that the process of talking over RAS‐DS results with consumers
is helpful in gaining a richer understanding of the perspectives, feelings and
priorities of the consumers they support. Those who use it to identify and develop
recovery goals also find it helpful in that process.

The most useful or meaningful way of using the RAS‐DS in practice is for staff and

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 consumers to talk about the ‘results’ together; identifying the recovery areas that
consumers feel positive about (rated 3 or 4) and celebrating these. Staff and consumers
should also look at and talk about the areas of recovery that could be worked on (the
ones they scored 1 or 2) and discuss which of these are most important to the consumer
and could therefore be incorporated into recovery action plans and goals.

Examples of questions you might ask....

 Can you tell me more about why you rated this one
this way?

 What would it take for us to get this one up to a 4?

 When you look at the RAS‐DS which things do you

think are most important to you/do you want us to
work on?

 and .... Don’t forget to celebrate the successes!!

REPEATED USE OF THE RAS‐DS TO SEE CHANGES OVER TIME

Recovery is a non‐linear process. Sometimes going backwards in a measure like this reflects
that consumers have taken on or are facing new challenges/risks. We know that risks and
challenges are essential components of the recovery journey. It is important not to assume
that a ‘backwards’ change is necessarily a negative. Again, a conversation is needed!

Positive conversations about ‘backwards’ changes in recovery scores can also lead to
opportunities to review and further develop relapse prevention plans and also to add to or
refine advanced directives if the organisation/service is courageous enough to engage in that
process.

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SECTION 4: SCORING
Often, for measures to be useful, we are required to convert scores to statistically adjusted measures
(using something called key forms). We are delighted to report that our data analysis shows an almost
perfect correlation between raw scores and rankings. We are therefore able to say that using raw
scores is acceptable (and obviously much simpler!).

TOTAL RECOVERY SCORE

It is OK to add the scores up for all 38 items to gain a total recovery score out of 152.

SCORING EACH RECOVERY DOMAIN

It is also OK to also have sub‐score totals for each recovery domain so that you can see relative
progress across domains. However, please remember that there are different numbers of
items/statements in each domain so converting to a percentage (%) domain score might be most
useful to consumers to see variance across domains).

To do this:
1. Add the item scores together for the domain
2. Divide the total for the domain by the number of items in that domain that have been completed by
the person (this will give you an average score for each domain)
3. Divide the average score by 4 and multiply by 100

Calculations:
Total Recovery Score Add all item scores. This will be a total recovery
score out of 152
Doing Things I Value Add all items This will give a percentage
Recovery Score Divide by 6 (or less if any items score for each domain
are not rated)
Divide by 4
Multiply by 100
Looking Forward Add all items
Recovery Score Divide by 18 (or less if any
items are not rated)
Divide by 4
Multiply by 100
Mastering My Illness Add all items
Recovery Score Divide by 7 (or less if any items
are not rated)
Divide by 4
Multiply by 100
Connecting and Belonging Add all items
Recovery Score Divide by 7 (or less if any items
are not rated)
Divide by 4
Multiply by 100

Help: We have developed an excel spreadsheet with calculation functions embedded. Please contact us
if you would like a copy.

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Important Note:
We understand that adding scores is useful when using the RAS‐DS as an outcome measure. However,
we want to re‐emphasise that perhaps the most useful or meaningful way of using the RAS‐DS in
practice is for staff and consumers to talk about the ‘results’ together as described above. That is, to
identify the recovery areas that consumers feel positive about and where successes have occurred
(perhaps rated 3 or 4) and to celebrate these as well as looking at and talking about the areas of
recovery that could be worked on (perhaps the ones they scored as a 1 or 2) and incorporated into
new recovery action plans and goals. Sometimes however, the aspect that consumers most want to
work further on and is most meaningful to their recovery is not the thing they scored most low.

Comments on rather than scores are often the most useful part of the RAS‐DS for discussion and
making plans together. For this reason, we have developed the RAS‐DS+. RAS‐DS+ has an additional
comments column for consumers to add thoughts and explanations about each item as they work
through the scale if the wish to. It also has an open‐ended question at the end: “Is there anything else
that is important to you and your recovery that was not covered?”

Additionally, a visual display of results can also be helpful for some consumers in reviewing and
‘interpreting’ their results. While many organisations have now built a graphing function into their
own on‐line systems, we have a graphing function built into an excel spreadsheet that we can send to
you. Please contact us if you would like this.

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SECTION 5: INSTRUMENT DEVELOPMENT &
RESULTS (USEFULNESS & PSYCHOMETRIC PROPERTIES)

THE JOURNEY OF RAS‐DS DEVELOPMENT

The RAS‐DS (Recovery Assessment Scale – Domains & Stages) has developed through
numerous iterative study cycles. Its development began with an analysis of the original 41‐
item Recovery Assessment Scale (RAS) developed in America (Gifford et al. 1995).
The RAS was selected originally because it had stronger reported psychometric properties
than any other recovery‐based instrument at that time. As you can see from our published
work, after testing, we found three main problems with the original instrument:
 poor category structure (although there were five points on the original scale, when we
did the analysis, there was only really meaningful differences between “Agree” / “Strongly
agree” and the other points of the scale – consumers tended to use it as a two point “yes” /
“no” scale.),
 a very significant ceiling effect (many consumers selected high scores on many items,
which suggested that there may be too few items relating to the later stage of recovery),
and
 a number of items did not seem to line up with the overall construct of “recovery” or were
repetitive.

In a second stage study, we used focus groups with consumers who reported being further
along their recovery journey in attempt to identify 'missing' items – that is, to identify key
achievements or challenges associated with later stages of the recovery journey. From these 2
studies we developed the RAS‐DS.

In the third stage of development, we trialled the RAS‐DS with the support of 3 large non
government services in two Australian states: The Richmond Fellowship Queensland, the
Schizophrenia Fellowship of NSW (now called One Door Mental Health) and Richmond PRA
(New South Wales) (now called Flourish Australia). Over 120 staff/consumer paired data sets
were obtained. Consumers completed the RAS‐DS and both consumer and staff member were
then asked to complete a questionnaire about its usefulness. Very preliminary analysis of the
data looked good (good item fit, internal reliability etc.) However, there was a repeated theme
in the qualitative data that we decided needed to be acted upon immediately. Staff and, more
importantly, consumers said that they needed another point in the rating scale between
“unsure” and “yes” ‐ they needed a “partial” point. Also, we could see from the quantitative
data that an additional point would enhance the sensitivity of the RAS‐DS to capture change
over time. We stopped the study, re‐worked the scale descriptors, trialled our preferred
descriptors with a small group of consumers and staff and recommenced the study.

A series of studies, conducted with both youth and adult populations from 2015 onwards,
collectively demonstrate the strength of the RAS‐DS. It is:
a) A useful tool that facilitates enhanced understandings (both personally for the consumer
and, through conversation, between consumer and staff partnerships), leading to more
collaborative and recovery‐oriented goal planning or personal recovery plans, and
b) A psychometrically strong tool that measures individual and service outcomes with a
focus on recovery

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 A SNAPSHOT OF RESULTS TO DATE:

A. ENHANCE UNDERSTANDINGS & FACILITATION OF RECOVERY‐ORIENTED GOAL

PLANNING

A taste of what consumers  Qualitative data shows clearly that doing the RAS‐DS
and MH workers said.... helps almost all consumers to think about and reflect
“My case manager understood me upon their recovery journey (both achievements to‐
and I understood me” Consumer date and areas to work on in the future)
“was useful with regard to forming  Qualitative data also shows that staff almost always find
the PRP” MH Worker
the process of talking over RAS‐DS results with
“Asked relevant questions to recovery consumers helpful in gaining a richer understanding
journey” Consumer of the perspectives, feelings and priorities of those
“Very useful as a measure of positive consumers with whom they work.
progress, rather than identifying
deficits” MH Worker  Consumers also recognised that staff had a better
“Felt different to last survey. I have understanding of them after discussions following
improved knowledge of symptoms. completion of the RAS‐DS.
Happier with situation.” Consumer

“Realisation of where my mental

 Those who use it to identify and develop recovery
health is at. My family can not be my goals also find it helpful in that process.
only support” Consumer

“it was a helpful tool to gain insight

TIME ‐ How long does it take?
into clients feelings on recovery” MH
Worker It will take most consumers between 5 and 15 minutes to
complete the RAS‐DS (around 80%) without any
“Did not realise how much things had support/reading.
improved until I did the second
survey” Consumer If people want to reflect very deeply on items, or if they
“notice big change in the way (I) think prefer/need assistance with reading statements and don’t
about recovery ‐ positive change” receive it, it may take longer than 15 minutes.
Consumer

“it is so nice to see smiles on my clients

face when they can relate to a
statement and we can talk about it” How EASY is it for consumers to use?
MH Worker
78% of consumers who used the RAS‐DS rated it as “easy”
“The 4 columns are much more useful or “very easy”. 20% of consumers rated it as “hard”. 2%
in identifying where community
members are at in their recovery and
rated it as “very hard”.
it helps us to see what we can work on Reasons given for easy/very easy ratings:
to help improve mental health” MH
Worker
“questions were easy to read and answer”; “just had to circle
my answer”
“It was useful in terms of opening up
discussion about specific issues the Reasons given for hard or very hard rating:
client deals with. Gave me some more “having to give it a great deal of thought”; “deep decisions” and
insight.” MH Worker
“trouble reading”

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 B. MEASURING INDIVIDUAL AND SERVICE LEVEL OUTCOMES (PSYCHOMETRIC
PROPERTIES)

Through‐out each stage of earlier development and testing of the RAS‐DS, raw data were
subjected to Rasch analysis using Winsteps (http://Winsteps.com, Chicago; Smith & Smith,
2004; Linacre, 2005). Unlike classic forms of analysis, Rasch analysis converts ordinal level
data into interval level data and this method of analysis is increasingly becoming the
preferred method of analysis in instrument development (Wolfe & Smith, 2006). A further
advantage of this method of analysis is that it is more robust with smaller data sets and where
there are missing data (some participants did not complete every question). We will not go
into further detail here, however, if readers would like more information about Rasch
analyses we refer them to the references above and are very happy to provide further detail.

In this manual we will only report on the analyses that are based on the current form of the
RAS‐DS that contains 38 items and has a 4‐point rating scale. Results from earlier stages can
be access in the following published manuscripts (Hancock et al 2011, Hancock et al 2012).
We merely present a user‐friendly summary of our findings here. A more detailed
understanding of the psychometric testing of this measure can be found in the following
publications:
Hancock, N., Scanlan, J.N., Honey, A., Bundy, A.C. & O’Shea, K. (2015). Recovery Assessment Scale – Domains &
Stages (RAS‐DS): Feasibility and measurement capacity. Australian and New Zealand Journal of Psychiatry. DOI:
10.1177/0004867414564084.

Scanlan, J.N., Hancock, N. & Honey A. (2018). 'The Recovery Assessment Scale – Domains and Stages (RAS‐DS):
sensitivity to change over time and convergent validity with level of unmet need. Psychiatry Research, 261, 560‐
564. DOI: 10.1016/j.psychres.2018.01.042

Hancock, N., Scanlan, J., Smith‐Merry, J., Gillespie, J. and Yen I (2018). Partners in Recovery program evaluation:
changes in unmet needs and recovery. Australian Health Services Review, 42(4), 445‐452. DOI:10.1071/AH17004

Hancock, N., Scanlan, J.N., Kightley, M. Harris, A. (2019). Recovery Assessment Scale – Domains and Stages (RAS‐
DS): measurement capacity, relevance, acceptability and feasibility of use with young people. Early Intervention
in Psychiatry. DOI: 10.1111/eip.12842

PUT SIMPLY:
 The RAS‐DS is a reliable and useful measure of recovery.
 The statements/items are all useful to the overall measurement.
 The 4‐point scale works well with almost all items. There are a couple that are unclear,
but we will need more data to see how they work.
 It is OK to add the scores up to gain a total recovery score out of 152.
 It is also OK to also have sub‐score totals for each recovery domain so that you can see
which domains people are doing better and less well in
 Either a number of people who used the RAS‐DS across these studies were at a ‘high’ stage
of recovery or ‘in recovery’ (a term used by some people to refer to “fully recovered”) OR
we have not yet identified all of the recovery‐oriented achievements that occur as people
approach being in‐recovery. This exploration will continue.
 More recent studies provide good evidence that RAS‐DS is sensitive to change. This is, if a
person’s recovery progresses or changes, this will be reflected in the RAS‐DS scores.

©2019 The University of Sydney Page 15

SECTION 6: OUR FUTURE PLANS/WHAT WE STILL
NEED TO EXAMINE & DEVELOP

DOES THE RAS‐DS MEASURE THE ENTIRE RECOVERY CONSTRUCT?

As we explained earlier, during the process of developing the RAS‐DS, we added items/statements that
consumers identified as missing and being important aspects of their later recovery journeys.

However, testing shows us that while those items are indeed part of the recovery construct and give a
richer/fuller instrument, they might not add sufficiently to the need for a ‘harder’ set of items, or items
relevant to later stages of recovery. This has led us to consider 2 possibilities:

1. The RAS‐DS still does not ‘capture’ or ask about all of the achievements of the later stage of recovery,
or

2. The RAS‐DS does capture or ask about all of the recovery ‘achievements, but many of the people
who used the instrument were in recovery.

This exploration will continue.

IS THE RAS‐DS SENSITIVE TO CHANGE?

As reported above, more recent studies provide good evidence that RAS‐DS is sensitive to
change. However, this work will continue. Without an alternative gold‐standard measure of
recovery to compare RAS‐DS changes to, building robust evidence of sensitivity to change is
challenging. To date we have used CANSAS as a proximal and related measure for comparison.
Sensitivity to change is an important aspect of instrument development/testing and to date we believe
that RAS‐DS has the most robust evidence of this when compared to other recovery measures.

EXAMINING THE RATING SCALE STRUCTURE WITH LARGER SETS OF DATA

While we are happy with the findings to date, further data will enable us to be more confident about
the order and separation of the rating scale structure for all items.

EXAMINING TEST‐RETEST RELIABILITY

We will be examining whether consumers use the RAS‐DS the same way when they use it repeatedly.
That is, would people completing the RAS‐DS give the same ratings today as they would tomorrow if
nothing had changed in terms of their recovery?

DOES THE USE OF THE RAS‐DS LEAD TO BETTER THERAPEUTIC ALLIANCE

AND GREATER CONSUMER CHOICE AND CONTROL IN THEIR RECOVERY
PLANNING?

RAS‐DS was always developed with this goal at the fore. With a solid body of evidence now behind its
measurement properties, we are commencing work to explore if and how using RAS‐DS can lead to
enhanced consumer/provider relationships and maximise the choice and control a consumer has in
their recovery planning and the actioning of these plans.

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CONTACT INFORMATION
If you have any further questions about the RAS‐DS, please contact Nicola Hancock

Dr Nicola Hancock
Senior Lecturer
Discipline of Occupational Therapy
Faculty of Health Sciences
Sydney University

P: +61 2 93519379
E: [email protected]

Or contact the RAS‐DS Team

E: [email protected]

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REFERENCES
Corrigan, P. W., Giffort, D., Leary, M., & Okeke, I. (1999). Recovery as a psychological construct.
Community Mental Health Journal, 35, 231–239. doi: 10.1023/A:1018741302682

Giffort, D., Schmook, A., Woody, C., Vollendorf, C., & Gervain, M. (1995). Recovery Assessment
Scale. Cambridge, MA: Human Services Research Institute.

Hancock, N., Scanlan, J.N., Honey, A., Bundy, A.C. & O’Shea, K. (2015). Recovery Assessment
Scale – Domains & Stages (RAS‐DS): Feasibility and measurement. Australian and New
Zealand Journal of Psychiatry. DOI: 10.1177/0004867414564084.

Hancock, N., Bundy, A., Honey, A., Helich, S., & Tamsett, S. (2012). Measuring the later stages of
the recovery journey: Insights gained from Clubhouse members. Community Mental Health
Journal. Doi: 10.1007/s10597‐012‐9533‐y

Hancock, N., Bundy, A., Honey, A., James, G., & Tamsett, S. (2011). Improving measurement
properties of the Recovery Assessment Scale (RAS) with Rasch analysis, American Journal
of Occupational Therapy, 65, e77‐e85. Doi: 10.5014/ajot.2011.001818.

Hancock, N., Bundy, A., Tamsett, S., & McMahon, M. (2012). Participation of Mental Health
Consumers in Research: Training addressed and reliability assessed. Australian
Occupational Therapy Journal, 59(3), 218‐224. Doi: 10.1111/j.1440‐1630.2012.01011.x

Hancock, N., Scanlan, J.N., Honey, A., Bundy, A.C. & O’Shea, K. (2015). Recovery Assessment
Scale – Domains & Stages (RAS‐DS): Feasibility and measurement capacity. Australian and
New Zealand Journal of Psychiatry. DOI: 10.1177/0004867414564084.

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©2019 The University of Sydney Page 18

APPENDIX 1:
RECOVERY ASSESSMENT SCALE – DOMAINS &
STAGES (RAS-DS)

©2019 The University of Sydney Page 19

 Name: ......................................................

RAS‐DS (Recovery Assessment Scale – Domains and Stages)

Instructions: Below is a list of statements that describe how people sometimes feel about themselves
and their lives. Please read each one carefully and circle the number to the right that best describes
you at the moment. Circle only one number for each statement and do not skip any items.

DOING THINGS I VALUE

A bit Mostly Completel
UNTRU TRU TRUE y TRUE
E E
1 It is important to have fun 1 2 3 4
2 It is important to have healthy habits 1 2 3 4
3 I do things that are meaningful to me 1 2 3 4
4 I continue to have new interests 1 2 3 4
5 I do things that are valuable and helpful to others 1 2 3 4
6 I do things that give me a feeling of great pleasure 1 2 3 4
LOOKING FORWARD
A bit Mostly Completel
UNTRU TRU TRUE y TRUE
E E
7 I can handle it if I get unwell again 1 2 3 4
8 I can help myself become better 1 2 3 4
9 I have the desire to succeed 1 2 3 4
10 I have goals in life that I want to reach 1 2 3 4
11 I believe that I can reach my current personal goals 1 2 3 4
12 I can handle what happens in my life 1 2 3 4
13 I like myself 1 2 3 4
14 I have a purpose in life 1 2 3 4
15 If people really knew me they would like me 1 2 3 4
16 If I keep trying, I will continue to get better 1 2 3 4
17 I have an idea of who I want to become 1 2 3 4
18 Something good will eventually happen 1 2 3 4
19 I am the person most responsible for my own improvement 1 2 3 4
20 I am hopeful about my own future 1 2 3 4
21 I know when to ask for help 1 2 3 4

Recovery Assessment Scale – Domains and Stages (RAS‐DS – Research Version 3).
©2015 Nicola Hancock and The University of Sydney.
Not to be copied or used for any other purpose without written permission from the author
([email protected])
 LOOKING FORWARD (continued)
A bit Mostly Completel
UNTRU TRU TRUE y TRUE
E E
22 I ask for help, when I need it 1 2 3 4
23 I know what helps me get better 1 2 3 4
24 I can learn from my mistakes 1 2 3 4
MASTERING MY ILLNESS
A bit Mostly Completel
UNTRU TRU TRUE y TRUE
E E
25 I can identify the early warning signs of becoming unwell 1 2 3 4
26 I have my own plan for how to stay or become well 1 2 3 4
There are things that I can do that help me deal with
27 1 2 3 4
unwanted symptoms

28 I know that there are mental health services that help me 1 2 3 4

29 Although my symptoms may get worse, I know I can handle 1 2 3 4
it
30 My symptoms interfere less and less with my life 1 2 3 4
My symptoms seem to be a problem for shorter periods of
31 1 2 3 4
time each time they occur

CONNECTING AND BELONGING

A bit Mostly Completel

UNTRU TRU TRUE y TRUE
E E
32 I have people that I can count on 1 2 3 4
33 Even when I don’t believe in myself, other people do 1 2 3 4
34 It is important to have a variety of friends 1 2 3 4
35 I have friends who have also experienced mental illness 1 2 3 4
36 I have friends without mental illness 1 2 3 4
37 I have friends that can depend on me 1 2 3 4
38 I feel OK about my family situation 1 2 3 4

Recovery Assessment Scale – Domains and Stages (RAS‐DS – Research Version 3).
©2015 Nicola Hancock and The University of Sydney.
Not to be copied or used for any other purpose without written permission from the author
([email protected])