Purpose – The purpose of this paper is to review the available evidence regarding the effectiveness and cost effectiveness of Recovery Colleges. To make suggestions for future research. Design/methodology/approach – Selective review of relevant published studies, including reports in the “grey” literature. Findings – Despite methodological limitations, it has been consistently found that attendance at Recovery Colleges is perceived to be useful and to help people progress towards their recovery goals. There is some evidence of reductions in service use (and therefore costs). In addition, there is evidence of beneficial effects for peer trainers and possible positive impact on staff attitudes. Research limitations/implications – The existing research highlights the need for further robust studies, using both qualitative and quantitative methods, to understand better the overall impact of Recovery Colleges and the underlying mechanisms of change. Practical implications – There is a need for further studies of the relationship between the “key defining features” and outcomes. This means the collection and pooling of systematic, “practice-based” evidence. Social implications – The introduction of an explicitly recovery educational (“learning”) model into mainstream mental health services seems to have a profound effect on reducing the power differences inherent in traditional professional/patient relationships. If this can be replicated across organisations it could facilitate the kind of fundamental cultural change necessary to give back recovery to the people who have always owned it. Originality/value – The information collected together in this paper is already publicly available, however it is difficult to find. The analysis and interpretation is original.

Purpose – This paper aims to describe the working of one of the first Recovery Colleges (RCs) and explore the defining characteristics. Design/methodology/approach – This study explores the ways in which an educational approach contributes to the process of recovery as observed in the Nottingham Recovery College (NRC). A mixed-method research design was adopted, combining interviews, observation and visual methods as well as analysis of quantitative data. The process contributed to the continuing development of “fidelity criteria”, or defining principles and key features, of the college. Findings – The NRC demonstrates the possibilities of offering an alternative approach within mental health services; one which is educationally rather than therapeutically informed. The design and operation of the college is informed by educational principles in the creation and execution of the curriculum. This is critically developed through processes of co-production and co-facilitation by those with professional and lived experience, supported by policy development, rigorous documentation and the creation of a supportive, but challenging culture and environment. Students are offered very real opportunities for involvement, progression and leadership within and beyond the college. Research limitations/implications – Whilst building on work on education in self-management, the RCs move beyond the transmission of information to create new relationships between mental health professionals and students (rather than “service users”) – and through this, the relationship between students and their “condition” appears to be transformed. Early evidence suggests the NRC also provides a model of interaction that is distinct in educational terms. Practical implications – There is significant interest nationally and internationally in the development and operation of RCs in England. RCs present a possibility of transformation in the lives of people with long-term mental health conditions, with outcomes such as greater confidence and hope for the future in addition to widening social networks and providing opportunities for progression. They are also important in the implementation of Recovery through organisational change and the remodelling of commissioning arrangements. Originality/value – This is the first paper to be presented for publication specifically on the NRC. There is currently little published research on RCs. These are unique (and varying) organisations which are creating considerable interest nationally and internationally. An exploration of their defining characteristics will feed into subsequent larger-scale research.

In this, the second half of this two-part article, the authors focus on ethical dilemmas in clinical supervision. Referring to the case vignettes included in the first part of this article (Vol 7(15): 920-3), the authors highlight how ethical dilemmas can arise and then provide some discussion on how they might be handled. As a result of the discussion, the authors conclude that there is a clear need for a specific set of guidelines to be produced that would help safeguard best practice within clinical supervision and ensure it remains an opportunity to help and support nurses in reflecting on their dilemmas, difficulties and successes (Cutcliffe and Proctor, 1998a). This would prevent supervision from becoming another form of management monitoring which might inadvertently prevent the resolution of intra- and interpersonal issues affecting the care of clients.

In this article, the first of two parts, the authors focus on ethical dilemmas in clinical supervision. Given that there may be several factors that contribute to the limited uptake of clinical supervision, the authors suggest that one reason might be the clinician's concern and confusion regarding the potential ethical dilemmas that could arise when providing clinical supervision. Most issues do not produce ethical dilemmas, but some do. Therefore, this article offers a brief description of the purpose and alleged benefits of supervision, and examines the current position of the law in regard to ethical dilemmas within supervision. It then provides six vignettes where supervisors are faced with ethical dilemmas. These will be discussed in the second part of this article.

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