A five-stage model compatible with psychological recovery is proposed, which offers a way forward for attaining recovery-orientated outcomes. After further empirical investigation, a version of this model could be utilized in quantitative research, clinical training and consumer education.

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Aim Investigate whether acute workload (1 week total distance) and chronic workload (4-week average acute workload) predict injury in elite rugby league players. Methods Data were collected from 53 elite players over two rugby league seasons. The 'acute:chronic workload ratio' was calculated by dividing acute workload by chronic workload. A value of greater than 1 represented an acute workload greater than chronic workload. All workload data were classified into discrete ranges by z-scores. Results Compared with all other ratios, a very-high acute:chronic workload ratio (≥2.11) demonstrated the greatest risk of injury in the current week (16.7% injury risk) and subsequent week (11.8% injury risk). High chronic workload (>16 095 m) combined with a veryhigh 2-week average acute:chronic workload ratio (≥1.54) was associated with the greatest risk of injury (28.6% injury risk). High chronic workload combined with a moderate workload ratio (1.02-1.18) had a smaller risk of injury than low chronic workload combined with several workload ratios (relative risk range from 0.3 to 0.7×/÷1.4 to 4.4; likelihood range=88-94%, likely). Considering acute and chronic workloads in isolation (ie, not as ratios) did not consistently predict injury risk. Conclusions Higher workloads can have either positive or negative influences on injury risk in elite rugby league players. Specifically, compared with players who have a low chronic workload, players with a high chronic workload are more resistant to injury with moderate-low through moderate-high (0.85-1.35) acute:chronic workload ratios and less resistant to injury when subjected to 'spikes' in acute workload, that is, very-high acute:chronic workload ratios ∼1.5.

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Objective: In order to realize the vision of recovery-orientated mental health services, there is a need for a model and a method of measuring recovery as the concept is described by mental health consumers. A preliminary five-stage model based on consumer accounts was developed in an earlier study by the authors. This next stage of the research program describes the development and initial testing of a stage measure which, when validated, can be used in testing that model. Method: Existing measures of recovery were reviewed to assess their concordance with the model, and a new measure, the Stages of Recovery Instrument (STORI) was subsequently developed. A postal survey was conducted of 94 volunteers from the NISAD Schizophrenia Research Register. Participants completed the STORI and measures of mental health, psychological wellbeing, hope, resilience and recovery. Results: The STORI correlated with all of the psychological health variables, and the five stage subscales were found to be internally consistent. An ordinal relationship between the stage subscales was demonstrated by the intercorrelations of the subscale scores and the pattern of correlations between the subscales and the other measures. However, a cluster analysis of items revealed an overlap in measurement of adjacent stages, with only three clear clusters emerging. Conclusions: The results provide preliminary empirical validation of the STORI as a measure of the consumer definition of recovery. However, refinement of the measure is needed to improve its capacity to discriminate between the stages of the model. The model could then be comprehensively tested using longitudinal methods and the inclusion of objective measures.