Cross-cultural de-centring of Recovery College tools: a 20-country Delphi study

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 globally applicable 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 “coproduction”, “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.