Thank you for all your support, Lizz! Couldn't have done this without you!

Photo: Olavi Ruhno

I'm extremely grateful to my loved ones, extraordinary interviewees, and amazing supervisors @lizzypearson.bsky.social , Anthony Richards, John Morrison at Royal Holloway, University of London @cvtrc.bsky.social

I argue that instead of evaluating interventions' “success”, more attention should be placed on assessing participant progress and creating a standardised progress measuring tool. Due to tertiary prevention processes being non-linear, relapse should be considered an inevitable part of programmes.

More importantly, there are several tensions between recommendations of researchers-policy makers and practitioners why the latter do not measure impact of their work with standardised tools. Some recommendations are difficult or close to impossible to practice in reality.

Why impact assessment is not practised? There are several reasons, including lack of trust in standardised tools and methods, and tendency to work based on professional intuition.

Programme development is tracked through monitoring or evaluation conducted by an outside evaluator or funder.

The result show that only 50% of interviewed exit workers measure participant progress with standardised tools or set criteria. To measure participant progress, practitioners employ screening, needs assessment, indicators of change, and standardised tools.

My thesis seeks answers to three questions: how do tertiary prevention intervention providers measure the progress or regression of participants; how do tertiary prevention intervention providers measure the impact of programmes; and what is the reasoning for not practising impact assessment.