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As organisations become increasing aware of the importance of mental health and wellbeing and especially how to aid recovery, published research* from Gemma Ramshaw and Helen St Clair-Thompson of the School of Psychology at Newcastle University, UK sheds some potentially valuable light on the role that mental toughness can play in recovery.  

Participants in the study completed three questionnaires – the mental toughness questionnaire MTQ48, the Recovery Assessment Scale and the Illness Management and Recovery scale. 

Since this study in 2021, the 4Cs Mental Toughness concept (from which the MTQ48 is derived) can now be understood in a little more detail. The 4Cs model is shown below: 


The researchers found a particularly strong relationship between the commitment and confidence in abilities factors of the 4Cs model of mental toughness and subjective mental illness recovery. In each case, mental toughness predicted a large proportion of the variance in subjective mental illness recovery.  

These findings suggest that mental toughness, in particular the Commitment factor – the ability to persevere and to reach targets successfully, and the Confidence In Abilities factor, the self belief in your abilities to complete difficult tasks, may either facilitate recovery from a mental illness, or increase as mental wellbeing increases. 

This resonates with a significant body of research from the University of Basel** which showed that there was a relationship between mental toughness (using the same 4Cs concept and MTQ48 measure) and the capability to deal with anxiety, stress and depression. This didn’t suggest a mentally tough individual was less likely to experience these. They weren’t. They proposed that the more mentally tough were better able to manage their responses to these. 

Studies from the same group revealed that adolescents with higher mental toughness scores are more likely to have a deeper sleep with fewer awakenings. 

Other studies on other aspects of health and well-being – diet, weight loss, fitness show similar patterns. And most studies show that all the mental toughness factors are related positively to wellbeing to different degrees. 

The authors of the Newcastle paper conclude: “The .. study revealed a potential role for mental toughness in subjective mental illness recovery, emphasising in particular commitment and confidence in abilities. This suggests that there may be value in considering mental toughness within clinical settings, such as when personal subjective recovery is being assessed.” 

Its seems that mental toughness and hopefully creating self awareness about an individual level of mental toughness across the different factors can become part of a armoury of approaches that help to minimise loss of wellbeing and help to optimise recovery when it has occurred. 

For more information about the 4Cs mental toughness concept and to train to use the MTQ measures, contact:  



*Gemma Ramshaw, Helen St Clair-Thompson: The relationship between mental toughness and subjective mental illness recovery , Elsevier, New Ideas in Psychology, 2021 

**AQR International maintains a directory of more than 200 peer reviewed research papers which look at the mental toughness concept in different settings and with different applications.  If interested contact