Figure - available from: Social Psychiatry and Psychiatric Epidemiology
This content is subject to copyright. Terms and conditions apply.
Shared meaning of personal recovery themes
Source publication
Purpose
Long-term data on recovery conceptualisation in psychotic illness are needed to support mental health services to organise themselves according to recovery-oriented frameworks. To our knowledge, no previous research has investigated how first-episode psychosis (FEP) service users (sampled across psychotic illness type) perceive recovery bey...
Similar publications
Objectives
The current study sought to qualitatively characterize the experiences of American users in a recent open trial of the Horyzons digital platform.
Methods
In total, 20 users on Horyzons USA completed semistructured interviews 12 weeks after their orientation to the platform and addressed questions related to (1) the platform, (2) their o...
Higher education institutions are uniquely placed to introduce emotional coping skills to promote resilience in pre-registration nurses in order to reduce anxiety and increase confidence before they enter clinical placement for the first time. In this qualitative study, we will explore the use of a 360-degree video in developing skills for coping....
Citations
... Regaining social status and being so-called normal or ordinary after FEP was thematized by many participants. The desire for normality (22,49,51) and the importance of recovering identity and a sense of self (62,63) appears as a core concern for people with lived experience of psychosis (24,62,64). For other participants, it seemed important for recovery to nd a less conventional lifestyle that suited them, although they were equally concerned with feeling included. ...
Background: Qualitative research frequently characterises recovery, but more knowledge on subjective experiences of facilitators of long-termrecovery in psychosis is needed. This interview study aimed to explore what people with first-episode psychosis (FEP) highlight as important for their long-term recovery.
Methods: Interviews with 20 individuals in recovery (personal and/or clinical) participating in two follow-up studies, 10 and 20-years after treatment start for a first episode schizophrenia or bipolar spectrum disorder. Interviews were thematically analysed by the research team that included a peer researcher.
Results: The analysis generated that personal agency was experienced as the overarching facilitator of recovery, with five themes: 1. Doing recovery in everyday life, involving agency in daily life; 2. Re-evaluating risk, involving re-evaluating limitations and stress reduction; 3. Becoming a caregiver, involving development from being cared for to taking care of others; 4. Negotiating normality, involving identity and social inclusion; 5. Owning and sharing your story, involving accepting lived experience and overcoming stigma.
Discussion: All participants described themselves as the main facilitators of their own recovery, and treatment as secondary to their efforts. Gradually testing limitations and taking risks, providing social support to others, as well as owning and sharing your story were crucial for promoting long-term recovery in FEP. Clinical implications include supporting service users’ agency with strength- based interventions and shared-decision making, and refining stress reduction psychoeducation in a long-term perspective.
... Co ważne, opisywanie problemów i sytuacji według PTMF nie dotyczy jedynie osób u których można byłoby zdiagnozować zaburzenie psychiczne, stosuje się ono do wszystkich, wszyscy bowiem podlegamy procesom na które ta propozycja podejścia do diagnozy zwraca uwagę. Tym samym rozróżnienie na zaburzenie i jego brak traci istotność a pomoc można 73 O'Keeffe, Sheridan, Kelly et al. (2022). 74 Hoffman (2019). ...
Głównym celem artykułu jest problematyzacja paternalizmu i dyrektywności w kontekście różnic między psychoterapią a poradnictwem. Często przyjmuje się, że psychoterapia dotyczy zaburzeń psychicznych, poradnictwo zaś kryzysów rozwojowych i innych problemów u osób zdrowych. Przyjęcie takiej perspektywy oraz etyki psychoterapeutycznej jest równoważne z przyjęciem dyskursu interwencji medycznej i wiąże się z traktowaniem pacjenta w sposób paternalizujący i dyrektywny. Jest to problematyczne, gdyż sama kategoria "zaburzeń psychicznych", jak i kryteria diagnostyczne poszczególnych diagnoz, krytykowane są z wielu różnych pozycji. Przykład Soterii, podejścia terapeutycznego dla osób z diagnozą psychozy lub schizofrenii, pokazuje, że nawet w przypadku takiej "ciężkiej choroby psychicznej", model pomocy bliższy poradnictwu, pozwalający na zachowanie większej autonomii i podmiotowości pacjenta, może być równie, a nawet bardziej, skuteczny, niż konwencjonalne podejście medyczne i psychoterapeutyczne operujące w aksjologii medycyny. Artykuł stanowić więc może punkt wyjścia do rozważań dotyczących sformułowania właściwego obszaru zainteresowań poradnictwa i psychoterapii, związanych z tym celów tych interwencji oraz konsekwencji etycznych takich decyzji.
... Mindfulness, cultivated through MBIs, is a highly relevant quality or skill for people with mental illness on their personal recovery journey. Personal recovery focuses on multi-facet personal and social outcomes, such as connectedness, identity, meaning, empowerment, hope, and optimism, which are individually defined and rated, beyond the reductionist focus on clinical and functional remission (Ellison et al., 2018;Leamy et al., 2011;O'Keeffe et al., 2022). This approach to recovery emphasises a holistic, person-centred approach that encourages individuals to understand and take responsibility to facilitate their recovery, which underpins global mental healthcare services (Bejerholm & Roe, 2018). ...
Objectives
The current study was conducted to translate and validate the short version of the Kentucky Inventory of Mindfulness Skills (KIMS-Short) for the Chinese mental health population to examine the association between mindfulness and personal recovery.
Method
A sample of 434 community mental health service users completed the Chinese KIMS-Short and measures of self-compassion, psychological distress, and personal recovery.
Results
Results from the first- and second-order confirmatory factor analyses confirmed the five-factor structure proposed by previous research. Validity and internal consistency reliability of the 17-item Chinese KIMS-Short (KIMS-17) were evident. As measured by KIMS-17, mindfulness had moderate to strong correlations with self-compassion, stress, depression, anxiety, and personal recovery measures. Participants with experience in contemplation scored significantly higher overall and in all domains of mindfulness and personal recovery measures than those without experience. Additionally, participants who regularly engaged in contemplative practices scored significantly higher overall and in all domains of mindfulness and personal recovery measures, except for the describing mindfulness skill, compared to those who did not engage in practices.
Conclusions
The KIMS-17 is an appropriate brief and multidimensional mindfulness measure for people with mental illness, regardless of their level of experience in contemplative practice. Engaging in contemplative practices, whether rarely or frequently, may contribute to improvement in mindfulness and facilitate personal recovery.
... Clinical recovery is inherently agnostic about economic and social structures. Personal recovery is understood as the personal and unique process towards a satisfying and contributing life even with the limitations caused by mental illness [10][11][12][13]. The understanding of personal recovery is permeated by ambiguity and complexity [11][12][13], and it has been attributed different connotations over time [7]. ...
... Personal recovery is understood as the personal and unique process towards a satisfying and contributing life even with the limitations caused by mental illness [10][11][12][13]. The understanding of personal recovery is permeated by ambiguity and complexity [11][12][13], and it has been attributed different connotations over time [7]. This understanding of recovery originated during a period of social upheaval and the transformation of public organisations and institutions (the 1960s). ...
... This practice subjected patients to a one-size-fits-all approach to treatment-supported recovery and simultaneously relegated the responsibility for the actualisation of clinical recovery to the individual patient. In effect, a "take it or leave it scenario" emerged on the grounds of the standardisation of clinical treatment [1,12]. The findings in the established research corresponded to the main finding of this study: a clinical standardisation of the concept of recovery. ...
The realisation of recovery as an overarching goal of mental health care services has proven difficult to achieve in practice. At present, concepts of recovery are contested and unclear, which affects their implementation in psychiatric practices. We examined social psychiatric policies about recovery with the aim to explore their underlying assumptions about recovery. Relevant texts from the policies’ knowledge bases were subjected to reflexive thematic analysis. We developed a central theme: “A clinical standardisation of the concept of recovery”. The theme involved meaning clusters that encompassed conflicting and commonly shared assumptions about recovery across the text corpus. We discussed the findings from discourse analytical and governmentality perspectives. In conclusion, the policies’ aim of providing clarity about recovery was circumvented by the very knowledge bases used to support their endeavours.
... Also relevant to the possibilities of a biased sample, years since first contact with mental health services exceeded 10 years for the vast majority of the present sample and symptom severity data were not captured. Previous research has emphasized the role of time in personal recovery meaning and the potential influence of symptom status on this meaning (O'Keeffe et al., 2022). Ongoing research, motivated by our findings here, could also explore the nuances of these impacts amongst individuals experiencing different phases of wellness (e.g., individuals deemed clinically high risk) and durations of illness (e.g., individuals experiencing their first episode of psychosis compared with the years beyond). ...
Objectives:
Recovery-oriented perspectives have become accepted worldwide as an alternative to the biomedical approach to conceptualizing and managing severe mental health problems. It has been proposed that one advantage of this is to support self-efficacy amongst people with a lived experience of psychosis, especially when recovery messages are presented by lived experience peers. The aim of the present study was to investigate the proposed psychological benefits of the recovery paradigm, by testing for possible differential impacts of recovery versus biomedical messages on self-efficacy beliefs and positive emotional state amongst people with experience of psychosis. It was hypothesized that (1) recovery-oriented messages, when presented by lived experience peers, would generate improvements in self-efficacy and positive emotions relative to biomedical messages presented by a professional and (2) recovery-oriented messages delivered by a professional would generate improvements in self-efficacy and positive emotions relative to biomedical messages delivered by a professional. We also explored whether recovery-oriented messages were more impactful when delivered by a lived experience peer versus a professional.
Design:
Experimental design with three within-subject video-based conditions.
Methods:
Fifty-three participants with lived experience of psychosis viewed three videos: (i) people with lived experience sharing their experiences of recovery; (ii) mental health professionals presenting traditional biomedical conceptualizations of psychosis; and (iii) mental health professionals presenting recovery perspectives. Participants provided baseline clinical and demographic information, and post-viewing ratings of experienced changes in self-efficacy and emotional state.
Results:
Hypothesis 1 was supported: both self-efficacy and positive emotions were significantly increased by a video of peers sharing personal recovery stories relative to professionals presenting biomedical messages. Hypothesis 2 was partially supported: when comparing videos of recovery versus biomedical messages delivered by professionals, significant relative benefits were found for positive emotions, but not self-efficacy.
Conclusions:
This experimental investigation generated a pattern of findings broadly supportive of the assumed psychological benefits of the recovery paradigm for people with lived experiences of psychosis. Findings must be interpreted with caution given the limitations of the present design, but encourage further experimental research to directly test the interpersonal impacts of the recovery paradigm.
... That is, a distinction is made between clinical recovery and personal recovery [83]. This grounding of recovery on the personal perspectives of people who are experts-by-experience is considered fundamental if advances in understanding recovery processes and mechanisms are to be made in ways that make a meaningful difference to experts-by-experience, scientists, clinicians and policy makers [93][94][95][96][97]. ...
... Personal recovery embraces and explores experiences of personal growth as a result of coming through, or better still, being able to simply 'be with' severe mental health problems [68,95,96,97,98]. There are extensive evidence-based examples of personal recovery in people with psychosis [82,83,88]. ...
... Yet, the question arises concerning the extent of the evidence for personal recovery in people experiencing both psychosis and suicidal thoughts/acts in tandem. From one of our qualitative studies looking at the experiences of resilience expressed by people who had suicidal thoughts/acts the following quote illustrates the way that resilience was seen to develop from coming through extremely difficult personal problems [73] Research that aims to understand recovery based on the views of a diverse range of people experiencing psychosis is expanding [93][94][95][96][97][98][99][100][101][102][103]. As we have seen from some of the qualitative work that we have presented, it is not necessarily the case that the only way of finding meaning in life whilst having mental health problems is to escape from those problems [73]. ...
It is important to understand the psychological factors which underpin pathways to suicidal experiences. It is equally as important to understand how people develop and maintain resilience to such psychological factors implicated in suicidal experiences. Exploring optimal routes to gaining this understanding of resilience to suicidal thoughts and acts in people with severe mental health problems, specifically non-affective psychosis, was the overarching aim of this position paper. There are five central suggestions: 1. investigating resilience to suicidal experiences has been somewhat overlooked , especially in those with severe mental health problems such as schizophre-nia; 2. it appears maximally enlightening to use convergent qualitative, quantitative and mixed research methods to develop a comprehensive understanding of resilience to suicide; 3. relatedly, involving experts-by-experience (consumers) in suicide research in general is vital, and this includes research endeavours with a focus on resilience to suicide; 4. evidence-based models of resilience which hold the most promise appear to be buffering, recovery and maintenance approaches; and 5. there is vast potential for contemporary psychological therapies to develop and scaffold work with clients centred on building and maintaining resilience to suicidal thoughts and acts based on different methodological and analytical approaches which involve both talking and non-talking approaches .
... W takim podejściu, powiększanie dobrostanu nie musi koniecznie oznaczać "redukcji objawów choroby", tak jak i "redukcja objawów choroby" niekoniecznie prowadzi do większego dobrostanu czy też wyższej jakości życia, a wyższy dobrostan możliwy jest też niezależnie od nasilenia samych "objawów chorobowych". Zresztą, sama koncepcja "zdrowienia" (recovery) kontestowana jest przez część pacjentów którym udało się "wyzdrowieć" (O'Keeffe et al., 2021). ...
Prezentowana tutaj praca doktorska, pod tytułem „Model biomedyczny w psychopatologii i opozycja wobec niego. Perspektywa psychologiczna” jest projektem w istocie rzeczy interdyscyplinarnym, łączącym perspektywę historyczną i socjologiczną (socjologii wiedzy i socjologii zdrowia i medycyny) czy nawet filozoficzną, z namysłem nad współczesnymi zagadnieniami dotyczącymi psychopatologii i terapii zaburzeń psychicznych, które odwołują się do współczesnej wiedzy psychologicznej i psychiatrycznej. Takie podejście wydaje się konieczne, bowiem zdrowie psychiczne, czy też szeroko rozumiana psychopatologia, jest „obiektem granicznym” (w znaczeniu jakie nadaje temu terminowi Good (2000)) badanym przez różne dyscypliny naukowe; rzetelne przyjrzenie się tej problematyce wymaga więc uwzględnienia różnych perspektyw i ich integrację. Celem pracy jest próba naszkicowania rozwiązań, które mogłyby stanowić realną alternatywę wobec biomedycznego modelu zaburzeń psychicznych, tak w praktyce stricte klinicznej, jak i badawczej.
There is a significant diversity in approach to ‘resilience’ in the context of mental health recovery following experiences of psychosis, varying from clinically measurable outcomes to a personal trait within a recovery ‘journey’. Given the contested nature of resilience within mental health literature, this study aimed to complete a scoping review to synthesise understandings of resilience by individuals with experiences of psychosis. Drawing on the holistic and person-centred principles that underpin social work approaches to mental distress, these perspectives are considered in the statutory, policy and critical contexts of British social work, establishing learning for practice. A meta-synthesis of qualitative studies was completed, drawing on searches of five databases (Social Care Online, APA PsychInfo, Cinahl, Medline and Web of Science), identifying twelve relevant papers. A thematic analysis identified three overarching themes (personal, social and professional factors) and eight associated sub-themes (personal responsibility, use of experience, coping strategies, peer support, social relationships, contribution, relationships with professionals and structured support). The study identifies systemic and life-course approaches as empowering service user engagements with psychosis, recovery and resilience, suggesting that the social work profession is well placed to engage with resilience enhancement in the context of mental health recovery.
This qualitative investigation explored how 18 chronically homeless adults with serious mental illness residing in emergency and temporary supportive housing facilities in Glasgow, Scotland, and New York City conceptualized personal recovery. Thirty-six interviews were conducted and analyzed using interpretative phenomenological analysis. The analysis produced four superordinate themes revealing how participants engaged with, envisioned, or disidentified with, the recovery idea, in the context of chronic life adversity, co-occurring conditions, a precarious present and an uncertain future. Health and social care providers should be responsive to clients’ diverse ideas about recovery and facilitate their exploration of authentic pathways to a “good life.”
