The Personal Meaning of Recovery Among Individuals Treated for a First Episode of Psychosis
Department of Health Outcomes and Health Services Research, London Health Sciences Centre, London, Ontario, Canada. Psychiatric services (Washington, D.C.)
(Impact Factor: 2.41).
04/2012; 63(6):548-53. DOI: 10.1176/appi.ps.201100424
There is little understanding of service users' conceptions of recovery in the early phase of psychotic disorders. An enhanced understanding of personal notions of recovery may help with the development and evaluation of interventions that address the concerns of service users. This study examined personal definitions of recovery among individuals recently treated in a specialized early-intervention service in Canada.
Semistructured interviews were carried out with 30 individuals three to five years after initial treatment of a first episode of psychosis. Interpretative phenomenological analysis was used to examine participants' personal meanings of recovery. A typology of recovery definitions was constructed.
A majority of individuals considered themselves to be recovered. Responses indicated that recovery is a multidimensional experience and is often a personalized and achievable goal at this early stage in treatment. Individuals described recovery as improvement in one or more of three domains: illness recovery, psychological and personal recovery, and social and functional recovery. There was variation in the extent to which individuals perceived that recovery involved alleviation of symptoms and elimination of underlying vulnerability to illness.
There were several components of the personal meanings of recovery from a first episode of psychosis and variations in the emphasis that individuals placed on each component. An overall positive outlook may be a function of younger age, shorter duration of illness, and receipt of client-centered comprehensive and phase-specific treatment. Improved understanding of personal notions of recovery can guide clinical practices to address service users' recovery goals.
Available from: Sini Jacob
- "The internal process enables the person to understand the person's being and helps the person to 'live the life rather than existing' (Peter). Consumers involved in many other studies also expressed similar views towards recovery, such as transformation of self and/or finding personal meaning (Aston & Coffey, 2012; Davidson et al., 2005; Hipolito, Carpenter-Song, & Whitley, 2011; Lakeman, 2010; Mancini, 2007; Mancini et al., 2005; McEvoy, Schauman, Mansell, & Morris, 2012; Piat et al., 2009; Windell, Norman, & Malla, 2012). Consumers, carers and nurses had consistent views on the external process of recovery. "
[Show abstract] [Hide abstract]
ABSTRACT: Abstract Background Mental health recovery is a prominent topic of discussion in the global mental health settings. The concept of mental health recovery brought about a major shift in the traditional philosophical views of many mental health systems. Aim The purpose of this article is to outline the results of a qualitative study on mental health recovery, which involved mental health consumers, carers and mental health nurses from an Area Mental Health Service in Victoria, Australia. This paper is part one of the results that explored the meaning of recovery. Methods The study used van Manen's hermeneutic phenomenology to analyse the data. Findings Themes suggested that the cohort had varying views on recovery that were similar and dissimilar. The similar views were categorised under two processes involving the self, an internal process and an external process. These two processes involved reclaiming various aspects of oneself, living life, cure or absence of symptoms and contribution to community. The dissimilar views involved returning to pre-illness state and recovery was impossible. Conclusion This study highlights the need for placing importance to the person's sense of self in the recovery process.
Available from: Paul H Lysaker
- "Another qualitative study identified social support, medication, meaningful activities, and lifestyle modifications as recovery facilitating factors in the view of people treated in a specialized early-intervention service (Windell & Norman, 2013). Symptom alleviation and social functioning have also been identified as critical components in the personal meaning of recovery, as described by young people experiencing psychosis (Windell, Ross, & Malla, 2012). Therefore, we wondered if persons recently diagnosed with psychosis have experiences that fit into Andresen's five stage model. "
[Show abstract] [Hide abstract]
This study sought to explore the links between recovery stages, symptoms, function, and narrative development among individuals with a recent onset of psychosis.DesignA qualitative longitudinal study was conducted including quantitative data at baseline.Methods
Forty-seven participants were administered the Indiana Psychiatric Illness Interview three times over 9 months and content analysis was performed. Participants also completed the Social Functioning Scale, the Brief Psychiatric Rating Scale – Expanded, the California Verbal Learning Test, and the Trailing Making Test at baseline. Descriptive discriminant analysis was performed.ResultsResults suggested that participants were mostly in the first two stages of recovery (moratorium, awareness) and that being in the awareness, rather than moratorium, stage was associated, to a different extent, with richer narrative development, better levels of psychosocial function, less negative and positive symptoms, and more years of education. Furthermore, recovery appeared to be a stable process over the assessment period.Conclusions
Recovery is a complex concept including objective and subjective aspects. In the recovery path of persons recently diagnosed with psychosis, social engagement, narrative development, and occupational functioning seem to be particularly important aspects. This study is a first step, and future research is needed with larger and more diverse participant pools, and assessments conducted over longer periods of time.Practitioner pointsAs greater level of social engagement was the most robust predictor of membership in the awareness versus moratorium stage, treatment of early psychosis should include interventions targeting social relations and social skills.As greater narrative development was the second most robust predictor, enhancing it via psychotherapy could be a pertinent clinical goal.
Available from: Srividya Iyer
[Show abstract] [Hide abstract]
ABSTRACT: Our objective was to describe the goals identified by patients upon entering a specialized programme for treatment of first-episode psychosis (FEP) in Chennai, India.
68 patients with FEP completed the Goal Attainment section of the Wisconsin Quality of Life-Client Questionnaire upon entry into treatment. Patients were asked to identify a maximum of three treatment goals and rate each identified goal on its importance and the extent of its achievement.
In the order of frequency of endorsement, the primary goals identified pertained to work, family/interpersonal relationships, education, symptom relief and psychological recovery, living condition, religion, finances, and household responsibilities. All patients identified at least one goal, 41 patients identified two goals, and 11 patients identified three goals.
Individuals with FEP in India present with a range of realistic and reasonable goals. Findings have implications for improving early intervention services in India by targeting patient-identified goals.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.