Making Sense of It All: Consumer Providers' Theories about Factors Facilitating and Impeding Recovery from Psychiatric Disabilities.
St. Louis University, School of Social Service, St. Louis, MO 63139, USA.Psychiatric Rehabilitation Journal (Impact Factor: 1.16). 02/2005; 29(1):48-55. DOI: 10.2975/29.2005.48.55
This qualitative study examined the accounts of fifteen adults regarding how they recovered from serious psychiatric disability. Interviews were analyzed using a grounded theory approach within a framework of Symbolic Interactionism. Recovery was identified as a dynamic process of personal growth and transformation. Barriers to recovery included paternalistic and coercive treatment systems, indifferent professionals, side effects from medication, and psychiatric symptoms. The existence of supportive relationships, meaningful activities and effective traditional and alternative treatments were identified as influential in facilitating recovery. The consumer providers who participated in this study provided important findings and fresh understanding about the recovery process.
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- "Examples of recovery-oriented services include peer support, shared decision-making, and consumer-directed care (Silverstein & Bellack 2008). From a personal recovery perspective, recovery tends to be viewed in highly individualized terms that involve living a satisfying life, taking responsibility, engaging in meaningful activities, and making progress toward self-defined goals within the constraints of one's illness (Mancini et al. 2005). A personal recovery perspective contrasts with a clinical recovery perspective that focuses on observer-rated improvement in predefined symptoms and functioning. "
ABSTRACT: Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce. Expected final online publication date for the Annual Review of Clinical Psychology Volume 12 is March 28, 2016. Please see http://www.annualreviews.org/catalog/pubdates.aspx for revised estimates.
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- "Patients often complain about being uninformed and unprepared to deal with these side effects, which sometimes can make them feel worse than the illness itself (McGrath, 2007). Lack of communication between patients and clinicians has also been identified as a barrier to recovery in mental health patients (McGrath, 2007; Dassori et al., 2003; Mancini et al., 2005; Thompson and McCabe, 2012). Patients generally do not self-report negative effects of treatment; therefore clinicians often underestimate their frequency, severity and subsequently the high possibility of non-adherence (Foster et al., 2008; Naber, 2008). "
ABSTRACT: The primary aim was to assess usability of the My Medicines and Me Questionnaire (M3Q) as a self-reported questionnaire for mental health patients to subjectively express side effects experienced with their psychotropic medications. The secondary aim was to evaluate patients' attitudes towards treatment and psychotropic medications following dialogue with their clinicians about side effects. Questionnaires were administered at six adult mental health facilities. A total of 205 participants were divided into intervention (facilitated dialogue) and non-intervention groups (no facilitated dialogue). The mean completion time for the M3Q was 15min (SD=6.5) with only 11 (5%) patients requiring assistance. The most commonly reported side effect was sedation (77%) and weight gain was ranked as the most bothersome (23%). The previously validated M3Q provided patients with the opportunity to express the impact these effects had on their lives. Side effects were the most common reason given for non-adherence. There were no significant changes in patient attitudes towards treatment and medications in the intervention group, mainly due to the logistical challenges in the clinicians' ability to view the questionnaire for the subsequent meeting with the patient. The M3Q demonstrated its usability in allowing patients to easily express their subjective experiences with side effects.
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- "ncini, Hardiman, & Lawson, 2005), elimination of stigma (Jacobson & Greenley, 2001; Ridgway, 2001), peer support (Mancini, 2007; Schön, Denhov, & Topor , 2009 ) , resilience ( Torgalsbøen & Rund , 2010), strong clinician – client relationship ( Green et al., 2008 ) , and social support ( Cohen, 2005 ; Davidson , 2003 ; Jacobson & Greenley , 2001 ; Mancini et al . , 2005 ; Schön et al . , 2009 ) are among the important facilitative psychosocial factors of recovery identi - fied in qualitative studies . Third , several psychosocial factors that have been investi - gated for their association with more favorable outcomes marked by circumscribed deterioration in function or less severe symptomatology have "
ABSTRACT: Objective: We assessed the prevalence of recovery from schizophrenia during the first year of community-based psychosocial rehabilitation and whether psychosocial attributes predicted the achievement of recovery beyond demographic and clinical characteristics. Method: We used data from 246 individuals with schizophrenia spectrum disorder collected at baseline and 6 and 12 months after admission to psychosocial rehabilitation. Results: The proportion of participants who showed recovery for either 6-month period and for 1-year period during the follow-up period was 19.86% and 7.53%, respectively. Although predictors of recovery for 1-year period could not be reliably estimated due to its low prevalence, higher levels of intrinsic motivation and more positive family relationships at baseline predicted recovery for either 6-month period after controlling for initial functioning capacity. Conclusion: In the context of psychosocial rehabilitation, individuals with schizophrenia have highly heterogeneous trajectories. Psychosocial attributes at the start of treatment are important contributors to successful recovery.