Notion Of Recovery Research Articles

Experiences of living with severe mental disorder: narratives about the personal recovery process.

The article approaches the subject of recovery, a sociopolitical movement, field of studies and practices that aims, from the experience of people living with mental disorders, to promote a more optimistic outlook of the prognosis. Aiming to understand the recovery process of people who experience severe mental disorders, qualitative research was developed, based on Gadamerian hermeneutics. We conducted in-depth interviews, in the form of life narratives, with five people who recognize themselves in the process of recovery, and are part of a mental health patient group. Based on narrative analysis, three axes were organized: recovery process facilitators and coping strategies; barriers of recovery process; and relationship with diagnosis. The discussion is based on Canguilhem's theory; in the logic of psychosocial care, and in theories about the notion of recovery. We identified important intersubjective and sociocultural resources for recovery, however, we concluded that these same elements may constitute barriers to a creative existence, as the social norm remains crossed by the stigma that accompanies mental disorders, and by hierarchical power relations.

Institution or Individuality? Some Reflections on the Lessons To Be Learned From Personal Accounts of Recovery From Schizophrenia

Abstract: In this paper, I argue for a social conception of subjectivity, via a philosophical reading of first-person accounts of recovery from schizophrenia, published in the Schizophrenia Bulletin . Following the hypothesis that these accounts exemplify a more general tension between, on the one hand, normative and social dimensions of the self, and on the other, experiential and psychological dimensions, the first section of the paper formulates the problem from a philosophical perspective inspired by Ludwig Wittgenstein's grammatical approach. The second section explores and rejects different possible readings (sociologistic, phenomenological, or narrativist readings), as conceiving the subject in too passive a relationship with him or herself, and as leading to overly skeptical conclusions about the claims in the first-person accounts insisting on the notion of recovery as a restoration of a sense of self and as empowerment. The third section suggests that a more positive answer can be given via the idea of a certain grammar of recovery governing these narratives, and sketches out how this relates to the more general philosophical question on subjectivity.

Experiências de convivência com o transtorno mental grave: narrativas sobre o processo de recuperação pessoal

Abstract The article approaches the subject of recovery, a sociopolitical movement, field of studies and practices that aims, from the experience of people living with mental disorders, to promote a more optimistic outlook of the prognosis. Aiming to understand the recovery process of people who experience severe mental disorders, qualitative research was developed, based on Gadamerian hermeneutics. We conducted in-depth interviews, in the form of life narratives, with five people who recognize themselves in the process of recovery, and are part of a mental health patient group. Based on narrative analysis, three axes were organized: recovery process facilitators and coping strategies; barriers of recovery process; and relationship with diagnosis. The discussion is based on Canguilhem’s theory; in the logic of psychosocial care, and in theories about the notion of recovery. We identified important intersubjective and sociocultural resources for recovery, however, we concluded that these same elements may constitute barriers to a creative existence, as the social norm remains crossed by the stigma that accompanies mental disorders, and by hierarchical power relations.

What is recovering? Reflection on the place of perception, time and norms in health recovery

The notion of recovery is frequently evoked in healthcare, but it carries with it a number of ambiguities: do we envisage a return to a state that preceded the illness, or a way of composing a new way of living based on the illness? In order to think more precisely about recovery, this paper proposes to take a philosophical look at the notion of norm and to develop its importance through an approach to time, body and world. This analysis will make it possible to clarify the existential aspects involved in health recovery, and to describe the issues at stake in the care relationship in terms of these dimensions of subjective experience.

Empowerment: a step towards the (r)evolution of recovery

We are witnessing a revolution in the field of mental health in France. The notions of recovery, empowerment and social inclusion drive us to transform our care practices. New care and support schemes are being devised throughout the entire French territory. In France, however, the concrete application of empowerment in the field is rather slow, as the notion’s theoretical complexity and promotion are significant moot points. In this article, we aim to address these French difficulties in order to suggest means of implementing empowerment-centered support methodologies. We demonstrate how this notion is correlated with other theoretical movements and how it overlaps with new notions with the aim of leading an ethical reflection. We also illustrate our reflection with clinical observations from the Un chez soi d’abord (equivalent of the US Housing First scheme) scheme.
 Keywords: Empowerment, Recovery, Housing First, Support, Ethics, Humanism

Exploring the Etiological Pathways of Problematic Pornography Use in NoFap/PornFree Rebooting Communities: A Critical Narrative Analysis of Internet Forum Data

Problematic pornography use (PPU) has been extensively studied in terms of its negative implications for various life domains. The empirical literature reveals measured outcomes of interpersonal and intrapersonal dysfunction in participants’ everyday living, supporting its classification as a disorder. The increasing number of complaints around PPU opens the door to the creation of online self-help rebooting communities. This qualitative study aimed to provide a better understanding of this behavior by investigating potential etiological pathways contributing to the onset of PPU, as they were expressed by members of the online NoFap/PornFree self-help communities with self-perceived PPU. The critical narrative analysis reveals a complex web of mutually informing causal connections. The dialectical relationship between situational resources, material conditions, and an embodied spectator gives rise to an online persona with motivations of self-exploration, experimentation, and socializing. A sense of vulnerability rendered the use of pornography as a means of escape and validation. Furthermore, commitment to abstinence, framed by the notions of recovery and relapse, was found to be a major factor for maintaining distress. The study highlighted the need for a thorough understanding of the etiological pathways of PPU for a more effective and targeted intervention. Moving beyond biomedical conceptualizations suggests an intervention whereby PPU is placed in a context of a crisis of meaning.

Service user and eating disorder therapist views on anorexia nervosa recovery criteria

ObjectivesRecovery from anorexia nervosa (AN) is difficult to define, and efforts to establish recovery criteria have led to several versions being proposed. Using the perspectives of people with histories of AN and therapists working in the field, we sought to explore the face validity of Khalsa et al (2017) as one of the most recent examples of proposed systematic recovery criteria.DesignWe interviewed 11 health service users (SUs) with histories of AN who had previously received treatment alongside 8 eating disorder therapists (EDTs), exploring their views on the proposed AN recovery criteria.MethodsData from verbal and written interviews were analysed thematically. Separate thematic analyses of SU and EDT interviews highlighted where concerns converged and diverged across participants.ResultsBoth groups saw some merits of having universally recognized recovery criteria, and the multidimensional approach was welcomed, but EDTs were uncomfortable with considering their use in therapy and SUs felt key components were missing around emotional coping and life quality. SUs disliked the prominence of body mass index (BMI) in the criteria, and all struggled with the proposed duration for recovery. Conceptually, the notion of recovery as an endpoint rather than a journey was contested.ConclusionsOur findings indicate disparities between academically derived recovery criteria and lived experiences and indicate perceived challenges in using such criteria in therapeutic settings. Including SUs and EDTs in the development of criteria may improve the likelihood of consolidating AN recovery criteria, but conceptual challenges remain.Practitioner points AN recovery is complex, and the use of research‐based AN recovery criteria in therapeutic settings could have a detrimental effect on SUs’ outcomes.EDTs should be aware of efforts to define AN recovery criteria.EDTs should engage with debates on defining AN recovery and seek to promote participation in such debates to SUs.

Defining and operationalizing the phenomena of recovery: a working definition from the recovery science research collaborative

A number of definitions exist for the concept of “recovery” in both the substance use disorder (SUD) and mental health (MH) fields. Previous attempts to define recovery have not reached consensus among experts within the field. Thus, the definition has remained diffuse at the expense of attempts to measure and evaluate treatment and recovery outcomes. The notion of recovery as an organizing principle between SUD and MH, collectively identified as behavioral health (BH), can be better served by a collaborative endeavor to define the word and concept of “recovery”. The Recovery Science Research Collaborative (RSRC), an interdisciplinary bi-annual collaboration among recovery researchers and professionals from across the country, sought to address the definition of recovery at the inaugural meeting in December 2017 at Kennesaw State University. The RSRC undertook this task with the primary goal of defining “recovery” for use in research – aiming to create a consensus definition that allows recovery to be clearly operationalized and effectively investigated.

Recovery: experiences of resistance to disablism?

This article explores whether it is fruitful to use a service user/survivor approach to recovery, by seeing recovery as survival of social invalidation. That is survival of the psychosocial forces that were the source of the experience of mental distress, and as survival of social oppression by the psychiatric services and/or wider society. It could be argued that the participants in this study in the United Kingdom and Sweden recovered, and reclaimed and (re)constructed positive identities. They actively resisted experiences of disablism and rebuilt their lives. By approaching recovery from a service user/survivor perspective, one is focusing on the social, structural and political aspects of the recovery process, and one is resisting biomedical, deviant and reductionist notions of recovery.

Impact of cognitive and social cognitive impairment on functional outcomes in patients with schizophrenia.

Schizophrenia is a severely disabling disease that affects millions of people worldwide. The notion of recovery from schizophrenia has recently become a topic of both research and clinical focus. With the advent of antipsychotic medications in the 1950s, many more patients achieved symptom remission than ever before. However, less than half of all patients have been able to achieve recovery. With so many drugs available to improve the symptoms of schizophrenia, why is the disorder still associated with such severe disability? In the last couple of decades, researchers and clinicians have begun to realize that a hindrance to widespread recovery is that available antipsychotic medications have been effective in treating the positive symptoms (hallucinations and delusions) of schizophrenia but not other features of illness such as cognitive impairment. Dysfunction in cognition and social cognition has a significant impact on patients' functional status, meaning that impaired cognition and social cognition should be treatment targets to improve the likelihood of recovery.

English

Strengths-based practice emphasizes the discovery, development, and expression of a variety of strengths as a significant strategy for well-being (Jones-Smith, 2014). The notion of recovery in mental health services refers to living well with mental illness and is often based in creating a self-narrative that includes mental illness but that is not defined by it, or in other words creating a self-narrative of strengths (Onken, Craig, Ridgway, Ralph, & Cook, 2007). The Leisure and Well-Being Model (LWM) (Carruthers & Hood, 2007; Hood & Carruthers, 2007) provides direction for the development of strengths-based therapeutic recreation (TR) programs and this article will describe the development, implementation, and evaluation plan for a TR program designed to address one of the distal goals of the LWM, “cultivation and expression of one’s full potential including strengths, capacities and assets” (Carruthers & Hood, 2007, p. 280) in outpatient mental health services. The literature on recovery in mental health treatment, strengths-based practice, positive psychology and narrative therapy provided the conceptual framework for the application of the LWM to TR services. The resultant program, entitled Be Your Best Self, is described in some detail and the ongoing plans for development and evaluation research are articulated.

JulieNetherland (eds) Critical Perspectives on Addiction. Advances in Medical Sociology Vol. 14. Bingley: Emerald. 2012. v + 243pp £64.73 ISBN: 978–1‐78052–930–1

JulieNetherland (eds) Critical Perspectives on Addiction. Advances in Medical Sociology Vol. 14. Bingley: Emerald. 2012. v + 243pp £64.73 ISBN: 978–1‐78052–930–1

Perceptions of recovery and prognosis from long-term conditions: The relevance of hope and imagined futures.

Analyses of the experiences of chronic conditions demonstrate the importance of moral worth and social meaning linked to undertaking self-management practices. Rather less attention has been paid to the contemplation and significance of adopting, embedding and continuing with established practices overtime. This study explored perceptions about recovery and prognosis from the point of view of people with long-term physical health conditions and compared these findings with the mental health literature. A longitudinal qualitative study was conducted incorporating semi-structured interviews and thematic analysis. Thirty-two participants identified as having a chronic long-term physical health condition such as heart disease and diabetes were included in the study. In line with the notions of recovery in the mental health field, respondents viewed recovery as a complex journey related to the ability to undertake things of value in everyday life. However, there were differences in relation to reflections on trajectories and imagined futures centred on physical health. These findings are discussed in the context of literature from the mental and physical health fields and recent health policies for those with long-term conditions. The study adds to existing literature by examining the similarities and differences in the experience of chronic physical and mental health conditions.

Differences and Similarities Between Functional and Personal Recovery in an Asian Population: A Cluster Analytic Approach

This study gathers empirical data to test whether two forms of recovery are related: (1) the traditional outcome-based notion of recovery from a mental illness, which is called “functional recovery,” and (2) the more recent, consumer-based concept of recovery in mental illness, which is called “personal recovery.” A total of 150 Chinese outpatients were recruited, 75 with bipolar disorder and 75 with schizophrenia, as determined by structured clinical interview. Participants were reported to be in clinical remission for at least the previous 6 months by treating psychiatrists. Personal recovery was measured with the Stages of Recovery Scale, and functional recovery was measured with residential and employment status. In addition to clinical and demographic data, self-report measures included functioning (confirmed through chart review) and a survey of the participant’s assessment of the importance of various elements of recovery. Personal recovery was significantly correlated with functional recovery; small effect size suggested that the two domains are far from identical. The strength of this correlation was stronger for participants with schizophrenia than for those with bipolar disorder. A cluster analysis also suggested that residential and employment statuses, along with personal recovery scores, were useful in differentiating participants. Patients were more likely to reach better recovery outcomes if they were female, married, had higher family income, and perceived social roles as less important to their recovery. Consistent with the consumer literature, personal recovery is related but still distinct from functional recovery. Personal recovery has more to do with life circumstances than with functioning status alone.

A critical discussion of the concept of recovery for mental health consumers in the Emergency Department

The Emergency Department has increasingly become the initial point of contact for mental health crisis assessment and intervention, and is the interface between community and inpatient care. Questions regarding the appropriateness of the Emergency Department in providing a suitable environment for people who have a mental health issue abound with commentary regarding the confidence and competence of general Registered Nurses to provide mental health care. Emergency Departments are busy noisy places where rapid assessments and response is the norm and is counterintuitive to contemporary mental health care. The model of care currently considered best practice in mental health is the Recovery-oriented model; a long term individualised approach to collaborative care. The notion of Recovery as understood and practised in contemporary mental health care is almost polarised to that which is embedded in generalist Emergency Registered Nurses' practice. As Emergency Departments play an integral role in the assessment of people experiencing mental illness, close collaboration and support is required between emergency and mental health specialities to achieve optimal client outcomes in an environment that is nested within the medical model. Furthermore, Emergency Department staff must be supported in acquiring the knowledge and skills required to care for and manage people with a mental health issue. This includes cognisance and understanding of the Recovery-oriented model of care which is the model of care considered best practice for this client group. This paper offers a critical discussion of the concept of recovery for mental health consumers in the Emergency Department.

‘That Weeping Constellation’: Navigating Loss in ‘Memoirs of Textured Recovery’

In The Year of Magical Thinking, Joan Didion laments the absence of any significant body of literature that will help her through her grief. I propose that the grief memoir fills this gap left by professional literature of bereavement and itself contributes to a community of mourners missing from contemporary grief practices as identified by Sandra Gilbert and Darian Leader. This genre, new to literary analysis, provides a fertile ground for the discussion of recent literary and psychoanalytic analyses of mourning that have resisted the neat split Freud draws between normal and pathological grief. My chosen texts deliberately complicate ‘packaged and frozen’ (Ellmann qtd. in Payne, Horn and Relf 78) notions of recovery while honouring what Jenny Diski calls the ‘texture of experience.’ As such, I am essentially identifying a sub-genre of the grief memoir, which I call ‘memoirs of textured recovery.’ What sets them apart is the performance of complex ‘recovered’ selves that show how ‘recovery,’ ambiguous and shifting in nature, calls for more complicated theories of mourning able to accommodate an understanding of grief not in terms of Freud's absolute recovery nor Tennyson's ‘loss forever new’ (Laura Tanner), but rather a space located somewhere in between.

Resistance and Reconstruction: Older Women Talk about Childhood Sexual Abuse

Research which explores the experiences of women, who have experienced childhood sexual abuse is, in the main, focused on young and middle aged women. The perspectives of older women is often absent or hidden in the literature. This study explores the experiences of 16 Australian women aged 57 years and older who have experienced childhood sexual abuse. It aims to privilege their views and highlight their particular contexts in order to redress professional assumptions regarding the notions of recovery. Additionally, in discussing their experiences, the women contribute to insights regarding the patterns of inequality which are produced as a result of dominant discourses that promote ageist and sexist prescriptions in the construction of the self. These insights demonstrate how the women have resisted a range of oppressive patterns in their everyday lives. The study follows a feminist research framework and aims to contribute to the fields of social work practice and critical feminist gerontology.

Work in Progress: Creative Recovery to Creative Livelihoods

The purpose of this study was to provide an update on the performative outcomes of the Creative Recovery project, an innovative community based Arts in Health initiative, since the initial launch in Lockhart River 2008, expansion to Aurukun in 2009, and Mornington Island in 2010. With works from those three communities, the exhibition Work In Progress was launched during the Creating Futures Conference 2010. Selections from that exhibition are presented here. The Arts in Health model is both a culturally appropriate and sustainable model for the meaningful engagement of Indigenous people living in remote communities experiencing mental health problems. These types of projects offer unique opportunities for social enterprise, utilizing creativity as the tool for social inclusion. It has the potential to provide a niche economic opportunity which builds on the notion of recovery as incorporating meaningful livelihoods.

Recovery - what it means to me

I have been working as a mental health user consultant for many years. Words have changed over time or in fact words have remained the same and the way they are interpreted changes. My diagnosis has changed from Manic Depression to Bipolar Disorder but my condition remains the same. A psychiatric labelling system is still in place and nobody asked me how I thought it applied to me. It suits the mental health system to give me a label and I know people are keen to know what is „wrong“ with them but as a wise unknown person said „labels are for parcels not people“. When I was first labelled in 1978 I was a patient in an asylum. This hospital looked like a prison with high walls with barbed wire on top apparently to keep us safe inside. The word asylum had changed from sanctuary, place of refuge to place of compulsory treatment. There was no care in the community that came later and now has become community treatment. I am from England, this is a UK view but similar tales can be told by users and survivors from all over Europe. Survivor is a contentious word when linked to mental health services. Survivor makes mental health workers uncomfortable as it implies we have survived mental health services which were uncaring, unkind and incompetent. This may be true but often is not and means in my view that we should be congratulated in having user mental health services and survived the experience both positive and negative. This demonstrates how words which were welcomed by the user/survivor movement as getting away from being a victim of your illness to having hope for the future by giving the prospect of recovery which did not seem to be there in services. However, our notion of recovery which gave us hope is now used to say „you are recovered“, „you do not need services to help keep you well“. I have been involved in developing a truth and reconciliation process to enable mental health services and mental health users/survivors to acknowledge the wrongs done in the name of psychiatric treatment. The opening statement sets out our view that „Recovery“ is no longer a service user led agenda. We feel that the term in the UK and other countries is becoming almost meaningless. As most health and social care services in England follow a recovery agenda, „Recovery“ has become equated with loss of services, loss of benefits and a push towards returning to work without the support, retraining and flexibility this would require. More Information at: Truth and Reconciliation in Psychiatry (TRIP) http://www.recoveryin-sight.com/the-capabilities-approach-a-draft-request-for-an-apology-comments-welcomed/ Some user/survivors are delighted to be considered recovered and are happy to be left to get on with life. However, they are not likely to have left their mental illness label behind. How many people are considered to be recovered and have a certificate from mental health services to say they no longer have a mental illness? One could say there is not a cure and therefore recovery is actually remission. I think this would be a more honest word to use together with an estimate of likelihood of relapse. This may bring us in to line with physical health services and this false divide between physical and mental health may start to mean a more holistic service for all citizens. Hopefully this debate on terminology and what it means will permeate the ENMESH conference. I hope there will be a dialogue which means users/survivors can work together to devise research which answers these questions and produces outcomes which are relevant to individual citizens’ not just collective groups of symptoms. I look forward to contributing to this discussion by summing up what the recovery stream has said. Hopefully together we can devise an action plan to take this debate forward. Keywords: European Network of Users and Survivors in Psychiatry (ENUSP), labelling, Truth and Reconciliation in Psychiatry (TRIP).

On the very idea of a recovery model for mental health

The recovery model has been put forward as a rival to the biomedical model in mental healthcare. It has also been invoked in debate about public policy for individual and...