Personal Recovery Research Articles

MOSAIC, an example of comprehensive and integrated social and health care: care and practices oriented towards personal recovery.

The Mosaic project is a socio-health integration model that promotes the personal recovery of people with severe mental illness in a territory of Central Catalonia: the Bages region. The recovery approach in mental health care promotes meaningful activities and social inclusion for people with mental health disorders. The aim of this study is to examine the relationship between the level of meaningful activities and other factors associated with the mental health recovery model. A cross-sectional design was used. Participants (n = 59) signed an informed consent and completed the following standardized instruments: Engagement in Meaningful Activities Survey; The Connor-Davidson Resilience Scale; Hert Hope Scale; and Recovery Assessment Scale. A Pearson correlation test was performed between the level of meaningful activities and life satisfaction, resilience, hope, and recovery. These data indicate that the amount of meaningful activities are strongly associated with variables related to the personal recovery process from mental health problems. The integration process of MOSAIC confirms the need to accompany the recovery processes through significant occupations.

Self-Stigma's Effect on Psychosocial Functioning Among People With Mental Illness.

Consequences of self-stigma exhibit a four-step regressive model from being aware of public stigma, to agreeing with it, to applying it to oneself, to resulting harm on the self. We hypothesize the relationship between self-stigma and psychosocial functioning is mediated by three constructs: the why try effect, stigma stress coping resources, and personal recovery. Two hundred eight people with depressive and bipolar disorders participated the study. Data partially supported the regressive model of self-stigma. Awareness was not found to be associated with other regressive stages. The model representing the path between self-stigma-harm and psychosocial functioning was significant and robust. The path was mediated by the why try effect and personal recovery. Findings echo the growing body of research attempting to describe outcomes of self-stigma, in this case, psychosocial functioning. Programs meant to erase self-stigma, and its effect on functioning should incorporate the why try effect and personal recovery as strategic ingredients.

Feasibility and acceptability of continuous identity cognitive therapy as a recovery-oriented suicide treatment for Veterans: A study protocol

BackgroundSuicide is a leading cause of death among Veterans, with rates significantly higher than the general population. To address this issue, it is crucial to develop and implement more effective treatments for Veterans with suicidal thoughts and/or behaviors, particularly those in the post-acute suicidal episode (PASE) stage. The present study aims to establish the feasibility and acceptability of a novel, recovery-oriented treatment called Continuous Identity Cognitive Therapy (CI-CT) for PASE Veterans. MethodsThis 3-year open-label pilot study will include three one-arm trials and a pilot randomized controlled trial (RCT). A total of 57 Veterans with a history of an acute suicidal episode within the previous year will be recruited. Primary outcome measures will include changes in personal recovery, suicidal thoughts, and behaviors. Secondary outcomes will include changes in self-identity, life satisfaction, and hopefulness. Feasibility and acceptability will be assessed through attendance and retention rates, drop-out rates, and client satisfaction. ConclusionThis study aims to develop and evaluate the feasibility and acceptability of a novel recovery-oriented intervention for Veterans experiencing PASE. If the intervention is found to be feasible and acceptable, a manualized version will be finalized and a large-scale multi-site RCT will be designed to assess its clinical efficacy on a broader Veteran population. The results of this trial will aid in the development of effective treatment and provide valuable insights into the preliminary feasibility, acceptability, and effectiveness of this approach in reducing suicidal thoughts and behaviors and promoting recovery and rehabilitation in this population.

“A springboard back to life”: The voices of people with mental health conditions on the process and outcomes of a pre-academic arts program

According to recent United Nations reports, actions are needed to improve the educational, occupational, and social justice of people with mental health conditions. This qualitative study examined a related innovative initiative in Israel, the Garage pre-academic arts program for people with mental health conditions. Based on the constructivist grounded theory approach, service users' voices on the program’s contribution and its change-process factors were collected via six focus groups of students and graduates from three academic cohorts (N = 51). The analysis resulted in “a springboard back to life” theoretical model, presenting the program’s process and outcomes. Participants highlighted components of the approach, the framework, and the arts in the program that contributed to their mental health, personal recovery, and integration into post-secondary education and work. The theoretical model provides valuable knowledge to program developers and policymakers that may promote the human rights and social inclusion of people with mental health conditions.

Personal recovery among people with opioid use disorder during treatment with extended-release naltrexone

Background and aimsRecovery from substance use disorders (SUD) has traditionally been equated with abstinence. “Personal recovery” however emphasizes recovery as a unique and personal process, supported by changes in connectedness, hope, identity, meaning and empowerment. This study aimed to examine personal recovery in people receiving extended-release naltrexone (XR-NTX); specifically investigate changes in personal recovery during treatment, identify groups of participants following distinct trajectories of recovery, and characteristics predicting group-belonging. MethodsOverall change in recovery (Questionnaire about the Process of Recovery, QPR) score was assessed by linear mixed model in a subsample of 135 people with opioid use disorder (OUD) participating in a 24 + 28-week trial of XR-NTX. Growth mixture model was used to identify potential groups of people following distinct trajectories of personal recovery. ResultsOverall, there was a significant change in QPR score during treatment. Four groups with distinct recovery trajectories were identified: “initially low– increase” (G1), “initially average– no change” (G2), “initially high– no change” (G3) and “initially high– increase” (G4). The groups were different with regards to level of psychological distress, social support, and the use of benzodiazepines. In addition, previous participation in opioid agonist treatment programs, current pain, life satisfaction, employment, heroin craving and previous use of heroin also differed between groups. ConclusionsPersonal recovery among people receiving XR-NTX follows different trajectories, and various factors are associated with personal recovery. Particular attention regarding psychological distress, social support and heroin use among patients commencing XR-NTX treatment is important to facilitate successful recovery trajectories.

Effectiveness of the early intervention service for first-episode psychosis in Navarra (PEPsNa): Broadening the scope of outcome measures.

This study compares the effectiveness of a new early intervention service for firstepisode psychosis (FEP) in patients under conventional treatment. Six primary and 10 secondary outcome measures are used to better characterize the comparative effectiveness between two FEP groups. This study plans to enroll 250 patients aged 15-55 years with FEP from all inpatient and outpatient mental health services and primary health care from January 2020 until December 2022. The control group will be composed of 130 FEP patients treated in mental health centers in the 2 years prior to the start of PEPsNa (Programa de Primeros Episodios de Psicosis de Navarra). The primary outcome measures are symptomatic remission, functional recovery, personal recovery, cognitive performance, functional capacity in real-world settings, and costs. The secondary outcome measures are duration of untreated psychosis, substance abuse rate, antipsychotic monotherapy, minimal effective dose of antipsychotic drugs, therapeutic alliance, drop-out rate, number of relapses, global mortality and suicidality, resource use, and general satisfaction in the program. This study arises from the growing need to broaden the scope of outcome measures in FEP patients and to account for unmet needs of recovery for FEPs. It aims to contribute in the dissemination of the NAVIGATE model in Europe and to provide new evidence of the effectiveness of early intervention services for stakeholders of the National Health Service.

Personal Well-being and Recovery in Peer Support Specialists Working at Psychiatric Hospitals.

Objectives: Personal well-being is a major part of recovery for the many people who experience mental illness. Peer support specialists are mental health professionals who have themselves experienced mental illness and use their recovery experiences to facilitate the healing of others. In this study, we explored how peer specialists view their subjective well-being in their work with others and how they perceive their profession. Methods: Seven peer specialists working in a psychiatric hospital participated in individual interviews. We asked them about their personal experiences, their subjective well-being, and their perceptions of the peer specialist profession. We analyzed the interviews thematically. Results: The peer specialists' responses emphasized the link between mental health recovery and subjective well-being. Our findings also indicated the importance of positive relationships and community belonging as fundamental to subjective well-being, and consequently, to recovery. Conclusions: The insights that peer support specialists have acquired and the tools they have mastered in their own recovery process highlight the valuable experience-based knowledge and skills they can provide to others. Future studies may investigate how the experience of their own well-being and recovery directly influences their work with others.

Facts and Personal Recovery Stories to Reduce Substance Use Disorder Stigma and Increase Support for Recovery Housing: a US Randomized Study

Facts and Personal Recovery Stories to Reduce Substance Use Disorder Stigma and Increase Support for Recovery Housing: a US Randomized Study

Understanding Certified Peer Recovery Specialists: The Essence is Connection

ABSTRACT As peer recovery specialists become more essential members of the continuum of care for people who use substances, gaps exist in our understanding of peers. This study tried to understand what attracted people to become Certified Peer Recovery Specialists, how they transitioned to embrace the approach, and how they stayed true to the model as it may not align with their personal recovery pathway. This qualitative study consisted of in-depth interviews with Certified Peer Recovery Specialists (n = 18) and thematic analysis of those interviews. One overarching theme was the importance of connection in all aspects of peer work. Regardless of their initial reactions, all participants reported buying into the multiple pathways and person-centered approach by the completion of the certification process. Peers also described an appreciation for the structures of support provided by agencies such as supervision to maintain fidelity to the model.

Exploring Personal Recovery in Schizophrenia: The Role of Mentalization.

Recovery is a broadly debated concept in the field of psychiatry research and in schizophrenia. Our study aims to understand the correlation between personal recovery from schizophrenia and factors such as mentalization, disability, quality of life, and antipsychotic side effects; Methods: Participants with schizophrenia (according to DSM-5 criteria) were consecutively recruited from the Psychiatry Unit of the University of Catania, Italy. Participants were assessed with the Recovery Assessment Scale (RAS), the Multidimensional Mentalizing Questionnaire (MMQ), the brief version of the WHO Disability Assessment Schedule (WHO-DAS), the EuroQoL-5 dimensions-5 levels, the Insight Orientation Scale (IOS) and the Glasgow Antipsychotic Side Effect Scale (GASS); Results: 81 patients were included. Our findings showed a positive correlation between RAS total scores and MMQ scores, especially in "good mentalizing" subdomains. IOS scores also had a positive association with RAS and MMQ scores. In contrast, poor mentalizing abilities negatively correlated with WHO-DAS 2.0 scores. While antipsychotic side effects influenced functioning, they did not impact perceived recovery. Conclusions: The study's results identified potential predictors of personal recovery from schizophrenia. These findings could contribute to creating tailored interventions to facilitate the recovery process.

Perceived stigma from mental health service providers and its adverse impact on service engagement and recovery among people with mental illness.

The present study investigated how perceived stigma from mental health service providers would influence the mental health recovery of people with mental illness. Specifically, this study examined whether perceived stigma from service providers would adversely affect the clinical, functional, and personal recovery of people with mental illness by exacerbating the content and process of self-stigma and service disengagement. A total of 353 people with mental illness completed questionnaires about perceived stigma from service providers, self-stigma content and process, service disengagement, and clinical, functional, and personal recovery. The associations among these variables were analyzed using structural equation modeling and bootstrap analyses. Structural equation modeling showed that perceived stigma from service providers was related to higher levels of self-stigma content and process, which were, in turn, related to greater levels of service disengagement and then lower levels of clinical, functional, and personal recovery. Bootstrap analyses further showed that perceived stigma from service providers had significant indirect effects on clinical, functional, and personal recovery through self-stigma content and process and service disengagement. Our findings show that perceived stigma from service providers may adversely affect mental health recovery through intensifying self-stigma and heightening service disengagement. These findings highlight the importance of mitigating the stigma-related experiences of people with mental illness in order to facilitate their mental health recovery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of Youth Flexible Assertive Community Treatment: outcomes of an 18-month observational study

PurposeThis Multicenter Youth Flexible ACT Study examined the effect of Youth Flexible Assertive Community Treatment on symptomatic, social, and personal recovery outcomes of adolescents dealing with multifaceted psychiatric and social care needs who do not readily engage in regular office-based mental health services.MethodsNewly admitted clients (n = 199) aged 12–24 years from 16 Youth Flexible ACT teams participated in this observational prospective cohort study. Client and practitioner questionnaires were administered every 6 months, up to 18 months. Latent growth curve analyses were conducted to examine changes in symptomatic, social, and personal recovery outcomes throughout Flexible ACT.ResultsOur analyses of client-reported outcomes showed a decrease in overall psychosocial difficulties, depressive symptoms, and subclinical psychosis symptoms. Moreover, outcomes showed improved social interaction with peers, quality of life, and feelings of empowerment and fewer contacts with the police/legal system. In addition, analyses of clinician-reported outcomes showed a decrease in problems related to family life, peer relationships, school/work attendance, emotional symptoms, and attentional problems. Problems related to personal finance, school and work status, substance misuse, disruptive and aggressive behavior, self-injury, and self-care and independence remained unchanged.ConclusionOur results showed that clients participating in Youth Flexible ACT improved in symptomatic, social, and personal recovery outcomes over 18 months. With its integrated approach and personalized care, this service delivery model is promising for adolescents unable to engage successfully in regular (office based) mental health support services.

The Mediating Role of Depression on the Relationship Between Personal Resources and Recovery Motivation Among Individuals with Drug Abuse Problems

This study aimed to investigate the relationship between personal resources, depression, recovery motivation, and the mediating role of depression among drug abusers. It samples 50 individuals identified with drug abuse problems aged between 16 to 35 years who participated in a treatment programme for drug abuse problems in Cure and Care Rehabilitation Centres. Data were collected through a self-report questionnaire using five instruments: The Patient Health Questionnaire (PHQ), Rosenberg Self-Esteem Scale (RSES), Alcohol Abstinence Self-Efficacy Scale (AASE), The Life Orientation Scale (TLOS), and Commitment to Sobriety (CSS). Data were analysed through SPSS 23 and Partial Least Square-Structural Equation Modelling (PLS-SEM). In the path model, the results demonstrate that personal resources are significantly associated with depression. The finding indicates the significant reciprocal relationship between depression and recovery motivation. The results of this study also reveal the importance of depression in mediating the relationship between personal resources and recovery motivation. This study proposes that high levels of depression could potentially decrease the possibility of recovery motivation in an individual. It can also be concluded that a significant relationship exists between personal resources, depression, and recovery motivation, with depression as a mediator among individuals with drug addiction. These findings imply that mental health issues should also be considered in the treatment plan for people with drug abuse so an individual’s resources can be maximised and their recovery motivation enhanced.

Social functioning mediates the relationship between psychiatric symptoms and recovery among veteran and community service users with serious mental illness.

Previous research has established the impact of psychiatric symptoms on social functioning, while there is a paucity of research examining how social functioning relates to personal recovery, an individual's self-assessment of their mental health recovery. This study examined the mediating effect of social engagement, interpersonal communication, and satisfaction with support in the relationship between distinct psychiatric symptom clusters and perceived mental health recovery. In a cross-sectional study, both patient self-report and provider assessment data were collected for 250 patients with serious mental illness (SMI) across four mental health service sites. Parallel mediation analytic models were used. Interpersonal communication partially mediated the relationship between positive and negative symptom clusters and personal recovery. Satisfaction with social supports partially mediated the relationship between excited symptoms and personal recovery. Both interpersonal communication and satisfaction with social supports partially mediated the relationship between general psychological distress and depressive symptoms and personal recovery. Collectively, social functioning mediators explained nearly half of the relationship between general psychological distress and excited symptoms and personal recovery and nearly all of the relationship between positive symptoms and personal recovery. Clinical providers working with persons with SMI should regularly assess social functioning in addition to assessing psychiatric symptoms and personal recovery factors and should incorporate social skills education into SMI group and individual treatments. Social functioning as a target of treatment may be especially beneficial for patients who are dissatisfied with other interventions or feel they have experienced the maximum benefit from treatment and are seeking additional methods to support personal recovery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Ambiguous Nature of Contextual Dynamics During Drug Addiction Recovery: A Qualitative Study of Personal Narratives

The concept of recovery has emerged as a prominent paradigm to understand processes of change in individuals with substance use problems. To date, most studies have focused on personal recovery as the key driving force of recovery journeys, generally individualizing the often-disabling social realities that persons in recovery face. To counterbalance this bias, this paper focuses on the contextual dynamics at stake during recovery processes, based on the lived experiences of 30 persons in drug addiction recovery in Flanders (Belgium). A Lifeline Interview Method was applied to elicit recovery narratives, which were thematically analysed. We found that interpersonal relationships, enabling and disabling places, and socio-economic factors facilitate or impede recovery in meaningful ways. The findings also show how these diverse contextual dimensions are interrelated and ambiguous. Researchers, policymakers, and treatment providers should acknowledge the relational nature of recovery and the invalidating impact of stigma across the three identified contextual levels.

단도박 자조모임(Gamblers Anonymous) 참여 경험 및 중독 회복의 본질적 의미에 대한 질적 연구

The purpose of this study was to examine how participation in G.A. group contributed to the recovery from gambling addiction. For this purpose, phenomenology was implemented while GA gatherings were observed, in-depth interviews were conducted with five GA members, and then the essential meaning of addiction recovery in G.A. was reviewed. The addiction recovery mechanism of GA group is to replace gambling behaviors with non-gambling behaviors, recover true-self, and connect with others, with relentless cognitive and behavioral effort in an affective atmosphere. The ultimate goal of GA is a personality change and recovery from gambling addiction is a by-product of this process. As a therapeutic mechanism, sustainability, expertise, and availability are the strengths of the GA group, so it is suggested that institutional and policy support is needed to further vitalize GA meetings.

Microplastics: Potential impacts on aquatic biodiversity

Microplastic pollution has been considered an issue of considerable concern for society and aquatic ecosystems due to plastics' unlimited applications and admirable properties. This review paper investigated various groups and sources of microplastics, their potential impacts on aquatic biodiversity, and the mitigation and treatment measures. Microplastics were grouped according to their sources as primary and secondary microplastics. Primary microplastics are generated more from land-based activities (98%) than sea-based activities (2%). Sources of primary microplastics are personal care products, industrial scrubbers, plastic powders, and microbeads, among others. While sources of secondary microplastics are losses of plastic materials during natural disasters, material lost or discarded from fishing vessels and aquaculture facilities, and oil and gas platforms, among others. Microplastics cause toxic effects, reduced food intake, delayed growth, oxidative damage, abnormal behaviour, a barrier to lipid metabolism, and affect fishes at molecular levels, causing genetic damage whereby microplastics absorb polycyclic aromatic hydrocarbons, which cause immunotoxicity, neurotoxicity and genotoxicity to marine species. Mitigation measures to reduce the microplastic pollution's effects include the removal of microbeads from personal care products, improved reuse, recycling and recovery of plastics, improved separation efficiency at wastewater treatment points and development of clean-up and bioremediation and phytoremediation techniques. Treatment methods include microfiltration, ultra-filtration, nanofiltration and reverse osmosis. Microplastics have varying effects on aquatic organisms, but these impacts can be mitigated and treated with different techniques and policy instruments. Therefore, the study recommends avoiding disposing of, reusing, recycling and recovering plastic substances in the aquatic environment for safe and clean waters.

Effects of an eating club for people with a psychotic disorder on personal recovery: Results of a randomized controlled trial

Background and objectivesMany people with a psychotic disorder are coping with severe psychosocial limitations related to their illness. The current randomized controlled trial (RCT) investigates the effects of an eating club intervention (HospitalitY (HY)) aimed to improve personal and societal recovery. MethodsIn 15 biweekly sessions participants received individual home-based skill training and guided peer support sessions in groups of three participants from a trained nurse. A multi-center RCT was conducted (intended sample size: n = 84; n = 7 per block) in patients with a diagnosis of schizophrenia spectrum receiving community treatment. HospitalitY was compared to a Waiting List Control (WLC) condition at three time points (baseline, end-of-treatment (8 months) and follow-up (12 months)) using personal recovery as primary outcome and loneliness, social support, self-stigma, self-esteem, social skills, (social) functioning, independency competence, and psychopathology as secondary outcomes. Outcomes were evaluated with a mixed modeling statistical procedure. ResultsThe HY-intervention had no significant effects on personal recovery or secondary outcomes. More attendance was associated with higher scores on social functioning. LimitationsWith N = 43 participants included, power was insufficient. Seven HY-groups were started, from which three discontinued before the sixth meeting, one HY group stopped due the start of the COVID-19 pandemic. ConclusionsDespite a promising pilot study on feasibility, the current RCT did not show any effects of the HY intervention. A mixed qualitative-quantitative research methods might be more appropriate for researching the HospitalitY-intervention to investigate what social and cognitive processes are at play in this peer guided social intervention.

Supporting recovery in persons with stress-related disorders: A reflective lifeworld research study of health care professionals in primary health care in Sweden

ABSTRACT Purpose The study aimed to describe primary health care professionals lived experiences of supporting recovery in persons with stress-related disorders. Methods This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Seventeen health care professionals working in primary health care were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling. Results Health care professionals experienced supporting recovery as a complex process with a need for a tailored approach, regardless of profession. In an alliance, the health care professionals encounter the persons where they are based on their own narratives about their life situation. In an interpersonal platform, the health care professionals use a lingering and flexible approach. Support is provided by encouraging existential reflection and learning as well as guiding the person to consider their own needs. This supports the person’s quest for a sustainable recovery process in his/her life situation. Conclusions We conclude that supporting recovery requires a genuinely person-centred care in which elements of existential care are crucial. Primary health care for persons with stress-related disorders could benefit from the development of additional research and models for such an approach.

Occupational therapy students’ perception on mental health recovery: A descriptive qualitative exploration

Introduction: In occupational therapy, emphasis is placed on the complex interplay between the client, the occupation and the environment, providing an opportunity for its practitioners to adopt recovery-oriented outcomes in interventions for people with mental health conditions. In this study, we seek to understand occupational therapy undergraduates’ perceptions of recovery for people with mental health conditions. Method: A qualitative descriptive study was conducted at a university in Singapore, which provides a pre-registration occupational therapy programme. Seventeen undergraduates were recruited (year 1, n = 5; year 2, n = 7 and year 3, n = 5). A semi-structured interview guide was used during the interview. Data collection took place from June to August 2022. Results: Using thematic analysis, two macro themes were discerned: the understanding of mental health conditions and the meanings of recovery. Sub-themes were created under each grouping to describe the data. Conclusions: This study explored the perceptions of mental health recovery among occupational therapy undergraduates. Occupational therapy students appeared to be well-aligned with personal and functional recovery perspectives when providing support for people with mental health conditions. However, there seems to be a need to emphasise the more nuanced aspects of delivering care within the culturally diverse setting of Singapore.