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Objective: Traumatic experiences are prevalent among people with serious mental illness and can significantly worsen outcomes. This study aimed to identify an urban cluster of trauma types, compare continuous distress ratings versus categorical experience of trauma for predicting outcomes such as depression and quality of life, and investigate the mediating role of recovery orientation in the impact of trauma exposure on outcomes. Method: Data came from an intervention study on African Americans with serious mental illness living in a large urban area; 212 participants completed baseline self-report measures of past trauma experiences, related distress levels, recovery, depression, and quality of life. Data were assessed using correlations and regressive path modeling. Results: Overall, 56.6% of participants reported experiences with trauma. Analyses suggested an urban cluster of trauma types that was self-reported by over 25% of participants. Distress due to trauma strongly correlated with greater depression as well as reduced quality of life and recovery. Interestingly, the categorical presence of trauma history (yes/no) had no significant relationship with any outcomes. Path analyses revealed that recovery mediated the impact of trauma distress on depression and quality of life, specifically implicating the recovery subfactor of hope. Conclusions and Implications for Practice: Results suggested that cognitive reframing focused on positive appraisals of overall recovery, and the hope subfactor can have a positive influence on trauma outcomes. The study supported the role of recovery in posttraumatic growth and suggests that hope can be used to help patients process trauma healthily. Impact and Implications: This study identified a cluster of traumas commonly experienced by urban African Americans with serious mental illness. Distress ratings—but not categorical presence of trauma history—predicted outcomes of depression and reduced quality of life, mediated by cognitive appraisal of recovery and specifically the hope subfactor of hope. Practitioners might use cognitive reframing toward schemas of recovery and hope to facilitate posttraumatic growth and improve patient outcomes. Research should further examine trauma clusters and their impact on outcomes. [ABSTRACT FROM AUTHOR]

Objective: Serious mental illnesses (SMI) often occur during early adulthood, just as young people are developing important aspects of their identity that can affect their recovery. Positive ethnic identity development is associated with stress coping and psychological well-being in young people. But, there is limited research to indicate how individual experiences of belonging and attachment to one's ethnic group influence personal recovery processes among young adults living with SMI. Method: Young adults living with SMI (95% identified as ethnic/racial minorities) were recruited from four outpatient psychiatric rehabilitation programs (N = 83). Multivariate regressions were used to examine relationships between predictors (demographics, psychiatric symptomatology, ethnic identity) and the dependent variables (perceived stress and personal recovery). Results: A stronger, more developed ethnic identity and fewer depressive symptoms were associated with higher ratings of personal recovery. Increases in psychiatric symptoms predicted increased perceived stress. Post hoc analyses showed that Black, Latino/a, and multiracial study participants' ethnic identity ratings were similar to those of same ethnic/racial group of young adults without SMI. Conclusions and Implications for Practice: Ethnic identity development could be a significant psychosocial factor shaping mental health recovery among minority young people living with SMI. Several factors associated with psychological well-being among ethnic and racial minority youth may account for this, including adaptive coping, social support, and a buffering effect against racism. Our findings indicate that assessing and developing a young person's ethnic identity-related strengths and resources as a means for improving the personalization of recovery services and enhancing the quality of care. Impact and Implications: This study is one of the first to examine the relationship between ethnic identity and important psychological outcomes of stress and personal recovery among young adults with SMI. Results show that young adults with a sense of attachment and belonging to their ethnic groups report significantly higher personal recovery, suggesting that ethnic identity could play an important role in reducing mental health disparities among minority young adults with SMI. [ABSTRACT FROM AUTHOR]

Objective: Evidence concerning strengths model of case management (SMCM) remains mixed. This study aimed to test the hypotheses that higher fidelity to SMCM is associated with improved quality of life (QoL), hope, community participation, community functioning, more days of competitive employment and of independent living, and fewer days of hospitalization. Methods: SMCM was implemented over a 3-year period, at seven sites in the Canadian provinces of Newfoundland and Labrador, Québec, and Ontario. Independent assessors visited 14 teams at the seven sites to evaluate fidelity at baseline and 6, 12, 18, 24, and 36 months later. Participants (N = 311) answered standardized questionnaires at 4.5-month intervals up to 18 months. Fidelity assessments were interpolated so they could be associated with questionnaire responses. Linear mixed-effects models and generalized linear models were estimated. Results: Fidelity increased significantly, with all sites except one achieving or approaching good fidelity within 36 months. Fidelity was not significantly associated with any of the outcome measures, although all estimated directions of relationships were consistent with our hypotheses. Conclusions and Implications for Practice: In a pragmatic study of real-world implementation of the strengths model at seven sites, no statistically significant relationships between fidelity and outcomes were found. Low variation in fidelity across individuals, modest sample size, and limited ability to detect change over 18 months, may have contributed to these null findings. Impact and Implications: Implementation of strengths model of case management (SMCM) was largely successful at seven sites in three Canadian provinces, but higher fidelity was not significantly associated with improved client outcomes. The sample size of 311 may have been insufficient. Given mixed findings from previous studies, and the compatibility of SMCM with a recovery orientation, further research, with strong designs and large sample sizes, is needed. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the mediating roles of self-esteem and self-efficacy on the relationship between family social networks and personal recovery among Chinese people with mental illness in Hong Kong. Methods: One hundred and twenty-five Chinese adults with mental illness from community mental health centers in Hong Kong were recruited for this study. Data were collected using a structured questionnaire. Results: Study results indicated that a large family network size was indirectly related to high levels of personal recovery through high self-efficacy. High perceived family support was directly related to high levels of personal recovery. In addition, high family criticalness was related to low levels of personal recovery directly and indirectly through low self-esteem. Conclusions and Implications for Practice: These findings suggest that using a family approach to enhance individuals' self-esteem and self-efficacy might promote personal recovery among people with mental illness in the Chinese context. Impact and Implications: This study found that family network size is indirectly related to personal recovery, via the effect of self-efficacy. Self-esteem mediates the relationship between family criticalness and personal recovery. Study findings underscore the importance of incorporating strategies to enhance self-esteem and self-efficacy into family interventions aiming to promote personal recovery among people with mental illness in the Chinese context. [ABSTRACT FROM AUTHOR]

Objectives: Although recovery for people with serious mental illness (SMI) has received considerable attention, there is a research gap on the related topics of well-being and happiness—subjects that have been widely studied in the general population. The objective of this study was to explore the experiences of happiness, well-being, and recovery from the perspectives of persons with SMI, and to examine similarities and differences among these constructs. Method: This qualitative study used semistructured interviews with a purposive sample of 30 adults with SMI to explore experiences of happiness, well-being, and recovery. Reflexive thematic analysis was applied to generate themes related to each concept. Results: Happiness was facilitated through relationships with natural and professional supports, engaging in meaningful activities that conferred a sense of accomplishment, using coping skills to reduce distress, engaging in recreational activities, and meeting basic material needs. Well-being was promoted through self-care activities and enhanced through relationships with professional supports. However, nearly one-fourth of participants expressed uncertainty about what well-being meant to them. Recovery was characterized as a process of overcoming illness or adversity through which personal control over symptoms and stressors is increased; recovery is also facilitated by supportive professional relationships. Conclusions and Implications for Practice: Most factors relating to the happiness of people with SMI are also factors that have been identified in theory and research as facilitating the happiness of the general population. Findings suggest that happiness should be considered an important new area of research, policy, and practice in the fields of psychiatric rehabilitation. Impact and Implications: Happiness, well-being, and recovery are important and fulfilling experiences for persons with serious mental illness. However, it is unclear how these concepts overlap or diverge from one another. Our findings suggest significant similarities but also important distinctions between happiness and recovery and that promoting happiness should be a priority area for mental health professionals, policymakers, and researchers. [ABSTRACT FROM AUTHOR]

Background: Recovery-oriented, strengths-based intervention engages service users' strengths and resources to support their recovery process. This model was developed in an American context and has been applied in Hong Kong. It is important to formulate an understanding of strengths better fit to Hong Kong Chinese. Aims: This exploratory qualitative study examined Hong Kong Chinese service users' views on strengths and preferred translation for the word strengths, along with its cultural nuances. Method: Twenty-six people with serious mental illnesses were individually interviewed at a mental health center in Hong Kong, based on a photo-elicitation technique and reflection on Chinese terms related to strengths. Analysis of data employed the constant comparative method. Results: Participants reported that social factors, such as support by helping professionals and engagement in family roles, as well as spiritual beliefs and practices, are important for recovery. These insights and their preferred translations of strengths generate a culturally nuanced understanding of strengths. Conclusions & Implications for Practice: The strengths model applied in Hong Kong can be enhanced by a more culturally nuanced perspective, for example, including the importance of family-based identity and filial piety, beliefs related to harmony and fate, and practices such as a temple or church attendance. Impact and Implications: This study investigates how Hong Kong Chinese people view strengths in facilitating recovery from mental illnesses. The term "strengths" in recovery was deemed synonymous with the terms ability (néng lì; 能力) and expertise (zhuān cháng; 專長) in Chinese. This study sheds light on how Chinese conceptualizations of "strengths" in recovery may be applied in interventions. [ABSTRACT FROM AUTHOR]

Objective: The primary purpose of the study was to explore and identify how components of recovery are associated with occupational performance and health among peer support specialists. Methods: One hundred and twenty-one peer support specialists were recruited from statewide peer certification training programs and the International Association of Peer Supporters. Study respondents completed a survey package including demographic questions and psychometrically sound self-report measures. Two hierarchical multivariable linear regression models were conducted to evaluate whether the recovery components of the process of recovery, social support for recovery, and work self-determination (i.e., work autonomy, work competence, and work relatedness) were associated with indicators of occupational performance (i.e., work engagement) and health (i.e., job satisfaction). Results: Work autonomy was associated with the occupational performance indicator, while the process of recovery and social support for recovery were the only recovery components associated with the indicator for occupational health. Conclusions and Implications for Practice: Findings support the importance of work self-determination and social support and recovery for occupational performance and health among peer support specialists. Mental health and rehabilitation professionals should address these key components of recovery when working with and supporting the work well-being of peer support specialists. Impact and Implications: Our findings indicated key components of recovery are linked to work well-being among peer support specialists. Despite the promotion of recovery among service users, there has been limited focus on the recovery process experienced by peer support specialists employed in mental health systems. These findings underscore the need for service providers, employers, and supervisors of peer support specialists to address both recovery and work well-being among peer support specialists. [ABSTRACT FROM AUTHOR]

Objective: Recovery from severe mental illnesses (SMI) has been described as an outcome (end state where persons are symptom free) or as a process (despite symptoms, people can pursue life goals). Less clear is whether recovery as a process has credibility in the substance use disorders (SUD) community. We examined how public perceptions and expectations of outcome and process between SMI and SUD differed. A severity effect within SMI and SUD categories was also examined. Method: Participants (N = 195) read definitions of SMI and SUD and completed an online survey of their agreement on: perceptions of recovery from SMI and SUD as outcome and process, and expectations of recovery as outcome and process. Participants were then given more and less severe SMI (i.e., schizophrenia vs. depression) and SUD (opiate vs. alcohol use) definitions. They then responded to recovery items SMI and SUD conditions with low and high severity. Results: For SMI, perceptions and expectations of recovery as process were endorsed more than outcome. Severity effect led to greater increases in perceptions and expectations about recovery as process. Specifically, differences between outcome and process for schizophrenia were significantly larger than for depression. For SUD, expectations of process were significantly lower than outcome ratings. One negative interaction was found for SUD expectations; difference scores for opiate users were smaller than for alcohol. Conclusions and Implications for Practice: We discussed implications for interventions that enhance recovery for people with SMI and SUD. This study shows that recovery as a process (symptom management) is more endorsed for persons with severe mental illnesses (SMI) whereas recovery as an outcome (symptom free) is more endorsed for people with substance use disorders (SUD). Distinction between process and outcome perspectives across two communities will shape individuals' recovery experience and inform good treatment practices. [ABSTRACT FROM AUTHOR]

Objective: This study examined the psychometric properties of a Chinese language version of the Recovery-Promoting Relationship Scale (RPRS) scale in a sample of persons with severe mental illness in Taiwan. Method: Five hundred ninety-two participants from 32 community psychiatric rehabilitation centers in Taiwan agreed to participate in this study. Principal component factor analysis with oblique rotation was performed. Internal consistency and external construct validity were also examined. Results: The results revealed a 2-factor solution that differed from the structure of the original RPRS. The first factor (F1) comprised 7 items in the Core Relationship Index and 7 items in the Recovery-Promotion Strategies Index of the original RPRS. The second factor (F2) comprised 8 items in the Recovery- Promotion Strategies Index and 1 item (I5) in the Core Relationship Index of the original RPRS. The reliability of F1 and F2 was 0.961 and 0.941, respectively. The entire scale and subscales all had a significant and moderate correlation with recovery and service use. Conclusions and implications for practice: This study provides initial psychometric support for a Chinese language version of the RPRS. Additionally, the use of core interpersonal skills was correlated with recovery-promoting strategies. The findings support the use of the RPRS as a guide to promote recovery-oriented services in Taiwan. [ABSTRACT FROM AUTHOR]

Objective: Recovery is the process through which one learns to overcome, manage, or live with the negative consequences of physical illness, mental illness, alcohol or drug misuse, or trauma. Homeless individuals endure many, or all, of these experiences. Previous research has shown that characteristics of homeless services, particularly the amount of choice they afford to service users, can influence recovery experiences, potentially by increasing a sense of mastery. The purpose of this study was to test the hypothesis that choice in housing and services would predict recovery in a number of domains, and that these relationships would be mediated by mastery. Method: Using survey data collected from a sample of homeless services users (n = 160) in Ireland, we conducted a series of cross-sectional mediation analyses to predict recovery in domains of physical health, psychiatric symptoms, alcohol and drug use, and community integration. Results: We observed the hypothesized mediational relationship for each recovery domain except alcohol use. That is, personal mastery mediated the relationship of perceived choice to self-appraised physical health, psychiatric symptoms, drug use, and physical and psychological aspects of community integration, but not alcohol use. Conclusions and Implications for Practice: Findings add further support to the growing body of evidence that suggests choice is centrally important to recovery experiences among individuals in homelessness. [ABSTRACT FROM AUTHOR]

Objective: The present study was designed to describe individuals receiving psychiatric rehabilitation (PR) service and investigate program outcomes and factors associated with progress in a multisite, descriptive evaluation across Pennsylvania. Method: Through an outcomes-monitoring process integrated into routine service delivery, survey responses from 408 individuals participating in PR were summarized. Linear mixed models were used to examine change over time in self-reported progress ratings in rehabilitation domains and factors associated with progress. Results: Significantly lower utilization of inpatient psychiatric service was observed in the 12 months after initiating PR versus the 12 months before service (15% vs. 24%; p = .002). Peer and case management service increased after initiation of PR. Specifying a domain as a goal in the service plan was associated with higher progress ratings in the learning (β = .75, p = 0001), working (β = 1.06, p = .0001), and physical wellness (β = 1.27, p = .0001) domains. Average hopefulness rating was positively and significantly associated with self-reported progress in all domains. Conclusions and Implications for Practice: The current investigation provides some evidence that individuals participating in PR decrease utilization of inpatient service. This finding and the goals and activities reported in domains over time support the added value of PR as a Medicaid-reimbursable service to managed care efforts to promote rehabilitation outcomes and recovery for individuals with psychiatric disabilities. [ABSTRACT FROM AUTHOR]

Objective: Trauma experienced by individuals with serious mental illnesses extends beyond physical and sexual abuse. This is among the first studies to examine verbal violence, both spoken and written words, experienced by individuals with serious mental illnesses. Method: Fifty individuals diagnosed with a schizophrenia-spectrum, bipolar, or major depressive disorder were recruited from community-based mental health agencies and reported on their experiences with 8 types of verbal violence identified in the literature, or related written comments, including: belittling, insulting, name-calling, teasing/ embarrassing, threatening, cursing, or yelling. They also reported on the frequency of such events and the perpetrators. Results: 82% of participants reported at least 1 type of verbal violence in their lifetime and 66% reported an incident in the past year. The most common experiences were being called names, belittled, and insulted, teased, or embarrassed in front of others. Top perpetrators were friends and parents. Conclusions and Implications for Practice: Verbal violence is a common experience with potentially devastating effects on mental health and well-being, sense of safety, and recovery and community participation among adults with serious mental illnesses. It is plausible that such comments deserve being recognized as "violence" on par with physical and sexual assaults, although further research would be useful to expand our knowledge about their effects on health, wellness, and community inclusion. New interventions that prevent, lessen, and eliminate such violence, may also be advisable. [ABSTRACT FROM AUTHOR]

Objective: This study examined the feasibility and acceptability of developing a recovery-oriented book club in an acute inpatient psychiatric setting, and the impact of participation on measures of hope and recovery orientation. Method: Participants were recruited from an inpatient psychiatric hospital and assigned to control (N = 13) or experimental (N = 13) conditions. Participants completed the Herth Hope Index (HHI) and the Mental Health Confidence Scale (MHCS) at baseline and follow-up. Book club participants completed a satisfaction survey. ANOVA was performed to examine changes on HHI and MHCS. Results: No significant differences were found between conditions on HHI or MHCS. On the satisfaction survey, most book club participants agreed "somewhat" or "strongly" that the intervention increased self-understanding (92.3%) and hope (61.6%). Conclusions and Implications for Practice: Book club groups may help individuals in inpatient psychiatric settings feel more hopeful. Future research may examine the adaptability of this intervention for outpatient settings. [ABSTRACT FROM AUTHOR]

Objectives: Recovery-oriented care is among the highest treatment priorities for the Veteran Health Administration, which has endorsed organizational change of mental health care to reflect recovery values. The purpose of this quality improvement project was to determine whether recovery interventions would yield positive outcomes when delivered on in inpatient psychiatry. Method: Recovery interventions on the unit included recovery-focused interdisciplinary team meetings, opportunities for stakeholder feedback, recovery staff education, increased group programming, peer support, and changes to treatment planning to include increased Veteran engagement and responsibility. Participants included 352 patients and 27 staff. Outcomes were number of restraints/seclusions used, 30-day readmission rates, and staff satisfaction. Results: Our results showed an overall decrease in restraint/seclusion use by over 50% and an increase in staff satisfaction. Conclusions and Implications for Practice: Our results suggest that implementing a recovery-oriented model of care in an acute psychiatric inpatient unit may have significant benefits for both staff and patients. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to assess the impact of a mental illness self-management intervention, called Wellness Recovery Action Planning (WRAP), on the use of and need for mental health services over time compared with nutrition and wellness education. Method: Participants were recruited from outpatient community mental health settings in Chicago, Illinois. Using a single-blind, randomized controlled trial design, 143 individuals were assigned to WRAP or to a nutrition education course and assessed at baseline and at 2-month and 8-month follow-up. The WRAP intervention was delivered by peers in recovery from serious mental illness who were certified WRAP educators over nine weekly sessions lasting 2.5 hrs. The nutrition education curriculum was taught by trained non-peer educators using the same schedule. Mixed-effects random regression analysis tested for differences between the two interventions in (a) self-reported use of 19 clinical, rehabilitation, peer, emergent, and ancillary services; and (b) self-reported need for these services. Results: Results of mixed-effects random regression analysis indicated that, compared with controls, WRAP participants reported significantly greater reduction over time in service utilization (total, individual, and group), and service need (total and group services). Participants in both interventions improved significantly over time in symptoms and recovery outcomes. Discussion: Training in mental illness self-management reduced the self-reported need for and use of formal mental health services over time. This confirms the importance of WRAP in an era of dwindling behavioral health service availability and access. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to refine and test the psychometric properties of a scale to measure provider attitudes about recovery. Method: This was a secondary data analysis that combined survey data from 1,128 mental health providers from 3 state hospitals, 6 community mental health centers, and 1 Department of Veterans Affairs (VA) medical center. Rasch analyses were used to examine item-level functioning to reduce the scale to a briefer, unidimensional construct. Convergent validity was assessed through correlations with related measures. Results: The Provider Expectations for Recovery Scale had strong internal consistency, was related to education and setting in expected ways, and was associated with lower levels of burnout and higher levels of job satisfaction. Conclusions and Implications for Practice: A 10-item scale of Provider Expectations for Recovery appears to be a useful tool to measure an important construct in recovery-oriented care. The process of refining the measure also highlights potential factors in how providers view recovery. [ABSTRACT FROM AUTHOR]

Objective: Peer providers experience unique recovery and growth processes. This study examines the relationship of these processes with multiple occupational characteristics related so peer work. Outcomes are examined using positive psychology concepts: psychological well-being, posttraumatic growth, and generatively, as well as established recovery and empowerment measures. Method: Thirty peer providers employed in s variety of mental-health agencies participated in the study and completed standardized measures of recovery and growth processes. Multiple past and present occupational characteristics were identified and coded based on a semistructured interview and a background questionnaire. Results: Multivariate analyses revealed a significant association between participants' generatively and past participation in peer-support/self-help groups, as well as past work in a helping profession. No associations were found between the characteristics of participants' present peer jobs and the examined recovery and growth processes. Conclusions and implications for Practice: The present findings have implications for the expansion of the peer-provider workforce, They suggest that encouraging and enabling peer-support groups and peer-run organizations may have positive impact on the generatively of peer providers, and may draw generative individuals to thin emerging occupational modality of mental- health recovery oriented service. Study findings underscore the need for future research on recovery processes from the perspective of positive psychology and highlight the value of peer exposure as a catalyst of recovery and growth. [ABSTRACT FROM AUTHOR]

Objective: Hope is a critical aspect of the recovery process for persons with serious mental illnesses. The goal of this pilot study was to assess the relationship between hope and symptoms for a cohort of individuals with mental illnesses receiving supported employment services. Method: A total of 74 participants enrolled in supported employment were assessed on their level of hopefulness, hopelessness and psychiatric symptoms. Correlations were performed to determine the relationship between hope and psychiatric symptoms, and hopelessness and psychiatric symptoms. Results: The findings indicated a significant inverse relationship between hope and symptoms, and a significant positive relationship between hopelessness and symptoms. Conclusions and Implications for Practice: Hope and symptoms were inversely related, highlighting the importance of developing a wellness strategy that addresses managing symptoms as part of one's recovery process. Additionally, this finding highlights the critical role of PsyR providers in supporting people in recovery with developing a wellness strategy that will both help ameliorate symptoms and increase hope. [ABSTRACT FROM AUTHOR]

Objective: This paper examines the types of goals being set by individuals in the context of Australian mental health services and whether goal type differs across the stages of recovery. Methods: Goal records of 144 individuals accessing services were reviewed to examine goal content, ratio of approach and avoidance oriented goals and changes across stages of psychological recovery. Results: Individuals further along in their recovery set significantly more approach goals and types of goals set appeared to reflect broader life roles. Conclusions and Implications for Practice: Setting approach goals and goals that reflect broader life roles tends to support the definition of psychological recovery as being "the movement towards" greater meaning and enhanced sense of self. [ABSTRACT FROM AUTHOR]

Objective: With the use of a qualitative approach, this study focuses on service providers' experiences and perspectives on recovery-oriented reform. Methods: Nine focus groups were conducted with a sample of 68 service providers recruited from three Canadian sites. Results: Three major themes were identified: 1) positive attitudes towards recovery-oriented reform; 2) skepticism towards recovery-oriented reform; and 3) challenges associated with implementing recovery-oriented practice. These challenges pertained to conceptual uncertainty and consistency around the meanings of recovery; application of recovery-oriented practice with certain populations and in certain contexts; bureaucratization of recovery-oriented tools; limited leadership support; and, societal stigma and social exclusion of persons with mental illnesses. Conclusions and Implications for Practice: The findings point towards challenges that might arise as system planners move ahead in their efforts toward implementing recovery within the mental health system. In this regard, we offer several recommendations for the planning of organizational and educational practices that support the implementation of recovery-oriented practice. [ABSTRACT FROM AUTHOR]

Objective: The promotion of recovery and quality of life is a major focus of national and local mental health system transformation efforts. There has been simultaneous interest in enhancing community participation as a facilitator of recovery. This study examines the community participation experiences of emerging adults and mature adults with serious mental illnesses and the relationship between various types of participation and recovery, quality of life, and meaning of life. Methods: Baseline data from the Consumer-Operated Service Program multisite study were utilized. The sample was recruited from traditional mental health services and consisted of 233 emerging adults and 1,594 mature adults. Ten areas of participation were examined: parenting, employment, volunteering, college student, group membership, civic engagement, peer support, friendships, intimate relationships, and engagement in religious/spiritual activities. Results: Emerging and mature adults differed in developmentally appropriate ways. Emerging adults and those who participated more had higher scores on the recovery, quality of life and meaning of life measures. Conclusions and Implications for Practice: The higher scores on the dependent variables may be explained by younger adults having greater hope and higher expectations that are typical for those at that stage of life and that living longer with a serious mental illness and being exposed longer to the mental health system may dampen hope. Participation in general, and specific areas of participation, were predictive of recovery-oriented outcomes. These results should inspire future developmentally-oriented research examining factors that facilitate recovery and provide direction to providers about participation areas that may be most beneficial in facilitating recovery. [ABSTRACT FROM AUTHOR]

Objective: This study investigated what women identifying as lesbian, gay, bisexual, uansgender, and/or queer (LGBTQ) think about mental health "recovery." Method We used a grounded theory analysis of 13 pailicipant interviews. Results: Three novel critiques emerged, including rejection of mental health "leeovely" based on participants' identities as "mad," sexual assault survivors, and/or LGBTQ. Conclusions and Implications for Practice: While a medicalized interpretation of "recovery" may not work for some women, alternative understandings, such as using "recovery" to heal from discrimination and demand systemic changes, have liberatory potential. It is essential that supporters discern and utilize each woman's chosen language. [ABSTRACT FROM AUTHOR]