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Although it is widely recognized that curricula should incorporate emerging knowledge about recovery as an attainable outcome for individuals with severe mental illness, little has been written about the clinical supervision of advanced students within a recovery model. For example, are there systematic issues a supervisor should anticipate and be prepared to address? How should a clinical supervisor assist students as they begin to try and apply their knowledge in a clinical context? To begin a dialogue about these issues, this article will propose that clinical supervision from a recovery model is faced with at least four semi-distinct challenges: the detection and avoidance of stigma, the setting of consensually valid and personally relevant goals, the development of a therapeutic relationship, and the assessment of barriers to recovery and outcomes.

Interventions for individuals with schizophrenia often involve helping clients become more aware of their condition so they can make informed decisions about their treatment and recovery. Yet the effect of awareness or admission of schizophrenia has remained elusive. Empirical research has found that awareness of illness is essential for people to make informed decisions about the future, to free themselves from blame for difficulties linked with illness, and to form and sustain bonds with others. However, this awareness has also been linked to depressed mood, lower self-esteem, and a diminished sense of well-being. In this article, we review the evidence and suggest that the effect of awareness on well-being may be mitigated by the meaning clients assign to their illness and whether it disrupts their life story. Evidence linking clients' internalized, stigmatizing beliefs about illness with demoralization is presented, and clinical implications are discussed.

Research has suggested that many individuals with schizophrenia have been exposed to significant trauma, not only after but also prior to the onset of illness. This article reviews the literature suggesting that exposure to certain kinds of trauma, including childhood sexual abuse, may increase the risk of developing schizophrenia. It also presents data from across studies that suggest a history of trauma may affect the course and symptom presentation of the disorder, resulting in higher levels of psychosocial dysfunction and higher levels of anxiety and hallucinations. An individual example is presented, and implications for case conceptualization, assessment, and treatment are discussed.

Recently, research has linked deficits in neurocognition, which emerge early in schizophrenia, with psychosocial impairments. However, it is uncertain how these deficits lead to sustained dysfunction. In this review, we explore how neurocognitive deficits could disrupt function at three levels: learning, coping preference, and self-concept. We offer a model in which neurocognitive impairment may directly limit skills acquisition and the development of a rich personal narrative. We suggest that both limited skills acquisition and an impoverished narrative may subsequently feed into a habitual style of avoidant coping, leading to a cycle of sustained dysfunction. Implications for cognitive, rehabilitation, and psychotherapeutic interventions are discussed.