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Background: This study considers how the COVID-19 pandemic impacted individuals recovering from a substance use disorder (SUD). Method: Fifty individuals recovering from SUD in Vermont, a rural New England state (U.S.), were recruited for an interview from 12-step recovery meetings (Alcoholics Anonymous, Narcotics Anonymous) as well as via word-of-mouth. Interviews were transcribed and coded, and qualitative analyses were performed. Results: Many of the participants who were in recovery prior to the pandemic starting remained substance-free and in recovery throughout the pandemic period. Some individuals used substances during the pandemic period, although not typically in the context of a relapse caused by negative emotions (eg, distress over a loved one contracting COVID-19). The majority of those individuals indicated that the risk of catching COVID-19 did not alter their substance use. Conclusions: Many individuals already in SUD recovery before COVID-19 remained in recovery despite the challenges of pandemic era. The role of peer support in recovering individuals managing negative emotions caused by COVID-19 is considered. [ABSTRACT FROM AUTHOR]

This article presents the findings from an evaluation of post-proceedings support (PPS) within Gloucestershire Family Drug and Alcohol Court (FDAC). PPS is offered to parents in the year immediately following a completed FDAC hearing. The article provides background on the formation and development of FDACs across England and FDAC evaluations, before detailing the specific delivery model in use in Gloucestershire. The evaluation that took place March 2020–July 2022 examined the delivery, effectiveness and impact of the support services provided to families after legal proceedings concerning child welfare due to parental substance misuse. Employing a mixed-methods approach, the study analysed quantitative data to assess outcomes such as parental cessation of substance misuse and family reunification, alongside qualitative insights through interviews exploring families' and professionals' perceptions and experiences. This evaluation sheds light on the strengths and limitations of this post-proceeding offer. It examines the extent to which the services can be said to contribute to sustainable recovery for parents and whether the model is transferable to other FDACs. It highlights the importance of continuing support for families and may provide 'conceptual' transferability and insights that will be relevant to other FDACs and beyond into children's and families' social work. [ABSTRACT FROM AUTHOR]

In 2019, the World Health Organization urged a global shift towards recovery‐focused practices in mental health care. In Western nations, this transition often prioritised individualism over collectivism. In contrast, collectivist societies prioritise recovery through community and social support. This study explored mental health recovery from the perspectives of consumers, carers and registered nurses in a mainly collectivist society (Saudi Arabia) using a qualitative exploratory descriptive design. Sixteen consumers, ten carers and eight registered nurses participated in online semi‐structured interviews. Inductive thematic analysis was employed to analyse English‐translated versions of the 34 interviews. Consolidated criteria for reporting qualitative studies 32‐item checklist were used. The study found that recovery was perceived as a process of transforming towards living a meaningful life of goals and values supported by trusted people who share moments of comfort and empowerment. A unique finding was the 'bond of recovery' a collectivist value that aid consumers' community integration in society. Saudi consumers' experiences of recovery were similar to consumers' movement narratives of recovery. Future research should establish a recovery‐focused educational program that incorporates our findings into a recovery‐oriented approach. This will facilitate providing a collaborative care between consumers, carers and nurses that centres around consumers' recovery goals and values. [ABSTRACT FROM AUTHOR]

To examine feasibility and acceptability of providing stepped collaborative care case management targeting posttraumatic stress disorder (PTSD) and pain symptoms after major traumatic injury. Participants were major trauma survivors in Victoria, Australia, at risk of persistent pain or PTSD with high baseline symptoms. Participants were block-randomized, stratified by compensation-status, to the usual care (n = 15) or intervention (n = 17) group (46% of eligible patients). The intervention was adapted from existing stepped collaborative care interventions with input from interdisciplinary experts and people with lived experience in trauma and disability. The proactive case management intervention targeted PTSD and pain management for 6-months using motivational interviewing, cognitive behavioral therapy strategies, and collaborative care. Qualitative interviews explored intervention acceptability. Intervention participants received a median of 7 h case manager contact and reported that they valued the supportive and non-judgmental listening, and timely access to effective strategies, resources, and treatments post-injury from the case manager. Participants reported few disadvantages from participation, and positive impacts on symptoms and recovery outcomes consistent with the reduction in PTSD and pain symptoms measured at 1-, 3- and 6-months. Stepped collaborative care was low-cost, feasible, and acceptable to people at risk of PTSD or pain after major trauma. After hospitalization for injury, people can experience difficulty accessing timely support to manage posttraumatic stress, pain and other concerns. Stepped case management-based interventions that provide individualized support and collaborative care have reduced posttraumatic stress symptom severity for patients admitted to American trauma centers. We showed that this model of care could be adapted to target pain and mental health in the trauma system in Victoria, Australia. The intervention was low cost, acceptable and highly valued by most participants who perceived that it helped them use strategies to better manage post-traumatic symptoms, and to access clinicians and treatments relevant to their needs. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore the experiences of care and recovery among older patients treated for physical trauma. Design: A qualitative study with a constructivist grounded theory design. Methods: Fifteen in‐depth interviews with older adults recovering from physical trauma were conducted and analysed between 2019 and 2023, in accordance with grounded theory methodology. Results: The findings show that for older patients who suffered physical trauma, the core category was the strive to recapture autonomy. This was achieved by means of Adaptation, Reflection and Interactions, which constitute the three main categories. Recovery involves facing and navigating various new life challenges, such as increased dependency on others, managing difficult symptoms and adapting in various ways to everyday life. The recovery process was influenced by fear, hope and the attitude towards new challenges. Conclusion: Older adults being cared for after a traumatic event have a difficult path to recovery ahead of them. Dealing with increased unwanted dependency on others was a main concern for the participants. Undertreated symptoms can lead to undesired isolation, delayed recovery and further increase unwanted dependency. On the other hand, hope, which was defined as having a positive approach to life and longing for the future, was a strong accelerating factor in the recovery process. Impact: As a result of this study, we have established that older patients experience the initial period after trauma as difficult and that support in the initial phase can be helpful when returning home. As healthcare services are under increasing pressure because of an ageing population, this study contributes by addressing an understudied population and clarifying their concerns. Reporting Method: Reporting adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. Patient or Public Contribution: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Background: Eating disorders are as common in Māori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Māori; however, research has focused on the experiences of non-Māori. This paper will describe explanatory factors, treatment experiences and what helps with recovery for Māori. Methods: Kaupapa Māori research methodology informed the methods and analysis. Fifteen semi-structured interviews comprised thirteen Māori participants with eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) and two whānau (support network) members. A thematic analysis was undertaken by a first cycle of coding that used deductive structural coding to identify data describing participants' perceived causes of eating disorders, their experience of treatment and recovery. A second cycle of coding used inductive analysis with descriptive and pattern coding. Results: Three overarching themes were antecedents (cumulative exposure), treatment (a system of complexities) and recovery (resource empowerment). Antecedents comprised cumulative exposure to body and sporting ideals and adversity as causal factors of eating disorders. In the treatment theme, a system of complexities critiqued rural settings for generalised mental health services, allocation of Māori cultural support, the economic burden of treatment, culturally incongruent treatment (methods, values) and a weight-focused discharge criterion. Recovery (resource empowerment) found appropriate health information, self-determination and connection to Māori culture and whānau aspirations helped with recovery. Conclusion: The diversity of birdcalls reminds us of the individuality of eating disorders. Health practitioners are reminded that just as the Tūī, Kākā and Kererū possess their own unique birdcalls, so do Māori with eating disorders and their whānau have their own experiences, needs and required treatment responses. [ABSTRACT FROM AUTHOR]

A significant change in mental health care has involved the need to implement recovery-oriented practices and services. However, recovery-oriented care has been poorly defined within acute care mental health settings. The central aims of the study were to increase knowledge about what constitutes a recovery-oriented environment within contemporary acute care units and to inform recovery-oriented nursing practice. Interpretative description was applied to answer the question: What strategies and resources do nurses identify as being most conducive to fostering a recovery-oriented environment in acute care mental health units? Purposive sampling was used to recruit 11 nurses from 6 acute care units. The inclusion criteria included a minimum of 1-year patients and holding active nursing registration. Nursing experience in community-based or chronic care settings and with children and adolescents were exclusion criteria. Six nurses also participated in a focus group. Key aspects of a recovery-oriented acute care environment included understanding the needs of individual patients along with the dynamics of the healthcare team. Nurses had important roles in promoting recovery-oriented environments and reported a need for increased resources to move beyond the bio-medical model and align practice with personal recovery. A recovery-oriented environment was described as a safe, peaceful and holistic environment with adequate space to balance needs for privacy, interaction and activity. This environment is fostered through respectful communication and healthy relationships among team members, patients, family and formal supports. These nurses had the knowledge, skill and desire to promote recovery-oriented environments, yet resources such as leisure activities and group therapy were required to promote personal recovery. [ABSTRACT FROM AUTHOR]

Background: Most people with alcohol use disorder (AUD) do not use treatment services, yet the majority ultimately resolve their AUD. As the phenomenon of untreated recovery remains poorly understood, we investigated the strategies used for recovery without treatment. Methods: We conducted semi-structured interviews with 65 adults (27 women, 37 White) with resolved AUD and no history of using specialty services (e.g., inpatient or outpatient rehabilitation, medication-assisted treatment). Using both inductive and deductive coding, we identified and elaborated themes and meanings. We verified our findings through nine member-check sessions with interviewers and interview participants. Results: Majorities of interview participants met criteria for severe lifetime AUD (84.6%), were in long-term recovery (>5 years; 81.5%), and indicated abstinence was their recovery goal (56.9%). Close to half (41.5%) had attended mutual-help groups (e.g., Alcoholics Anonymous). We identified five active strategies (Changing Contexts, Social Connections. Activities, Substitution, and Other Strategies) and four additional factors (Mutual-help Groups, Self-Reliance, Spirituality, and Aging/Maturing) that contributed to their recovery. Most participants employed multiple strategies and were intentional in adopting the ones that best suited them. By far, the two most common strategies were Changing Contexts (reported by 69.2% of participants) whereby people reduced their alcohol exposure by modifying social networks or physical settings and relying on Social Connections (reported by 67.7%), especially connections to people with similar lived experiences and struggles. Notably, Social Connections and Mutual-Help groups were the themes most often discussed jointly. Among other contributing factors mentioned, Spirituality appeared to play an important, but not universal, role as it was invoked by approximately half (49.2%) of participants. Conclusions: Our study confirms that recovery without specialty treatment is possible, and that multiple strategies and contributing factors help to achieve it. These findings may inform novel interventions to support recovery among people unwilling or unable to obtain treatment for AUD. [ABSTRACT FROM AUTHOR]

The rate of relapse for people in recovery for substance use disorder is as high as 85% within the first 12 months of recovery, however, research on the lived experience of relapse is limited. The present qualitative study investigated the experience of relapse with people who have Methamphetamine use disorder and the reasons why they returned to recovery. The exploratory study recruited five (n = 5) adults who identified as having Methamphetamine use disorder. All participants had sought treatment for more than 12 months, they were attending an addiction support service, and had experienced a relapse within the past 15 months. Interviews were conducted in which participants were asked an open-ended question about their most recent relapse and the negative consequences associated with their drug use. Data were analyzed using thematic analysis. A return to daily drug use led to negative consequences such as relationship breakdowns, poor mental health and acting in ways that went against the participant's morals and values. This study provides an insight into the types of experiences people who relapse after seeking treatment for Methamphetamine use disorder may have and how these experiences can influence their decision to return to recovery. People who regularly attend a recovery program are still susceptible to relapse. Those who have maintained abstinence for a period of time prior to relapse may be able to assess the negative consequences of their drug use more easily. This prior experience of recovery might influence their decision to stop using again. A return to daily drug use led to negative consequences of substance misuse. The negative consequences encountered by people who relapse may include relationship breakdowns, poor mental health and acting in ways that go against the person's morals and values. The negative consequences of substance misuse can influence people's decisions to return to recovery. People who regularly attend an addiction support service remain vulnerable to relapse. [ABSTRACT FROM AUTHOR]

Context: Best practice guidelines for the recovery and return to work (RTW) of people with mental disorders recommend access to the services of an interdisciplinary team combining pharmacological, psychological and work rehabilitation interventions. In the Canadian context, primary healthcare services are responsible for providing these services for people with common mental disorders, such as depressive or anxiety disorders. However, not everyone has easy access to these recommended primary healthcare services, and previous studies suggest that multiple personal, practice‐related and organizational factors can influence the patient's journey. Moreover, previous studies documented that family physicians often work in silos and lack the knowledge and time needed to effectively manage by themselves patients' occupational health. Thus, the care and service trajectories of these patients are often suboptimal and can have important consequences on the person's recovery and RTW. Objective and Population Studied: Our study aimed to gain a better understanding of the patient journeys and the factors influencing their access to and experience with primary healthcare services while they were on sick leave due to a common mental disorder. Methods: A descriptive qualitative research design was used to understand and describe these factors. Conventional content analysis was used to analyze the verbatim. Results: Five themes describe the main factors that influenced the patient's journey of the 14 participants of this study: (1) the fragmented interventions provided by family physicians; (2) patients' autonomy in managing their own care; (3) the attitude and case management provided by the insurer, (4) the employer's openness and understanding and (5) the match between the person's needs and their access to psychosocial and rehabilitation services. Conclusions: Our findings highlight important gaps in the collaborative practices surrounding the management of mental health‐related sick leave, the coordination of primary healthcare services and the access to work rehabilitation services. Occupational therapists and other professionals can support family physicians in managing sick leaves, strengthen interprofessional and intersectoral collaboration and ensure that patients receive needed services in a timelier manner no matter their insurance coverage or financial needs. Patients of Public Contribution: This study aimed at looking into the perspective of people who have lived or are currently experiencing a sick leave related to a mental health disorder to highlight the factors which they feel hindered their recovery and RTW. Additionally, two patient partners were involved in this study and are now engaged in the dissemination of the research results and the pursuit of our team research programme to improve services delivered to this population. [ABSTRACT FROM AUTHOR]

Objectives: This qualitative evaluation was guided by two questions: 1) How does peer recovery support (PRS) support American Indian (AI) people in recovery from substance use disorders? and 2) What makes PRS effective? Methods: We utilized a descriptive qualitative study design to explore the essence of PRS. Semi-structured interviews were conducted with six AI peers to explore the perceptions and lived experiences of recovery from one urban Montana location. Data analysis involved coding all the transcripts using the priori codes developed, then identifying key themes from the coded data. Results: Themes and interview data helped us explore how PRS supports recovery and potential reasons why it is effective for AI populations. Peers indicated that the program helped them maintain their recovery, and the role of peer mentors was critical to their success. Themes of belonging, connection, and compassion were common among peers interviewed. They also felt that recovery is a spiritual process. The peers had limited recommendations for improving the program, except the need for funding sustainability. Conclusions: Understanding how people recover is the first step in addressing the current substance misuse epidemic facing our nation. This evaluation outlined the qualitative impacts of PRS, the spiritual nature of PRS, the context of PRS, and recommendations from peers involved in the program. More work is needed to explore how to sustain PRS programs and integrate PRS into existing community-based settings, like churches, social services, urban AI centers, and other locations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Exploring the perceptions of individuals with traumatic brain injury (TBI) towards their brain injury recovery across the continuum of care may offer insights to support engagement with rehabilitation services. Illness narratives are a potentially valuable avenue for examining perceptions of recovery that may influence engagement. AIMS: The aim of this study is to explore the perspective of individuals with severe TBI towards their communication, brain injury and recovery experiences at 6 months, 1 year and 2 years post‐injury. METHODS & PROCEDURES: Discourse samples were obtained from 12 participants with severe TBI at 6 months, 1 year and 2 years following injury. A standardised protocol was used to elicit responses relating to perceptions of communication, the brain injury narrative, and perceptions of recovery facilitators. A thematic analysis of the discourse samples was completed. OUTCOMES & RESULTS: Three overarching themes were identified: experiences of communication recovery are diverse (Theme 1), varied experiences of recovery and rehabilitation (Theme 2), and continuous and lifelong journey of recovery (Theme 3). Primary communication concerns included presence of anomia, dysarthria, conversational topic difficulties, impacts of fatigue and memory difficulties. Illness narratives revealed the importance of re‐establishing a sense of self and the perceived importance of a strong social network post‐injury. CONCLUSIONS & IMPLICATIONS: The varied nature of communication challenges and recovery after TBI highlights the need for holistic, multidisciplinary support as well as inclusion of family and friends in the recovery process. Social communication intervention is a perceived priority area for individuals with TBI. Illness narratives may also play a valuable role in therapy and help to shape post‐injury identity. Managing the impacts of fatigue on communication and encouraging individuals to take ownership over their recovery and treatment may also help to improve patient outcomes. Supporting individuals to construct positive brain injury narratives that reaffirm a sense of self and include perspectives of family and friends may offer a potential future avenue for rehabilitation. Tailored but flexible, team‐based service delivery models for individuals with TBI that span from acute to long‐term care are warranted. What this study adds?: What is already known on this subject: Communication recovery from traumatic brain injury (TBI) is complex and multifaceted. The perceptions of individuals with TBI toward their communication recovery is largely unknown. To establish rehabilitation services that meet the needs of these individuals, we need to understand how they experience communication recovery. What this paper adds to existing knowledge: Social communication interventions were perceived as a priority for intervention by individuals with TBI. Fatigue was identified as perceived barrier to communication recovery. Taking ownership over one's recovery process was revealed as a facilitator of recovery. Illness narratives were found to strengthen post‐injury identity over time. What are the potential or actual clinical implications of this work?: Speech pathologists should prioritise social communication interventions and fatigue management for communication. Facilitating ownership of the recovery process and offering long‐term supports are key aspects of treatment. Supporting positive illness narratives as part of treatment may facilitate post‐injury identity construction. [ABSTRACT FROM AUTHOR]

Objective: Admissions to hospitals for people with anorexia nervosa (AN) often last over 2 months, during which significant time is often spent with other patients, but there is little qualitative research on the impact on recovery of the inter‐patient relationships. Our aim was to conduct qualitative interviews with people with a history of inpatient treatment for AN, focusing on the impact of interactions and relationships between patients during hospital admission on recovery, including short‐term and long‐term effects. Method: We conducted nine semi‐structured, one‐to‐one interviews, specifically exploring the helpful and unhelpful aspects of inter‐patient relationships during inpatient treatment for AN. No type of relationship was either included or excluded. Participants were recruited as volunteers in response to an online advertisement; all who met the eligibility criteria were selected. Interviews were transcribed and analyzed using thematic analysis. Results: Thematic analysis identified five themes: (1) comparison and justification, (2) learnt unhelpful behaviors, (3) dealing with distress, (4) compassion, and (5) role‐modeling. All participants expressed conflicting feelings about their relationships with other patients, but generally described developing more resilience to negative effects as they got closer to recovery. Positive effects, such as compassion, appeared to hold significance long term in participants' recovered lives. Discussion: The detailed exploration of themes in this study provides a deeper understanding of inter‐patient relationships during inpatient treatment for AN. This could aid clinical decision‐making when choosing appropriate treatment settings for individual patients as well as informing clinical practice in hospital. Public Significance: This study closely examines the effect on recovery of relationships with other patients during hospital treatment for AN, a severe eating disorder. Findings might help hospital staff to understand the feelings of those they look after and develop ways to protect patients from the negative effects of peer relationships and enhance the positive ones, to support recovery in hospital. [ABSTRACT FROM AUTHOR]

Accessible Summary: What the paper adds to existing knowledge?: Personality disorder is a serious mental health condition affecting up to 52% of psychiatric outpatients and 70% of inpatients and forensic patients. People with a diagnosis of personality disorder have higher morbidity and mortality than those without.Service users and carers reported a lack of training for staff in the management of individuals with a diagnosis of personality disorder, particularly with regard to self‐harm and suicidal behaviours.Staff burnout creates barriers to compassionate person‐centred care for individuals with a diagnosis of personality disorder as staff struggled to accommodate the nature of the presentation when under significant emotional, psychological and professional strain caused by understaffing and lack of support. What are the implications for practice?: This paper adds new knowledge by informing services of ways to improve care provision from the perspectives of both carers and service users.A more holistic and less medicalised approach to the treatment of problems associated with a diagnosis of a personality disorder should be adopted, and personality disorder training introduced for all healthcare practitioners, to improve patient outcomes. Introduction: There is limited understanding of the experience of people with complex mental health (CMH) needs, including those with a diagnosis of personality disorder (PD) and carers of those individuals. Little is known about carers of those in inpatient forensic settings, yet it has been identified that they may have additional needs when compared to general carers. Research highlights that community carer support services were perceived as inadequate and out‐of‐area placements were described as putting an added strain on ability to support loved ones. Understanding PD within a population of people with CMH needs and how a diagnosis described as PD impacts on care and treatment experience is vital to providing high‐quality care. Aim: To evaluate the care experience of service users and carers with lived experience of a diagnosis of PD and out‐of‐area placements. Method: Semi‐structured interviews were conducted with six service users and four carers to explore the experiences and perspectives of people with a diagnosis of PD. Interviews were audio recorded and thematically analysed. Results: Four interrelated themes were developed; Influence of a diagnosis of PD on Staff, Early and Appropriate Intervention, Recognition of the Individual and Training and Knowledge of people with a diagnosis of PD. Discussion: Anti‐stigma interventions for staff, research on care provision and structural changes to services including more evidence‐based therapy for individuals with a diagnosis of PD may help reduce disparate treatment and improve prognosis for recovery. Implications for Practice: This paper informs services of ways to improve care provision from the perspective of carers and service users. A more holistic and less medicalised approach to the treatment of problems associated with diagnoses of PD should be adopted, and PD training for all healthcare practitioners to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Substance misuse is a pernicious health concern for many unhoused people. A deep understanding of turning points – what propels someone to take concrete action toward addressing substance misuse – is needed to inform recovery policies and practices. This study sought to identify common elements in turning points among unhoused people vis-à-vis a phenomenological qualitative approach. Twenty people (Mage = 47.47, SD = 9.75; 50% female) who self-identified as being in recovery while unhoused participated in semi-structured interviews in Anchorage, Alaska, a community with high rates of both houselessness and substance misuse. Survival (life- and health-sustaining), individual (intrapersonal), and relational (interpersonal) motivations all shaped turning points. Limitations include the possible underrepresentation of individuals using a harm-reduction approach or capturing differences by housing type. Programs to address substance misuse should consider these motivations. Future research should identify and refine turning points and work to understand how they interact with change processes. [ABSTRACT FROM AUTHOR]

Purpose: To explore the recovery narratives of 13 young women who had fallen ill with severe Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS), during childhood and adolescence, with the focus on what they had to say about their past experiences from the perspective of the present. Method: A qualitative narrative approach, informed by a phenomenological theoretical perspective, was adopted to explore what the women found significant and meaningful in their recovery process. Data analysis of in-depth narrative interviews was performed which are presented to readers through the stories of two particular participants. Results: The first story describes how one participant made a recovery by testing her body's tolerance and working to create a more confident self. The second story describes a complex exploration of possibilities for action in recovery, along with a struggle to make sense of setbacks and hold on to what has been gained. Conclusion: Recovering from ME/CFS emerges as an inter-personal, contextual, fragile and nonlinear process of homecoming, based on gradually rising bodily based self-knowledge. Illness slowly fades away into the background, and there is the prospect of a healthier tomorrow. [ABSTRACT FROM AUTHOR]

Purpose: There is a lack of research informing service requirements for older (aged≥55 years) forensic mental health patients. The aim of this research was to increase knowledge about older forensic mental health patients' quality of life, wellbeing, recovery, and progress, in order to make recommendations of how to facilitate and enhance these factors. Methods: In-depth interviews with patients (N = 37) and staff (N = 48) were undertaken; data were analysed using thematic analysis. Results: Environmental (e.g., physical, structural and facilities), relational (staff, family and friends) and individual (characteristics, feelings, behaviours) factors were identified as enablers and/or obstacles to wellbeing, recovery, progress and quality of life. Conclusions: The physical and psychological environment of services needs to be adapted to meet the needs of patients. Therapeutic relationships with staff should be encouraged and a person-centred and individual recovery approach adopted. Prosocial relationships with peers, friends and family need to be fostered to enable positive recovery outcomes. Older patients should be empowered to develop a sense of autonomy to enable quality of life, wellbeing, and recovery, and progress. [ABSTRACT FROM AUTHOR]

Purpose: There is a pressing need for substance use services to know more about how to promote recovery from substance use problems, particularly in later life. Psychological sense of community (PSOC) is an important recovery dimension. This study aims to clarify in what ways PSOC and communities influence later life recovery processes. Method: A collaborative and deductive reflexive thematic approach was used to analyse 23 interviews with older adults in recovery from different substance use problems. Results: The findings suggest that PSOC and recovery in later life include multiple communities (relational, geographical, substance use-related, ideal and service-related) and affective states (PSOC and NPSOC). Older adults' recovery, moreover, can be described as personal and heterogenic (with respect to community relationships, individual needs, type of substance use problem, age of onset and meaningful activities). Conclusions: The findings confirm age of onset, type of substance use problem and community memberships as essential to later life recovery. They also supplement prior evidence on community resources and challenges to later life recovery. Importantly, the new findings extend and nuance current understandings of later life recovery. Taken together, the article illustrates MPSOC as a useful concept, with central practical and theoretical implications for later life recovery. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to illuminate the lived experiences and the path of recovery for adults sustaining a hip fracture before the age of 60. Methods: Participants were purposively sampled from a prospective multicenter cohort study in Sweden and Denmark, and narrative interviews were conducted with 19 individuals 0.7-3.5 years after the fracture. We used a phenomenological hermeneutic method to describe the participants' expressed essential meaning. Results: The experience of sustaining a hip fracture was expressed as a painful and protracted process of regaining self-confidence, function, and independence. It also implied a sense of growing old from one day to the next. Participants were afraid of new falls and fractures, resulting in an increased wariness. When expressing fears and persisting symptoms, participants described being neglected and marginalized by the healthcare system, which was perceived as non-receptive and routinely driven by a notion that hip fractures affect only the elderly. Rehabilitation targeted towards needs different from those of elderly individuals was requested. Conclusion: The lived experience of sustaining a hip fracture in individuals under 60 includes substantial challenges in everyday life, even up to 3.5 years after the injury. Rehabilitation pathways tailored to the needs of younger patients are requested. [ABSTRACT FROM AUTHOR]

Purpose: This study explored the experiences of people with stress-related illness participating in a nature-based intervention programme in a northern natural setting. Methods: A longitudinal case study was conducted with two women participating in a nature-based intervention programme on a farm. Data were collected by semi-structured interviews, diaries, rating scales, and self-assessment. Qualitative data were analysed by qualitative content analysis and quantitative data are presented descriptively. Results: The theme of finding a source for recovery and well-being permeates all categories. The participants perceived the farm and nature to be a calming refuge; they learned to be in the present and could manage the tasks. In togetherness with each other and the facilitator on the farm they felt understood and confident, experienced joy, and found opportunities for change. They gained knowledge and positive memories and found new approaches in life. Self-assessment questionnaires indicated improvements of functioning in everyday life and reduced stress-related exhaustion at the end of the NBI programme. Conclusions: Nature-based interventions lasting for a relatively short period seem to promote health and may be a complement to other treatments of stress-related illness. Further research is needed with a larger number of participants and in various natural settings. [ABSTRACT FROM AUTHOR]

According to the WHO, people diagnosed with schizophrenia in developing countries recover more fully than people with the same diagnosis in developed countries. At a time when international organizations are attempting to scale up biomedical psychiatric interventions in India and other low-income countries, it is important to understand why a place like India is doing better in recovery from serious psychosis. Interviews of 20 people diagnosed with schizophrenia in Kerala, India were conducted to determine level of functioning and quality of worklife. Quantitative assessments of the relations between these factors were undertaken along with qualitative, ethnographic analysis of narratives of interviewees. Analysis of interviews shows that quality of worklife is correlated with higher functioning among this group, and service user narratives claim that work enabled their recovery. Comparisons to other research further indicates that people in India with this diagnosis are more often employed than people with the same diagnosis in the United States and Europe. Employment and the quality of worklife appear to be positively related to recovery in terms of increasing functionality among people diagnosed with schizophrenia in this part of India. Certain employment programs and sociocultural factors likely contribute to differences in outcome. [ABSTRACT FROM AUTHOR]

There is currently no consensus regarding what outcome domains to measure following lower limb prosthetic rehabilitation. Prosthetic users have a unique insight into important outcome domains, little is currently known about their critical viewpoint. A total of 37 participants who underwent lower limb amputation in the last five years were recruited from UK limb fitting centres and social media. Data were collected using focus groups and interviews and analysed using reflexive thematic analysis. Five themes were identified. 1) The ability to participate in important activities, 2) how participants were able to undertake these activities, i.e., independently, with ease, safely and with minimal equipment. 3) A comfortable, easy-to-use prosthesis, 4) the importance of managing pain and finally, 5) adjusting and accepting their new normal. These five themes, or outcome domains, did not exist in isolation, but appeared to interact with each other, contributing to, or inhibiting the participant's holistic sense of recovery. Understanding important outcome domains that define what recovery means to people following amputation can help to inform domain consensus, as well as direct the focus of rehabilitation. Domain consensus would guide the selection of measurement tools that evaluate prosthetic interventions in a meaningful way. There is currently no consensus around which outcome domains should be measured following prosthetic rehabilitation. Outcome domains of importance from a patient's perspective focus on participation in important activities, prosthesis comfort, pain management, and acceptance of their new normal. Identifying these domains can help direct the focus of rehabilitation as well as inform outcome measurement practice. The interrelated nature of these domains suggests the need for a physical and psychosocial multi-domain approach to outcome measurement in prosthetic rehabilitation, with patient priorities at its centre. [ABSTRACT FROM AUTHOR]

There is a well-established literature examining how perpetrators of child sexual abuse (CSA) neutralise the norms and beliefs that ordinarily prohibit such behaviours. However, there has been substantially less focus on how such techniques of neutralisation might also be applied by people and groups who were not directly involved in the abuse, who we might expect to be more supportive. Drawing on a thematic analysis of an open-ended survey (n=140) and semi-structured interviews (n=21) with adults who experienced childhood sexual abuse this paper examines societal responses to disclosure. Identifying three key techniques of neutralisation, it explores how families, professionals and institutions use wider discourses that deny the victim/survivor, deny or minimise harm and silence by appealing to loyalty. The results demonstrate how significant others can constrain, rather than support, the process of disclosure and recovering from CSA. [ABSTRACT FROM AUTHOR]

Background: People experiencing substance use disorders (SUD) face myriad challenges in maintaining changes in substance use after treatment. Mobile phones can play a role in supporting the recovery process. To date, research has not explored how individuals use mobile phones to seek social support as they enter SUD recovery. Objectives: We sought to understand how individuals in SUD treatment use mobile technology in support of their recovery. Methods: We conducted semi-structured interviews with thirty individuals in treatment for any SUD in northeastern Georgia and southcentral Connecticut. Interviews explored participants' attitudes toward mobile technology and how they used mobile technology while using substances, in treatment, and in recovery. Qualitative data were coded and analyzed using thematic analysis. Results: We identified three major themes related to how participants: (1) adapted their use of mobile technology as they entered recovery, (2) relied on mobile technology for social support while in recovery, while (3) some found aspects of mobile technology triggering. Many individuals in SUD treatment reported using mobile phones to buy or sell drugs; as such, they took measures to adapt their use of mobile technology as they changed substance use behaviors. As they entered recovery, individuals relied on mobile phones for affiliational, emotional, informational, and instrumental support, though some did share they found some aspects of mobile phones triggering. Conclusion: These findings highlight the importance of treatment providers engaging in conversations around mobile phone use to help individuals avoid triggers and connect with social supports. These findings uncover new opportunities for recovery support interventions utilizing mobile phones as a delivery mechanism. [ABSTRACT FROM AUTHOR]

A co-design project, consisting of individual and collective design activities, was organized with clients of a mental health service, in order to explore its potential to support people with psychosis. The group met for approximately two hours, weekly, for six months, participating in design activities and collectively deciding on the project purpose and outcome – a boardgame. The experience of one group participant (Anthony) is explored, selected as the first case study within an Interpretative Phenomenological Analytical (IPA) framework. Following IPA's ideographic focus, Anthony's case was purposefully selected, as it portrayed a detailed picture, informing theoretical reflection on designing as therapeutic. The paper includes Anthony's first-hand account, combined with an analysis of data from three semi-structured interviews, photographic evidence and a reflective diary kept by the lead researcher. Results suggest that, for Anthony, design activity: a) helps developing a sense of agency b) is experienced as grounding in reality c) contributes to the development of inter-personal relationships, and d) has a different sense of rhythm than artistic practice. These results are contextualized within literature on the lived experience of psychosis and suggest that designing can be beneficial for people with psychosis, providing the backdrop for further research and practice. [ABSTRACT FROM AUTHOR]

Background: Many critically ill patients report a change in their health‐related quality of life after intensive care unit (ICU) discharge. Patients who experience delirium during their ICU stay are perceived as a fragile group of ICU survivors, and the 'quality of life' phenomenon needs to be studied among these patients. Aim: To explore everyday life experiences of critically ill patients with delirium during the ICU stay, from ICU discharge until 1‐year follow‐up, focusing on their health‐related quality of life and cognitive function. Study Design: We used a descriptive qualitative research design and interviewed patients 1 year after ICU admission. The participants were recruited from a pre‐planned one‐year follow‐up study of 'Agents Intervening against Delirium for patients in the Intensive Care Unit trial'. Data were analysed using Framework Analysis Method and content analysis. Results: Nine women and eight men participated and reported a struggle when returning to everyday life or adapting to a new normality from hospital discharge to 1 year later. None of the participants had been aware of the challenges they would face after hospital discharge. They described a need for more information about these challenges to themselves and about primary care to better understand their situation and the struggles they experience during recovery. One overall theme emerged from the analysis 'From enduring to adapting' with three subthemes: 'Struggling to regain a functional life', 'Struggling to regain normal cognition' and 'Distressing manifestations from the ICU'. Conclusions: To improve recovery and the quality of rehabilitation for critically ill patients suffering from delirium, it is essential to understand the phenomenon of ICU survivorship and what this fragile group of patients is going through. It is necessary to bridge the gap between secondary and primary care so patients can receive optimal training and support when needed. Relevance to Clinical Practice: Bridging the gap between primary and secondary healthcare services is urgently needed to improve rehabilitation for ICU survivors after critical illness. [ABSTRACT FROM AUTHOR]

Recovery is known to be enhanced by meaningful interactions between patients and mental health staff. However, nurses may become distanced from patients, and patients may spend most of their time in inpatient mental health care alone. This study aimed to explore how patients experience the intervention Daily Talks, a patient-driven innovation intended to enhance meaningful interactions between patients and staff. Fourteen in-depth interviews were performed with patients who participated in Daily Talks. The interviews were analysed using reflexive thematic analysis. The results of the participants' experiences of Daily Talks are presented in four themes: 1.Interpersonal and active interaction where individual factors matter 2.A patient-controlled space 3.A multi-use intervention and 4.A part of the daily healthcare structure. Participants stated that Daily Talks improved the relationship between patients and their nursing staff, and they stressed the importance of patients having control over both time and content in the Daily Talks. Daily Talks was used to vent emotions and thoughts, handle situations and create strategies, and become part of a helpful structure. The results support the value of Daily Talks, indicating that Daily Talks may facilitate helpful structures and meaningful relationships between patients and nursing staff. [ABSTRACT FROM AUTHOR]

Peer support groups have become widely utilized among those in recovery from problematic substance use. Yet, these peer-based programs vary and research examining their effectiveness has yielded mixed results. Relatively less is known about the impacts of arts-based peer recovery programs. Some research suggests that theatre may offer a powerful tool to address biopsychosocial changes among individuals in recovery. To explore the role of arts-based peer support programs, we draw on qualitative interviews with performers in two arts-based recovery programs. Our findings suggest that arts-based peer recovery programs may aid individuals in recovery in four main ways. Performing allowed participants to build relationships with others in recovery, channel experiences creatively while challenging stigma, foster confidence and recovery-identity formation, aiding participants in working through emotional impacts of prior substance use. These findings support emerging scholarship examining the role of performance in challenging stereotypes about substance use to aid those in recovery. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine factors and characteristics associated with changes in knowledge among adults receiving education within the first 8 weeks post-concussion. The study also aimed to understand desired preferences (i.e. content, format) for education post-concussion from the perspective of patients and physicians. Patient-participants (17–85 years) were prospectively recruited within one week of a concussion. Participants received education over visits from Weeks 1 to 8 post-injury. Primary outcome measures were participant responses on a concussion knowledge questionnaire at Weeks 1 (n = 334) and 8 (n = 195), and feedback regarding education through interviews. Other variables collected included preexisting medical history, physician assessed recovery and symptoms. There was a significant increase in average knowledge on the concussion knowledge questionnaire across time (71% vs 75% correct; p = 0.004). Participants with higher levels of education, female sex and preexisting diagnoses of depression or anxiety had more correct responses at Week 1. Healthcare providers had varying comfort levels addressing mood-related symptoms. There is a need to tailor education provided to concussion patients based on preinjury characteristics, i.e., mood disorders and demographic factors. Healthcare providers may need additional training in addressing mood symptoms and should modify the approach to fit patients' unique needs. [ABSTRACT FROM AUTHOR]

To examine the lived experiences of young people successfully managing life with ADHD and investigate the applicability of adult models of Recovery to these individuals. Twenty-seven young people aged 15–31 years participated in qualitative interviews. Participants' success was indicated by employment, school attendance, absence of acute mental health episodes, or absence of chronic alcohol or drug use. Thematic analysis identified specific components of their life successes and challenges. The emergent framework comprised four elements: (i) Recovernance (RE) (a portmanteau merging 'Recovery' and 'Maintenance'; ongoing adjustment to maintain one's personal best without an end point); (ii) Personal Optimization (PO) (continuously striving to maximize function and adjust one's goals given fluctuating impairments and internal resources); (iii) Self (S) (facing internal challenges and developing internal resilience); and (iv) Environment (E) (facing external challenges and fostering external resilience). These four elements yielded the acronym 'REPOSE'. Recovery in young people with ADHD was not a linear journey, with many missteps leading to greater self-knowledge, life skills and mastery. Progress was leveraged on securely anchored internal and external resilience factors against the prospect of setbacks. Findings provide new concepts and novel lexicons to extend existing concepts in Recovery. Counselling and therapy for young people with ADHD should foster self-understanding, goal setting and self-vigilance as an ongoing process to build their capacity to tackle setbacks and adversities. Counselling and therapy for young people with ADHD focus on a strengths-based approach building internal and external resources, such as developing skills and establishing social connections that build infrastructure in the environment for meaningful participation. [ABSTRACT FROM AUTHOR]

Background: To understand if supported accommodations (SA) are promoting the recovery of people with serious mental disorders, quality of life (QoL) is an important outcome. This study aimed to analyse the association between QoL and experiences of care in general and to identify specific experiences of care that are associated with QoL in users of SA. Methods: A random sample of users of 42 SA was interviewed to obtain standardized measures of QoL and personal experiences of care. The sample was also characterized according to sociodemographic and clinical aspects. Linear regressions models analysed the association between QoL and experiences of care, adjusting for potential confounders. Results include estimated regression coefficients, corresponding 95% confidence intervals and p-values. Results: The number of users interviewed was 272. The median QoL was 4.9 (2.3–6.8) out of 7. Although 84.9% of users were satisfied with the care received, only 16.2% felt involved in their treatment. Feeling safe (β =.73; 95% CI [0.22–1.24], p =.006) and having privacy (β =.42; 95% CI [0.09–0.75], p =.014) influenced QoL. Involvement in care (β =.44; 95% CI [0.13–0.74], p =.006), safety and privacy (β =.72; 95% CI [0.44–0.99], p = 8.38e-07) and user-professional relationship (β =.42; 95% CI [0.14–0.69], p =.003) were also associated with QoL. Conclusions: Feeling safe, having privacy, feeling involved in care and having good user-professional relationships influence the QoL of users. These findings have implications from the political and economic level to the organizational and individual levels. [ABSTRACT FROM AUTHOR]

People with a migration background and ethnic minorities (MEM) with substance use problems are confronted with stigma due to their ethnicity and substance use. This study explores how living with multiple stigmatized identities impacts substance use recovery among MEM. We conducted 34 in‐depth interviews with a diverse sample of MEM with substance use problems in Flanders, Belgium. A Qualitative Content Analysis using Earnshaw's stigma framework revealed that their recovery processes are challenged by accumulated stigma based on different intersectional statuses, namely ethnicity, substance use, psychological problems, criminal histories, poverty, unemployment and gender. These stigmas can negatively influence their well‐being, increase problem substance use and act as a barrier to recovery capital. While stigma moderators, which determine how stigma unfolds within society, were spread across the micro‐to‐macro continuum (from personal to social, community and macro‐cultural features), mediators that influence the role of stigma in recovery were mainly psychosocial. Hence, prevention and intervention strategies should be aimed at reducing stigma on the macro, meso and micro level, while individuals and communities can limit the impact of public stigma on recovery through constructive personal and collective coping and action mechanisms. [ABSTRACT FROM AUTHOR]

Outcomes from participating in a six-week small-group living skills program, periodically implemented over two years with twelve adult mental health consumers, are reported as a case study. Occupational therapy and recovery-oriented approaches underpinned the development and implementation of the program thus it was important that outcome measures aligned with these perspectives. Data were gathered pre and post program using the Canadian Occupational Performance Measure (COPM) and the Life Skills Profile-16 (LSP-16) in each iteration of the program. Two occupational therapy program facilitators were interviewed about their experience of running the program and using these measurement tools. COPM occupational performance (p = 0.001) and COPM satisfaction (p = 0.004) scores indicated significant change at post-program whereas the LSP-16 total and subscale scores did not (p = 0.132 for total scores). Facilitator insights into the experience of implementing the living skills program and the perceived alignment of the COPM and LSP-16 with recovery-oriented practice are reported. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous research has shown that people with traumatic injuries have unmet information needs with respect to their injuries, management, and recovery. An interactive trauma recovery information booklet was developed and implemented to address these information needs at a major trauma center in Victoria, Australia. OBJECTIVE: The aim of this quality improvement project was to explore patient and clinician perceptions of a recovery information booklet introduced into a trauma ward. METHODS: Semistructured interviews with trauma patients, family members, and health professionals were undertaken and thematically analyzed using a framework approach. In total, 34 patients, 10 family members, and 26 health professionals were interviewed. RESULTS: Overall, the booklet was well accepted by most participants and was perceived to contain useful information. The design, content, pictures, and readability were all positively appraised. Many participants used the booklet to record personalized information and to ask health professionals questions about their injuries and management. CONCLUSION: Our findings highlight the usefulness and acceptability of a low-cost interactive booklet intervention to facilitate the provision of quality of information and patient–health professional interactions on a trauma ward. [ABSTRACT FROM AUTHOR]

Relatively few studies have explicitly examined whether and how shelter-type, temporary or emergency accommodation shapes homeless clients' personal (mental health) recovery. A transatlantic phenomenological qualitative study was conducted to examine the influence of those services on personal recovery. Eighteen chronically homeless adults with a history of serious mental illness were recruited from several temporary accommodation services in New York City (NYC), U.S., and Glasgow, Scotland. Participants completed repeat in-depth interviews and a novel one-week multimedia mobile phone diary. The interpretative phenomenological analysis (IPA) produced three overarching group experiential themes: ' everything was just starting to fall into place'; 'caught in a trap' ; and ' trials and tribulations '. Collectively, the findings underscore the duality of influence of temporary accommodation on recovery. Those ambiguous spaces confronted participants with existential uncertainty, volatility and chronic boredom, but also proffered opportunities for envisioning and enacting recovery. Embarking on recovery while residing in temporary accommodation is possible, even for those enduring chronic life adversity. However, it is contingent upon enabling socio-material, affective and relational resources. Implications are discussed for theorising recovery as a contextually embedded, relational phenomenon, and for providing recovery-oriented support across the housing continuum. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to examine the process of surviving child abuse in people with a mental illness in order to develop an explanatory theory. The study utilized the grounded theory approach. Seventeen community-dwelling adults with a mental illness who had experienced child abuse were interviewed. For the in-depth interview, the lifeline interview method was used. Data were collected from July 14, 2019, to February 28, 2020. The constant comparative method was used for analysis, to identify similarities and differences between different statements, and similar phenomena or theories were compared and analyzed continuously. The central phenomena were "losing oneself" and "in a precarious state." Participants used "expressing," "standing on one's own feet," and "avoiding" as coping strategies. Observed outcomes were "making life work for them" and "living with others." The core category was "losing myself, embracing myself as someone in a precarious state, and being reborn as the master of my life." Positive religious coping, having a supportive network, and emotional or physical distance from difficult situations played a major role in surviving participants' experiences of child abuse and being victimized because of their mental illness. Our findings provide a theoretical basis for understanding people with mental illness who have survived child abuse, and suggest that opportunities for sharing their stories, facilitating self-reliance, and avoiding the causes of their difficulties all play a role in their healing process. Based on this study, it is expected that clinical experts and policy developers will be able to formulate evidence-based interventions and policies. [ABSTRACT FROM AUTHOR]

Opportunities and barriers for occupational engagement among residents in supported housing. Research shows that people with psychiatric disabilities view supported housing (SH) as a possibility for social contact, but also as entailing a risk of deprived self-determination. There is, however, little research on the target group's engagement in everyday occupations. To explore SH residents' opportunities and barriers for occupational engagement. Sixteen participants were interviewed, and data was analysed using content analysis. An overarching theme, Struggling to create meaning and seeking affection, and three underlying categories, emerged. Finding meaning through self-chosen occupations and support focussed on receiving support, doing self-chosen occupations, and having social contacts. Feeling neglected and insecure limits engagement in occupations was related to feelings of not being seen by staff, and insecurity, which hampered daily life. The third theme was Having a negative self-image and low level of ability hinders an active life. Residents' self-view and ability to create an inner drive for being active was important for occupational engagement, which was linked to social connectedness. Occupational based interventions and a personal recovery approach is warranted in order to facilitate needs for meaningful occupations. The results from the study can be used to further develop optimal support within SH units. [ABSTRACT FROM AUTHOR]

Background: The current emphasis among addiction treatment providers is to use person-first language, such as "a person with a substance use disorder," as a way to reduce stigma around addiction and resulting barriers to treatment. This study considers how individuals recovering from substance use feel about the terms "alcoholic" and "addict," particularly how they self-identify and whether they believe the terms carry stigma. Method: Thirty-five individuals were interviewed, recruited primarily, but not exclusively, from 12-step meetings (Alcoholics Anonymous, Narcotics Anonymous), from 3 locations throughout a rural New England state. Interviews were transcribed and coded in Atlas Ti qualitative analysis software, and a content analysis of text coded with "stigma" was conducted. Results: Some comments reflected a belief that the terms "addict" and "alcoholic" carry a stigma. However, more comments rejected the notion of these being stigmatized terms; or acknowledged the stigma but reflected the subject's lack of internalizing of any stigma. Comments reflected other themes including a sense of pride, identity and ownership when self-identifying as an addict or alcoholic. Several comments suggested that person-first language is part of a larger movement to "soften everything," without changing the underlying condition (addiction). The findings may reflect the fact that subjects were recruited from 12-step programs, where the convention is to self-identity using the terms "alcoholic" and/or "addict." Conclusions: Some individuals seeking treatment for addiction may prefer self-identifying using old-school terminology (addict, alcoholic) rather than person-first language, for a variety of reasons (eg, they do not internalize the stigma of such terms). [ABSTRACT FROM AUTHOR]

This qualitative study aims to explore the factors that motivate people in recovery from substance use disorder in Kuantan to remain in a self-help group. A total of five recovering self-help group members participated in this study. The findings indicated that people in recovery decided to continue their participation in a self-help group in order to obtain support that helps them sustain their recovery. Furthermore, respondents explained that the self-help group empowers them to give back to society. The respondents in this study also emphasized that the presence of a positive group leader is vital in maintaining their motivation to continue their participation in the self-help group. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore older adults' experiences of and approaches to managing their long-term health and mobility after traumatic injury. A longitudinal qualitative study was undertaken with older adults following traumatic injury in Victoria, Australia. Fifteen participants (≥65 years) were interviewed at three years post-injury (n = 15), and re-interviewed at four (n = 14) and five years (n = 12) post-injury. Using a framework approach, a longitudinal thematic analysis was performed. Older age at the time of injury was identified by participants as a key factor influencing their recovery. Many participants reported actively attempting to regain their strength and fitness in the first five years following injury. However, their age, injury impacts, other health conditions, and weight gain made it difficult to achieve recovery goals. Many older adults reported a decline in their physical function over time. While these experiences and persistent disability constrained or changed the quality of social relationships, community participation, and independence, several participants described adapting to their functional limitations, and managing their secondary conditions over time. In our cohort, the intertwined combination of ageing, injury, and comorbid conditions negatively affected health and mobility, reinforcing the need for preventative strategies. Older adults recovering from traumatic injury may benefit from specialised care pathways that offer long-term and tailored therapies, with programs and services specific to their needs and goals. An integrated service approach by injury insurers, health care, primary care, disability, and aged care could more clearly identify and effectively address the individual needs and goals of older adults with complex conditions. Health and social services that work with people with injuries to develop personalised coping strategies can reduce anxiety related to uncertainty about the future, promote well-being, and support participation in valued activities. [ABSTRACT FROM AUTHOR]

Self-efficacy plays a role in the process of making lifestyle changes. After bariatric surgery, patients must adapt to several lifelong lifestyle changes. The aim of this study was to explore patients' experiences of recovery after bariatric surgery in those reporting low preoperative self-efficacy. This qualitative inductive interview study included 18 participants. Individual interviews were conducted approximately one year after the surgery. Data were analysed using thematic analysis. The analysis identified one theme, and five subthemes describing recovery after bariatric surgery. Participants described being at a crossroads before surgery and having to make a change. After surgery, they had to learn to handle their new situation, which included getting to know their new body, handling thoughts about themselves, and managing social relations. To enhance their situation, support and information were essential. Social relations, support, successes, and challenges influenced their self-efficacy, and thoughts about adopting lifestyle changes, maintaining motivation, and handling setbacks. Recovery one year after bariatric surgery is an ongoing process that involves challenges encountered in lifestyle changes and physical and psychological transformations. Self-efficacy is not static and is influenced during the recovery process. Support and information are essential to enhance patient recovery after bariatric surgery. [ABSTRACT FROM AUTHOR]

Objective: This article examines the relationship between inpatient mental health units' adherence to recovery-oriented care and 30-day patient readmission. Method: The sample included patients admitted to one of 34 Veterans Health Administration inpatient mental health units. Recovery-oriented care was assessed using interviews and site visits. Patient characteristics and readmission data were derived from administrative data. Findings: Overall recovery orientation was not associated with readmission. Exploratory analyses found higher scores on a subsample of items pertaining to inpatient therapeutic programming were associated with lower patient readmissions. Additionally, patients with more prior service use and substance abuse or personality disorders were more likely to be readmitted. Conclusions and Implications for Practice: A growing body of literature supports the association between psychotherapeutic services in inpatient units and better patient outcomes. However, further research is needed to examine this association. More work is needed to develop appropriate psychotherapy services for the inpatient setting and support their implementation. Impact and Implications: While this study did not find an overall association between recovery-oriented inpatient mental health services and patient readmission, it did show an association between the provision of therapeutic services and readmissions. These findings support the importance of developing therapeutic models appropriate for acute inpatient settings as well as supporting their provision. [ABSTRACT FROM AUTHOR]

The existing psychosocial Support activities in the Northern Territory, Australia, are mostly delivered through individualised outreach and client‐centred Support programs and do not currently have a strong Peer focus. To address this gap, a Peer‐Led Education Pilot was developed and implemented in Darwin, Australia. The pilot was comprised of three separate but overarching stages, and each stage was independently evaluated. In this article, results from Stage 1 will be presented, with a specific focus on the role of Peer‐to‐Peer communication in improving participants' mental health and Recovery skills. This stage involved the delivery of the My Recovery program to self‐nominated participants, and the evaluation was aimed at reporting on the appropriateness and effectiveness of the program. The evaluation was qualitative in design involving individual pre‐ and post‐program interviews with program participants (npre = 14, npost = 16) between August and October 2019. The program was well received by participants and helped build their capacity to understand and self‐manage their mental health and/or alcohol and other drug issues in an inclusive, non‐clinical, non‐judgemental space. The results highlighted the importance of including a strong Peer focus in the existing psychosocial Support services available for people with mental health issues in Darwin. The findings also underscored the inclusion of those with lived experience of mental health challenges in the design and delivery of such programs. [ABSTRACT FROM AUTHOR]

Objective: Although self-compassion has been shown to facilitate eating disorder (ED) remission, significant barriers to acquiring this skill have been identified. This is particularly true for tertiary care populations, where ED behaviours provide a valued identity and readiness issues are highly salient. In this research, the voices and perspectives of patients who have recovered as well as those in later stages of tertiary care treatment were captured using qualitative methods. Methods: Seventeen individuals with a lengthy ED history (seven fully recovered, 10 currently in recovery-focused residential treatment) participated in audio recorded interviews. Using a visual timeline, participants described the development of their understanding of self-compassion, barriers to self-compassion and how these barriers were overcome. Results: Three processes were identified, reflecting different levels of readiness. Challenging my beliefs involved overcoming cognitive barriers to the concept of self-compassion (i.e. coming to see self-compassion as helpful), and set the stage for dealing with the world around me and rolling up my sleeves, which reflected preparatory (i.e. freeing oneself from difficult life circumstances) and active (i.e. having the courage to do the work) change efforts, respectively.Conclusions: These findings may help patients embarking on tertiary care treatment to envision a roadmap of supportive processes and help clinicians tailor interventions to patient level of readiness for self-compassion. [ABSTRACT FROM AUTHOR]

Mental health 'recovery narratives' are increasingly used within teaching, learning and practice environments. The mainstreaming of their use has been critiqued by scholars and activists as a co-option of lived experience for organisational purposes. But how people report their experiences of telling their stories has not been investigated at scale. We present accounts from 71 people with lived experience of multiple inequalities of telling their stories in formal and informal settings. A reflexive thematic analysis was conducted within a critical constructivist approach. Our overarching finding was that questions of power were central to all accounts. Four themes were identified: (1) Challenging the status quo; (2) Risky consequences; (3) Producing 'acceptable' stories; (4) Untellable stories. We discuss how the concept of narrative power foregrounds inequalities in settings within which recovery stories are invited and co-constructed, and conclude that power imbalances complicate the seemingly benign act of telling stories of lived experience. [ABSTRACT FROM AUTHOR]

To disentangle the key steps of the return to work (RTW) process and offer clearer recovery-focused and sustainable RTW for people on sick leave due to common mental disorders (CMDs). This participatory research involves two large Canadian organizations. In each organization, we established an advisory committee composed of RTW stakeholders. We collected information in semi-structured interviews from RTW stakeholders (n = 26) with each member of the advisory committee in each organization, as well as with employees who had recently experienced CMDs. The interviews examined the RTW process for employees on sick leave due to CMDs as well as RTW stakeholders' perceptions of barriers and facilitators. A thematic approach was used to synthesize the data, following which, results were discussed with the two advisory committees to identify solutions considering key RTW steps. Ten common key steps within the three RTW phases emerged from the semi-structured interviews with RTW stakeholders and discussions with the two advisory committees: 1) At the beginning of sickness absence and involvement of disability management team (phase 1), we found 3 steps (e.g., taking charge of the file), 2) during the involvement in treatment rehabilitation with health professionals and preparation of the RTW (phase 2), 4 steps (e.g., RTW preparation), and finally 3) the RTW and follow-up (phase 3) consists of 3 steps (e.g., gradual RTW). A participatory study involving RTW stakeholders helped identify 10 common key steps within three phases to support RTW sustainability of people with CMDs. Future research will need to address how RTW coordinators intervene in the RTW process of employees with CMDs within these steps. Rehabilitation professionals will benefit from a detailed description of the RTW process (10 steps spread out over 3 RTW phases), allowing them to standardize it while adopting a personalized approach for the employee on sick leave. Rehabilitation professionals are informed of stakeholders' role and actions required in the RTW process; as such the communication between RTW stakeholders should be improved. RTW coordinators will be able to tailor more precisely their intervention, considering the detailed RTW process and RTW stakeholders' role and actions, and thus will become the pivot occupational health specialists for the RTW process. [ABSTRACT FROM AUTHOR]

Ablation procedures are common for patients with atrial fibrillation (AF), yet evidence is limited about patient perceptions of their recovery following ablation. We sought to expand understanding of this recovery process. Twenty participants undergoing their first AF ablation completed semi-structured interviews prior to ablation (baseline) and at one, three, and six months post AF ablation. Pre-procedure education is modeled after education used for other ablation procedures, preparing patients to expect a single recovery trajectory. We identified two recovery trajectories that varied in speed of symptom resolution: sustained improvement and pseudo improvement. Recovery was slower than expected in both trajectories. Moreover, returning to desired activity levels consistently lagged behind other symptom resolution by approximately two months. A more accurate understanding of what patients experience post-ablation, as illustrated in these findings, serves as a beginning step to alter patient education prior to AF ablation to better prepare individuals for the recovery process. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Frontline forensic mental health staff often face challenges when providing recovery‐orientated care, as they must balance between caring for the forensic psychiatric patient and at the same time ensuring safety and security for all other patients and staff at the ward.Research shows that balancing between care and custody in everyday clinical practice is possible, but more practical nursing studies showing ways of balancing power relations are needed to guide clinical practice.Online video games are increasingly recognized as promising new tools to promote social relations, establish competencies and re‐articulate power relations in therapeutic environments. What the paper adds to existing knowledge?: This paper provides insights into how using online video gaming interventions may influence the establishment of social power relations of staff and forensic psychiatric patients. It adds to existing research by providing a conceptual way to study and understand how mental health nurses may balance between care and custody, delivering care to accommodate patients' needs without compromising safety and security at the ward.This study answers a call in current research by providing qualified knowledge regarding the use of online video gaming to build and sustain therapeutic relations in mental health care. What are the implications for practice?: Our paper suggests that balancing between care and custody is possible by using online video gaming interventions in forensic psychiatry. It moreover provides practice‐close knowledge that may inspire and guide clinical mental health nurses to further develop online video gaming interventions in mental health care for the benefit of their patients. Introduction: In recovery‐oriented care, forensic psychiatric nurses must engage in care relationships with forensic psychiatric patients (FPs) whilst focussing on ward security. Online video games (OVGs) may provide a platform for negotiating power and social relations. Studies showing how OVG interventions may influence power balances in forensic psychiatric care are needed to guide clinical practice. Aim: Our aim was to study how power relations were articulated between FPs and staff in an OVG intervention in a Danish forensic psychiatric ward. Method: Data consist of three months of observational data and interviews with three staff members and six patients. We used sociologist Pierre Bourdieu's framework of field, power and capital to analyze data. Results: The OVG intervention consisted of two power fields, "in‐game" and "over‐game." In‐game concerned the practice of gaming. Over‐game described the organization of the gaming intervention. Specific logics, skills and symbolic capitals drove power in each field. Discussion: Power in‐game was open to FPs and staff, leading to symmetric power relations. Power over‐game was open to staff only, resulting in asymmetrical power relations. Implications for practice: Online video game interventions may facilitate power balancing in forensic psychiatry. These insights may guide the development of new OVG interventions for patients and nurses in mental health care. [ABSTRACT FROM AUTHOR]

Stakeholder's views on the role of recovery capital, including issues and barriers, that might address service provision for individuals with alcohol- and drug-related problems are important for improving outcomes. Six focus groups (n = 35) and five networking public participation events took place across five counties in the South East Region of Ireland. This was to capture the views of service providers, service users, their families and friends, and the wider community in measures to address recovery capital. Transcripts and field notes were analyzed using the recovery capital framework to generate emerging themes. Re-integration into the service users' own community, access to employment, education, and accommodation, and structures to help build self-esteem were considered to be significant factors in the building of recovery capital and maintaining sobriety. Societal attitudes regarding substance use appears to be a significant barrier in building recovery capital. The shared experiences among those in recovery and service provision suggest the need for expansive education on substance use across society. This research highlights the need for greater integration between policy and practice. Providing an assessment of evidence-based recovery-orientated interventions is likely to improve the system. [ABSTRACT FROM AUTHOR]

Background/aims As mental health services focus on recovery orientated service delivery, there is a need to adopt recovery orientated approaches in interventions that promote physical activity. This article presents a process of using and modifying an experience-based co-design approach to develop an intervention that can be used to promote physical activity in mental health services: the 'Move with Recovery' programme. Methods A facilitated experience-based co-design approach was undertaken over four sessions. This approach included the use of a trigger film of touchpoints and sample physical activity experiences of service users, in addition to the use of a storyboard for emotional mapping and prioritising exercises. The final two co-design sessions involved programme prototyping and development using the TIDieR framework. Results The outcome of this process, the Move with Recovery programme, was a peer-developed and peer-led, community-focused programme structured around nine action points. It is made up of a combination of motivation, education and support sessions, together with light intensity aerobic activity sessions that is structured using the TIDieR framework, and intended for implementation in the recovery college. In this regard, the developed programme is inherently recovery orientated in its design and its aim. conclusions The developed programme can be embedded into existing mental health services that lack integrated exercise resources. This articles details the experience-based co-design process undertaken here and offers future learning for using experience-based co-design to promote physical activity in mental health. [ABSTRACT FROM AUTHOR]