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A life course approach recognizes the role of turning points in adding twists and turns in individuals' addiction recovery processes. The notion of certain key life events that trigger turning point experiences offers a valuable theoretical construct for understanding processes of change. The current study aimed to identify turning points and assess the role of contextual dynamics in generating long-term changes, based on lived experiences of persons in drug addiction recovery. A qualitative research design was applied using a Lifeline Interview Method (LIM), allowing a retrospective lens to elicit recovery narratives. Purposive sampling was utilized to compose a heterogeneous group of thirty persons in self-defined drug addiction recovery in Flanders (Belgium). An interpretative phenomenological approach was adopted during a thematic analysis, grounding the research claims in respondents' lived experiences. Key moments of change that were reported by participants are: (1) adverse drug-induced experiences; (2) becoming a parent; (3) 'hitting rock bottom'; (4) (dis)engagement of social networks and environments; and (5) addiction treatment. The findings illustrate the role of contextual dynamics that can facilitate (or hamper) experiencing these life events as turning points toward change. This study contradicts the notion of a single event or turning point causing abrupt changes in individuals' addiction trajectories. Contextual dynamics and meaning-making processes simultaneously influence whether specific life events can facilitate change. Treatment providers, researchers, and policymakers should take into account the process-based, situational, and relational nature of recovery. [ABSTRACT FROM AUTHOR]

Following the paradigm shift to recovery in the Anglophone world, recovery is also gaining momentum in drug policy and practice in Flanders (Belgium) and the Netherlands. Since the meaning of recovery is being debated internationally, broadening the assessment of how the recovery framework is applied in policy discourse and how it is implemented in various international contexts is imperative. This comparative policy analysis aims to assess similarities and differences in addiction recovery vision, implementation, and evaluation in Flanders and the Netherlands. The thematic analysis draws upon a triangulation of different data collection methods: a focus group (n = 14) and interviews (n = 21) with key figures in the addictions field, followed by analyses of relevant policy documents (n = 9). Our findings show that a holistic vision of addiction recovery is endorsed in both countries. Although differences in policy development occurred (i.e. centrally driven in Flanders versus 'bottom-up' in the Netherlands), similar challenges emerged concerning recovery-oriented addiction policies. While policymakers in Flanders and the addiction sector in the Netherlands strongly proclaim recovery, structural implementation, dedicated funding, and systematic evaluation of recovery-oriented policies are lacking. This study suggests that systematic inclusion of experts by experience and aligning government and practice level funding and policies are crucial. [ABSTRACT FROM AUTHOR]

Objective: To examen the short‐term and long‐term responses of sexual assault victims who attended a sexual assault centre. Methods: Semi‐structured interviews were held with twelve victims of sexual assault who received help from a sexual assault centre. Analyses were done in Atlas.ti. via a process of open, axial and selective coding. Results: Shortly after assault, the victims' response was to strike a balance between denial and acknowledgement that the violence was real and not their fault. In the ling term most victims experienced a dynamic recovery process with fluctuating responses. Their social support network played a crucial role in reaching out for professional care. Conclusion: Shortly after assault sexual violence victims need the violence to be acknowledged by skilful, empathic care providers. In the long term, victims experience vitims experience a dynamic recovery process with fluctuating responses in which continuity of care is of the utmost importance. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Care planning and coordination are currently insufficiently based on scientific insights due to a lack of knowledge on this topic.Most patients with severe mental illness receive long‐term treatment from specialized mental health services.This long‐term, highly intensive treatment is not always the best option for two reasons. Firstly, because as long as a patient receives intensive treatment aimed at safety, it is hard for that patient to take full responsibility for their own life. Secondly, because care is not available unlimitedly, some patients are waiting to receive specialist mental healthcare while others who do not need it anymore still receive it. What this paper adds to existing knowledge?: Most stable patients with severe mental illness can be treated outside of specialized mental health services.Some patients are too dependent on a specific mental healthcare professional to be referred to primary healthcare. In such instances, a referral will most likely lead to destabilization and the referral will therefore be unsuccessful.Patients preferred primary healthcare to specialized mental health services, mainly because of the absence of stigma associated with the latter.There should be more attention for personal recovery (especially the social support system) of patients with severe mental illness who are referred to primary healthcare services. What are the implications for practice?: Most stable patients with severe mental illness can be treated in primary healthcare.Professionals in primary healthcare should keep personal recovery in mind when treating patients, focusing on problem solving skills and also making use of social support systems. Aim/question: Care planning and coordination are currently insufficiently based on scientific insights due to a lack of knowledge on this topic. In the United Kingdom and the Netherlands, most patients with severe mental illness receive long‐term specialized mental healthcare, even when they are stable. This study aims to explore the outcome of these stable patients when they are referred to primary healthcare. Methods: Patients (N = 32) receiving specialized mental healthcare that were referred to primary healthcare were interviewed in focus groups, as were the involved professionals (N = 6). Results: 84% of the participants still received primary healthcare after 12 months. Despite the successful referral, the patient's personal recovery did not always profit. The participants of the focus groups agreed that some patients were too dependent on a specific mental healthcare professional to be referred to primary healthcare. Discussion: Most stable patients with severe mental illness can be referred to primary healthcare. Personal recovery and dependency on a specific healthcare provider should be considered when referring a patient to primary healthcare. Implications for practice: Professionals in community mental healthcare teams should consider a referral to primary mental healthcare in stable patients. Professionals in primary healthcare should keep the patient's personal recovery in mind. [ABSTRACT FROM AUTHOR]

BackgroundSubthreshold depression (SUBD) in later life is common and important as prodromal state and prominent risk factor in the development of major depressive disorder (MDD). Indicated prevention can reduce the incidence of MDD among people with SUBD substantially, but needs to be targeted to those that are truly at risk of developing MDD.MethodN = 341 eligible participants with SUBD were included from the first (1992/1993), second (1995/1996) and third (1998/1999) cycle from the Longitudinal Aging Study Amsterdam (LASA) by using a two-stage screening design. LASA is an ongoing prospective cohort study in The Netherlands among the older population (55–85 years). At baseline (1992/1993) N = 3107 participants were interviewed and follow-up cycles were conducted every 3 years until 2008/2009, resulting in maximal 17 years of observational period. The proportion of people that developed MDD, remained SUBD, or recovered from SUBD was measured and Cox proportional regression analyses were performed to investigate 29 putative predictors of MDD and recovery from SUBD.ResultsN = 153 (44.9%) recovered from SUBD, N = 138 (40.5%) remained chronically SUBD, and N = 50 (14.7%) developed MDD (incidence rate 15.1/1000 person-years). Women, high neuroticism, more chronic diseases, high body mass index, smoking and less social support predicted conversion to MDD. Men, low neuroticism and absence of pain predicted recovery from SUBD.ConclusionsAlthough older people with SUBD are clearly at risk of developing MDD, the majority did not, even after a long and thorough follow-up. Given the risk factors that were uncovered, targeting and prevention of MDD in those at very high risk is feasible. [ABSTRACT FROM AUTHOR]

“Recovery Is Up to You,” a 12-week peer-run group experience for persons with major psychiatric problems, has had positive effects on important elements of recovery: empowerment, hope, and self-efficacy beliefs. Determining if such an experience would be equally efficacious for persons with addiction problems is the focus of this study. The 12-week course was experienced by eight groups of persons with addiction problems and the outcome, measured in terms of the response of participants and of the group leaders, was a favorable one as the course was found to be supportive of the recovery process, providing the participants and peer group leaders alike with new perspectives on meaningful living. [ABSTRACT FROM AUTHOR]

Relatively little is known about the course of symptoms in patients suffering from burnout and even less about the status of their cognitive functioning. We followed 40 burnout patients and 40 healthy controls who had participated in a previous study on the effect of motivational interventions on cognitive performance in an experimental task and repeated these measurements two years later (T2). The burnout patients, who had received psychological treatment, showed substantial improvement regarding burnout symptoms and cognitive performance at T2. The pre-post-effect size for symptom reduction was large. Importantly, cognitive performance and responsiveness to motivational interventions improved to normal levels. The patients no longer fulfilled the criteria for burnout or any other psychiatric disorder. Despite these improvements, burnout patients still experienced more exhaustion, general fatigue, depressive symptoms and general distress in comparison to healthy controls and compared to normed groups. The same pattern was observed with regard to cognitive performance: performance improved but remained below normal levels. Perceived job competence, involvement in work and responsiveness to rewards had returned to normal levels. The results indicate that although recovery from burnout is possible, symptoms may persist over the long term (here, two years). This should be taken into consideration by employers. [ABSTRACT FROM AUTHOR]

Objective. To strengthen trauma-informed health care by exploring parents’ experiences of assisting their child after single-incident trauma (eg, violence, accidents, and sudden loss). Method. Semistructured interviews with parents (N = 33) of 25 exposed children (8-12 years). Results. Responsive parenting after trauma emerged as a core theme, consisting of (a) being aware of a child’s needs and (b) acting on these needs. The authors identified 14 strategies, such as comparing behavior with siblings’ behavior and providing opportunities to talk. Parents felt that their capacity to be responsive was influenced by their own level of distress. Conclusion. The authors propose a model of Relational PTSD (posttraumatic stress disorder) and Recovery to assist health care professionals working with children exposed to trauma. The results also point to the need to recognize the challenge that parents face when supporting a child after traumatic exposure and to align more with parents about procedures that may cause the child to be reminded of the event. [ABSTRACT FROM PUBLISHER]