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Background: The relationship between personal choice and mental health recovery in the context of supported housing has not been explored. Aims: To gain an understanding of how choice facilitates recovery processes in supported housing environments for those with serious mental illness (SMI). Method: Qualitative in-depth interviews were conducted with 24 tenants with SMI living in supported housing. Results: Choice while living in supported housing was a large contributor to wellbeing and mental health recovery. Tenants valued three domains of choice: (1) choosing to be responsible for one's life, (2) choosing how to organize one's social life and (3) choices that make them feel "at home". Conclusion: This is one of the first studies on choice and recovery for persons who have transitioned to supported housing. Findings reveal the need for research to move beyond focusing on choice of housing (e.g. housing type) and explore the scope and relevance of choice in housing. [ABSTRACT FROM AUTHOR]

Background: The recovery movement has become highly influential in research and services for people who experience psychosis. However, the precise meaning of recovery from psychosis is contested, and there are concerns that the language of the recovery movement may be co-opted to serve other priorities. Aims: To investigate carers' constructions of the meaning of recovery from psychosis. Method: A qualitative study, using synthetic discursive psychology to analyse transcripts of semi-structured interviews with seven carers recruited from an Early Intervention in Psychosis service, where recovery approaches were practised. Results: We found medical accounts of recovery to be highly influential used both frequently and as a key reference point, even when describing alternative, non-medical accounts of recovery. Such alternative accounts of recovery in the data were fragementary and participants tended to use such accounts to signal some kind of trouble or disruption. Conclusions: Explanations of the objectives of recovery approaches cannot escape comparison with a medical repertoire of recovery. Such explanations may benefit from illustration using personal accounts of recovery that contain concrete detail. Creating conditions of safe uncertainty around the meaning of recovery may be an important aim for clinicians and services. [ABSTRACT FROM AUTHOR]

Objective: Our goal was to examine potential predictors of a comprehensive operationalization of eating disorder recovery, characterized by physical, behavioral, and cognitive recovery, focusing on constructs related to self‐concept, personality, and negative affect. Method: Participants were women with a history of an eating disorder who provided data via survey and interview at two time points separated by about 7–8 years and who met criteria for an eating disorder diagnosis at baseline (N = 36). Results: Logistic regression models revealed that self‐esteem was a significant predictor of recovery status (OR = 1.12, p =.039) such that individuals with higher self‐esteem at baseline demonstrated significantly greater odds of being in full recovery at follow‐up. However, when self‐esteem was considered in a set along with baseline imposter phenomenon and anxiety, no single construct emerged as a significant unique predictor of recovery in logistic regression analyses. Discussion These results highlight the potential importance of self‐esteem in relation to recovery, with clinical implications related to bolstering self‐esteem as part of eating disorder treatment. Future research should continue to explore predictors using a comprehensive operationalization of eating disorder recovery in larger, more diverse samples to optimally identify factors associated with achieving recovery. [ABSTRACT FROM AUTHOR]

. Even though emerging evidence suggests that participation in arts-based group programs are helpful in supporting mental health, the field lacks an established theorical framework. This study explored the extent to which participants' experiences of singing or creative writing groups aligned with theorising proposed by the social cure approach.. Semi-structured interviews were conducted with 25 choir members, and 23 creative writing group members with chronic mental health conditions at two time points. Transcripts of the interviews were examined by four coders using thematic analysis.. Consistent with social cure theorising, participation in the choir and creative writing group facilitated meeting participants' needs for belonging, support, self-efficacy, purpose, and positive emotions.. This study demonstrated the psychosocial mechanisms by which participation in arts-based groups can enhance mental health. We conclude that engagement with the social cure framework may be useful to structure practice in this field. [ABSTRACT FROM AUTHOR]

This qualitative study used a grounded theory approach to explore the lived experience of psychotropic medication use in the recovery process of 18 participants who had a diagnosis of schizophrenia, bipolar disorder, or major depression but who were successful in recovery without ongoing medication use. Participants' narratives depicted a continuum of medication experiences in their recovery process centered on three key recovery factors identified by participants: basic functioning, deeper healing, and hope for recovery. For each recovery factor, participants' experiences ranged from perceiving medication as promoting recovery to perceiving medication as impeding their recovery, with mixed experiences in between. Findings suggested that the role of medication in recovery is multifaceted and individualized. Mental health providers should avoid a one-size-fits-all philosophy on medication for major mental health conditions, and should be responsive to individual situations and needs. [ABSTRACT FROM AUTHOR]

Evidence‐based psychological treatments for trichotillomania (TTM) can be effective; however, relapse is common and consumers have indicated poor satisfaction with treatment outcomes. The aim of this study was to identify participants' perspectives of critical factors associated with short‐ and long‐term recovery following their brief, intensive peer‐support retreat for TTM. A mixed methods longitudinal design was used to evaluate a 3‐day residential peer‐support retreat attended by eight women who self‐referred into the retreat. Semi‐structured interviews were conducted at post‐retreat (n = 6) and 12‐month follow‐up (n = 5). Self‐report measures of symptom severity, mood and quality of life were completed at baseline (n = 7), post‐retreat (n = 6), 6‐month follow‐up (n = 5) and 12‐month follow‐up (n = 5). An inductive thematic analysis was performed to identify themes within the interview transcripts. Quantitative outcome data was used to confirm, challenge, provide context for, and link qualitative findings within the broader literature. Quantitative outcome data demonstrated reduced TTM severity from baseline to post‐retreat. By 6‐month follow‐up, symptoms had relapsed to baseline levels. Participants' perspectives of factors associated with recovery immediately after the retreat included group‐based processes (e.g., sharing, normalisation, safety, and enhanced motivation/accountability) and individual processes (e.g., readiness for change, self‐regulation skills). The qualitative and quantitative data conveyed similar outcomes at both post‐retreat and 12‐month follow‐up. Brief, immersive peer‐support retreats for TTM may facilitate equivalent symptom reductions as longer, therapist‐delivered cognitive behavioural treatments for some individuals. [ABSTRACT FROM AUTHOR]

Research on addiction recovery often focuses on traditional and well-established groups such as Alcoholics Anonymous or SMART Recovery. Recently, another type of recovery group has emerged within communities. These groups are based around social activities and have not been studied in the literature. This study qualitatively identified individuals' experiences within these groups. Semi-structured interviews were carried out with 10 abstinent members of social-based groups, who had previously experienced drug or alcohol dependence. Interpretative phenomenological analysis was employed on the transcripts to try and understand the individuals' experiences of being involved in these groups. Four themes emerged from the participants' experiences: (a) group's role in their recovery, (b) personal choice and flexibility in recovery experience, (c) group as an inclusive family unit, and (d) active involvement in the recovery group. These findings are discussed in relation to previous literature, and the value of these groups for recovering individuals is highlighted. [ABSTRACT FROM AUTHOR]

Peer recovery services are a community-based treatment option for people suffering from mental illness and/or substance use problems. Peer services provide an alternative to inpatient care and can help decrease costs associated with hospitalization or incarceration of the mentally ill. Yet, scant research has explored the effect of these services, particularly in rural communities. The current study assesses the impact of peer services on peer mentees' and mentors' recovery capital, quality of life, and general wellness. Consumers of peer services completed three surveys every three months for approximately 18 months. Quantitative analyses demonstrated that subjects had a marginal change in their recovery capital, but quality of life and general wellness were unaffected. Peer providers' experiences were also explored through interviews. Qualitative analyses revealed that providers have a positive outlook regarding peer services but would benefit from greater resources and additional training. Policy and community implications are also discussed. [ABSTRACT FROM AUTHOR]

Data on treatment for AUD (Alcohol Use Disorders) in developing countries are scarce. This study explores aspects of early recovery and correlates of alcohol use after residential AUD treatment in Uganda. 78 respondents were followed up using, among others, the ASI-6, HCSL-37A and WHOQOL–BREF. They were interviewed within two weeks after admission in residential treatment and six months later. Significant reductions in addiction severity and psychopathology, as well as improvements in Quality of Life (QoL) were observed after treatment. Treatment environment, individual characteristics and problems with close friends were the main predictors of early recovery from AUD. [ABSTRACT FROM AUTHOR]

Background: There is no consensus on how to best define recovery in gambling disorder. This minimizes clinicians' abilities to apply optimal treatment goals and contributes to inconsistency in the use of outcome variables to evaluate interventions. Current understanding of recovery is largely based on professional opinion and theoretical models of gambling disorder. This study aimed to examine core features of recovery identified by service users with lived experiences. Methods: Thematic analysis was applied to qualitative data from 32 face-to-face interviews. Interviewees were at various stages of help-seeking for gambling problems mostly related to electronic gaming machines via self-exclusion and/or specialized gambling counseling. Results: Recovery was perceived by the participants as a continuous process that encompasses periods of improvement and decline. Several key themes of recovery emerged; participants highlighted the importance of developing insight into the psychological and environmental processes that contribute to their gambling problem. Insight helped participants feel empowered to successfully manage their gambling urges and behavior. Recovery extended to building a meaningful life beyond gambling, which involved engagement in alternative activities and fostering strong social relationships. It included stabilization of personal finances and achieving general psychological health and wellbeing. Conclusions: Findings challenge acute symptom-focused models of recovery by broadening the definitional boundaries to include sustained improvements across multiple psychosocial dimensions. Greater emphasis should be given to service user-defined elements of recovery in treatment and research. The long-term perspective of the recovery process has implications for extending standard follow-up assessment intervals in gambling treatment studies. [ABSTRACT FROM AUTHOR]

Background: Research in the field of substance misuse shows that identity change is key to recovery. Theories typically focus on either personal or social factors in this process; however, a framework encompassing agency and communion has proved useful in understanding narratives in similar populations. Objectives: The study proposes that agency and communion provide useful constructs through which to examine substance misuse and recovery. Method: The Life As A Film\(LAAF) and repertory grids were used to explore agency and communion in a sample of 32 participants. Results: Smallest Space Analysis of LAAF content revealed four narrative structures according to elements of agency and communion. Case examples indicated that agency and communion themes related to a recovery identity, and an absence of themes was associated with substance misuse. Repertory grid analysis revealed a pattern of fixed low agency and communion constructs in cases of substance misuse, and a transformed high agency-communion construct system in cases of recovery. Transformation from a low agency and communion substance-using identity toward a high agency and communion recovery identity was illustrated. Conclusions: The exploratory results highlight the centrality of agentic and communal growth in identity-transformative recovery from substance misuse. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the experiences of mentally disordered offenders (MDOs) conditionally discharged from secure hospitals on a restrictive Section of the Mental Health Act (Section 37/41). Design/methodology/approach: Data were derived from seven semi-structured interviews from three forensic community teams. Findings: Thematic analysis identified seven predominant themes: (1) the uncertainty of the discharge timeframe; (2) fear of jeopardising discharge; (3) progress; (4) engagement with community life; (5) barriers to social engagement; (6) evolving identity and (7) someone to turn to. Findings are discussed in relation to the recovery model and the good lives model. Practical implications: The findings highlight the importance of fostering trust between MDOs and their care teams to encourage help-seeking. They also suggest that resources should be sequenced appropriately throughout the discharge process, to match the "window of engagement" and maximize impact and effectiveness. Originality/value: This research gained rarely obtained first-hand perspectives from MDOs, with the findings contributing to a more effective evaluation of the discharge pathway. [ABSTRACT FROM AUTHOR]

In 2017, approximately 1.5 million American adolescents had a substance use disorder (SUD). Adolescents with SUD risk hindering their neurological development, which can result in problems with memory and self-regulation, and in turn disrupt their education, relationships, and life opportunities. Treating adolescents with SUD is challenging. Thus, effective models that help adolescents engage in long-term recovery are needed. The Alternative Peer Group (APG) is an adolescent recovery support model that incorporates pro-recovery peers and sober social activities into standard continuing care practices. In this qualitative study thematic content analysis methods were used to explore transcripts from in-depth interviews with adolescent APG participants collected in a prior study. The aim of this secondary analysis was to get a clear understanding of adolescents' perceptions of the advantages and disadvantages of APGs for supporting SUD recovery. Findings suggest that pro-recovery peer and adult role models, structured activities and a positive social climate that promotes fun, a sense of belonging, and accountability are continuing care elements that are likely to help adolescents resolve their ambivalence about SUD recovery and increase their motivation to engage in the hard work of recovery. These findings can inform the design of effective recovery support model services that promote long-term recovery for adolescents with SUD. [ABSTRACT FROM AUTHOR]

Background: Understanding the concept of recovery in severe mental illnesses such as schizophrenia from the social and cultural aspects is important as it will help in developing models of recovery and appropriate interventions. Client and caregiver perspectives on recovery play a significant role in shaping these models and interventions. Hence, the aim of this study was to understand how clients with schizophrenia and their caregivers perceive recovery and to examine the differences between male and female clients with schizophrenia. Materials and methods: A total of 100 clients with schizophrenia and 80 caregivers of clients with schizophrenia were included in the study after written informed consent. A semi-structured proforma was used to collect the sociodemographic profile and illness variables. A questionnaire was developed to assess the indicators of recovery from mental illness and was administered to study participants. Descriptive statistics including frequency and percentages were used along with the chi-square test for analysis. Results: The most common indicators of recovery for the clients with schizophrenia were absence of symptoms (88%), no relapse (70%) and going back to work (70%), while for the caregivers were absence of symptoms (100%), becoming independent (92.5%) and no relapse (91%). Indicators of recovery were similar between male and female clients with schizophrenia except for the need to stop medication as an indicator of recovery observed significantly more in females (p =.006). Most clients used internal validation of indicators to assess their recovery (79%). Conclusion: Results indicate that clients and caregivers from India perceive recovery as being symptom free, able to go back to work and being independent. Clients with schizophrenia use internal validation to assess recovery. Gender does not play a role in the perceptions toward recovery in schizophrenia. These results will help in developing models of recovery for severe mental illness in Indian context leading to tailored interventions. [ABSTRACT FROM AUTHOR]

Changes in identity are critical to managing transitions to recovery from substance and alcohol addictions. Identity change is particularly important for mothers, whose recovery processes are often in the context of critical but complex family relationships and societal expectations. But research and practice often underestimate the relational dimensions that promote or inhibit changes in one's identity during recovery. Here we analyze data from a study that involved interviews with 30 formerly incarcerated women participating in a community‐based substance use treatment program in the Midwest. Drawing from Constructivist Grounded Theory Methods, our analysis identified three factors shaping levels of engagement with family members: (1) the relational consequences of a shared past; (2) ascribing permanence to the old identity of "addict" versus the ability to see women's capacity to change; and (3) the current provision of caregiving support to participants' children. Our analysis supports and extends existing research by highlighting how family can both promote and inhibit a recovery identity process. We discuss potential implications for theorizing "recovery" and "identity" as relational and identify key elements to support practices more attuned to the hidden complexity of family support. [ABSTRACT FROM AUTHOR]

Background: Identifying patient perspectives about recovery may help the service providers to enhance active participation of patients in their recovery. Aim: This study aimed to explore patients' perspectives about factors affecting recovery from schizophrenia. Methods: A semi-structured interview schedule was used to explore the perceptions of 18 patients diagnosed with schizophrenia. The interviews were recorded, transcribed and analysed. Codes were identified and similar codes were grouped together and main themes were identified. Results: Nine main themes on facilitators and barriers of recovery from schizophrenia were derived. Conclusion: Deeper understanding of patients' perspectives of recovery from schizophrenia can help mental health professionals to plan appropriate recovery-oriented services. [ABSTRACT FROM AUTHOR]

Purpose: Stroke is an abrupt event that often leaves survivors with long term disabilities, causing role changes, and financial strains on households. The profound impact of stroke on survivors may lead to a decline in quality of life due to the physical, psychological, and social difficulties they experience. Taking Malaysia as an example, this study aimed to explore the impact of stroke on survivors and how health services influence their recovery in low and middle-income countries (LMIC). Method: An ethnographic approach with data obtained primarily through in-depth interviews was used. Twenty-seven participants identified as having suffered a stroke were drawn from a health and demographic surveillance system in Malaysia. Results: The physical and social disruption of the lives of stroke survivors was intensified by the resultant financial constraints placed upon individuals, families and households, compounded by inadequate support from the health, and welfare systems. Despite the disruption to their lives, most participants were, at least in part, able to reestablish their lives through various factors that include a strong family support and active coping strategies. Conclusion: In LMIC, recovery can be shaped by the family unit and through active coping strategies especially those in relation to spirituality. The impact of stroke on survivors and lack of specialized stroke care compromise the recovery process and quality of life for stroke survivors in low and middle-income countries. Support from the family and reinforcement of religious coping were judged to successfully aid recovery. Physical and emotional impairments as well as psychosocial wellbeing of survivors in the context of environmental factors need to be addressed. [ABSTRACT FROM AUTHOR]

Social factors seem to play an important role in people's recovery processes, yet little attention has been given to such aspects in relation to early psychosis. In this study, we explored how young adults with first episode psychosis experienced relationships inside and outside the mental healthcare services related to their early recovery processes. We interviewed ten young adults who had been in contact with an early detection team for psychosis. The analysis involved thematic and reflexive team-based methods and drew on hermeneutic–phenomenological perspectives. We identified two themes concerning relationships with professionals: 1) being seen as a unique person with preferences and 2) getting help when you are lost. We came across three additional themes, this time, in relation to family and friends: 3) supportive family networks, 4) they cannot understand everything, and 5) different kinds of friendships. Our findings revealed that people both within and outside mental healthcare services were seen as essential (for better or worse) and often played complementary roles. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In Hungary the psychological care provided during the rehabilitation of patients with chronic illnesses is insufficient. Patients with addiction, on the other hand, appear to make more use of psychological services. Narratives of patients recovering from addiction and patients with various chronic illnesses were examined in order to gain a better understanding of psychological phenomena during rehabilitation. Methods: Semi-structured interviews were carried out. Narrative and thematic analysis was used in order to determine the structure and characteristics of patients' narratives. Results: The narratives of patients recovering from addiction were found to be more structured and uniform; they identified with their illness and played an active role in their recovery. Patients with a chronic illness mainly recounted passive events and physical difficulties. Stigmatization was mentioned by both groups. Implications for practice: The level of stigmatization experienced by patients with a chronic illness may be one of the reasons why they use healthcare services more frequently than patients with an addiction. The authors believe that teaching patients to provide good narratives about suffering from and recovering from chronic illnesses may aid them in the rehabilitation process. An adaptive mixture of different illnesses and addiction narratives might be beneficial in the recovery process of various patient groups. [ABSTRACT FROM AUTHOR]

The past decade has witnessed increased attention to the benefits of companion animals on human health, though little attention has been paid to the potential to support recovery from a substance use disorder. Amidst an opioid crisis in Canada, studying this overlooked source of support may be beneficial. This study explores how companion animals support the recovery of seven methadone maintenance treatment patients in a Canadian core neighborhood. Through semi-structured interviews and a thematic analysis, the findings demonstrate that individuals' companion animals support their recovery in four areas of their lives: (i) social, (ii) health and wellbeing, (iii) home, and (iv) purpose and empowerment. These themes were found to align with and expand upon the four dimensions of a Life in Recovery outlined by the Substance Abuse and Mental Health Services Administration. Structuring the paper by the expanded categories, this study introduces how companion animals fulfilled supportive roles that other humans could not or chose not to provide, while the human-animal bond encouraged a strengths-based approach to individuals' recovery. This helped foster positive self-identity and a perceived choice over individuals' recovery pathways. [ABSTRACT FROM AUTHOR]

Background: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a relatively common disabling illness in adolescents that may limit participation in daily life. Aim: This study explored interactions between the illness experiences of adolescents with CFS/ME, their occupational lives and expectations for the future. Methods: Seven adolescents with CFS/ME were interviewed. The interviews were analyzed using thematic analysis. Results: Three themes were developed. 'Being ruled by an unfamiliar and inexplicable body', which illustrated that altered and strange bodies seemed to separate and disrupt the participants from their former occupational lives. 'On the sideline of life with peers', which demonstrated that the informants spent time at home, doing undemanding activities instead of participating in activities with peers. 'A coherent connection between present and future life', which was reflected by how the participants eventually accepted their situation and rebuilt a meaningful occupational life and value of self. Conclusion: CFS/ME made the body unfamiliar and disconnected informants from participating in their usual daily occupations. A coherent interaction between body, occupational life and social self was achieved by taking their new body into account and adjusting their occupations accordingly. This practice enabled the participants to hope for a better future life. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to explore the ways in which "small things" may be of importance for people with mental health difficulties. Method: Empirical material from three different studies was reanalysed through a phenomenological, dialogical, approach. Results: We discovered some paradoxical aspects of small things: i.e., they could be about "something" that was difficult or even impossible to identify. The unidentifiable could be about bodily, sensual experiences that are superficial (i.e., belonging to the surface). The interaction with others highlighted as significant could be about doing something fun, talking nonsense or kidding around, and hence not at all about making sense of something—a kind of important nonsense. We summarize these aspects in three themes: the importance of the unidentifiable, the superficial and nonsense. These aspects can be regarded as small things—even "nothings"—that make it possible "to stay in the world". Conclusion: We elaborate on the findings in relation to the following: Gumbrecht's critique of the prevailing hermeneutic world-view with its idea that "interpretation is humankind's exclusive way of relating to the world", Ingold's idea that social life is lived in relations of "interfacility" and hence a turn to surfaces is needed for a "restoration of social life", and Biesta's idea of existence as "coming into the world in the presence of others". [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore quality of life (QOL) during the first year of recovery after stroke in North Norway and Central Denmark. Method: Individual in-depth interviews with 11 stroke survivors were performed twelve months after stroke onset. An interpretative, inductive approach shaped the interview process and the processing of data. Results: We found that QOL reflected the individuals' reconstruction of the embodied self, which was identified by three intertwined and negotiating processes: a familiar self, an unfamiliar self, and a recovery of self. Further, we found that reconstruction of the embodied self and QOL could be framed as an ongoing and interrelated process of "being, doing, belonging and becoming". Enriching social relations, successful return to work, and continuity and presence in professional support during recovery enhanced the experience of QOL. Fatigue and sustained reduced function hindered participation in meaningful activities and influenced the perceived QOL negatively. Conclusions: The two countries differed in descriptions of continuity and support in the professional follow-up during the recovery process, influencing the degree of encouragement in reconstructing the embodied self. Reconstruction of the embodied self is a means of understanding stroke survivors' QOL during the first year of recovery, supporting an individualized and tailored rehabilitation practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to examine what was beneficial and what was challenging in a group intervention for young adults based on RENEW principles in a municipal employment centre. RENEW (Rehabilitation for Empowerment, Natural support, Education, and Work) is an education-oriented support model for young people. Method: The eight young adults who participated in the group and three mentors who led the group were interviewed about their experiences with the group, and a workshop was held for staff to validate the themes found in the study. Results: Three themes emerged, one denoted the importance of helpful personal relationships, both between the mentors and the young adults and among the young adults; another denoted how an authentic attitude from the mentors made group exercises inconspicuous as the group members experienced activities in the group as originating from spontaneous, genuine interest rather than the manual-based exercises they were. The last theme conveyed how the group process was challenged by the institutionally regulated compulsory attendance and the mentors' lack of teamwork resources. Conclusions: The study suggests that meeting young adults authentically and flexibly combining a certain element of self-disclosure with a manual-based group intervention such as RENEW can strengthen relatedness and convey hope, thereby supporting educational rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Developing recovery-oriented services, and ensuring genuine consumer participation in all aspects of services are central components of contemporary Australian mental health policy. However, attitudes of mental health professionals present a significant barrier. Given the positive impact of education on health professionals' attitudes, particularly when consumers are involved, further exploration of consumer involvement in education is required. Aims: To enhance understanding of the role consumers can play within mental health nursing education. Method: A qualitative exploratory project was undertaken involving individual interviews with mental health nurse academics and consumer educators. Results: Two main themes emerged from nurse participants: Recovery in action, consumer educators were able to demonstrate and describe their own recovery journey; and not representative, some participants believed consumer educators did not necessary reflect views and opinions of consumers more broadly. Two main themes for consumers were: the truth about recovery, consumer educators demonstrated recovery as an achievable goal; and not a real consumer, where health professionals to dismiss the consumer experience as unrepresentative and therefore not credible. Conclusions: Consumer participation can contribute positively to nurse education, however representativeness presents a major barrier, potentially enabling nurses to dismiss experiences of consumer academics and educators as exceptional rather than typical. [ABSTRACT FROM AUTHOR]

Background: Recovery processes in borderline personality disorder (BPD) are poorly understood. Aims: This study explored how recovery in BPD occurs through routine or specialist treatment, as perceived by service users (SUs) and therapists. Methods: SUs were recruited from two specialist BPD services, three community mental health teams, and one psychological therapies service. Semi-structured interviews were conducted with 48 SUs and 15 therapists. The "framework" approach was used to analyse the data. Results: The findings were organized into two domains of themes. The first domain described three parallel processes that constituted SUs' recovery journey: fighting ambivalence and committing to taking action; moving from shame to self-acceptance and compassion; and moving from distrust and defensiveness to opening up to others. The second domain described four therapeutic challenges that needed to be addressed to support this journey: balancing self-exploration and finding solutions; balancing structure and flexibility; confronting interpersonal difficulties and practicing new ways of relating; and balancing support and independence. Conclusions: Therapies facilitating the identified processes may promote recovery. The recovery processes and therapeutic challenges identified in this study could provide a framework to guide future research. [ABSTRACT FROM AUTHOR]

Recovery colleges are formal learning programs that aim to support people with a lived experience of mental illness. In this study, we aimed to explore the experiences of participants in a pilot recovery college that opened in Adelaide, South Australia, in 2016. A qualitative exploratory study was conducted involving interviews with learners (n = 8) and focus groups with lived experience facilitators (course facilitators with a lived experience of mental illness, n = 5), Clinician facilitators (mental health service staff facilitators, n = 4), and care coordinators (staff providing case management support, n = 5). Three main themes (hope, identity, and the recovery college as a transition space) and two subthemes (recovery college experience and outcomes) were identified. The results showed that the recovery college provided a transition space for shifting learners' identities from patient to student, facilitated by the experiences and outcomes of the recovery college, providing hope for the future. This study highlights the importance of providing mentally healthy and non‐stigmatizing learning environments to promote and cement recovery for people with a lived experience of mental illness. [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]

This study explores the lived experience of hospitalisation from the perspective of people with a mental health disorder. This hermeneutic‐phenomenological study, which forms part of a larger qualitative serial inquiry, uses a participatory research design, with analysis inspired by interpretative phenomenological analysis. Fourteen participants were interviewed twice: first during hospitalisation and then again 3 months following hospital discharge. Findings are reported from the entire interview data set. Our findings suggest that mental health hospitalisation is a contradictory experience for patients. On one hand, our study participants experienced the hospital as a place where it is alright to be vulnerable, while on the other hand participants experienced hospitalisation as a burden of everyday stigma and signs of depersonalisation. We conclude that it is important to recognise that patients in need of inpatient treatment for mental illnesses are, in fact, people first and foremost. More reflective practice can be developed by shifting the focus to recovery‐oriented practices to and open dialogue‐based approaches. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the experiences of Japanese community mental health nurses (CMHNs) that help form the basis of their nursing philosophies. Design and Methods: This study uses the narrative research method. I conducted participant observation and narrative interviews with nine CMHNs in Japan. Findings: Four themes emerged: (1) experiences as consumers' peers; (2) nurses' own recovery; (3) high levels of spirituality; and (4) a free spirit. Practice Implications: Recognizing these nurses' intrinsic experiences could help to shift mental health nursing paradigms from those based on biomedical models to newer perspectives found in recovery models. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to understand the recovery phenomena and to explore participants' perspectives on the biopsychosocial facilitators and barriers affecting their recovery after a minor transport injury. Methods: A qualitative method was used involving semi‐structured interviews with 23 participants who sustained a minor transport injury. Interviews and analysis were guided by the biopsychosocial model (BPS) of health. The outcomes were themes capturing biopsychosocial barriers to, and personal experiences of, recovery using a previously defined framework. Results: The themes indicate that recovery is a multifaceted phenomenon affected by comorbidities such as chronic pain, depression and anxiety. A range of subsequent complexities such as the inability to self‐care and undertaking daily domestic duties, and incapacity to participate in recreational activities were major barriers to recovery. These barriers were found to be an on‐going source of frustration, dissatisfaction and a perceived cause of depressive symptomatology in many participants. Most participants reported mixed feelings of the care received. Other common issues raised included a lack of understanding of the assessment time, regular follow‐up, guidance and on‐going support. Conclusion: This study revealed that recovery after a minor transport‐related injury was a challenging, complex, demanding and a long‐term process for the individuals in this study. Findings from this limited cohort suggested that, for participants to return to their pre‐accident health status, a more coordinated approach to information and care delivery may be required. [ABSTRACT FROM AUTHOR]

Background: Recovery education centers (RECs) offer recovery supports through education rather than traditional health services. The Supporting Transitions and Recovery Learning Centre (STAR) in Toronto, Canada, is among the few that are internationally focused on individuals with histories of homelessness. Although research suggests that RECs positively impact participants, there is a paucity of rigorous studies and none address the engagement and impacts on homeless individuals. Aims: This protocol describes a realist-informed evaluation of STAR, specifically examining (1) if STAR participation is more effective in promoting 12-month recovery outcomes than participation in usual services for individuals experiencing housing instability and mental health challenges and (2) how STAR participation promotes recovery and other positive outcomes. Methods: This study uses a quasi-experimental mixed methods design. Personal empowerment (primary outcome) and recovery, housing stability, social functioning, health service use and quality of life (secondary outcomes) data were collected at baseline, and 6 and 12 months. Intervention group participants were recruited at the time of STAR registration while control group participants were recruited from community agencies serving this population after screening for age and histories of housing instability. Interviews and focus groups with service users and providers will identify the key intervention ingredients that support the process of recovery. Results: From January 2017 to July 2018, 92 individuals were recruited to each of the intervention and control groups. The groups were mostly similar at baseline; the intervention group's total empowerment score was slightly higher than the control group's (M (SD): 2.94 (0.23) vs 2.84 (0.28), p =.02), and so was the level of education. A subset of STAR participants (n = 20) and nine service providers participated in the qualitative interviews and focus groups. Conclusion: This study will offer important new insights into the effectiveness of RECs, and expose how key REC ingredients support the process of recovery for people experiencing housing instability. [ABSTRACT FROM AUTHOR]

Objective: A site visit protocol was developed to assess recovery promotion in the organizational climate and culture of programs for veterans with serious mental illnesses. Method: The protocol was pilot-tested in 4 programs: 2 that had scored high on the pilot version of a staff survey measure of program-level recovery promotion and 2 that had scored low. Two-person teams conducted onsite visits and assigned global and organizational domain ratings. Interrater agreement was assessed by examining adjacent agreement and computing weighted kappa. Results: The on-site protocol had good interrater agreement and discriminated between sites that scored high and low on the staff survey. Conclusions and Implications for Practice: This site visit protocol and procedure shows promise for evaluating recovery promotion in milieu-based programs. After further refinement of this tool, adaptations could be developed for accreditation protocols or for program self-assessment and quality improvement efforts. [ABSTRACT FROM AUTHOR]

Objective: We aimed to replicate the concurrent validity of a comprehensive definition of eating disorder recovery (physical, behavioral, and cognitive indices) in a sample followed up 7–8 years from baseline, and to examine, for the first time with this comprehensive definition, predictive validity. Method: Participants were 66 women with a history of an eating disorder and 31 age‐matched controls who completed an online survey and phone interview. Results: In general, women who were fully recovered were statistically indistinguishable from controls and had significantly less eating disorder attitudes and behaviors than the partially recovered and eating disorder groups. Being fully recovered at baseline was a robust predictor of stability: of those fully recovered at baseline, 80% remained fully recovered at follow‐up. One‐third of those with an eating disorder and one‐half of those in partial recovery at baseline attained full recovery at follow‐up. Discussion: These findings support the current operationalization of eating disorder recovery, encompassing physical, behavioral, and cognitive indices, as valid and highlight that full recovery is not only possible but predicts full recovery years later. Future research should examine this operationalization in diverse samples and study trajectories of recovery to identify predictors. [ABSTRACT FROM AUTHOR]

Hope is a pivotal part of recovery in a broad range of health conditions, including those relating to the field of mental health and substance abuse. People who experience co-occurring mental health and substance-use problems are often bound to use services that are not suited to their needs. In this study, our aim is to explore how service users experience barriers to help and assistance, and to determine the manner by which these barriers may influence their experiences of hope. Data were collected through in-depth interviews with nine participants, and these were analyzed using a thematic approach. This analysis produced the following three overarching themes: "battles with bureaucracy"; "distance, disempowerment, and de-individualization"; and "no clean slates." [ABSTRACT FROM AUTHOR]

There are unique methodological challenges to studying and assessing recovery in myalgic encephalomyelitis and chronic fatigue syndrome. This study explored these challenges through interviewing 13 physicians who treat myalgic encephalomyelitis and chronic fatigue syndrome. Our deductive thematic analysis produced four themes to consider when approaching recovery: lifespan differences in the illness experience; the heterogeneity of myalgic encephalomyelitis and chronic fatigue syndrome—case definitions, etiological stance, and misdiagnosis; patient follow-up and selection bias; and assessment logistics. We discuss how researchers and clinicians can use these considerations when working with patients, drafting recovery criteria, and interpreting treatment outcomes. [ABSTRACT FROM AUTHOR]

In recent years, there has been a move away from the medical model of care for people with borderline personality disorder, as hospital admission comes with a number of risks and potential adverse consequences. Although long‐term outpatient‐based therapy is successful, this may not be an option for those whose condition is in need of stabilisation. Brief admission for crisis intervention has been successful and is now widely used; however, research that examines both the staff and clients' perceptions of a dedicated programme is lacking. Open Borders is a residential recovery‐oriented programme that provides brief admission, respite, and phone coaching for people with borderline personality disorder who are heavy users of the public mental health system. In this paper, the authors report the perspectives of clients and staff of the Open Borders programme obtained through semi‐structured interviews. Thematic analysis of client and staff perspectives identified four common themes: 'Benefits of the programme', 'Enhanced client outcomes', 'Impact of the physical environment', and 'Ways of enhancing service delivery'. In addition, analysis of the staff perspectives included the theme 'Emotional impact on staff'. Benefits of the programme included the small supportive team approach, flexibility of the staff to spend time with the clients to tailor care, and the relaxed, welcoming environment. Enhanced client outcomes included a reduction in self‐harming and hospitalization and an increase in self‐efficacy. These results support the move away from the medical model and the empowerment of clients to self‐manage their symptoms while fostering hope and self‐determination. [ABSTRACT FROM AUTHOR]

"Shared experience" has been described as a key element of peer-delivered services, but it is not well-understood how it is used in practice, particularly among peer specialists working in more conventional mental health agencies. In-depth qualitative interviews were conducted with eight peer specialists and two supervisors working in a Peer Wellness Program within a Housing First agency to explore peer specialists' approach to service delivery, with a focus on the role of shared experience. Peer specialists rarely reported explicitly sharing experiences related to mental health with clients, but described how it was nevertheless ever-present through the unique ways it shaped features of their practice (e.g., empathy, patience, consistency, listening, unstructured time, and a client-centered approach). In contrast, explicit discussion of shared experiences related to other life domains, such as culture, physical health, and significant life events, were frequently relied upon to support and build rapport with clients. [ABSTRACT FROM AUTHOR]

Many older community-living persons with schizophrenia report unmet psychological and social needs. The Amsterdam-based New Club is a novel facility that intends to foster self-reliance and social participation in this group. To explore participants' and staff perceptions, a naturalistic qualitative study combined participant observation with interviews. The results illustrate how the New Club contributes to the personal and social recovery of its participants. At the personal level, attending the facility, activation and feeling accepted were valued positively. At the social level, engaging with others, experiencing a sense of community, and learning from one another's social skills were positive contributors. Next, various environmental factors proved important. The New Club demonstrates the feasibility of creating a facility that offers an accepting and non-demanding social environment to older community-living individuals with severe mental illnesses. It may offer a suitable alternative for the more demanding psychotherapeutic interventions offered to younger populations. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of intimate partners of people with an eating disorder. Design: Qualitative grounded theory study. Methods: In‐depth interviews were conducted with 18 partners of people with an eating disorder from 2013–2016. Data were analysed using the principles of classic grounded theory including, concurrent data collection and analysis, theoretical sampling, constant comparative analysis and memo writing. Results: Partners encounter disruptions to their lives when their significant other experiences an eating disorder. As a result, partners engage in a four‐stage cyclical process involving: encountering a disruption; becoming an informed self; countering the disruption and reclaimed livability. By engaging in this process partners learn to support their significant other, remain committed to the relationship and recover their own lives. The process is drawn together and defined as the theory of 'Reconstructing Livability'. Conclusion: The theory of 'Reconstructing Livability' provides a unique conceptualization of the experiences of partners who are living with a person with an eating disorder. It highlights the challenges faced by partners when supporting the recovery of their significant other and the intimate relationship, while reclaiming their own lives. Impact: This study addresses the dearth of knowledge and understanding of partners' experiences. Partners engage in a process to enable them support recovery of their significant other and their own lives, but this is hindered by the challenges and unmet needs they experience. The theory provides a basis on which nurses can provide effective and timely supports to partners. [ABSTRACT FROM AUTHOR]

Websites advocating the benefits of eating disorders ("Pro-Ana") tend to reinforce and maintain restrictive eating and purging behaviors. Yet remarkably, no study has explored individual accounts of disengagement from these sites and the associated meanings. Using narrative inquiry, this study sought to address this gap. From the interviews of six women, two overarching storylines emerged. The first closely tied disengagement to recovery with varying positions of personal agency claimed: this ranged from enforced and unwelcomed breaks that ignited change, to a personal choice that became viable through the development of alternative social and personal identities. A strong counternarrative to "disengagement as recovery" also emerged. Here, disengagement from Pro-Ana was storied alongside a need to retain an ED lifestyle. With "recovery" being just one reason for withdrawal from Pro-Ana sites, clinicians must remain curious about the meanings individuals ascribe to this act, without assuming it represents a step toward recovery. [ABSTRACT FROM AUTHOR]

Peer providers of mental health services use their personal illness and recovery narratives to help other mental health service users. Despite a substantial body of evidence supporting the effectiveness of these providers, little is known about the underlying strategies they employ in their professional practice. In this study, I used in-depth interviews with 23 peers to explore the most important practices they used in their day-to-day work with others. Results indicated that peers engaged in a reflexive process to strategically use their personal illness and recovery stories to help others re-story their life narratives. Peers also used communication strategies from motivational and cognitive–behavioral treatment approaches to engage, inspire, and mentor other service users. Findings suggest the need for research that further explores the rhetorical strategies used by peers using narrative methods. The development and testing of professional development opportunities to assist peers in maximizing their therapeutic potential are also warranted. [ABSTRACT FROM AUTHOR]

Purpose: The onset of psychosis typically develops during adolescence, a crucial period for beginning the transition from family to independence and developing a stable sense of self. Recovery amongst adolescents experiencing early onset psychosis has not yet been investigated with reference to its influence on self-identity. The purpose of this paper is to explore the impact living with early onset psychosis has on self-identity for adolescents in recovery. Design/methodology/approach: A purposive sample of ten adolescents aged between 16 and 18 years from an Early Intervention Service in the Scottish National Health Service were recruited. All had experienced at least one episode of psychosis and were within three years of first contact with the service. Semi-structured interviews were adopted to capture adolescents' perspectives concerning their experiences of recovery from psychosis and the impact on self-identity. All interviews were audio-recorded, transcribed and thematically analysed. Findings: Qualitative analysis of adolescents' accounts revealed how recovery from psychosis involves working with individual explanatory frameworks concerning uncertain identities and status ambiguity, a decrease in referent points and unfavourable social comparisons (emphasising loss, grief and self-criticism). Research limitations/implications: Supporting adolescents experiencing early psychosis involves education, rebuilding relationships with self and others and providing access to psychotherapeutic interventions to aid self-identity development when needed. Originality/value: The originality of this paper lies in the importance of identity, recovery, human reconnection, advocacy and community reintegration for adolescents experiencing psychosis. Public mental health campaigns to tackle the stigma surrounding psychosis are essential to assisting adolescents in developing their sense of self through their recovery journeys. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder (BD) is a chronic mental disorder, and family members play a key role in taking care of the affected individuals. The recovery movement has gradually transformed mental health services, for example, through the introduction of peer support services (sharing of expert-by-experience knowledge), and it has challenged the prevailing view that people with mental illness cannot recover. Aims: Through this study, the researchers explored how family caregivers in a Chinese context conceptualise recovery, how caregivers interact with peer support workers (PSWs) and how they perceive peer support services. Methods: Fourteen family caregivers from community settings participated in individual semi-structured interviews. The data were analysed through thematic analysis. Results: Family caregivers had multifaceted definitions of recovery and had various degrees of contact with PSWs. The views and experiences shared by PSWs were hope-instilling for caregivers and changed their perception of BD and their loved ones. Some limitations of PSWs were also identified. Conclusion: Social connectedness and functional outcomes were important indicators of recovery among Chinese family caregivers. Caregivers began to understand the benefits of PSWs after experiencing their services. Peer-led services could be a helpful support for both service users and family caregivers. [ABSTRACT FROM AUTHOR]

Background: The recent interest in recovery from mental health problems has not meaningfully addressed the perspectives of ethnic minorities. Aim: To contribute to the discussion of recovery-oriented service with a study on the experience of Chinese people using UK mental health services. Methods: In-depth life history interviews were carried out with the users. The qualitative data were analysed using thematic analysis. Results: Four themes emerged as hindrances to personal recovery: (1) language difficulty creates hurdles, (2) diagnostic label is experienced as a double-edged sword, (3) treatment-related stigma and (dis)empowerment are identified, and (4) grievances are found in hospitalisation. Discussion: Having mental illness and being an ethnic minority in the UK experienced double hazard in their recovery journey. While the deprivation of agency and the stigma process in the health care system hinders their recovery, they are further disadvantaged by their ethnic minority status. Four pointers for service improvement, that apply to Chinese users in the United Kingdom and have general implications for users beyond this group, are proposed. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: While there is no single definition of the concept of recovery for people with mental illness, hope has been recognized as a guiding principle; the belief that it is possible for a person to regain a meaningful life, despite serious mental illness.Little is known about the recovery process of women diagnosed with schizophrenia per se, with only six studies offering the woman's voice identified and these all having taken place in developed countries.No studies on this topic have been carried out in Sub‐Saharan Africa, including Swaziland. What this paper adds to existing knowledge?: This study provides unique insight into what is important to Swazi women, diagnosed with schizophrenia, in their process of their recovery.Because of current trends in migration, the findings of this study may provide mental health professionals with a better understand of the needs of those from this particular Sub‐Saharan country.The study discusses a range of issues affecting women including being labelled as mentally ill, stigma and discrimination, the importance of the sociocultural context of illness and positive attributes which promote women's recovery. What are the implications for practice?: This study provides mental health practitioners with insights and understanding of the lives of women from a Sub‐Saharan developing country. This will be helpful for better understanding of the context of mental illness both for practitioners supporting the development of services in such countries and for those working in Western countries with migrant populations. Introduction: Globally, twenty‐four million people live with schizophrenia, 90% living in developing countries. While most Western cultures recognize service user expertise within the recovery process, this is not evident in developing countries. In particular, Swazi women diagnosed with schizophrenia experience stigma from family, community and care providers, thus compromising their recovery process. Aim: This study aimed to explore the experiences and meanings of recovery for Swazi women living with schizophrenia. Methodology: Interpretive phenomenological analysis was used. Fifteen women were recruited from Swaziland National Psychiatric Hospital out‐patients' department, and face‐to‐face interviews were conducted. Findings: Four super‐ordinate themes were identified: (a) The emotionality of "illness of the brain"; (b) Pain! Living with the illness and with others; (c) She is mad just ignore her; and (d) Being better. Discussion: Discussion focuses on the findings of this study and a number of positive and negative implications emanating from them: labelling, stigma and the roles of family, culture and religious beliefs on the process of recovery. Implications for practice: This study provides practitioners with insight into the importance of the sociocultural context of the lives of women diagnosed with schizophrenia and how, in understanding this, mental health care could be improved. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to reach beyond existing research into the mental health benefits of arts-based or educational opportunities, to discover the particular impact on members' recovery processes of being part of a committed, long-term troupe or community – specifically focussing on specialist theatre companies. Design/methodology/approach: Following a literature review investigating the growing number of theatre troupes for mental health service users, qualitative research was conducted into one such company. In-depth qualitative interviews were conducted with six company members. Thematic analysis of interview transcripts was then cross-checked and enriched through a group interview with six other members. Findings: Two overarching themes emerged: the importance of "being known" within the company (key sub-themes included "intuitive democracy" and the "paradox of reliability"), and the ways in which individuals "branched out" from this secure basis into artistic, professional and voluntary roles, while remaining company members. Research limitations/implications: The findings from this small-scale study, while not necessarily generalisable to other long-term communities of care and learning with a "troupe" or "team" structure, would provide valuable starting points for a larger-scale investigation. Practical implications: If generalisable, institutions in the mental health and educational worlds should place more emphasis on developing and resourcing long-term models of support. Social implications: The specialist theatre company model contrasts with prevalent individualised, time-limited services for those experiencing mental ill health. Originality/value: The study provides compelling narrative evidence to amplify understanding of how "connectedness" is experienced within a troupe, and may enable individuals with mental illnesses to progress further in their recovery journey. [ABSTRACT FROM AUTHOR]

In existing recovery studies, binary distinctions between 'spoiled' identities defined by drug-related practices and relationships on the one side, and 'un-spoiled' drug-free identities on the other, are dominant. Similarly, in contexts of youth drug-treatment, substance-using friends are generally viewed as 'bad company', while non-using friends are considered as recovery promoters. This article, however, joins the growing chorus of qualitative researchers beginning to question critically this 'spoiled-unspoiled' distinction. Based on 30 qualitative interviews with 15 young people recruited from a Danish drug-treatment database, we investigate how drug-experienced youth perform recovering identities vis-à-vis their still-using friends. Employing a performative approach to identity formation, we demonstrate how such identity processes play out, and the dilemmas and ambivalences they entail. For example, while drug-using friends are regularly positioned as 'bad company', this is often accompanied by sentiments such as loss and frustration. Our analysis suggests that young people in recovery are easily trapped between societal expectations related to factors such as education on the one hand, and comfortability and connectedness with friends on the other. However, by means of carefully balanced 'borderwork', participants did occasionally manage to integrate using friends into their recovering identities without positioning them as 'bad company' per se. On this basis, we discuss whether breaking bonds with friends who still use drugs is imperative for any process of recovery, and argue that treatment programmes should focus on reconfiguring drug-related friendships, while taking seriously the notion that recovering youth are not necessarily interested in abandoning relations with drug-using friends. [ABSTRACT FROM AUTHOR]