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Vita A, Barlati S, Porcellana M, Sala E, Lisoni J, Brogonzoli L, Percudani ME, Iardino R. The patient journey project in Italian mental health services: results from a co-designed survey on clinical interventions and current barriers to improve the care of people living with schizophrenia. Front Psychiatry 2024; 15:1382326. [PMID: 38606407 PMCID: PMC11007707 DOI: 10.3389/fpsyt.2024.1382326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/04/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction The Patient Journey Project aimed to analyze the scenario among Italian Mental Health Services (MHS) to understand the clinical interventions that are properly implemented and the ones deserving further implementation to design an effective treatment plan for patients living with schizophrenia (PLWS). Methods The 60-items survey was co-designed with all the stakeholders (clinicians, expert patients and caregivers) involved in the Patient Journey and focused on three phases of schizophrenia course: early detection and management, acute phase management, long-term management/continuity of care. Respondents were Heads of the Mental Health Departments and Addiction Services (MHDAS) or facilities directors throughout Italian MHS. For each statement, respondents expressed the consensus on the importance and the degree of implementation in clinical practice. Results Considering the importance of the statement, strong consensus was reached for most of the statements. Good levels of implementation were found on 2/17 statements of early detection and management, on 3/16 statements for acute phase management and on 1/27 statements of long-term management/continuity of care. Poor levels of implementation were found on 1/17 statements of early detection and management, none of acute phase management, and 4/27 statements for long-term management/continuity of care. Moderate levels of implementation were found on 14/17 statements for early detection and management, on 13/16 statements of acute phase management, and on 22/27 statements of long-term management/continuity of care. Thus, among Italian MHDAS, most interventions for PLWS were moderately implemented in clinical practice. Discussion Italian MHS have to provide new strategies and structural actions to overcome these current limitations and barriers to effectively improve the journey of PLWS. The areas that deserve most implementation include interventions during the early stage (especially the continuity of care between Child and Adolescent Mental Health Services and Adult Mental Health Services), the evidence-based psychosocial interventions during the chronic stages of the disorder, and the continuity of care after acute hospitalization.
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Affiliation(s)
- Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Porcellana
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | - Elisa Sala
- Department of Political and Social Sciences, University of Pavia, Pavia, Italy
| | - Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
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Lorien LM, Arthur M, Keiler K, Lowry J, Ryan K. Recovery-oriented practice in a hospital mental health service. Int J Ment Health Nurs 2024. [PMID: 38459635 DOI: 10.1111/inm.13316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/10/2024]
Abstract
As part of mental health reform in Australia, new policies were introduced to support recovery-oriented practice; however, little has changed in hospital settings focused on managing risk and remediating acute symptoms. Previous studies have indicated that patients' experiences of personal recovery, during a hospital admission, may not mirror that of people living in the community, with patients being more likely to experience disconnection, hopelessness and disempowerment. Using a Participatory Health Research approach, eight mental health professionals, a patient advocate and an external researcher formed a research partnership to answer the question: How can staff enhance recovery-oriented practice in a hospital-based mental health service? The COREQ checklist was used for reporting the methods, analysis and findings. The methods comprised patient focus groups (n = 16 participants), interviews with managers (n = 7) and an online survey for staff (n = 17). Researchers analysed the feedback from the consultations using inductive thematic analysis, identifying two themes: relational recovery and recovery interventions. The findings indicate that relational recovery is key to recovery during a hospital admission and interventions that increase connectedness or reduce the impact of symptoms enhance personal recovery.
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Affiliation(s)
- Leonie M Lorien
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
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3
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Kraiss JT, Ten Klooster PM, Chrispijn M, Stevens A, Doornbos B, Kupka RW, Bohlmeijer ET. A multicomponent positive psychology intervention for euthymic patients with bipolar disorder to improve mental well-being and personal recovery: A pragmatic randomized controlled trial. Bipolar Disord 2023; 25:683-695. [PMID: 36856065 DOI: 10.1111/bdi.13313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Mental well-being and personal recovery are important treatment targets for patients with bipolar disorder (BD). The goal of this study was to evaluate the effectiveness of an 8-week group multicomponent positive psychology intervention (PPI) for euthymic patients with BD as an adjunct to treatment as usual (TAU) compared to TAU alone. METHODS Patients with BD were randomized to receive TAU (n = 43) or the PPI in addition to TAU (n = 54). The primary outcome was well being measured with the Mental Health Continuum-Short Form. Personal recovery was measured with the Questionnaire about the Process of Recovery. Data were collected at baseline, mid-treatment, post-treatment and 6- and 12-month follow-up. Life chart interviews were conducted at 12 months to retrospectively assess recurrence of depression and mania. RESULTS Significant group-by-time interaction effects for well-being and personal recovery were found favouring the PPI. At post-treatment, between-group differences were significant for well-being (d = 0.77) and personal recovery (d = 0.76). Between-group effects for well-being were still significant at 6-month follow-up (d = 0.72). Effects on well-being and personal recovery within the intervention group were sustained until 12-month follow-up. Survival analyses showed no significant differences in time to recurrence. CONCLUSIONS The multicomponent PPI evaluated in this study is effective in improving mental well-being and personal recovery in euthymic patients with BD and would therefore be a valuable addition to the current treatment of euthymic BD patients. The fact that the study was carried out in a pragmatic RCT demonstrates that this intervention can be applied in a real-world clinical setting.
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Affiliation(s)
- Jannis T Kraiss
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Peter M Ten Klooster
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | | | - Anja Stevens
- Centre for Bipolar Disorders, Dimence Mental Health, Deventer, The Netherlands
| | - Bennard Doornbos
- Department of Specialized Training, Psychiatric Hospital Mental Health Services Drenthe, Outpatient Clinics, Assen, The Netherlands
- Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands
| | - Ralph W Kupka
- VU University Medical Center, Department of Psychiatry, Amsterdam Public Health research center, Amsterdam, The Netherlands
| | - Ernst T Bohlmeijer
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
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Ma M, Shi Z, Chen Y, Ma X. Recovery journey of people with a lived experience of schizophrenia: a qualitative study of experiences. BMC Psychiatry 2023; 23:468. [PMID: 37369995 DOI: 10.1186/s12888-023-04862-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 05/11/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Mental health recovery involves an integration of clinical and psychosocial frameworks. The recovery journey of individuals diagnosed with schizophrenia and the factors that influence it have been extensively studied. Because the recovery journey is culturally influenced, we examined the recovery process expriences of individuals diagnosed with schizophrenia in China, focusing on the influence of a Confucian-dominated collectivist and family-centred culture. METHODS An Interpretive Phenomenological Analysis (IPA) study was conducted; data were gathered through in-depth interviews with 11 individuals with lived experience of schizophrenia. RESULTS Four themes were identified in this study: traumatic illness experiences, influence of the family, motives for recovery, and posttraumatic growth, comprising ten subthemes. "For the family" and "relying on oneself" are the main drivers of recovery for individuals with a Chinese cultural background. Some people believe that taking care of themselves is an important way to ease the burden on their families and treat them well. There is a link between 'for the family' and 'relying on oneself. CONCLUSIONS Individuals living with schizophrenia in China have undergone significant traumatic experiences and have profound interactions with their families. Post-traumatic growth reflects an increase in the individual's connection to others and individual agency. It also suggests that the individual is not receiving enough support outside of the family. The impact of individual agency and family relationships should be considered in services that promote recovery, and clinic staff should enhance support outside the home to the individuals.
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Affiliation(s)
- Min Ma
- Wuhan Mental Health center, Wuhan Hospital for Psychotherapy, Rehabilitation Department, Wuhan, China
| | - Zhidao Shi
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yanhong Chen
- China University of Geosciences Wuhan, Wuhan, China
| | - Xiquan Ma
- Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Percudani ME, Iardino R, Porcellana M, Lisoni J, Brogonzoli L, Barlati S, Vita A. The Patient Journey of Schizophrenia in Mental Health Services: Results from a Co-Designed Survey by Clinicians, Expert Patients and Caregivers. Brain Sci 2023; 13:brainsci13050822. [PMID: 37239294 DOI: 10.3390/brainsci13050822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/29/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The Patient Journey Project aims to collect real-world experiences on schizophrenia management in clinical practice throughout all the phases of the disorder, highlighting virtuous paths, challenges and unmet needs. METHODS A 60-item survey was co-designed with all the stakeholders (clinicians, expert patients and caregivers) involved in the patient's journey, focusing on three areas: early detection and management, acute phase management and long-term management/continuity of care. For each statement, the respondents expressed their consensus on the importance and the degree of implementation in clinical practice. The respondents included heads of the Mental Health Services (MHSs) in the Lombardy region, Italy. RESULTS For early diagnosis and management, a strong consensus was found; however, the implementation degree was moderate-to-good. For acute phase management, a strong consensus and a good level of implementation were found. For long-term management/continuity of care, a strong consensus was found, but the implementation level was slightly above the cut-off, with 44.4% of the statements being rated as only moderately implemented. Overall, the survey showed a strong consensus and a good level of implementation. CONCLUSIONS The survey offered an updated evaluation of the priority intervention areas for MHSs and highlighted the current limitations. Particularly, early phases and chronicity management should be further implemented to improve the patient journey of schizophrenia patients.
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Affiliation(s)
- Mauro Emilio Percudani
- Department of Mental Health and Addiction Services, Niguarda Hospital, 20162 Milan, Italy
| | | | - Matteo Porcellana
- Department of Mental Health and Addiction Services, Niguarda Hospital, 20162 Milan, Italy
| | - Jacopo Lisoni
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
| | | | - Stefano Barlati
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
| | - Antonio Vita
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, 25123 Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy
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Faith LA, Howie JH, Blanco E, Jarvis SP, Rempfer MV. Therapeutic alliance in a cognitive rehabilitation programme for people with serious mental illness: A qualitative analysis. Psychol Psychother 2022; 95:958-969. [PMID: 35810321 DOI: 10.1111/papt.12412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 06/12/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Therapeutic alliance is an important element of evidence-based treatments for people diagnosed with a serious mental illness. Cognitive enhancement therapy (CET) is an efficacious cognitive rehabilitation programme that emphasizes coach-participant relationships. The purpose of this study was to examine experiences of therapeutic alliance among CET participants. DESIGN We used an exploratory qualitative approach. METHODS Semi-structured interviews were conducted with 24 participants diagnosed with a serious mental illness. Interview transcripts were analysed by three independent coders using thematic analysis. RESULTS Four themes related to therapeutic alliance emerged: (1) positive regard; (2) collaboration; (3) authenticity; (4) negative alliance. CONCLUSIONS Findings suggest that therapeutic alliance is an important component of CET that bolsters the learning environment and ensures a positive group experience. Our qualitative analyses contribute greater understanding of how strong therapeutic relationships impact people with serious mental illnesses participating in evidence-based treatments beyond psychotherapy context.
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Affiliation(s)
- Laura A Faith
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana, USA.,Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
| | - J Hunter Howie
- Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
| | - Emily Blanco
- Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
| | - Stephen P Jarvis
- University Health Behavioral Health, Kansas City, Missouri, USA.,University of Missouri School of Medicine, Kansas City, Missouri, USA
| | - Melisa V Rempfer
- Department of Psychology, The University of Missouri, Kansas City, Missouri, USA
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McLeod B, Meyer C, Meyer D, Nunan C, Murray G, Farhall J, Thomas N. Do recovery-oriented messages improve self-efficacy and positive emotions amongst people with lived experience of psychosis? Experimental investigation. Psychol Psychother 2022; 95:1003-1017. [PMID: 35906746 PMCID: PMC9796912 DOI: 10.1111/papt.12415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/25/2022] [Accepted: 06/29/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Recovery-oriented perspectives have become accepted worldwide as an alternative to the biomedical approach to conceptualizing and managing severe mental health problems. It has been proposed that one advantage of this is to support self-efficacy amongst people with a lived experience of psychosis, especially when recovery messages are presented by lived experience peers. The aim of the present study was to investigate the proposed psychological benefits of the recovery paradigm, by testing for possible differential impacts of recovery versus biomedical messages on self-efficacy beliefs and positive emotional state amongst people with experience of psychosis. It was hypothesized that (1) recovery-oriented messages, when presented by lived experience peers, would generate improvements in self-efficacy and positive emotions relative to biomedical messages presented by a professional and (2) recovery-oriented messages delivered by a professional would generate improvements in self-efficacy and positive emotions relative to biomedical messages delivered by a professional. We also explored whether recovery-oriented messages were more impactful when delivered by a lived experience peer versus a professional. DESIGN Experimental design with three within-subject video-based conditions. METHODS Fifty-three participants with lived experience of psychosis viewed three videos: (i) people with lived experience sharing their experiences of recovery; (ii) mental health professionals presenting traditional biomedical conceptualizations of psychosis; and (iii) mental health professionals presenting recovery perspectives. Participants provided baseline clinical and demographic information, and post-viewing ratings of experienced changes in self-efficacy and emotional state. RESULTS Hypothesis 1 was supported: both self-efficacy and positive emotions were significantly increased by a video of peers sharing personal recovery stories relative to professionals presenting biomedical messages. Hypothesis 2 was partially supported: when comparing videos of recovery versus biomedical messages delivered by professionals, significant relative benefits were found for positive emotions, but not self-efficacy. CONCLUSIONS This experimental investigation generated a pattern of findings broadly supportive of the assumed psychological benefits of the recovery paradigm for people with lived experiences of psychosis. Findings must be interpreted with caution given the limitations of the present design, but encourage further experimental research to directly test the interpersonal impacts of the recovery paradigm.
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Affiliation(s)
- Bronte McLeod
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Catherine Meyer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Denny Meyer
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - Cassy Nunan
- Wellways AustraliaMelbourneVictoriaAustralia
| | - Greg Murray
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia
| | - John Farhall
- La Trobe UniversityMelbourneVictoriaAustralia,NorthWestern Mental HealthMelbourneVictoriaAustralia
| | - Neil Thomas
- Centre for Mental HealthSwinburne University of TechnologyMelbourneVictoriaAustralia,Alfred HospitalMelbourneVictoriaAustralia
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8
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Lin E, Harris H, Black G, Bellissimo G, Di Giandomenico A, Rodak T, Costa-Dookhan KA, Shier R, Rovet J, Gruszecki S, Soklaridis S. Evaluating recovery colleges: a co-created scoping review. J Ment Health 2022:1-22. [PMID: 36345859 DOI: 10.1080/09638237.2022.2140788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recovery Colleges (RCs) are education-based centres providing information, networking, and skills development for managing mental health, well-being, and daily living. A central principle is co-creation involving people with lived experience of mental health/illness and/or addictions (MHA). Identified gaps are RCs evaluations and information about whether such evaluations are co-created. AIMS We describe a co-created scoping review of how RCs are evaluated in the published and grey literature. Also assessed were: the frameworks, designs, and analyses used; the themes/outcomes reported; the trustworthiness of the evidence; and whether the evaluations are co-created. METHODS We followed Arksey and O'Malley's methodology with one important modification: "Consultation" was re-conceptualised as "co-creator engagement" and was the first, foundational step rather than the last, optional one. RESULTS Seventy-nine percent of the 43 included evaluations were peer-reviewed, 21% grey literature. These evaluations represented 33 RCs located in the UK (58%), Australia (15%), Canada (9%), Ireland (9%), the USA (6%), and Italy (3%). CONCLUSION Our findings depict a developing field that is exploring a mix of evaluative approaches. However, few evaluations appeared to be co-created. Although most studies referenced co-design/co-production, few described how much or how meaningfully people with lived experience were involved in the evaluation.
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Affiliation(s)
- Elizabeth Lin
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Holly Harris
- Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
| | - Georgia Black
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Gail Bellissimo
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Terri Rodak
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Rowen Shier
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Jordana Rovet
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sam Gruszecki
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sophie Soklaridis
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
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9
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Hancock J, Perich T. Personal recovery in psychological interventions for bipolar disorder: a systematic review. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2083484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Jasmine Hancock
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Tania Perich
- School of Psychology, Western Sydney University, Sydney, Australia
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10
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Gandhi S, Jayaraman S, Sivakumar T, John AP, Joseph A, Prathyusha PV. Can employment in a café change Clientele Attitude towards the staff when they are Persons with Mental Illness? Int J Soc Psychiatry 2022; 68:541-547. [PMID: 33506712 DOI: 10.1177/0020764021990068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Clientele's attitude toward Persons with Mental Illness (PwMI) changes over a period of time. The aim of this study was to explore and understand how and whether perception about PwMI changes when they are seen working like persons without mental illness among those availing services of ROSes café at NIMHANS, Bengaluru. METHODS The descriptive research design was adopted with purposive sampling. Community Attitude toward Mentally Ill (CAMI) a self -administered questionnaire of was administered to measure the clientele attitude towards staff with mental illness in ROSes Café (Recovery Oriented Services). A total of 256 subjects availing services from the ROSes café recruited in the study. Chi-square and Mann-Whitney U test was computed to see the association and differences on selected variables. RESULTS The present study results showed that subjects had a positive attitude seen in health care professionals in the domains of benevolence (BE) (28.68 ± 3.00) and community mental health ideology (CMHI) (31.53 ± 3.19), whereas non-health care professionals had showed negative attitude in the domain of authoritarianism (AU) (30.54 ± 3.42) and social restrictiveness (SR) (30.18 ± 3.05). Education, employment, marital, income, and working status were significantly associated with CAMI domains. CONCLUSION PwMI also can work like people without mental illness when the opportunities are provided. The community needs to regard mental illness in the same manner as chronic physical illness diabetes mellitus and allow PwMI to live a life of dignity by creating and offering opportunities to earn livelihood which would help them recover with their illnesses.
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Affiliation(s)
- Sailaxmi- Gandhi
- National Institute of Mental Health and Neuro Sciences, Bangalore, KA, India
| | - Sangeetha Jayaraman
- National Institute of Mental Health and Neuro Sciences, Bangalore, KA, India
| | - Thanapal Sivakumar
- National Institute of Mental Health and Neuro Sciences, Bangalore, KA, India
| | - Annie P John
- National Institute of Mental Health and Neuro Sciences, Bangalore, KA, India
| | - Anoop Joseph
- National Institute of Mental Health and Neuro Sciences, Bangalore, KA, India
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11
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Lutz M, Zani D, Fritz M, Dudeck M, Franke I. A review and comparative analysis of the risk-needs-responsivity, good lives, and recovery models in forensic psychiatric treatment. Front Psychiatry 2022; 13:988905. [PMID: 36386990 PMCID: PMC9659584 DOI: 10.3389/fpsyt.2022.988905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/10/2022] [Indexed: 11/04/2022] Open
Abstract
Forensic mental health care primarily focuses on aspects of safety. Treatment is involuntary, and personal rights are highly restricted. Both direct and indirect coercion and significant power imbalances can impede not only the psychological state of inpatients but also their treatment motivation and the therapeutic process in general. However, successful treatment is essential to enable patients to regain their freedom. Therefore, the question arises whether and how health professionals, without disregarding the potential risks, can enable forensic psychiatric patients to experience meaningfulness and self-efficacy in their lives. In offender rehabilitation, the Risk-Need-Responsivity (RNR) model and Good Lives Model (GLM) are widely established theories. The RNR model focuses not only on the risk of recidivism but also on those needs of a person that provoke or prevent criminal behavior and the individual's ability to respond to various kinds of interventions. In contrast, the GLM aims to reduce the risk of re-offending by enabling an individual to live a "good life," i.e., a meaningful and fulfilling life. Originally developed in correctional services, i.e., for offenders without severe mental disorders, both the RNR model and the GLM have also been tested in forensic psychiatric treatment contexts. The Recovery Model is based on the concept of personal recovery in mental health care and is understood as the development of a sense of purpose and mastery in one's own life during the process of coping with the sequelae of a mental disorder. It is a central element of rehabilitation in general, but is also being increasingly applied in forensic psychiatric treatment settings. This review aims to compare the central concepts of the three models, in particular regarding personal development, and the current evidence for their efficacy in mentally disordered offenders.
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Affiliation(s)
- Maximilian Lutz
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Davide Zani
- Department of Forensic Psychiatry, Psychiatric Services Grisons, Chur, Switzerland
| | - Michael Fritz
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Manuela Dudeck
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Irina Franke
- Department of Forensic Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.,Department of Forensic Psychiatry, Psychiatric Services Grisons, Chur, Switzerland
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12
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Chirio-Espitalier M, Schreck B, Duval M, Hardouin JB, Moret L, Bronnec MG. Exploring the Personal Recovery Construct in Bipolar Disorders: Definition, Usage and Measurement. A Systematic Review. Front Psychiatry 2022; 13:876761. [PMID: 35815013 PMCID: PMC9263970 DOI: 10.3389/fpsyt.2022.876761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
Personal recovery from psychiatric disorders is a journey toward a satisfying and hopeful life despite the possible persistence of symptoms. This concept has gained interest and become an increasingly important goal in mental health care programmes. Personal Recovery is well described in the context of severe mental illnesses in general, but little is known about this journey in bipolar disorders and the factors underlying it. A systematic review was conducted according to the PRISMA recommendations, focusing on studies exploring personal recovery in bipolar disorder specifically. The latter have integrated a comprehensive approach to the concept, the existing means of measurement or have explored the levers of recovery in care. Twenty-four articles were selected, including seven qualitative, 12 observational, and five interventional studies. The Bipolar Recovery Questionnaire was the only scale developed de novo from qualitative work with bipolar people. Personal recovery did not correlate very closely with symptomatology. Some elements of personal recovery in bipolar disorder were similar to those in other severe mental illnesses: meaning in life, self-determination, hope, and low self-stigma. Specific levers differed: mental relationships with mood swings, including acceptance and decrease in hypervigilance, and openness to others, including trust and closeness. The studies highlighted the role of caregiver posture and the quality of communication within care, as well as the knowledge gained from peers. The choice to exclude articles not focused on bipolar disorder resulted in the provision of very specific information, and the small number of articles to date may limit the scope of the evidence. New components of personal recovery in bipolar disorder emerged from this review; these components could be taken into account in the construction of care tools, as well as in the caregiving posture. Strengthening skills of openness to others could also be a central target of recovery-focused care.
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Affiliation(s)
- Marion Chirio-Espitalier
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Benoit Schreck
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Melanie Duval
- Department of Public Health, University Hospital of Nantes, Nantes, France
| | - Jean-Benoit Hardouin
- Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
| | - Leila Moret
- Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France.,Department of Public Health, University Hospital of Nantes, Nantes, France
| | - Marie Grall Bronnec
- Nantes University, CHU Nantes, UIC Psychiatrie et Santé Mentale, Nantes, France.,Nantes University, Univ Tours, CHU Nantes, INSERM, MethodS in Patients Centered Outcomes and HEalth ResEarch, SPHERE, Nantes, France
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13
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Probert J. Moving Toward a Human Rights Approach to Mental Health. Community Ment Health J 2021; 57:1414-1426. [PMID: 33934236 PMCID: PMC8088315 DOI: 10.1007/s10597-021-00830-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/24/2021] [Indexed: 11/29/2022]
Abstract
The University of Florida Counseling and Wellness Center (UFCWC) has implemented peer support and professional training programs to address human rights identified within advocacy groups comprised of individuals who have, themselves, been diagnosed with mental illness. These programs are moving the UFCWC toward fulfilling a 2017 United Nations report emphasizing rights-based professional training, provision of genuine informed consent, and availability of non-compromised peer support alternatives. Collaborating with student peers, four UFCWC faculty members have facilitated forms of peer support developed within service-user movements, while openly identifying experiences of reclaiming their own lives from the impacts of adversity, intense mental distress, and traumatizing responses of others to their distress. In the wake of the current pervasive health, economic, and social justice crises, professionals have a collective opportunity to recognize the human experience and rights of those suffering mental distress. These UFCWC programs offer one example of steps taken toward that goal.
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Affiliation(s)
- Jim Probert
- Division of Student Affairs/Department of Psychology, University of Florida Counseling and Wellness Center, 3190 Radio Road, P.O. Box 112662, Gainesville, FL, 32611-2662, USA.
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14
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Mancinelli E, Sharka O, Lai T, Sgaravatti E, Salcuni S. Self-injury and Smartphone Addiction: Age and gender differences in a community sample of adolescents presenting self-injurious behavior. Health Psychol Open 2021; 8:20551029211038811. [PMID: 34659789 PMCID: PMC8512283 DOI: 10.1177/20551029211038811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to identify the variables (i.e., internalizing, and externalizing problems, self-control, emotion dysregulation, and alexithymia) relevant for Smartphone Addiction and non-suicidal self-injury (NSSI), conceptualized as emotion-regulation strategies, also assessing age and gender differences. Based on power analysis, N = 78 Italian adolescents (11-19 years; Mage = 14.24; SD = 1.56; 73.1% females) were considered. Step-wise multivariate linear regressions evidence a mutual association between NSSI and Smartphone Addiction, particularly relevant in pre-adolescence. Low self-control is significantly associated with the Smartphone Addiction, while emotion dysregulation and alexithymia with NSSI. This study supports NSSI and Smartphone Addiction conceptualization as emotion-regulation strategies and the importance of prevention interventions.
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Affiliation(s)
- Elisa Mancinelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Ona Sharka
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | | | - Eleonora Sgaravatti
- The Net-ONLUS, Padua, Italy.,Complex Psychology Unit - Infancy, Adolescence and Family, USSL3, Via Piazzetta Unità d'Italia, Padua, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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15
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Hawsawi T, Stein-Parbury J, Orr F, Roche M, Gill K. Exploring recovery-focused educational programmes for advancing mental health nursing: An integrative systematic literature review. Int J Ment Health Nurs 2021; 30 Suppl 1:1310-1341. [PMID: 34231293 DOI: 10.1111/inm.12908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 01/10/2023]
Abstract
Recovery-focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery-oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery-focused educational programmes have not fully address nurses' learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery-focused educational programmes for mental health nurses. A systematic search of electronic databases and hand-searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers' recovery, had four subthemes: consumers' involvement, multidisciplinary approach, profession-specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery-focused care planning. The final theme, nurses' learning experiences, included the subthemes: understanding recovery, the positive effects of recovery-focused educational programmes, and implementation of recovery-oriented practices. Based on these findings, a mental health nursing recovery-focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery-focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes.
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Affiliation(s)
- Tahani Hawsawi
- Faculty of Nursing, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Jane Stein-Parbury
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Fiona Orr
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Michael Roche
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
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16
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Kraiss JT, ten Klooster PM, Frye E, Kupka RW, Bohlmeijer ET. Exploring factors associated with personal recovery in bipolar disorder. Psychol Psychother 2021; 94:667-685. [PMID: 33742536 PMCID: PMC8451787 DOI: 10.1111/papt.12339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/05/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Personal recovery is increasingly recognized as important outcome for people with bipolar disorder (BD), but research addressing associated factors of personal recovery in this group remains scarce. This study aimed to explore the association of sociodemographic variables, social participation, psychopathology, and positive emotion regulation with personal recovery in BD. METHODS Baseline data from a randomized controlled trial and survey data were combined (N = 209) and split into a training (n = 149) and test sample (n = 60). Block-wise regression analyses and model training were used to determine the most relevant predictors. The final parsimonious model was cross-validated in the test sample. RESULTS In the final parsimonious model, satisfaction with social roles (β = .442, p < .001), anxiety symptoms (β = -.328, p < .001), manic symptoms (β = .276, p < .001), and emotion-focused positive rumination (β = .258, p < .001) were independently associated with personal recovery. The model explained 57.3% variance in personal recovery (adjusted R2 = .561) and performed well in predicting personal recovery in the independent test sample (adjusted R2 = .491). CONCLUSIONS Our findings suggest that especially social participation, anxiety and positive rumination might be relevant treatment targets when aiming to improve personal recovery. PRACTITIONER POINTS Personal recovery is considered an increasingly important outcome for people with chronic mental health conditions, including bipolar disorder. We found that anxiety and manic symptoms as well as positive rumination and social participation were independently associated with personal recovery in bipolar disorder. Therefore, these outcomes might be relevant treatment targets when aiming to improve personal recovery in bipolar disorder. Possible interventions to improve these outcomes are discussed, including supported employment and vocational rehabilitation for social participation and exercising with savoring strategies to increase positive rumination.
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Affiliation(s)
- Jannis T. Kraiss
- Department of Psychology, Health, and TechnologyCenter for eHealth and Well‐being ResearchUniversity of TwenteEnschedeNetherlands
| | - Peter M. ten Klooster
- Department of Psychology, Health, and TechnologyCenter for eHealth and Well‐being ResearchUniversity of TwenteEnschedeNetherlands
| | - Emily Frye
- Department of Psychology, Health, and TechnologyCenter for eHealth and Well‐being ResearchUniversity of TwenteEnschedeNetherlands
| | - Ralph W. Kupka
- PsychiatryAmsterdam Public Health Research InstituteVrije UniversiteitAmsterdam UMCThe Netherlands
| | - Ernst T. Bohlmeijer
- Department of Psychology, Health, and TechnologyCenter for eHealth and Well‐being ResearchUniversity of TwenteEnschedeNetherlands
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17
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Tyler E, Lobban F, Long R, Jones SH. Developing a recovery-focused therapy for older people with bipolar disorder: a qualitative focus group study. BMJ Open 2021; 11:e049829. [PMID: 34348954 PMCID: PMC8340279 DOI: 10.1136/bmjopen-2021-049829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES As awareness of bipolar disorder (BD) increases and the world experiences a rapid ageing of the population, the number of people living with BD in later life is expected to rise substantially. There is no current evidence base for the effectiveness of psychological interventions for older adults with BD. This focus group study explored a number of topics to inform the development and delivery of a recovery-focused therapy (RfT) for older adults with BD. DESIGN A qualitative focus group study. SETTING Three focus groups were conducted at a university in the North West of England. PARTICIPANTS Eight people took part in the focus groups; six older adults with BD, one carer and one friend. RESULTS Participant's responses clustered into six themes: (1) health-related and age-related changes in later life, (2) the experience of BD in later life, (3) managing and coping with BD in later life, (4) recovery in later life, (5) seeking helping in the future and (6) adapting RfT for older people. CONCLUSIONS Participants reported a range of health-related and age-related changes and strategies to manage their BD. Participants held mixed views about using the term 'recovery' in later life. Participants were in agreement that certain adaptations were needed for delivering RfT for older adults, based on their experience of living with BD in later life. The data collected as part of the focus groups have led to a number of recommendations for delivering RfT for older adults with BD in a randomised controlled trial (Clinical Trial Registration: ISRCTN13875321).
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Affiliation(s)
- Elizabeth Tyler
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Fiona Lobban
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Rita Long
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Steven H Jones
- Division of Health Research, Lancaster University, Lancaster, UK
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18
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Narratives about the Experience of Mental Illness: the recovery Process in Brazil. Psychiatr Q 2021; 92:573-585. [PMID: 32827099 DOI: 10.1007/s11126-020-09824-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED This paper analyzes ten recovery narratives of people with a serious mental illness who received mental health services in the public health care system of the city of Campinas, Brazil. We describe the person's recovery process and their relationship with the clinical services they received. This is a very needed conversation because the incorporation of recovery and recovering citizenship concepts in clinical practice are still incipient in South America. Most importantly, this research adds to the dialogue around recovering citizenship in different cultures. METHODS We used phenomenological methodology to interpret data drawn from the participant's life course interview (using the McGill Illness Narrative Interview). RESULTS We found that a) Before receiving services, people were overwhelmed by symptoms, but did not know what was going on; b) Loved ones and clinicians explained symptoms as part of a mental illness, and the proposed treatment was largely accepted; c) Mental health treatment was seen as helpful but not enough to address what was meaningful for their lives; d) People regained a life in their community, they felt proud of their recovery process, and solidarity and collectivism seemed to play important roles in their recovery process. DISCUSSION We identified similarities and differences in the recovery process of people with serious mental illness receiving public mental health services in Campinas, Brazil, when compared to the international literature. Receiving mental health services was very helpful for participants, principally when feeling overwhelmed by symptoms. Mental health services seemed to be less effective in helping people regain a meaningful life in their communities. Solidarity from friends and family members was recognized as an important recovery asset.
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19
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Chang YC, Chang LH, Hsu ST, Huang MW. Professional perspectives on providing recovery-oriented services in Taiwan: a qualitative study. BMC Psychiatry 2021; 21:154. [PMID: 33726694 PMCID: PMC7962288 DOI: 10.1186/s12888-021-03152-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/04/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The experiences of professionals in well-established recovery-oriented programs are valuable for professionals in similar practice settings. This study explored professionals' experiences with providing recovery-oriented services in community psychiatric rehabilitation organizations. METHODS Semi-structured interviews were conducted with 14 professionals from five recovery-oriented psychiatric rehabilitation organizations in Taiwan. The interviews were recorded and transcribed verbatim. Thematic analysis was used for the qualitative data analysis. RESULTS The analyses documented three main themes with 13 subthemes. Recovery-oriented service implementation included seven subthemes: Enabling clients to set their own goals and make decisions, using a strengths-based approach, establishing partnerships with clients, improving individuals' self-acceptance, encouraging community participation, seeking family, peer, and organizational support, and building team collaboration. Problems with implementing recovery-oriented services included limited policy and organizational support, a lack of understanding of recovery among professionals, stigma, clients' lack of motivation or self-confidence in their own ability to achieve recovery, and passive or overprotective family members. Strategies to resolve implementation problems included policy changes and organizational support, improving the recovery competence and confidence of professionals, and family and public education. CONCLUSIONS To date, this is the first known study examining the perspectives of mental health professionals who have experience implementing recovery-oriented services in Asia. The participants identified family collaboration, anti-stigma efforts, and changes in policy and attitudes as critical to successful implementation and delivery of recovery-oriented services.
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Affiliation(s)
- Yen-Ching Chang
- grid.64523.360000 0004 0532 3255Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ling-Hui Chang
- grid.64523.360000 0004 0532 3255Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Su-Ting Hsu
- grid.414813.b0000 0004 0582 5722Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Meng-Wen Huang
- Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.
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20
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Kraiss JT, Ten Klooster PM, Moskowitz JT, Bohlmeijer ET. The relationship between emotion regulation and well-being in patients with mental disorders: A meta-analysis. Compr Psychiatry 2020; 102:152189. [PMID: 32629064 DOI: 10.1016/j.comppsych.2020.152189] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/15/2020] [Accepted: 06/11/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The importance of both specific emotion regulation strategies and overall deficits in emotion regulation in the context of psychopathology is widely recognized. Besides alleviating psychological symptoms, improving mental well-being is increasingly considered important in treatment of people with mental disorders. However, no comprehensive meta-analysis on the relationship between emotion regulation and well-being in people with mental disorders has been conducted yet. OBJECTIVE The aim of the current study was to synthesize and meta-analyze evidence regarding the relationship between emotion regulation and well-being in clinical samples across studies. METHOD A systematic literature search was conducted in PsycINFO, PubMed and Scopus and 94 cross-sectional effect sizes from 35 studies were meta-analyzed to explore this relationship. To be eligible for the meta-analysis, studies had to include a clinical sample, assess at least one specific emotion regulation strategy or overall deficits in emotion regulation and include well-being as outcome. RESULTS The findings showed significant small to moderate negative relationships with well-being for the strategies avoidance (r = -0.31) and rumination (r = -0.19) and positive relationships with reappraisal (r = 0.19) and acceptance (r = 0.42). Grouping together putative adaptive and maladaptive strategies revealed similar sized relationships with well-being in the expected direction. Overall deficits in emotion regulation showed a negative moderate correlation with well-being (r = -0.47). No substantial difference in relationships was found when clustering studies into hedonic and eudaimonic well-being. CONCLUSION Our findings suggest that emotion regulation is not merely related with psychopathology, but also with well-being in general as well as hedonic and eudaimonic well-being. Therefore, it might also be important to improve emotion regulation when aiming to improve well-being in people with mental disorders.
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Affiliation(s)
- Jannis T Kraiss
- University of Twente, Centre for eHealth and Well-being Research, Department of Psychology, Health, and Technology, Enschede, the Netherlands.
| | - Peter M Ten Klooster
- University of Twente, Centre for eHealth and Well-being Research, Department of Psychology, Health, and Technology, Enschede, the Netherlands
| | - Judith T Moskowitz
- Department of Medical School Sciences, Feinberg School of Medicine, Osher Center for Integrative Medicine, Northwestern University, Chicago, USA
| | - Ernst T Bohlmeijer
- University of Twente, Centre for eHealth and Well-being Research, Department of Psychology, Health, and Technology, Enschede, the Netherlands
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21
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Geerling B, Kraiss J, Kelders S, Stevens A, Kupka R, Bohlmeijer E. The effect of positive psychology interventions on well-being and psychopathology in patients with severe mental illness: A systematic review and meta-analysis. THE JOURNAL OF POSITIVE PSYCHOLOGY 2020. [DOI: 10.1080/17439760.2020.1789695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- B. Geerling
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - J.T. Kraiss
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - S.M. Kelders
- Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - A.W.M.M. Stevens
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
| | - R.W. Kupka
- VU Medisch Centrum, Public Health Research Institute, Afdeling Psychiatrie, GGZ inGeest, Amsterdam UMC, Amsterdam, The Netherlands
| | - E.T. Bohlmeijer
- Dimence, SCBS Centre for Bipolar Disorders, Deventer, The Netherlands
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22
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İpçi K, Yildiz M, İncedere A, Kiras F, Esen D, Gürcan MB. Subjective Recovery in Patients with Schizophrenia and Related Factors. Community Ment Health J 2020; 56:1180-1187. [PMID: 32277339 DOI: 10.1007/s10597-020-00616-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/06/2020] [Indexed: 11/26/2022]
Abstract
Subjective recovery is a personally perceived recovery involving other factors beyond clinical recovery. This study aims at investigating the factors related to subjective recovery in patients with schizophrenia living in Turkey. This study assessed 120 clinically stable outpatients with schizophrenia or schizoaffective disorder using the clinical and psychosocial scales. Gender, type of the diagnosis of disease, and age of the illness onset were found to be correlated with the subjective recovery. Subjective recovery was significantly correlated with CGI-S (r = - 0.25), total PANSS score (r = - 0.29), global assessment of functioning (r = 0.27), social functioning (r = 0.43), internalized stigma (r = - 0.38), self-esteem (r = 0.56), depression (r = - 0.59), and hopelessness (r = - 0.55). Hopelessness and self-esteem were found to be predictive of the subjective recovery explaining 52% of the variance. It can be argued that efforts to promote hope and self-esteem contribute to the subjective recovery.
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Affiliation(s)
- Kübra İpçi
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Izmit, Kocaeli, Turkey
| | - Mustafa Yildiz
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Izmit, Kocaeli, Turkey.
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey.
| | - Aysel İncedere
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Izmit, Kocaeli, Turkey
| | - Fatma Kiras
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey
| | - Duygu Esen
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey
| | - Mehmet B Gürcan
- Department of Psychiatry, Kocaeli University School of Medicine, Umuttepe, 41001, Izmit, Kocaeli, Turkey
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23
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Ricci ÉC, Leal E, La-Rotta EIG, Onocko-Campos R, O'Connell M. Cross-cultural adaptation of the recovery self-assessment instrument (RSA–R) person in recovery version to Brazilian Portuguese (Pt/Br). JOURNAL OF PUBLIC MENTAL HEALTH 2020. [DOI: 10.1108/jpmh-02-2020-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The Recovery Self-Assessment (RSA–R) in Revised Version is an instrument designed to assess the degree to which mental health programs and services implement recovery-oriented practices. The purpose of this paper is to conduct a cross-cultural adaptation of the RSA–R instrument for use in local mental health services in the city of Campinas, State of São Paulo, Brazil.
Design/methodology/approach
This method for cross-cultural adaptation of the instrument included a series of iterative steps including preparation, translation, back translation, harmonization, expert evaluation, focus groups, in-depth interviews, expert opinion and pilot study.
Findings
A multi-rater assessment of the equivalence of content between the original RSA–R and the translated version revealed that each of the 32 items achieved at least 88% agreement in terms of equivalency. A multi-step harmonization process revealed additional suggestions for improvements in readability, comprehension and applicability to Brazilian context. An expert in youth and adult education provided additional stylistic recommendations. Combined, this iterative approach to cross-cultural translation resulted in an adapted version of the instrument that was well understood, culturally appropriate and adequate for further verification of psychometric properties.
Originality/value
The recovery process in Brazil and in the USA has culturally determined differences in terms of the way mental disorders are understood, diagnosed and treated. Moreover, there are different notions of what constitutes desirable results of recovery, health care and welfare. At the present time, there are few, if any, available cross-cultural instruments to assess the recovery-orientation of services between Brazil and the USA.
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24
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Enrique A, Duffy D, Lawler K, Richards D, Jones S. An internet-delivered self-management programme for bipolar disorder in mental health services in Ireland: Results and learnings from a feasibility trial. Clin Psychol Psychother 2020; 27:925-939. [PMID: 32445611 PMCID: PMC7754375 DOI: 10.1002/cpp.2480] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/11/2020] [Accepted: 05/22/2020] [Indexed: 01/03/2023]
Abstract
Bipolar disorder (BD) is a chronic condition that requires continued care. Psychological interventions are recommended by clinical guidelines but there are treatment barriers that prevent patients to access these services. Internet-delivered self-management interventions are promising alternatives to improve treatment accessibility in patients with BD. Several studies indicate that these interventions are acceptable and beneficial for patients with BD, but no studies have been conducted in routine care settings. This trial aimed to examine the feasibility, acceptability, and preliminary efficacy of implementing an internet-delivered, clinician-supported intervention for BD as an adjunct to treatment as usual at two secondary-care services in Ireland. This study used an uncontrolled design with mixed-methods evaluation. Feasibility and acceptability were assessed in terms of recruitment, use of the intervention, and satisfaction from both clinicians and patients' perspectives. Personal recovery, quality of life, and severity of symptoms were measured at baseline and post-intervention. Fifteen patients signed consent and used the programme for 10 weeks. Usage of the intervention was adequate with high frequency of tool usage. There was a significant improvement in patients' sense of personal recovery (z = 2.38, p = .017). The intervention was found acceptable and easy-to-use; however, implementation barriers will need to be overcome for scaling the intervention. This is the first study testing the feasibility of a digital intervention for patients with BD in public mental health services in Ireland. More research is needed in order to increase the understanding of how to promote the integration and the uptake of digital interventions for individuals with BD.
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Affiliation(s)
- Angel Enrique
- E-mental Health Research Group, School of Psychology, University of Dublin, Trinity College, Dublin, Ireland.,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Daniel Duffy
- E-mental Health Research Group, School of Psychology, University of Dublin, Trinity College, Dublin, Ireland.,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Kate Lawler
- E-mental Health Research Group, School of Psychology, University of Dublin, Trinity College, Dublin, Ireland.,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Derek Richards
- E-mental Health Research Group, School of Psychology, University of Dublin, Trinity College, Dublin, Ireland.,Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - Steven Jones
- Spectrum Centre for Mental Health Research, University of Lancaster, Lancaster, UK
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25
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Husain W. Barriers in Seeking Psychological Help: Public Perception in Pakistan. Community Ment Health J 2020; 56:75-78. [PMID: 31542848 DOI: 10.1007/s10597-019-00464-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/12/2019] [Indexed: 01/01/2023]
Abstract
Mental health services are globally less utilized because of several psychosocial barriers that vary from culture to culture. Regarding Pakistan, a serious knowledge gap existed in this regard. The current study was aimed at exploring the barriers for Pakistanis which stop them from seeking psychological help. The survey involved 3500 participants from 5 cities. The sample was sufficiently rich to be categorized based on gender, age, education, profession and income. Data was gathered through interviews and a self-report questionnaire. Lack of faith in psychological treatment, prior personal experience, religious fatalism, carelessness for mental disorders, social defame, personal shame, bad reputation of mental health practitioners, prohibition by family, and fear of treatment were found to be the barriers in seeking psychological help. To overcome these barriers, the participants of the current study suggested the mental health practitioners of the country to raise awareness on mental health and improve mental health services.
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Affiliation(s)
- Waqar Husain
- Department of Humanities, COMSATS University, Park Road, Islamabad, Pakistan.
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26
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Faith LA, Collins JO, Decker J, Grove A, Jarvis SP, Rempfer MV. Experiences of empowerment in a community cognitive enhancement therapy program: an exploratory qualitative study. PSYCHOSIS 2019. [DOI: 10.1080/17522439.2019.1632920] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Laura A. Faith
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jen O. Collins
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Jenna Decker
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Amber Grove
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
| | - Stephen P. Jarvis
- Truman Medical Center Behavioral Health, Kansas City, MO, USA
- Department of Psychiatry, University of Missouri, Kansas City, MO, USA
| | - Melisa V. Rempfer
- Department of Psychology, The University of Missouri, Kansas City, MO, USA
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27
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Roosenschoon BJ, Kamperman AM, Deen ML, van Weeghel J, Mulder CL. Determinants of clinical, functional and personal recovery for people with schizophrenia and other severe mental illnesses: A cross-sectional analysis. PLoS One 2019; 14:e0222378. [PMID: 31532805 PMCID: PMC6750648 DOI: 10.1371/journal.pone.0222378] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 08/29/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To analyze the relationships between insight, medication adherence, addiction, coping and social support-components of Illness Management and Recovery (IMR)-as determinants of clinical, functional and personal recovery in patients with schizophrenia and other severe mental illnesses. Our rationale lay in the interrelations between these concepts suggested in a conceptual framework of IMR. METHODS The cross-sectional design used baseline data of outpatient participants in a randomized clinical trial on IMR (N = 187). We used structural equation modeling (SEM) to describe pathways between degrees of insight, medication adherence, addiction, coping and social support, and degree of clinical, functional and personal recovery. We also explored whether clinical recovery mediated functional and personal recovery. RESULTS Our final model showed that coping was associated with clinical, functional and personal recovery. Direct associations between coping and functional and personal recovery were stronger than indirect associations via clinical recovery. Although SEM also showed a significant but weak direct pathway between social support and functional recovery, there were no significant pathways either between social support and clinical or personal recovery, or between insight, medication adherence, addiction and any type of recovery. CONCLUSIONS Coping may be a determinant of all three types of recovery, and social support a determinant of functional recovery. Clinical recovery appears not to be a prerequisite for functional or personal recovery. While our results also suggest the relevance of improving coping skills and of enhancing social support, they only partially support the conceptual framework of IMR.
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Affiliation(s)
- Bert-Jan Roosenschoon
- ESPRI Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
- Parnassia Psychiatric Institute, The Hague, the Netherlands
- * E-mail:
| | - Astrid M. Kamperman
- ESPRI Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Mathijs L. Deen
- Parnassia Psychiatric Institute, The Hague, the Netherlands
- Faculty of Social and Behavioral Sciences, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Jaap van Weeghel
- Parnassia Psychiatric Institute, The Hague, the Netherlands
- Tilburg University, Department of Social and Behavioral Sciences, TRANZO Scientific Center for Care and Welfare, Tilburg, the Netherlands
| | - Cornelis L. Mulder
- ESPRI Epidemiological and Social Psychiatric Research Institute, Department of Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands
- Parnassia Psychiatric Institute, Antes/Bavo Europoort, Rotterdam, the Netherlands
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Wang W, Zhou Y, Chai N, Liu D. Cognitive–behavioural therapy for personal recovery of patients with schizophrenia: A systematic review and meta-analysis. Gen Psychiatr 2019; 32:e100040. [PMID: 31552381 PMCID: PMC6738704 DOI: 10.1136/gpsych-2018-100040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 07/03/2019] [Accepted: 07/17/2019] [Indexed: 11/03/2022] Open
Abstract
BackgroundTo date, cognitive–behavioural therapy (CBT) trials have primarily focused on clinical recovery; however, personal recovery is actually the fundamental aspect of the recovery process. The aim of this study was to summarise and synthesise the existing evidence regarding the effectiveness of CBT for personal recovery in patients with schizophrenia.AimThis study aimed to determine the effectiveness of CBT for personal recovery in patients with schizophrenia.MethodsA systematic search of the literature in PsycINFO, PubMed, Cochrane (CENTRAL), Embase and Web of Science (SCI) was conducted to identify randomised controlled trials reporting the impact of CBT interventions on personal recovery in patients with schizophrenia. The estimated effect sizes of the main study outcomes were calculated to estimate the magnitude of the treatment effects of CBT on personal recovery. We also evaluated the CBT’s effect size at the end-of-treatment and long-term (follow-up) changes in some aspects of personal recovery.ResultsTwenty-five studies were included in the analysis. The effect of CBT on personal recovery was 2.27 (95% CI 0.10 to 4.45; I2=0%; p=0.04) at post-treatment and the long-term effect size was 2.62 (95% CI 0.51 to 4.47; I2=0%; p=0.02). During the post-treatment period, the pooled effect size of CBT was 0.01 (95% CI −0.12 to 0.15; I2=33.0%; p>0.05) for quality of life (QoL), 0.643 (95% CI 0.056 to 1.130; I2=30.8%; p<0.01) for psychological health-related QoL, −1.77 (95% CI −3.29 to −0.25; I2=40%; p=0.02) for hopelessness and 1.85 (95% CI 0.69 to 3.01; I2=41%; p<0.01) for self-esteem. We also summarised the effects of CBT on QoL (subscale scores not included in the evaluation of the pooled effect size), self-confidence and connectedness, and all results corresponded to positive effects. However, there was insufficient evidence regarding the long-term effects of CBT on personal recovery.ConclusionsCBT is an effective therapy with meaningful clinical effect sizes on personal recovery and some aspects of personal recovery of schizophrenia after treatment. However, the effect is relatively immediate and rapidly decreases as time progresses. Therefore, in the future, more studies should focus on the mechanism of CBT for personal recovery and the factors that influence the long-term effects of CBT.Trial registration numberCRD42018085643.
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Affiliation(s)
- Weiliang Wang
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
| | - Yuqiu Zhou
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
| | - Nannan Chai
- School of Nursing, Chifeng University, Chifeng, Inner Mongolia Autonomous Region, China
| | - Dongwei Liu
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
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Kraiss JT, Klooster PM, Chrispijn M, Stevens AW, Kupka RW, Bohlmeijer ET. Measuring personal recovery in people with bipolar disorder and exploring its relationship with well‐being and social role participation. Clin Psychol Psychother 2019; 26:540-549. [PMID: 31034683 PMCID: PMC9328380 DOI: 10.1002/cpp.2371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/22/2019] [Accepted: 04/25/2019] [Indexed: 11/17/2022]
Abstract
The relevance of personal recovery receives increasing attention in mental health care and is also important for people with bipolar disorder (BD). There is a need for reliable and valid instruments measuring personal recovery. Therefore, the current study evaluated the psychometric properties of a Dutch translation of the Questionnaire about the Process of Recovery (QPR) in a sample of people with BD and explored the relationship with constructs of well‐being, social role participation, and psychopathology. A cross‐sectional survey study was conducted in which 102 people diagnosed with BD completed the QPR. Factor structure of the QPR was evaluated by conducting confirmatory factor analyses (CFA), and internal consistency was assessed by calculating reliability coefficients. Convergent validation measures assessed well‐being, social role participation, and symptomatology. Incremental validity was determined by evaluating the ability of the QPR to explain variance in symptomatology above and beyond well‐being. Findings of the CFA supported a unidimensional factor structure, and internal consistency estimates were excellent. Scores of the QPR showed strong correlations with convergent measures, but were only weakly associated with manic symptomatology. Moreover, personal recovery explained additional variance in symptoms of depression and anxiety above and beyond well‐being, indicating incremental validity. The QPR appears to be a reliable and valid tool to assess personal recovery in people with BD. Our findings underline the importance of personal recovery in the context of treatment of BD. Personal recovery demonstrates a substantial overlap with well‐being.
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Affiliation(s)
- Jannis T. Kraiss
- Centre for eHealth and Well‐being Research, Department of Psychology, Health, and TechnologyUniversity of Twente Enschede Netherlands
| | - Peter M. Klooster
- Centre for eHealth and Well‐being Research, Department of Psychology, Health, and TechnologyUniversity of Twente Enschede Netherlands
| | - Melissa Chrispijn
- Center for Bipolar DisordersDimence Mental Health Deventer Netherlands
| | | | - Ralph W. Kupka
- Amsterdam UMC, Vrije Universiteit, PsychiatryAmsterdam Public Health research institute Amsterdam Netherlands
| | - Ernst T. Bohlmeijer
- Centre for eHealth and Well‐being Research, Department of Psychology, Health, and TechnologyUniversity of Twente Enschede Netherlands
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Echezarraga A, Las Hayas C, López de Arroyabe E, Jones SH. Resilience and Recovery in the Context of Psychological Disorders. JOURNAL OF HUMANISTIC PSYCHOLOGY 2019. [DOI: 10.1177/0022167819851623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Smith-Merry J, Goggin G, Campbell A, McKenzie K, Ridout B, Baylosis C. Social Connection and Online Engagement: Insights From Interviews With Users of a Mental Health Online Forum. JMIR Ment Health 2019; 6:e11084. [PMID: 30912760 PMCID: PMC6454344 DOI: 10.2196/11084] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 11/23/2018] [Accepted: 01/09/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Over the past 2 decades, online forums for mental health support have emerged as an important tool for improving mental health and well-being. There has been important research that analyzes the content of forum posts, studies on how and why individuals engage with forums, and how extensively forums are used. However, we still lack insights into key questions on how they are experienced from the perspective of their users, especially those in rural and remote settings. OBJECTIVE The aim of our study was to investigate the dynamics, benefits, and challenges of a generalized peer-to-peer mental health online forum from a user perspective; in particular, to better explore and understand user perspectives on connection, engagement, and support offered in such forums; information and advice they gained; and what issues they encountered. We studied experiences of the forums from the perspective of both people with lived experience of mental illness and people who care for people with mental illness. METHODS To understand the experience of forum users, we devised a qualitative study utilizing semistructured interviews with 17 participants (12 women and 5 men). Data were transcribed, and a thematic analysis was undertaken. RESULTS The study identified 3 key themes: participants experienced considerable social and geographical isolation, which the forums helped to address; participants sought out the forums to find a social connection that was lacking in their everyday lives; and participants used the forums to both find and provide information and practical advice. CONCLUSIONS The study suggests that online peer support provides a critical, ongoing role in providing social connection for people with a lived experience of mental ill-health and their carers, especially for those living in rural and remote areas. Forums may offer a way for individuals to develop their own understanding of recovery through reflecting on the recovery experiences and peer support shown by others and individuals enacting peer support themselves. Key to the success of this online forum was the availability of appropriate moderation, professional support, and advice.
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Affiliation(s)
- Jennifer Smith-Merry
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Gerard Goggin
- Department of Media and Communications, Faculty of Arts and Social Science, The University of Sydney, Sydney, Australia
| | - Andrew Campbell
- Cyberpsychology Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Kirsty McKenzie
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Brad Ridout
- Cyberpsychology Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Cherry Baylosis
- Department of Media and Communications, Faculty of Arts and Social Science, The University of Sydney, Sydney, Australia
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Boucher ME, Groleau D, Whitley R. Recovery from severe mental illness in Québec: The role of culture and place. Health Place 2019; 56:63-69. [PMID: 30710835 DOI: 10.1016/j.healthplace.2019.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/28/2018] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
This paper examines the role of culture and place in recovery from severe mental illness amongst a group of Québécois living in Montreal, Canada. Results indicate that dominant cultural characteristics of Québécois, such as a marked Roman Catholic heritage, use of the French language and a close affiliation with the natural territory of Québec can all play important roles in recovery from severe mental illness. The findings suggest that participants weave together places with cultural, familial and personal meaning to create their own healing landscapes. We propose ways to leverage place and dominant cultural traits to facilitate recovery.
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Affiliation(s)
- Marie-Eve Boucher
- Douglas Mental Health University Institute, 6875 boulevard LaSalle, Montréal, Quebec, Canada H4H 1R3; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1
| | - Danielle Groleau
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1; Lady Davis Institute, Jewish General Hospital, 3755 Côte-Ste-Catherine Road, Montreal, Quebec, Canada H3T 1E2
| | - Rob Whitley
- Douglas Mental Health University Institute, 6875 boulevard LaSalle, Montréal, Quebec, Canada H4H 1R3; Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, Quebec, Canada H3A 1A1.
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Browne J, Edwards AN, Penn DL, Meyer-Kalos PS, Gottlieb JD, Julian P, Ludwig K, Mueser KT, Kane JM. Factor structure of therapist fidelity to individual resiliency training in the Recovery After an Initial Schizophrenia Episode Early Treatment Program. Early Interv Psychiatry 2018; 12:1052-1063. [PMID: 27860369 DOI: 10.1111/eip.12409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 07/28/2016] [Accepted: 09/20/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Evidence-based approaches and early intervention have improved the long-term prognosis of individuals with schizophrenia. However, little is known about the therapeutic processes involved in individual therapy in first-episode psychosis. A comprehensive psychosocial/psychiatric programme for this population, NAVIGATE, includes an individual therapy component, individual resiliency training (IRT). Fidelity of clinicians' adherence to the IRT protocol has been collected to ensure proper implementation of this manual-based intervention. These data can provide insight into the elements of the therapeutic process in this intervention. MATERIALS AND METHODS To achieve this goal, we first examined the factor structure of the IRT fidelity scale with exploratory factor analysis. Second, we explored the relationships among the IRT fidelity ratings with clinician years of experience and years of education, as well as client's baseline symptom severity and duration of untreated psychosis. RESULTS AND CONCLUSIONS Results supported a 2-factor structure of the IRT fidelity scale. Correlations between clinician years of education and fidelity ratings were statistically significant.
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Affiliation(s)
- Julia Browne
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexandra N Edwards
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - Piper S Meyer-Kalos
- Minnesota Center for Chemical and Mental Health, School of Social Work, University of Minnesota, St. Paul, Minnesota
| | - Jennifer D Gottlieb
- Center for Psychiatric Rehabilitation, Departments of Occupational Therapy, Psychology, & Psychiatry, Boston University, Boston, Massachusetts
| | - Paul Julian
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelsey Ludwig
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Departments of Occupational Therapy, Psychology, & Psychiatry, Boston University, Boston, Massachusetts
| | - John M Kane
- Division of Psychiatry Research, Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, New York, New York
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Kraiss JT, ten Klooster PM, Chrispijn M, Trompetter HR, Stevens AW, Neutel E, Kupka RW, Bohlmeijer ET. B-positive: a randomized controlled trial of a multicomponent positive psychology intervention for euthymic patients with bipolar disorder - study protocol and intervention development. BMC Psychiatry 2018; 18:335. [PMID: 30333004 PMCID: PMC6192172 DOI: 10.1186/s12888-018-1916-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 10/01/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is characterized by recurrent (hypo)manic and depressive episodes, alternating with euthymic states in which patients are relatively symptom free. Besides clinical recovery, it is important to also strive for improvement of mental well-being and personal recovery. One prominent field focussing on the improvement of well-being is positive psychology. However, studies assessing the effects of positive psychology or personal recovery interventions for people with BD are scarce and have used weak methodological designs. The study described in this protocol article aims to assess the effectiveness of a multicomponent positive psychology intervention ("Living well with bipolar disorder") adjusted for people with BD in the euthymic phase to improve well-being and personal recovery. METHOD The study concerns a pragmatic randomized multicenter trial. The principle objective of the study is to assess whether the positive psychology intervention offered to BD patients in remission in addition to usual care (CAU) is more effective than CAU. The study will include 112 participants randomized to either the experimental condition receiving the intervention in addition to CAU or the control condition receiving CAU. The study population are patients with BD I or II in the euthymic phase. The inclusion criteria are 1) diagnosis of BD I or BD II, 2) between the ages of 18-65, 3) four or more supportive sessions in the last year, and 4) only residual depressive or manic symptoms. Patients are excluded if they are in a depressive or manic episode, have current addiction problems or have optimal levels of well-being. Measurements take place at baseline, post-intervention and follow-up 6 and 12 months from baseline. Outcomes of measures include positive well-being, personal recovery, psychopathology, self-compassion, positive relationships, dampening of positive affect and relapse. DISCUSSION The outlined study will be the first RCT examining the effects of a multicomponent positive psychology intervention for patients with bipolar disorder. Several limitations, including generalizability of the results and possible attrition issues, are discussed in advance. TRIAL REGISTRATION This study has been registered in the Netherlands Trial Register ( NTR6729 ) on 12 October 2017.
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Affiliation(s)
- Jannis T. Kraiss
- 0000 0004 0399 8953grid.6214.1Center for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, PO Box 217, Enschede, 7500 AE the Netherlands
| | - Peter M. ten Klooster
- 0000 0004 0399 8953grid.6214.1Center for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, PO Box 217, Enschede, 7500 AE the Netherlands
| | - Melissa Chrispijn
- Specialized Center for Bipolar Disorders, Dimence group, Pikeursbaan 3, Deventer, 7411 GT the Netherlands
| | - Hester R. Trompetter
- 0000 0001 0943 3265grid.12295.3dCenter of Research on Psychological and Somatic Disorders, TS Social and Behavioral Sciences, Tilburg University, PO Box 90153, Tilburg, 5000 LE the Netherlands
| | - Anja W.M.M. Stevens
- Specialized Center for Bipolar Disorders, Dimence group, Pikeursbaan 3, Deventer, 7411 GT the Netherlands
| | - Erica Neutel
- Dutch Association for Manic Depressives and Relatives, Stationsplein 125, Amersfoort, 3818 LE the Netherlands
| | - Ralph W. Kupka
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Psychiatry, VU University Medical Center, Oldenaller 1, Amsterdam, 1081 HJ the Netherlands
| | - Ernst T. Bohlmeijer
- 0000 0004 0399 8953grid.6214.1Center for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, PO Box 217, Enschede, 7500 AE the Netherlands
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Byrne L, Schoeppe S, Bradshaw J. Recovery without autonomy: Progress forward or more of the same for mental health service users? Int J Ment Health Nurs 2018; 27:1459-1469. [PMID: 29446509 DOI: 10.1111/inm.12446] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2018] [Indexed: 11/29/2022]
Abstract
In Western nations, the Recovery approach has become a widely accepted philosophy and treatment concept in mental health. Yet, community understanding of the Recovery approach remains largely unexplored. This study aimed to investigate (i) people's awareness of the principles underpinning the Recovery approach in mental health, and (ii) the treatment approaches people consider most important, and whether these align with the Recovery approach. To achieve these aims, a random sample of 1217 Australian adults participated in the National Social Survey (QSS) via telephone interview. People's experience with mental health services, the importance they place on various treatment approaches, and their awareness of principles underpinning the Recovery approach were assessed. Analyses were conducted using descriptive statistics. Most participants (94%) agreed that 'regardless of the severity of symptoms experienced and/or the mental illness diagnosis, being diagnosed with a mental illness means there is always hope for a meaningful life'. Moreover, most participants considered treatments in line with the Recovery approach as important. However, few participants (35%) agreed with the principle that 'after diagnosis, the person themselves should direct the long-term management of their mental illness, rather than a medical professional'. Australian people were to some extent aware of the principles underpinning the Recovery Approach, particularly with regard to hope, ability to live a meaningful life, and the importance of support from family, friends, and others living with mental illness. Nonetheless, autonomy was not highly prioritized, with the prevailing view that management of mental illness should be directed by the medical profession.
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Affiliation(s)
- Louise Byrne
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia.,School of Management, RMIT University, Melbourne, Victoria, Australia
| | - Stephanie Schoeppe
- Physical Activity Research Group, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Julie Bradshaw
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
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Van Eck RM, Burger TJ, Schenkelaars M, Vellinga A, de Koning MB, Schirmbeck F, Kikkert M, Dekker J, de Haan L. The impact of affective symptoms on personal recovery of patients with severe mental illness. Int J Soc Psychiatry 2018; 64:521-527. [PMID: 29992846 DOI: 10.1177/0020764018784610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Clinical recovery is often defined as remission of symptoms. Personal recovery is described as growing beyond the catastrophic effects of mental illness, sometimes despite ongoing symptoms. AIMS To examine the relationship between the severity of clinical symptom domains and personal recovery in patients with severe mental illness (SMI). METHODS Symptom severity and personal recovery of 105 outpatients with SMI at Mentrum, part of Arkin Institute for Mental Health in Amsterdam, the Netherlands, were assessed using the Brief Psychiatric Rating Scale-Expanded Version (BPRS-E) and the Mental Health Recovery Measure (MHRM). Correlation and regression analyses were used to investigate the associations. RESULTS The multiple regression analysis showed that only affective symptoms significantly predicted personal recovery, whereas neither positive nor negative symptom severity added to the explained variance in the model. CONCLUSION The association between affective symptoms and personal recovery in patients with SMI implies that treatment of affective symptoms may advance personal recovery, and/or support of personal recovery may improve mood, whereas focussing on treatment of psychotic symptoms might not be the key to personal recovery. More research is needed to elucidate causal interrelations.
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Affiliation(s)
- Robin Michael Van Eck
- 1 Mentrum, part of Arkin Institute for Mental Health, Amsterdam, The Netherlands.,2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Thijs Jan Burger
- 2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Astrid Vellinga
- 1 Mentrum, part of Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Frederike Schirmbeck
- 2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Martijn Kikkert
- 3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Jack Dekker
- 3 Arkin Institute for Mental Health, Amsterdam, The Netherlands.,5 Department of Clinical Psychology, Free University, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- 2 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.,3 Arkin Institute for Mental Health, Amsterdam, The Netherlands
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Piat M, Sabetti J, Padgett D. Emergent leadership among tenants with psychiatric disabilities living in supported housing. Int J Ment Health Nurs 2018; 27:1127-1136. [PMID: 29277953 DOI: 10.1111/inm.12428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 11/29/2022]
Abstract
The overall aim of this study was to explore the experiences of people with psychiatric disabilities living as tenants in independent, supported apartments for the first time. Supported housing provides an alternative to structured, custodial housing models, such as foster homes, or board-and-care homes, for clients in public mental health systems. This article reports findings on how leadership emerged among tenants after making the transition from custodial to supported housing. Semi-structured interviews were conducted with tenants (n = 24) and included questions on their housing history, current living situation, relationships with staff, participation, and understanding or experience of leadership. Interviews were transcribed verbatim, codes generated, and a thematic analysis conducted using a constructivist approach. The findings revealed an understanding and appreciation of leadership among tenants, who identified six pathways to leadership in their housing as a response to unmet tenant needs. Most tenant leaders emerged outside of formal authority or power structures. Supported housing provides a unique social setting and empowering community where the potential of persons with psychiatric disabilities to assume leadership may be realized and further developed. Mental health professionals working in community housing networks are well placed to harness these face-to-face tenant communities, and their natural leaders, as an additional tool in promoting tenant recovery, mutual help, neighbourhood integration, and the broader exercise of citizenship.
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Affiliation(s)
- Myra Piat
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Judith Sabetti
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Deborah Padgett
- Silver School of Social Work, New York University, New York City, NY, USA
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Hancock N, Smith-Merry J, Jessup G, Wayland S, Kokany A. Understanding the ups and downs of living well: the voices of people experiencing early mental health recovery. BMC Psychiatry 2018; 18:121. [PMID: 29728097 PMCID: PMC5935906 DOI: 10.1186/s12888-018-1703-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 04/23/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The aim of this study was to better understand early-stage mental health recovery experiences of people living with severe and persistent mental illness and complex needs. METHODS Semi-structured, in-depth interviews were conducted with 13 people engaged in an Australian program specifically designed for people facing complex barriers to their recovery. Interview data were analysed thematically using constant comparative methods. RESULTS Participants described engaging with seven interconnecting aspects of early recovery: (1) engaging with the challenge of recovery; (2) struggling for a secure and stable footing; (3) grieving for what was and what could have been; (4) seeking and finding hope; (5) navigating complex relationships; (6) connecting with formal and informal support, and finally, (7) juggling a complexity of health issues. CONCLUSIONS This study illuminated the complexity of earlier-stage recovery which was characterised both by challenging personal circumstances and a hope for the future. It illustrated that even at an early point in their recovery journey, and amidst these challenging circumstances, people still actively engage with support, draw on inner strengths, source resources and find accomplishments. Stability and security was foundational to the ability of participants to draw on their own strengths and move forward. Stability came when material needs, including housing, were addressed, and an individual was able to connect with a supportive network of workers, carers, friends and family.
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Affiliation(s)
| | | | - Glenda Jessup
- 0000 0004 1936 834Xgrid.1013.3The University of Sydney, Sydney, Australia
| | - Sarah Wayland
- 0000 0004 1936 7611grid.117476.2University of Technology, Sydney, Sydney, Australia
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Abstract
PURPOSE OF REVIEW Schizophrenia has a heterogeneous range of end states, from severe cases requiring repeated hospitalization to cases in which a single illness episode is followed by complete remission. The purpose of the present review is to examine recent literature on recovery in schizophrenia, focusing on the predictive factors and on the possibility to achieve it. RECENT FINDINGS Roughly half of schizophrenia patients recovered or significantly improved over the long term, suggesting that functional remission is possible. Several factors predict the course of schizophrenia, including demographic, clinical, and treatment characteristics, as well as socioeconomic variables. Antipsychotics are a fundamental element of schizophrenia treatment, although the available antipsychotics have significant limitations. In this context, psychosocial interventions are supported by substantial evidence of efficacy in many outcome measures and rehabilitation interventions should be considered as an evidence-based practice and need to become a part of the standard treatment of schizophrenia. SUMMARY As recovery is a multidimensional concept, some authors suggested that at least two areas should be taken into account: clinical remission and social functioning. Functional outcome should be a priority target for therapeutic interventions in schizophrenia and in this perspective measuring treatment response, remission and functional recovery is essential. Only an integrated and multifaceted approach involving pharmacotherapy, psychosocial interventions, and attention to environmental circumstances can improve outcome in schizophrenia.
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Van Eck RM, Burger TJ, Vellinga A, Schirmbeck F, de Haan L. The Relationship Between Clinical and Personal Recovery in Patients With Schizophrenia Spectrum Disorders: A Systematic Review and Meta-analysis. Schizophr Bull 2018; 44:631-642. [PMID: 29036720 PMCID: PMC5890469 DOI: 10.1093/schbul/sbx088] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Patients describe experiencing personal recovery despite ongoing symptoms of psychosis. The aim of the current research was to perform a meta-analysis investigating the relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders. A comprehensive OvidSP database search was performed to identify relevant studies. Correlation coefficients of the relationship between clinical and personal recovery were retrieved from primary studies. Meta-analyses were performed, calculating mean weighted effect sizes for the association between clinical and personal recovery, hope, and empowerment. Additionally, associations between positive, negative, affective symptoms, general functioning, and personal recovery were investigated. The results show that heterogeneity across studies was substantial. Random effect meta-analysis of the relationship between symptom severity and personal recovery revealed a mean weighted correlation coefficient of r = -.21 (95% CI = -0.27 to -0.14, P < .001). We found the following mean weighted effect size for positive symptoms r = -.20 (95% CI = -0.27 to -0.12, P < .001), negative symptoms r = -.24 (95% CI = -0.33 to -0.15, P < .001), affective symptoms r = -.34 (95% CI = -0.44 to -0.24, P < .001) and functioning r = .21 (95% CI = -0.09 to 0.32, P < .001). The results indicate a significant small to medium association between clinical and personal recovery. Psychotic symptoms show a smaller correlation than affective symptoms with personal recovery. These findings suggest that clinical and personal recovery should both be considered in treatment and outcome monitoring of patients with schizophrenia spectrum disorders.
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Affiliation(s)
- Robin Michael Van Eck
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Thijs Jan Burger
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Astrid Vellinga
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
- Mentrum, part of Arkin, Amsterdam, The Netherlands
| | - Frederike Schirmbeck
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Jas E, Wieling M. Providers' competencies positively affect personal recovery of involuntarily admitted patients with severe mental illness: A prospective observational study. Int J Soc Psychiatry 2018; 64:145-155. [PMID: 29277105 DOI: 10.1177/0020764017749864] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE There is limited research on the patient-provider relationship in inpatient settings. The purpose of this study was to measure the effect of mental healthcare providers' recovery-promoting competencies on personal recovery in involuntarily admitted psychiatric patients with severe mental illness. METHODS In all, 127 Dutch patients suffering from a severe mental illness residing in a high-secure psychiatric hospital reported the degree of their personal recovery (translated Questionnaire about Processes of Recovery questionnaire (QPR)) and the degree of mental healthcare providers' recovery-promoting competence (Recovery Promoting Relationship Scale (RPRS)) at two measurement points, 6 months apart. ANALYSES (Mixed-effects) linear regression analysis was used to test the effect of providers' recovery-promoting competence on personal recovery, while controlling for the following confounding variables: age, gender drug/alcohol problems, social relationships, activities of daily living, treatment motivation and medication adherence. RESULTS Analyses revealed a significant positive effect of providers' recovery-promoting competencies on the degree of personal recovery ( t = 8.4, p < .001) and on the degree of change in personal recovery over time ( ts > 4, p < .001). CONCLUSION This study shows that recovery-promoting competencies of mental healthcare providers are positively associated with (a change in) personal recovery of involuntarily admitted patients. Further research is necessary on how to organize recovery-oriented care in inpatient settings and how to enhance providers' competencies in a sustainable way.
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Affiliation(s)
- Ellen Jas
- 1 Institute of Mental Health Care, GGZ Drenthe, Assen, The Netherlands
| | - Martijn Wieling
- 2 Center for Language and Cognition Groningen, University of Groningen, Groningen, The Netherlands
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Baker E, Fee J, Bovingdon L, Campbell T, Hewis E, Lewis D, Mahoney L, Roberts G. From taking to using medication: recovery-focused prescribing and medicines management. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.110.008342] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SummaryMental health services are increasingly supporting recovery-oriented practice as a basis for service delivery. There is considerable overlap between the values and approaches associated with recovery-based practice and those already endorsed as good psychiatric practice. However, these agreed principles may not be consistently applied and further steps may be needed if the reorientation of the relationship between psychiatrists and people using psychiatric services is to fully reflect recovery principles. This article describes ways in which psychiatric practice could develop, including conceptualising medication as one of many possible recovery tools that a person can actively use to support their well-being, and a range of practices available to professionals to support people in taking up an active stance in relation to medication. It also identifies recovery-supportive practices for when someone is unable to fully participate in decision-making, owing to crisis, loss of capacity or concerns about safety.
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Lamanna D, Stergiopoulos V, Durbin J, O'Campo P, Poremski D, Tepper J. Promoting continuity of care for homeless adults with unmet health needs: The role of brief interventions. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:56-64. [PMID: 28569397 DOI: 10.1111/hsc.12461] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2017] [Indexed: 06/07/2023]
Abstract
Promoting timely and continuous care for people experiencing homelessness has been a challenge in many jurisdictions, plagued by access barriers and service fragmentation. As part of a larger programme evaluation, this study used qualitative methods to examine the role of a brief interdisciplinary intervention in supporting continuity of care for this population in a large Canadian urban centre. The intervention provides time-limited case management, primary and psychiatric care, and peer accompaniment to homeless adults with unmet health needs discharged from hospital. Data were collected from 52 study participants between July 2013 and December 2014. Three focus groups were conducted with service providers and people with lived experience of homelessness, and 29 individual, semi-structured interviews were conducted with service users and other key informants. Transcripts were analysed using thematic analysis. Analysis was informed by existing frameworks for continuity of care, while remaining open to additional or unexpected findings. Findings suggest that brief interdisciplinary interventions can promote continuity of care by offering low-barrier access, timely and responsive service provision, including timely connection to long-term services and supports, appropriate individualised services and effective co-ordination of services. Although brief interdisciplinary interventions were perceived to promote access, timeliness and co-ordination of care for this population with complex health and social needs, gaps in the local service delivery context can present persisting barriers to care comprehensiveness and continuity.
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Affiliation(s)
- Denise Lamanna
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Vicky Stergiopoulos
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Janet Durbin
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Performance Measurement and Evaluation Research, Provincial System and Support Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Patricia O'Campo
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Poremski
- Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Institute of Mental Health, Singapore, Singapore
| | - Joshua Tepper
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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Long-Acting Injectable Second-Generation Antipsychotics Improve Negative Symptoms and Suicidal Ideation in Recent Diagnosed Schizophrenia Patients: A 1-Year Follow-up Pilot Study. SCHIZOPHRENIA RESEARCH AND TREATMENT 2018; 2018:4834135. [PMID: 30245878 PMCID: PMC6136552 DOI: 10.1155/2018/4834135] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/31/2018] [Accepted: 08/14/2018] [Indexed: 12/18/2022]
Abstract
Long-acting injectable second-generation antipsychotics (LAI-SGA) are typically used to maintain treatment adherence in patients with chronic schizophrenia. Recent research suggests that they may also provide an effective treatment strategy for patients with early-phase disease. The aim of this study is to evaluate clinical and psychosocial outcomes among recent and long-term diagnosed schizophrenia outpatients treated with LAI-SGA during a follow-up period of 12 months. Stable schizophrenia patients receiving LAI-SGA with 5 or less years of illness duration (n = 10) were compared to those with more than 5 years of illness duration (n = 15). Clinical data was assessed through the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Columbia Suicide Severity Rating Scale (C-SSRS), the Recovery Style Questionnaire (RSQ), and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) Managing Emotion branch. Recently diagnosed patients showed greater improvement versus patients diagnosed for more than 5 years in adjusted mean GAF score, in PANSS factor score for negative and depressive symptoms, and in severity and intensity of suicidal ideation. Our preliminary findings support the hypothesis that LAI-SGA may influence the course of the illness if administered at the early phase of the illness. However, replicate studies are needed, possibly with larger samples.
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Ashman M, Halliday V, Cunnane JG. Qualitative Investigation of the Wellness Recovery Action Plan in a UK NHS Crisis Care Setting. Issues Ment Health Nurs 2017; 38:570-577. [PMID: 28718759 DOI: 10.1080/01612840.2017.1300840] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Crisis theory suggests that in addition to presenting a threat to mental well-being, crises are also opportunities where successful interventions can lead to successful outcomes. UK mental health crisis teams aim to reduce hospital admission by treating people at home and by building resilience and supporting learning from crisis, yet data on repeat crisis episodes suggest this could be improved. This qualitative study sought to explore the Wellness Recovery Action Plan (WRAP) as a means of supporting resilience-building and maximising the opportunity potential of crisis. The following themes emerged: The meaning of crisis; Engaging with the WRAP process; WRAP and self-management; and Changes and transformations. This research suggests that WRAP has potential in supporting recovery from crisis, revealing insights into the nature of crisis which can inform the further development of crisis services.
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Affiliation(s)
- Michael Ashman
- a Woodfield House , Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust , Doncaster , UK
| | - Vanessa Halliday
- b The School of Health and Related Research , The University of Sheffield , Sheffield , UK
| | - Joseph G Cunnane
- c The Opal Centre , Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust , Doncaster , UK
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Happell B, Bennetts W, Tohotoa J, Wynaden D, Platania-Phung C. Promoting recovery-oriented mental health nursing practice through consumer participation in mental health nursing education. J Ment Health 2017; 28:633-639. [DOI: 10.1080/09638237.2017.1294734] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Brenda Happell
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Woden, ACT, Australia,
| | - Wanda Bennetts
- Independent Mental Health Authority, Melbourne, Australia, and
| | - Jenny Tohotoa
- School of Nursing and Midwifery, Curtin University, Perth, Australia
| | - Dianne Wynaden
- School of Nursing and Midwifery, Curtin University, Perth, Australia
| | - Chris Platania-Phung
- SYNERGY: Nursing and Midwifery Research Centre, University of Canberra and ACT Health, Woden, ACT, Australia,
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Hochberger JM, Lingham B. Utilizing Peplau's Interpersonal Approach to Facilitate Medication Self-Management for Psychiatric Patients. Arch Psychiatr Nurs 2017; 31:122-124. [PMID: 28104049 DOI: 10.1016/j.apnu.2016.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 08/11/2016] [Accepted: 08/15/2016] [Indexed: 10/21/2022]
Abstract
This article focuses on the nurse's role in applying Peplau's interpersonal theory of nursing to medication self-management and self-administration through teaching, supporting and partnering with patients.
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Byrne L, Roper C, Happell B, Reid-Searl K. The stigma of identifying as having a lived experience runs before me: challenges for lived experience roles. J Ment Health 2016; 28:260-266. [PMID: 27841058 DOI: 10.1080/09638237.2016.1244715] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Lived experience practitioners can contribute to improved outcomes for people with mental illness, supplementing traditional mental health services and reducing health care costs. However, lived experience practitioners frequently face stigma and discrimination within their work roles. AIM To understand the impact of stigma and discrimination on the effectiveness of lived experience roles from the perspective of lived experience practitioners. METHOD In-depth interviews were conducted with 13 lived experience practitioners within a grounded theory study. RESULTS Issues of stigma and discrimination were identified as a core category of this study. Participants described stigma and discrimination so prevalent as to be considered a "normal" part of their working life. Professional isolation and attitudinal barriers from colleagues were seen to inhibit the effectiveness of lived experience roles. CONCLUSIONS Lived experience practitioners can provide a vital contribution to stigma reduction broadly, however, the stigma and discrimination they face within work roles must be addressed to allow this contribution to be effective.
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Affiliation(s)
- Louise Byrne
- a Lived Experience in Mental Health Lecturer, School of Nursing & Midwifery, Division of Higher Education, Central Queensland University , Rockhampton , Queensland , Australia
| | - Cath Roper
- b Consumer Academic, Centre for Psychiatric Nursing, University of Melbourne , Carlton , Australia
| | - Brenda Happell
- c Faculty of Health , and ACT Health, Professor of Nursing, Executive Director, SYNERGY, Nursing and Midwifery Research Centre, University of Canberra, Canberra Hospital, WODEN , Australia
| | - Kerry Reid-Searl
- d Professor of Nursing, School of Nursing and Midwifery, Division of Higher Education, Central Queensland University , Rockhampton , Queensland , Australia
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Jorge-Monteiro MF, Ornelas JH. "What's Wrong with the Seed?" A Comparative Examination of an Empowering Community-Centered Approach to Recovery in Community Mental Health. Community Ment Health J 2016; 52:821-33. [PMID: 27072950 DOI: 10.1007/s10597-016-0004-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 04/07/2016] [Indexed: 10/22/2022]
Abstract
This cross-sectional group comparison aimed to examine whether personal empowerment, recovery and community integration were associated with the individual's participation in an empowering community-centered model of intervention. Ninety-three participants from an empowering community-centered community mental health organization were compared with a matched group of individuals from standard interventions of four equivalent organizations. Results showed that participants taking advantage of the empowering community-centered approach were more involved in high recovery-oriented programs; and attained higher levels of personal goals and hope, empowerment, and of community integration. An involvement in high recovery-oriented programs (supported employment or independent housing) revealed improved outcomes for the individual. In conclusion, the findings suggested a transformative impact of the empowering community-centered model both at the individual and the program level by altering the resource accessibility and social conditions for people who experience mental illness. The implications of findings for transforming community mental health practice are discussed in detail.
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Affiliation(s)
- Maria F Jorge-Monteiro
- ISPA - Instituto Universitário, Rua Jardim do Tabaco, No. 34, 1149-041, Lisbon, Portugal.
| | - José H Ornelas
- Department of Clinical and Health Psychology, ISPA - Instituto Universitário, Lisbon, Portugal
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50
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Cohen O. How do we Recover? An Analysis of Psychiatric Survivor Oral Histories. JOURNAL OF HUMANISTIC PSYCHOLOGY 2016. [DOI: 10.1177/0022167805277107] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article analyzes interview and survey data collected during the course of the MindFreedom International Oral History Project from June 1 through September 1, 2001. The purpose of the MindFreedom Oral History Project was to gather stories of experiences in the mental health system from the psychiatric survivor or ex-patient perspective. Thirty-six people participated in the study, most of who consider themselves “psychiatric survivors.” Qualitative and quantitative analysis reveals four major themes emerging from these histories: trauma, social control, internalized oppression, and recovery. The focus of this article is on the theme of recovery. Participants demonstrated resiliency and a strong ability to “recover.” No “magic bullet” was found to work for all participants’ recovery process; instead, participants used a variety of self-designed strategies to recapture their once broken lives.
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Affiliation(s)
- Oryx Cohen
- Western Massachusetts Training Consortium
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