Saturday, 15 January 2005 - 2:00 PM
This presentation is part of: Recovery from Severe Mental Illness
The Process of Recovery from Severe and Persistent Mental IllnessWilliam Bradshaw, PhD, University of Minnesota, Marilyn Armour, PHD, University of Texas-Austin, and David Roseborough, MSW, University of Minnesota.
Purpose: The purpose of this longitudinal hermeneutic phenomenological study was to examine the lived experience of persons recovering from serious and persistent mental illness (SPMI). It describes the process of recovery based on data collected at 9, 18 and 30 months from persons who participated in psychosocial case management services. Method: Forty-four adults with SPMI referred to county case management services were recruited for the study. Audio-taped semi-structured interviews were conducted for 1hour at three different times to elicit client narratives about their experience in recovery. The interviews were transcribed, read and coded to cluster thematic aspects in each case and across cases. Atlas-ti was used to recode transcripts and retrieve quotes to dimensionalize each essential theme. Transcripts were reread for confirming and disconfirming evidence for each theme. Results: An empirically derived description of the recovery process found three distinct phases: 1) demoralization, 2) developing mastery and independence, and 3) social reintegration. Critical issues and tasks in each phase for consumers and case managers were identified that facilitated recovery. Three essential processes emerged from the consumers' experience: 1) a personal process of goal achievement, 2) person and environment transactional processes, and 3) interpersonal processes in the case manager consumer relationship. The nine content areas in recovery work included the following: clinical care, peer support and relationships, family support, work/meaningful activity, power and control, stigma, access to resources, education. Implications for Practice: These findings provide a developmental model of the recovery process from the consumers' perspective that can inform practice in several ways. The model can help consumers and case managers understand and deal with predictable personal, social and relational issues that emerge in the process of recovery. The model highlights the importance of the case manager consumer relationship in recovery, the need for clients to be active collaborators in determining areas of therapeutic attention, and the necessity for case managers to attend to the unique and changing relationship needs of the consumer in each phase of recovery. The identification of phase-specific obstacles offer new insights into problems of motivation and non-adherence in treatment. Findings suggest important areas for consumer and family education, staff training and advocacy services.
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