Sunday, 16 January 2005 - 8:00 AM

This presentation is part of: Beyond Mental Health Treatment: Research on Psychosocial Rehabilitation Services

Problem-Solving, Recovery, and Mental Health Caregiving: A Qualitative Study

2. Problem-solving, Recovery, and Mental Health Caregiving: A Qualitative Study

Purpose: Funded by the Ohio Department of Mental Health (ODMH), and using convenient sampling techniques, two mental health consumer groups were investigated to study the types of caregiving relationships that correlate with ODMH principles of recovery.

Methods: In the first group, three consumers (e.g., one major depression and two schizophrenia) were studied for 24 months while they engaged in problem-solving with informal and formal caregivers. In the second group, three case managers and three of their consumers (e.g., two schizophrenia and one schizo-affective disorder) were studied for 24 months while they engaged in problem-solving activities. Participant-observation methods were used to collect data; a total of 628 problem-solving events were observed and coded (e.g., 401 events among the consumer caregivers (or first research group) and 227 events among the case manager/ consumer dyad—or second research group). Data analysis utilized coding strategies from the literature on problem-solving and the qualitative literature on the subjective experience of recovery from schizophrenia.

Results: The case study examples and aggregate results show that formal and informal mental health problem-solving activity (i.e., the external world of resource acquisition and help with daily living activities) can be correlated with practical and intuitive caregiving concepts—doing-for, doing-with, doing-for-oneself, and standing-by-to-admire—and that the consumer’s internal experience of recovery (i.e., the emotional process of recovery) can also be correlated with practical and intuitive concepts—overwhelmed, struggling-with-disability, living-with-disability, and living-beyond-disability. The findings are used to argue that principles of mental health recovery (e.g., hope and self-mastery) and services (e.g., clinical, work\meaningful activity, peer, and family) do in fact relate to what caregivers actually do. Findings are limited by the qualitative research design, thus generalization, validity and reliability will need further development.

Implications: Finally, using intersubjective and social psychology theories, it is argued that self-mastery and hope—basic recovery principles—are products of relationships that use practical concepts to guide the process of recovery; the implications for the training and the practice of recovery case management are discussed.

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