Discovering the Turning Points of Recovery: A Qualitative Study on Recovery Processes of Clients with Severe DSM Diagnoses Who Were Able to Recover without Ongoing Reliance of Medications

Background: Mental health conditions could be experienced as “traumatic” by an individual because of their pervasive and prolonged impacts. While advances in psychotropic medications have significantly contributed to mental health treatment, there is a growing literature that focuses on resilience without reliance on medication in a person’s recovery process. Some clients encountered critical moments, epiphanies, or spiritual experiences that triggered positive changes in their recovery trajectories. However, few studies have explored these “turning points” in a person’s recovery process.

Methods: This was a qualitative study that adopted an emergent design based on the constant comparison method suggested by a grounded theory approach. The aim of this study was to explore the lived experience of “turning points” in participants’ recovery process when they were not relying on psychotropic medications. Twenty participants were recruited for in-depth interviews based on theoretical sampling. Inclusion criteria were people: (1) who have been formally diagnosed with a DSM diagnosis of schizophrenia, bipolar, or major depression, (2) who have not used psychotropic medications for at least the past year of their recovery process; (3) people who meet the operationalized definition of recovery, and also have scores above the clinical cut-off of SCL-10. Three research team members were involved in the data analysis process. Line by line open coding of the data began after the first several transcripts followed by focused codes based on research team discussion. Redundant codes were consolidated based on developing theoretical perspectives. All codes were then reviewed by the full team until consensus was reached prior to the final coding process.

Results: Many participants identified the “turning points’ of their recovery as regaining a sense of self-control as a result of certain specific events. These events could be as simple as reading literary works, watching movies, or specific interpersonal encounters. However, common to these specific events were a resultant process of reflections that led to a discontinuous change in perspectives pertaining to mental health symptoms and solutions. These perspective changes related to the normalization of the mental health problem, the feeling of being connected to others, the belief of faith, and the decision to let go of the problem. In addition, participants identified social interactions with close others (e.g. partners, families) and peers (e.g. other patients), as significant factors leading to these turning moments. Participants not only just “survived” their mental health problems but thrived and experienced growth after these turning points that included reconsidering one’s potential, finding new meanings of life and so on.

Implications: Findings of this qualitative inquiry highlighted potential turning points in the recovery process of people who had a major DSM diagnosis. Understanding these “turning points’ should have significant implications for developing non-pharmaceutical, behavioral interventions to facilitate recovery process. Suggestions such as involving in social interactions, engaging in literary activities, accepting self and others, and being open can function as treatment components for strengths-based, behavioral interventions and programs. Study findings also contributed to the knowledge regarding mechanisms of change for people who were able to recover without ongoing reliance on psychotropic medications.