Experiencing the process of clinical recovery from first-episode psychosis: What worked?

 
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Presentation First Author: 
Jone Bjornestad
Abstract: 

In order to provide systematic and tailored recovery-oriented services in first-episode psychosis (FEP), service users, their families and support system need valid and applicable evidence-based knowledge of mechanisms facilitating recovery. Today, such knowledge is primarily based on qualitative studies, non-systematic reviews and position papers employing convenience samples and different definitions of personal recovery. While the course and prognosis of FEP have improved following the introduction of antipsychotic medication and structured psychosocial treatment, there is lack of research on how clinically recovered service-users experience processes of recovery and factors facilitating and explaining such processes. This is the first explorative study to systematic investigate such factors in a sample of clinical recovered service-users.

Objective: Explore and understand factors perceived by service users to facilitate recovery in FEP both from subjective and contextual perspectives. In doing so, we aim to systematically identify and describe specific, personally relevant experiences as well as environmental and treatment-related factors, which are perceived as explaining and facilitating recovery.

Methods: To interpret and report experiences, meanings and reality of the participants this study followed a participatory thematic analysis approach, utilized within an interpretative-phenomenological theoretical and epistemological framework. To facilitate user involvement the objectives and procedures were developed and carried out within the framework of user-involved research. Based on criterion sampling – clinical recovery – 20 participants (mostly young adults) were recruited from the ongoing Early Intervention in Psychosis TIPS-1 and TIPS-2 studies. The interviews were analyzed using a meaning condensation procedure resulting in a main theme: (1) Willpower and personal agency and 5 related themes: (2) Well-intentioned and persistent pressure from family and friends, (3) Sustainable and meaningful everyday projects, (4) Work and school – life mastery and feeling of dignity, (5) Tailored treatment – continuity, hope and sensitive pressure, (6) Anti-psychotic medication – some benefits many costs.

Practice/Policy Implications: This type of knowledge generation and systematization is significant to develop a valid, service-user informed knowledge base and to inform future mixed-method and quantitative investigations. It may also increase the coherence between service users, families and their support system, as well as improve recovery-oriented treatment.

Conclusion: Findings support that “good outcome” in FEP is facilitated when individuals present a resilient sense of perceived self-efficacy beliefs. Focus within environmental and therapeutic interventions should be on supporting and facilitating such beliefs when present and on building them when missing. In order to provide systematic and tailored recovery-oriented services in first-episode psychosis (FEP), service users, their families and support system need valid and applicable evidence-based knowledge of mechanisms facilitating recovery. Today, such knowledge is primarily based on qualitative studies, non-systematic reviews and position papers employing convenience samples and different definitions of personal recovery. While the course and prognosis of FEP have improved following the introduction of antipsychotic medication and structured psychosocial treatment, there is lack of research on how clinically recovered service-users experience processes of recovery and factors facilitating and explaining such processes. This is the first explorative study to systematic investigate such factors in a sample of clinical recovered service-users.

Conference Name: 
Date of Presentation: 
9th Oct 2015
Type of presentation: 
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