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Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

Experiences of support in working toward personal recovery goals: a collaborative, qualitative study

Authors: Eva Biringer, Larry Davidson, Bengt Sundfør, Torleif Ruud, Marit Borg

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Recovery can be understood as a subjective process guided by personal expectations, goals and hopes. The aim of the study was to explore how persons using a Community Mental Health Centre (CMHC) experienced that their expectations for treatment, and goals and hopes for recovery were supported by the health professionals during treatment.

Methods

Employing a hermeneutic–phenomenological approach, eight service users were interviewed about their expectations for treatment and their goals and hopes for recovery at the start of their contact with health professionals at a CMHC. Two years later, they were re-interviewed about their experiences of treatment and support from the health professionals in their work towards these goals and hopes. A collaborative approach was adopted. A co-researcher with lived experience took part in all stages of the study. Data were analysed by means of a data-driven stepwise approach in line with thematic analysis.

Results

Five themes reflecting how participants experienced support from health professionals at the CMHC in their work towards their recovery goals were elicited, as follows: developing an understanding of oneself and one’s mental health problems; learning how to change feelings and behaviours; being ‘pushed’ into social arenas; finding helpful medication; and counselling in family, practical and financial issues. The participants’ expectations about counselling with regard to longer-term family, practical, and financial challenges were insufficiently met by the CMHC. In the experience of the service users, recovery occurred within the context of their everyday life with or without the support of their professional helpers.

Conclusions

To facilitate recovery, health professionals should acknowledge the service user’s personal goals and hopes and take a more comprehensive and longer-term approach to his or her needs and desires. Acknowledging and facilitating recovery goals by offering counselling with regard to family, practical and financial issues seems particularly important.
Appendix
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Literature
1.
go back to reference Davidson L, Roe D. Recovery from versus recovery in serious mental illness: One strategy for lessening confusion plaguing recovery. J Mental Health. 2007;16(4):459–470.CrossRef Davidson L, Roe D. Recovery from versus recovery in serious mental illness: One strategy for lessening confusion plaguing recovery. J Mental Health. 2007;16(4):459–470.CrossRef
2.
go back to reference Anthony WA. A recovery-oriented service system: Setting some system level standards. Psychiatr Rehabil J. 2000;24(2):159–168.CrossRef Anthony WA. A recovery-oriented service system: Setting some system level standards. Psychiatr Rehabil J. 2000;24(2):159–168.CrossRef
3.
go back to reference Davidson L, O’Connell M, Tondora J, Lawless M, Evans A. Recovery in Serious Mental Illness: A New Wine or Just a New Bottle? Professional Psychol: Res and Practice. 2005;36(5):480–487.CrossRef Davidson L, O’Connell M, Tondora J, Lawless M, Evans A. Recovery in Serious Mental Illness: A New Wine or Just a New Bottle? Professional Psychol: Res and Practice. 2005;36(5):480–487.CrossRef
4.
go back to reference Slade M, Leamy M, Bacon F, Janosik M, Le Boutillier C, Williams JJ, Bird V. International differences in understanding recovery: systematic review. Epidemiol Psychiatr Services. 2012;21(4):353–364.CrossRef Slade M, Leamy M, Bacon F, Janosik M, Le Boutillier C, Williams JJ, Bird V. International differences in understanding recovery: systematic review. Epidemiol Psychiatr Services. 2012;21(4):353–364.CrossRef
5.
go back to reference Chambers E, Cook S, Thake A, Foster A, Shaw S, Hutten R, Parry G, Ricketts T. The self-management of longer-term depression: learning from the patient, a qualitative study. BMC Psychiatry. 2015;15:172.CrossRefPubMedPubMedCentral Chambers E, Cook S, Thake A, Foster A, Shaw S, Hutten R, Parry G, Ricketts T. The self-management of longer-term depression: learning from the patient, a qualitative study. BMC Psychiatry. 2015;15:172.CrossRefPubMedPubMedCentral
6.
go back to reference Slade M. 100 ways to support recovery. In: Rethink recovery series. vol. 1. London: Rethink; 2009 Slade M. 100 ways to support recovery. In: Rethink recovery series. vol. 1. London: Rethink; 2009
7.
go back to reference Slade M, Bird V, Le Boutillier C, Williams J, McCrone P, Leamy M. REFOCUS Trial: protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams. BMC Psychiatry. 2011;11(1):185.CrossRefPubMedPubMedCentral Slade M, Bird V, Le Boutillier C, Williams J, McCrone P, Leamy M. REFOCUS Trial: protocol for a cluster randomised controlled trial of a pro-recovery intervention within community based mental health teams. BMC Psychiatry. 2011;11(1):185.CrossRefPubMedPubMedCentral
8.
go back to reference Slade M. Everyday Solutions for Everyday Problems: How Mental Health Systems Can Support Recovery. Psychiatr Services. 2012;63(7):702–704.CrossRef Slade M. Everyday Solutions for Everyday Problems: How Mental Health Systems Can Support Recovery. Psychiatr Services. 2012;63(7):702–704.CrossRef
9.
go back to reference Farkas M, Gagne C, Anthony W, Chamberlin J. Implementing recovery oriented evidence based programs: identifying the critical dimensions. Community Ment Health J. 2005;41(2):141–158.CrossRefPubMed Farkas M, Gagne C, Anthony W, Chamberlin J. Implementing recovery oriented evidence based programs: identifying the critical dimensions. Community Ment Health J. 2005;41(2):141–158.CrossRefPubMed
10.
go back to reference Le Boutillier C, Leamy M, Bird VJ, Davidson L, Williams J, Slade M. What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatric Services (Washington, DC). 2011;62(12):1470–1476.CrossRef Le Boutillier C, Leamy M, Bird VJ, Davidson L, Williams J, Slade M. What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatric Services (Washington, DC). 2011;62(12):1470–1476.CrossRef
11.
go back to reference Lakeman R. Mental health recovery competencies for mental health workers: a Delphi study. Journal of Mental Health (Abingdon, England). 2010;19(1):62–74.CrossRef Lakeman R. Mental health recovery competencies for mental health workers: a Delphi study. Journal of Mental Health (Abingdon, England). 2010;19(1):62–74.CrossRef
12.
go back to reference Morgan DG. ‘Please see and advise’: a qualitative study of patients’ experiences of psychiatric outpatient care. Soc Psychiatry Psychiatr Epidemiol. 1999;34(8):442–450.CrossRefPubMed Morgan DG. ‘Please see and advise’: a qualitative study of patients’ experiences of psychiatric outpatient care. Soc Psychiatry Psychiatr Epidemiol. 1999;34(8):442–450.CrossRefPubMed
13.
go back to reference Stotland NL, Mattson MG, Bergeson S. The recovery concept: clinician and consumer perspectives. J Psychiatr Pract. 2008;14 Suppl 2:45–54.CrossRefPubMed Stotland NL, Mattson MG, Bergeson S. The recovery concept: clinician and consumer perspectives. J Psychiatr Pract. 2008;14 Suppl 2:45–54.CrossRefPubMed
14.
go back to reference Andresen R, Caputi P, Oades L. Do clinical outcome measures assess consumer-defined recovery? Psychiatry Res. 2010;177:309–317.CrossRefPubMed Andresen R, Caputi P, Oades L. Do clinical outcome measures assess consumer-defined recovery? Psychiatry Res. 2010;177:309–317.CrossRefPubMed
15.
go back to reference Bridges JF, Slawik L, Schmeding A, Reimer J, Naber D, Kuhnigk O. A test of concordance between patient and psychiatrist valuations of multiple treatment goals for schizophrenia. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy. 2013;16(2):164–176.CrossRef Bridges JF, Slawik L, Schmeding A, Reimer J, Naber D, Kuhnigk O. A test of concordance between patient and psychiatrist valuations of multiple treatment goals for schizophrenia. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy. 2013;16(2):164–176.CrossRef
16.
go back to reference Rosenheck R, Stroup S, Keefe RSE, McEvoy J, Swartz M, Perkins D, Hsiao J, Shumway M, Lieberman J. Measuring outcome priorities and preferences in people with schizophrenia. Br J Psychiatry. 2005;187(6):529–536.CrossRefPubMed Rosenheck R, Stroup S, Keefe RSE, McEvoy J, Swartz M, Perkins D, Hsiao J, Shumway M, Lieberman J. Measuring outcome priorities and preferences in people with schizophrenia. Br J Psychiatry. 2005;187(6):529–536.CrossRefPubMed
17.
go back to reference Davidson L, Andres-Hyman R, Bedregal L, Tondora J, Fry J, Kirk T. From “Double Trouble” to “Dual Recovery”: Integrating Models of Recovery in Addiction and Mental Health. J Dual Diagn. 2008;4(3):273–290.CrossRef Davidson L, Andres-Hyman R, Bedregal L, Tondora J, Fry J, Kirk T. From “Double Trouble” to “Dual Recovery”: Integrating Models of Recovery in Addiction and Mental Health. J Dual Diagn. 2008;4(3):273–290.CrossRef
18.
go back to reference Slade M. Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Serv Res. 2010;10(26):1–14. Slade M. Mental illness and well-being: the central importance of positive psychology and recovery approaches. BMC Health Serv Res. 2010;10(26):1–14.
19.
go back to reference Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445–452.CrossRefPubMed Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199(6):445–452.CrossRefPubMed
21.
go back to reference Ministry of Health and Care Services. National Action Plan for Mental Health 1999-2006. Oslo: Ministry of Health and Care Services; 1998. Ministry of Health and Care Services. National Action Plan for Mental Health 1999-2006. Oslo: Ministry of Health and Care Services; 1998.
22.
go back to reference Biringer E, Davidson L, Sundfor B, Ruud T, Borg M. Service users’ expectations of treatment and support at the Community Mental Health Centre in their recovery. Scand J Caring Sci. 2016. doi:10.1111/scs.12364. Biringer E, Davidson L, Sundfor B, Ruud T, Borg M. Service users’ expectations of treatment and support at the Community Mental Health Centre in their recovery. Scand J Caring Sci. 2016. doi:10.​1111/​scs.​12364.
24.
go back to reference Laverty S. Hermeneutic phenomenology and phenomenology: a comparison of historical and methodological considerations. Int J Qual Methods. 2003;2(3):21–35.CrossRef Laverty S. Hermeneutic phenomenology and phenomenology: a comparison of historical and methodological considerations. Int J Qual Methods. 2003;2(3):21–35.CrossRef
25.
go back to reference Finlay L. Unfolding the Phenomenological Research Process: Iterative Stages of “Seeing Afresh”. J Humanistic Psychol. 2013;53:172–201.CrossRef Finlay L. Unfolding the Phenomenological Research Process: Iterative Stages of “Seeing Afresh”. J Humanistic Psychol. 2013;53:172–201.CrossRef
26.
go back to reference Giorgi A. The Descriptive Phenomenological Method in Psychology. Pittsburgh: Duquesne University Press; 2009. Giorgi A. The Descriptive Phenomenological Method in Psychology. Pittsburgh: Duquesne University Press; 2009.
27.
go back to reference Smith B, Smith D, editors. The Cambridge Companion to Husserl. 4th ed. Cambridge: Cambridge University Press; 1995. Smith B, Smith D, editors. The Cambridge Companion to Husserl. 4th ed. Cambridge: Cambridge University Press; 1995.
28.
go back to reference Thomas P, Burch T, Ferlie E, Jenkins R, Wright F, Sachar A, Ruprah-Shah B. Community-oriented integrated care and health promotion - views from the street. London Journal of Primary Care. 2015;7(5):83–88.CrossRefPubMedPubMedCentral Thomas P, Burch T, Ferlie E, Jenkins R, Wright F, Sachar A, Ruprah-Shah B. Community-oriented integrated care and health promotion - views from the street. London Journal of Primary Care. 2015;7(5):83–88.CrossRefPubMedPubMedCentral
29.
go back to reference Thomson R, Holland J. Hindsight, foresight and insight: the challenges of longitudinal qualitative research. Int J Soc Res Methodol. 2003;6(3):233–244.CrossRef Thomson R, Holland J. Hindsight, foresight and insight: the challenges of longitudinal qualitative research. Int J Soc Res Methodol. 2003;6(3):233–244.CrossRef
30.
go back to reference Vallance R. Working with longitudinal qualitative data: using NVivo as an analytic tool. Paper preented at the 6th International strategies in Qualitative Research Conference, Durham, 21-23 September 2005. In.; 2005. Vallance R. Working with longitudinal qualitative data: using NVivo as an analytic tool. Paper preented at the 6th International strategies in Qualitative Research Conference, Durham, 21-23 September 2005. In.; 2005.
31.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
32.
go back to reference Bollini P, Tibaldi G, Testa C, Munizza C. Understanding treatment adherence in affective disorders: a qualitative study. J Psychiatr Ment Health Nurs. 2004;11(6):668–674.CrossRefPubMed Bollini P, Tibaldi G, Testa C, Munizza C. Understanding treatment adherence in affective disorders: a qualitative study. J Psychiatr Ment Health Nurs. 2004;11(6):668–674.CrossRefPubMed
33.
go back to reference Kogstad RE, Ekeland TJ, Hummelvoll JK. In defence of a humanistic approach to mental health care: Recovery processes investigated with the help of clients’ narratives on turning points and processes of gradual change. J Psychiatr Ment Health Nurs. 2011;18(6):479–486.CrossRefPubMed Kogstad RE, Ekeland TJ, Hummelvoll JK. In defence of a humanistic approach to mental health care: Recovery processes investigated with the help of clients’ narratives on turning points and processes of gradual change. J Psychiatr Ment Health Nurs. 2011;18(6):479–486.CrossRefPubMed
34.
go back to reference Gillard S, Turner K, Neffgen M. Understanding recovery in the context of lived experience of personality disorders: a collaborative, qualitative research study. BMC Psychiatry. 2015;15:183.CrossRefPubMedPubMedCentral Gillard S, Turner K, Neffgen M. Understanding recovery in the context of lived experience of personality disorders: a collaborative, qualitative research study. BMC Psychiatry. 2015;15:183.CrossRefPubMedPubMedCentral
35.
go back to reference Prins MA, Verhaak PF, Bensing JM, van der Meer K. Health beliefs and perceived need for mental health care of anxiety and depression--the patients’ perspective explored. Clin Psychol Rev. 2008;28(6):1038–1058.CrossRefPubMed Prins MA, Verhaak PF, Bensing JM, van der Meer K. Health beliefs and perceived need for mental health care of anxiety and depression--the patients’ perspective explored. Clin Psychol Rev. 2008;28(6):1038–1058.CrossRefPubMed
36.
go back to reference Veseth M, Binder P-E, Borg M, Davidson L. Toward Caring for Oneself in a Life of Intense Ups and Downs A Reflexive-Collaborative Exploration of Recovery in Bipolar Disorder. Qual Health Res. 2012;22(1):119–133.CrossRefPubMed Veseth M, Binder P-E, Borg M, Davidson L. Toward Caring for Oneself in a Life of Intense Ups and Downs A Reflexive-Collaborative Exploration of Recovery in Bipolar Disorder. Qual Health Res. 2012;22(1):119–133.CrossRefPubMed
37.
go back to reference Gudde CB, Olso TM, Antonsen DO, Ro M, Eriksen L, Vatne S. Experiences and preferences of users with major mental disorders regarding helpful care in situations of mental crisis. Scand J Public Health. 2013;41(2):185–190.CrossRefPubMed Gudde CB, Olso TM, Antonsen DO, Ro M, Eriksen L, Vatne S. Experiences and preferences of users with major mental disorders regarding helpful care in situations of mental crisis. Scand J Public Health. 2013;41(2):185–190.CrossRefPubMed
38.
go back to reference Billsborough J, Mailey P, Hicks A, Sayers R, Smith R, Clewett N, Griffiths CA, Larsen J. ‘Listen, empower us and take action now!’: reflexive-collaborative exploration of support needs in bipolar disorder when ‘going up’ and ‘going down’. J Mental Health. 2014;23(1):9–14.CrossRef Billsborough J, Mailey P, Hicks A, Sayers R, Smith R, Clewett N, Griffiths CA, Larsen J. ‘Listen, empower us and take action now!’: reflexive-collaborative exploration of support needs in bipolar disorder when ‘going up’ and ‘going down’. J Mental Health. 2014;23(1):9–14.CrossRef
39.
go back to reference Vagholkar S, Hare L, Hasan I, Zwar N, Perkins D. Better access to psychology services in primary mental health care: an evaluation. Austr Health Review. 2006;30(2):195–202.CrossRef Vagholkar S, Hare L, Hasan I, Zwar N, Perkins D. Better access to psychology services in primary mental health care: an evaluation. Austr Health Review. 2006;30(2):195–202.CrossRef
40.
go back to reference Constantino M, Ametrano R, Greenberg R. Clinician Interventions and Participant Characteristics That Foster Adaptive Patient Expectations for Psychotherapy and Psychotherapeutic Change. Psychotherapy. 2012;49(4):557–569.CrossRefPubMed Constantino M, Ametrano R, Greenberg R. Clinician Interventions and Participant Characteristics That Foster Adaptive Patient Expectations for Psychotherapy and Psychotherapeutic Change. Psychotherapy. 2012;49(4):557–569.CrossRefPubMed
41.
go back to reference Hobbs M, Baker M. Hope for recovery - how clinicians may facilitate this in their work. Journal of Mental Health (Abingdon, England). 2012;21(2):144–153.CrossRef Hobbs M, Baker M. Hope for recovery - how clinicians may facilitate this in their work. Journal of Mental Health (Abingdon, England). 2012;21(2):144–153.CrossRef
42.
go back to reference Russinova Z. Providers’ Hope-Inspiring Competence as a Factor Optimizing Psychiatric Rehabilitation Outcomes. J Rehabil. 1999;16(4):50–57. Russinova Z. Providers’ Hope-Inspiring Competence as a Factor Optimizing Psychiatric Rehabilitation Outcomes. J Rehabil. 1999;16(4):50–57.
43.
go back to reference Nair S. Life goals: the concept and its relevance to rehabilitation. Clin Rehab. 2003;17:192–202.CrossRef Nair S. Life goals: the concept and its relevance to rehabilitation. Clin Rehab. 2003;17:192–202.CrossRef
44.
go back to reference Wong T, Fry P, editors. The Human Quest for Meaning A Handbook of Psychological Research and Clinical Applications. 1998th ed. Mahwaw New Jersey London: Lawrence Erlbaum Associaties, Publishers; 1998. Wong T, Fry P, editors. The Human Quest for Meaning A Handbook of Psychological Research and Clinical Applications. 1998th ed. Mahwaw New Jersey London: Lawrence Erlbaum Associaties, Publishers; 1998.
45.
go back to reference Sælør K, Ness O, Semb R. Taking the plunge: Service users’ experiences of hope within the mental health and substance use services. Scand Psychol. 2015;2(e9):1–19. Sælør K, Ness O, Semb R. Taking the plunge: Service users’ experiences of hope within the mental health and substance use services. Scand Psychol. 2015;2(e9):1–19.
46.
go back to reference Marriage K, Petrie J, Worling D. Consumer Satisfaction With an Adolescent Inpatient Psychiatric Unit. Canadian Journal of Psychiatry Revue Canadienne de psychiatrie. 2001;46:969–975.PubMed Marriage K, Petrie J, Worling D. Consumer Satisfaction With an Adolescent Inpatient Psychiatric Unit. Canadian Journal of Psychiatry Revue Canadienne de psychiatrie. 2001;46:969–975.PubMed
47.
go back to reference Borg M, Kristiansen K. Recovery-oriented professionals: Helping relationships in mental health services. J Mental Health. 2004;13(5):493–505.CrossRef Borg M, Kristiansen K. Recovery-oriented professionals: Helping relationships in mental health services. J Mental Health. 2004;13(5):493–505.CrossRef
48.
go back to reference Borg M, Davidson L. The nature of recovery as lived in everyday experience. J Mental Health. 2008;17(2):122–140.CrossRef Borg M, Davidson L. The nature of recovery as lived in everyday experience. J Mental Health. 2008;17(2):122–140.CrossRef
49.
go back to reference Biringer E, Davidson L, Sundfør B, Lier H, Borg M. Coping with mental health issues: Subjective experiences of self-help and helpful contextual factors at the start of mental health treatment. J Mental Health (Abingdon, England). 2015;25(1):23–7. Biringer E, Davidson L, Sundfør B, Lier H, Borg M. Coping with mental health issues: Subjective experiences of self-help and helpful contextual factors at the start of mental health treatment. J Mental Health (Abingdon, England). 2015;25(1):23–7.
50.
go back to reference Sosial- og helsedepartementet. Om opptrappingsplan for psykisk helse 1999 - 2006 In: Helsedepartementet S-o, Editor. Oslo: Sosial- og Helsedepartementet; 1998. Sosial- og helsedepartementet. Om opptrappingsplan for psykisk helse 1999 - 2006 In: Helsedepartementet S-o, Editor. Oslo: Sosial- og Helsedepartementet; 1998.
51.
go back to reference Davidson L. Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia. New York: New York University Press; 2003. Davidson L. Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia. New York: New York University Press; 2003.
52.
go back to reference Davidson L, Borg M, Martin I, Topor A, Mezzina R, Sells D. Processes of recovery in serious mental illness: Findings from a multi-national study. Am J Psychiatr Rehabil. 2005;8:177–201.CrossRef Davidson L, Borg M, Martin I, Topor A, Mezzina R, Sells D. Processes of recovery in serious mental illness: Findings from a multi-national study. Am J Psychiatr Rehabil. 2005;8:177–201.CrossRef
53.
go back to reference Borg M. Bedringsprosesser slik de leves i hverdagslivet: Brukererfaringer ved alvorlige psykiske lidelser. Tidsskr Nor Psykologforening. 2009;26(5):452–459. Borg M. Bedringsprosesser slik de leves i hverdagslivet: Brukererfaringer ved alvorlige psykiske lidelser. Tidsskr Nor Psykologforening. 2009;26(5):452–459.
54.
go back to reference Finlay L. “Outing” the Researcher: The Provenance, Process, and Practise of Reflexivity. Qual Health Res. 2002;12:531–544.CrossRefPubMed Finlay L. “Outing” the Researcher: The Provenance, Process, and Practise of Reflexivity. Qual Health Res. 2002;12:531–544.CrossRefPubMed
Metadata
Title
Experiences of support in working toward personal recovery goals: a collaborative, qualitative study
Authors
Eva Biringer
Larry Davidson
Bengt Sundfør
Torleif Ruud
Marit Borg
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-1133-x

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