Resilience and recovery: Insights from service users experiencing psychosis

According to a recent article published in the British Journal of Social Work, how service users perceive resilience is influenced by personal, social and professional factors. Research led by Harry Bark from the University of Bath also revealed that these views are changeable and can be influenced by life experiences.

Bark writes: In the context of mental health recovery, resilience is understood by individuals who have experienced psychosis as a diverse and multifaceted trait and resource. Personal, social and career factors all inform an individual’s experience of resilience, which is important to see as a dynamic and ever-changing perspective, subject to radical change through life experience.

The present study aimed to investigate the perspectives on resilience of individuals who have experienced psychosis. To accomplish this goal, Bark gathered articles on recovery and resilience and identified common themes. For the current study, studies were considered if they were peer-reviewed, written in English, focused on adult service users, and used qualitative or mixed methods. Additionally, the studies must have been published in 2012 or later. Research that does not meet these criteria, such as being unpublished, using only quantitative methods, published in a language other than English, focusing on experts rather than users service or published before 2012, will be excluded from the study.

The final review included 12 articles with a total of 179 participants. The age range of the participants was 18-75 years old. Most studies (9) used purposive sampling to select participants based on specific characteristics, while two studies used convenience sampling and 1 study used a combination of both methods. France. All studies used one-on-one interviews to collect data, with 10 studies using semi-structured interviews and 2 studies using unstructured interviews.

The current study conducted by Bark identified three themes and eight subthemes related to resilience. The first theme, Personal Factors, includes three subthemes: personal responsibility, use of experience, and coping strategies. Of the 12 articles reviewed, five of them mentioned personal responsibility. Study participants’ understandings of personal responsibility included recognizing distressing and triggering situations, planning for crisis management, and seeking support. They also see personal responsibility as an intense approach that involves living in the present moment and focusing on the present.

The use of heuristics was discussed in seven of the twelve included studies. The use of experience includes reframing past psychotic episodes as opportunities for learning and growth while emphasizing challenges and obstacles as stepping stones to growth. One participant emphasized that without experiencing extreme pain in the past, it is impossible to determine a person’s level of recovery.

In 6 of the 12 included studies, coping strategies were discussed. The subtheme emphasizes the importance of having a plan in place to deal with grief and using positive reframing as a conscious way to identify positive changes that occur after the experience. first psychotic episode. Additionally, the theme includes the idea of ​​reestablishing emotional structures after psychosis through non-activities such as relaxation and meditation.

Bark identified a second theme, social factors, with three subthemes: peer support, social relationships, and contributions. Of the 12 studies analyzed, 7 of them considered peer support to be an essential component of resilience. Peer support helped create a sense of community among participants and made them feel more confident in managing future difficulties. It also helps reduce the stigma and feelings of alienation that many participants experience due to their mental disorders.

For many participants, social relationships such as family had a foundational impact. They pointed out that their responsibilities to their families motivated them on their recovery journey. However, the author notes that families can also act as barriers to recovery if they have poor understanding of mental disorders and the recovery process.

Of the 12 studies, 4 studies talked about contribution. Participants discussed contributing in two ways: helping others recover from psychotic episodes and finding employment. The ability to contribute in these ways enhanced participants’ confidence and self-esteem while helping them become aware of their own needs.

Among the themes identified by Bark, the final theme was professional factors, which included two subthemes: relationships with experts and structured support. Of the 12 studies analyzed, five discussed relationships with experts. Participants emphasized the importance of seeking professional help during crises, especially when other coping mechanisms fail. Emotional support, empathy, and respect are important in building good relationships with professionals. However, the author warns that generic approaches by professionals can harm both the recovery process and resilience, leading service users to abandon specialist help as a means of choice when faced with unpleasant interactions.

Of the 12 articles discussed, structured support was mentioned in 3. Many participants emphasized the importance of structured, professional support from practitioners who are empathetic and compassionate towards with their recovery and resilience. However, one participant viewed mandatory structured support as a source of suffering rather than resilience.

The author acknowledges two limitations of the current study. First, the quality of the included articles was not assessed, potentially leading to the inclusion of studies that lacked validity. Second, the included articles had varying ways of recording demographic information, which prevented the current study from fully exploring how demographic factors, such as race, influence perspective on resilience. Additionally, it is worth noting that the recent study only included articles published in English, which significantly limits its generalizability to non-English speakers.

Studies have shown that practicing resilience can positively impact mental health and overall well-being. Likewise, becoming a peer support worker is thought to enhance personal understanding and resilience, ultimately leading to better recovery outcomes for service users. However, some research suggests that the concept of resilience may not be applicable to all cultures because it can be viewed and interpreted differently. A study has highlighted that Western perspectives on resilience may not be relevant to non-Western audiences.

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Bark, H. (2023). Resilience as part of the recovery process: The perspectives of people with experience of mental disorders and studying for British mental health social work practice. Evaluate scope. British Journal of Social Work. (Link)