A Qualitative Study of the Subjective Appraisal of Recovery Among People with Lived Experience of Schizophrenia in Poland

Abstract

The objective of this study was to explore definitions of recovery among Polish service users with lived experience of schizophrenia and to hear their recommendations regarding elements that should be considered in the planning of a recovery oriented psychosocial intervention. Four semi-structured focus groups were conducted in the Institute of Psychiatry and Neurology in Warsaw, Poland. A total of 28 service users' narratives were examined using the inductive thematic analysis approach. Five main recovery themes emerged from the combined users accounts, listed in order of frequency: psychological dimension of recovery, relationships with others, wellness strategies, clinical understanding of recovery and support systems. Service user recommendations referred to the above identified recovery themes as well as indications that the intervention should be flexible, individualized, and facilitative of personal growth. The findings indicate that for service users with lived experience of schizophrenia in Poland it is culturally feasible to embrace the person-oriented approach to practice and develop a recovery-oriented psychosocial intervention emphasizing psychological domains of recovery such as positive identity, personal strengths, or meaning and purpose in life alongside the other relevant recovery dimensions. Actions regarding the system level of change are also required.

Factors Predicting Response to the Recovery-Oriented Cognitive Behavioural Workshop for Persons Diagnosed with Schizophrenia

“…The workshop was developed based on results from the systematic literature review (Nowak et al 2016) indicating that there is a need to develop more recovery-oriented interventions and a focus group study (Nowak et al 2017) that guided the development of workshop modules. As psychological recovery was the most widely supported theme, the first three modules focused on personal definitions of recovery, strengthening positive sense of self, and value-based goal setting, whereas the content of further modules referred to more objective recovery domains, such as self-management of mental and physical health as well as enhancing relationships with others.…”

‘Being normal’ and self-identity: the experience of volunteering in individuals with severe mental disorders—a qualitative study

“…Previous studies6 42 43 recommend community interventions targeted at maintaining a positive identity,6 which is related to decreasing the negative effects associated with self-stigma, such as low self-esteem, a lack of hope, lower compliance to treatment and a decrease in the quality of life 42. Within the recommended interventions,6 42 43 the development of meaningful occupations provides new opportunities for constructing alternative identities to that of the illness 16 40 44. Identities that are linked to work contexts have shown to facilitate the acquirement of a new self-concept that is different to the disorder, integrating the same into their personal and social identity 45…”

Development and Evaluation of a Recovery-Oriented Cognitive Behavioural Workshop for People Diagnosed with Schizophrenia

“…Results of the systematic review by Nowak et al (2016) indicated a need to develop more recovery-oriented CBT interventions, which can foster personal recovery and address the disabilities of people diagnosed with schizophrenia. To make the workshop meaningful for Polish service users, themes derived from the focus group study carried out by Nowak et al (2017) guided the development of the workshop's content. Seven modules were formulated and manualized, applying a wide variety of traditional and ‘third wave’ CBT techniques.…”

“…Cognitive behavioural therapy (CBT) is a treatment of choice for psychosis, but few recovery-focused, cognitive behavioural interventions are available for schizophrenia as shown in a study by Nowak et al (2017). An evaluation of whether a CBT intervention targeting personal recovery can also support people diagnosed with schizophrenia in overcoming disabilities experienced in daily life is required as this could provide a more comprehensive strategy for the recovery of people with schizophrenia.…”

“…In response to those needs, a recovery-oriented workshop combining the existing evidence-based approaches, such as CBT, with the desired aspects of recovery identified by Polish service users diagnosed with schizophrenia was developed. However, the implications of the workshop's implementation in clinical practice are universal as the intervention targeted a wide range of recovery domains, referring not only to the subjective or existential aspects but also to the clinical, physical, or social domains as described in the Nowak et al (2017) study.…”