Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention

Abstract

BackgroundFor people with persisting psychotic disorders, personal recovery has become an important target of mental health services worldwide. Strongly influenced by mental health service consumer perspectives, personal recovery refers to being able to live a satisfying and contributing life irrespective of ongoing symptoms and disability. Contact with peers with shared lived experience is often cited as facilitative of recovery. We aimed to develop and pilot a novel recovery-based digitally supported intervention for people with a psychotic illness.MethodsWe developed a website to be used on a tablet computer by mental health workers to structure therapeutic discussions about personal recovery. Central to the site was a series of video interviews of people with lived experience of psychosis discussing how they had navigated issues within their own recovery based on the Connectedness–Hope–Identity–Meaning–Empowerment model of recovery. We examined the feasibility and acceptability of an 8-session low intensity intervention using this site in 10 participants with persisting psychotic disorders and conducted a proof-of-concept analysis of outcomes.ResultsAll 10 participants completed the full course of sessions, and it was possible to integrate use of the website into nearly all sessions. Participant feedback confirmed that use of the website was a feasible and acceptable way of working. All participants stated that they would recommend the intervention to others. Post-intervention, personal recovery measured by the Questionnaire for the Process of Recovery had improved by an average standardized effect of d = 0.46, 95% CI [0.07, 0.84], and 8 of the 10 participants reported that their mental health had improved since taking part in the intervention.ConclusionIn-session use of digital resources featuring peer accounts of recovery is feasible and acceptable and shows promising outcomes. A randomized controlled trial is the next step in evaluating the efficacy of this low intensity intervention when delivered in conjunction with routine mental health care.

Recovery After Psychosis: Qualitative Study of Service User Experiences of Lived Experience Videos on a Recovery-Oriented Website (Preprint)

“…This study explored consumers' experiences of using an innovative and interactive recovery-oriented website, SMART [27,28]. Overall the findings show that using the SMART website was viewed as positively supporting participants in their personal recovery journeys.…”

“…It includes material on recovery (introduction and promoting hope); managing stress (common stressors and coping strategies); health (self-managing physical health, medication, diet and sleep); me empowerment (interactions with mental health services, rights and advocacy); and life (meaning, values and goals in life). Thirty-seven videos of 2-3 minutes length, featuring seven male and four female peers, are embedded throughout the website (full details in [27]). Eleven videos introduce each of the peers, who are of diverse age, ethnicity, employment status and sexuality [27].…”

“…Thirty-seven videos of 2-3 minutes length, featuring seven male and four female peers, are embedded throughout the website (full details in [27]). Eleven videos introduce each of the peers, who are of diverse age, ethnicity, employment status and sexuality [27]. Twenty-six videos show four to six peers talking about their experiences, views and actions in relation to specified topics, for example, 'experiences of making changes' (health topic), 'identifying our strengths' (me topic), and 'views on getting the most out of services'…”

“…The SMART interactive website was designed through consultation with mental health consumers to promote recovery, to be accessible to people experiencing psychosis and for optimal use on a tablet computer or mobile phone [27]. It includes material on recovery (introduction and promoting hope); managing stress (common stressors and coping strategies); health (self-managing physical health, medication, diet and sleep); me empowerment (interactions with mental health services, rights and advocacy); and life (meaning, values and goals in life).…”

“…The Self-Management And Recovery Technology (SMART) research program has involved the development of an interactive website of recovery-oriented resources primarily based on videos of people with lived experience of psychosis discussing how they have navigated issues in their own recovery [27]. Content was designed with input from people with experience of mental ill-health and founded on the conceptual framework of the CHIME recovery processes [8].…”