Recovery in Psychosis: Perspectives of Clients with First Episode Psychosis

Abstract

Introduction: Recovery from psychosis relates to connectedness, hope for the future, identity, meaning in life and empowerment. The process of recovery is often described as gradual and non-linear, with many stages and turning points, and without a definitive end point. This qualitative study aims to understand what recovery means to clients, to better understand their unique recovery process and what helps in recovery among clients with lived experience of first episode psychosis (FEP) in a developed Asian setting. Materials and Methods: The study design and interview guide development included inputs from persons with psychosis, following which 7 focus group discussions were conducted with 40 FEP clients of a tertiary care psychiatric institute. Results: Thematic qualitative analysis identified three themes: 1) meaning of recovery (where participants expressed their views on what recovery meant to them); 2) recovery as a journey (due to the constant ups and downs in the long process of recovery, it was often articulated as a “journey”); and 3) facilitators of recovery (related to resources, practices and experiences that supported their recovery). Conclusion: The emergent themes provide an understanding of the meaning of recovery to persons with FEP, their experiences as they proceed with their recovery journey and factors they found helpful. The importance of acceptance of the condition and the personal role the individual plays in his or her own recovery was evident in the narratives of the participants. The study suggests a need to incorporate recovery-relevant approaches right from the first episode of psychosis. Ann Acad Med Singapore 2020;49:186–98 Key words: Meaning of recovery, Qualitative, Thematic analysis

Growth in the Aftermath of Psychosis: Characterizing Post-traumatic Growth in Persons With First Episode Psychosis in Singapore

“…It must be cultivated and fostered through intentional conversations to bring about positive cognitive ruminations and self-disclosure. A qualitative study on EPIP patients' perspective of recovery revealed three areas in which were facilitators to personal recovery: personal agency, social and emotional support, treatment and services, faith and spirituality, and others resources ( 55 ). Encouraging a young person with FEP to take ownership of life and mental well-being could go a long way to enhance their recovery.…”

The lived experience of psychosis: a bottom‐up review co‐written by experts by experience and academics

“…As previously discussed, one core component of psychosis is the disruption of the person's natural engagement with the world. Following a first episode, young individuals often view their recovery as being able to feel "normal" again 195 , which essentially means reintegrating into society 192 , re-entering the workforce or going back to study in socially valuable roles 193 . Therefore, they feel that interventions supporting their study or work help them in regaining their sense of purpose 177,202 and confidence 226 : "I waged this war not because I am so brave but because I absolutely had to in order to keep my job" 170 .…”

“…Recovery from psychosis is commonly experienced as a cyclical and ongoing process that requires active involvement 94 , and is hardly ever "complete" 194 . This recovery "journey" 133,192 is filled with back-and-forth, rather than being a linear path with a set endpoint: "a long, solitary journey, with almost as much shock and fear at its outset as with the psychosis" 133 . It is, therefore, a dialectical process on its own.…”

“…185 . A such, recovery is not necessarily about returning to the "past self" 192 , but implies assimilation of the experience into a new sense of self and a transformed understanding of the world and the person's role in it 83 .…”

The personal recovery movement in Singapore – past, present and future

“…Additionally, in 2020, The Tapestry Project SG, a peer-led ground-up movement and platform for people to share their mental health lived experiences was also formally registered as a mental health organisation, continuing its empowerment of people with mental illness through storytelling mediums. In addition, literature examining the personal recovery approach also began to emerge in 2019 to 2020, exploring the lived experiences of people with psychosis 16 and hoarding, 17 evaluating peer support services, 18 and testing various recovery-oriented measurement tools. 19,20 It may be observed that the latter half of the 2010s was an indicator of an impending paradigm shift and the beginning of more personal recovery-oriented perspectives being seeded across the mental healthcare landscape in Singapore.…”