Social Work in Mental Health, 19(5), 2021, pp.457-475.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
In England, implementation and adoption of recovery-orientated (RO) practice has been slow and uneven. This qualitative study explored the barriers and enablers to the implementation and adoption of RO practice in community mental health provider organizations. Thirteen registered managers took part in semi-structured interviews. Four themes were identified: RO practice is not an entirely alien concept; RO practice is a labor intensive and skilled activity; Families need to be on onboard with RO support; and Limited community capacity for RO support. The most salient barriers and/or enablers were: staff training, public misconceptions of mental illness, and joint-working with families.
(Edited publisher abstract)
In England, implementation and adoption of recovery-orientated (RO) practice has been slow and uneven. This qualitative study explored the barriers and enablers to the implementation and adoption of RO practice in community mental health provider organizations. Thirteen registered managers took part in semi-structured interviews. Four themes were identified: RO practice is not an entirely alien concept; RO practice is a labor intensive and skilled activity; Families need to be on onboard with RO support; and Limited community capacity for RO support. The most salient barriers and/or enablers were: staff training, public misconceptions of mental illness, and joint-working with families.
(Edited publisher abstract)
Subject terms:
community mental health services, mental health problems, severe mental health problems, recovery;
Mental Health and Social Inclusion, 25(2), 2021, pp.183-194.
Publisher:
Emerald
Purpose: Overview of coaching for recovery. The paper aims to show an overview of work that was carried out over 11 years with groups of mental health and physical staff. As the facilitator who had run this course for the duration in Nottingham, this was an excellent opportunity to be at the forefront of a brand new project. Design/methodology/approach: The introduction of the skills are taught and treating the person, administering medication and not focussing on the inner person or personal recovery. The staff review has shown that in the clinical context change is happening from the inside out. Practical implications: “Helps change culture”; “change of work practice”; “it changed staff focus – not so prescriptive”; “powerful questions let clients come to their own conclusions”; “coaching gives
(Edited publisher abstract)
Purpose: Overview of coaching for recovery. The paper aims to show an overview of work that was carried out over 11 years with groups of mental health and physical staff. As the facilitator who had run this course for the duration in Nottingham, this was an excellent opportunity to be at the forefront of a brand new project. Design/methodology/approach: The introduction of the skills are taught over two consecutive days followed by a further day a month later. The idea of coaching is to be enabled to find the answers in themselves by the use of powerful questions and using the technique of the grow model, combined with practice enables the brain to come up with its own answers. Using rapport and enabling effective communication to deliver the outcome. Findings: Evidence from staff/clients and the purpose of the paper shows that when you step back it allows the individual patients/staff to allow the brain to process to create to come up with their solutions, which then helps them to buy into the process and creates ownership. Research limitations/implications: The evidence suggests that the approach that was there prior to the course was very much a clinical approach to working with clients and treating the person, administering medication and not focussing on the inner person or personal recovery. The staff review has shown that in the clinical context change is happening from the inside out. Practical implications: “Helps change culture”; “change of work practice”; “it changed staff focus – not so prescriptive”; “powerful questions let clients come to their own conclusions”; “coaching gives the ability to find half full. Helps to offer reassurance and to find one spark of hope”. Social implications: This has shown that the approach is now person-centred/holistic. This has been the “difference that has made the difference”. When this paper looks at the issues from a different angle in this case a coaching approach, applying technique, knowledge and powerful questions the results have changed. The same clients, same staff and same problems but with the use of a different approach, there is the evidence of a different outcome, which speaks for itself. The coaching method is more facilitative, therefore it illicit’s a different response, and therefore, result. Originality/value: The results/evidence starts with the individual attending and their commitment to the process over the two-day course. Then going away for the four weeks/six for managers and a commitment again to practice. Returning to share the impact if any with the group. This, in turn, helps to inspire and gain motivation from the feedback to go back to work invigorated to keep going.
(Edited publisher abstract)
Community Mental Health Journal, 57(5), 2021, pp.994-999.
Publisher:
Springer
Objective: People with serious mental illnesses are exposed to high rates of verbal abuse. This study examines the impact of such experiences on loneliness and social support, which is hypothesized to ultimately diminish recovery. Method: Fifty participants with serious mental illnesses reported on their experiences with verbal abuse, loneliness, social support, and recovery. Results: Verbal abuse was found to be related to loneliness and social support, and both mediated the relationship between verbal abuse and recovery. Conclusions and Implications for Practice: Verbal abuse is an all too common experience of people with serious mental illnesses that ultimately affects their recovery. Specifically, exposure to verbal abuse may impact recovery by increasing sense of loneliness and perceived social support. The implications are that a heightened awareness of verbal abuse and its impact on recovery should draw attention to interventions that decrease exposure and increase self-advocacy to combat negative outcomes.
(Edited publisher abstract)
Objective: People with serious mental illnesses are exposed to high rates of verbal abuse. This study examines the impact of such experiences on loneliness and social support, which is hypothesized to ultimately diminish recovery. Method: Fifty participants with serious mental illnesses reported on their experiences with verbal abuse, loneliness, social support, and recovery. Results: Verbal abuse was found to be related to loneliness and social support, and both mediated the relationship between verbal abuse and recovery. Conclusions and Implications for Practice: Verbal abuse is an all too common experience of people with serious mental illnesses that ultimately affects their recovery. Specifically, exposure to verbal abuse may impact recovery by increasing sense of loneliness and perceived social support. The implications are that a heightened awareness of verbal abuse and its impact on recovery should draw attention to interventions that decrease exposure and increase self-advocacy to combat negative outcomes.
(Edited publisher abstract)
Subject terms:
mental health problems, recovery, abuse, loneliness;
Purpose: Psychological developmental informed theories imply that addiction is not exclusively due to the addictive properties of the substance but that early psycho-social experiences are influential on later life. The purpose of this paper is to understand substance dependency, relapse and recovery amongst community-based substance using offenders in relation to their childhoods, relationships rehabilitation programme), to understand their substance use and recovery from their own perspectives. Findings: Four main superordinate themes were developed illustrating participants extremely adverse childhoods. Substance use was a means to cope with current and past trauma and crises and to help manage the emotions and mental health which could accompany these difficulties. Managing recovery was about
(Edited publisher abstract)
Purpose: Psychological developmental informed theories imply that addiction is not exclusively due to the addictive properties of the substance but that early psycho-social experiences are influential on later life. The purpose of this paper is to understand substance dependency, relapse and recovery amongst community-based substance using offenders in relation to their childhoods, relationships and significant life events, from their perspective. A key aim was to help better inform policy and practice. Design/methodology/approach: A qualitative study (interpretative phenomenological analysis) was used to understand the impact of childhood, relationships and significant life events amongst (N = 17) adult ex/offenders with substance use dependency problems, (who were part of the UK Government rehabilitation programme), to understand their substance use and recovery from their own perspectives. Findings: Four main superordinate themes were developed illustrating participants extremely adverse childhoods. Substance use was a means to cope with current and past trauma and crises and to help manage the emotions and mental health which could accompany these difficulties. Managing recovery was about learning to manage life itself, including emotions, mental health problems, trauma/responses, relationships and everyday life. Originality/value: This group is under researched where qualitative methods have been used. The study focussed on early-psycho-social experiences and relationships and the influence of these throughout the life cycle, in relation to their substance use. The study was informed by theories often used in therapeutic settings but rarely in research, (Orford, 2008; Khantzian, 2012; Flores, 2012, Van Der Kolk, 2014).
(Edited publisher abstract)
Background: Recent “Life as a film” (LAAF) studies demonstrate a relationship between themes of agency and communion in life stories and substance misuse recovery, contrasting with theme deficits in addicted populations, suggesting pathways to positive identity change. The present study aims to elucidate other key constructs differentiating recovery and non-recovery to comprehensively model interactive narrative processes. Methods: The LAAF procedure was used to collect personal narratives in a cohort of 32 active or recovering substance users. Narratives were coded for themes of interest and an inventory was used to assess recovery. Results: Analysis revealed two narrative structures: the first, comprising self-mastery, unity, redemption, healer, and happy ending, was significantly correlated with recovery outcomes, representing a Victory story; the second, comprising compulsion, avoidance, contamination, escapist, and sad ending, significantly correlated with non-recovery outcomes, representing a Defeat story. Conclusions: Findings build on previous observations to reveal constellations of interrelated self-story themes distinguishing activity or recovery from substance misuse. This enriches understanding of psychological processes associated with ongoing addiction and recovery, developing a meaningful framework of opposing narrative structures using the LAAF model, with proposed integrated pathways to positive identity and behavioral change.
(Edited publisher abstract)
Background: Recent “Life as a film” (LAAF) studies demonstrate a relationship between themes of agency and communion in life stories and substance misuse recovery, contrasting with theme deficits in addicted populations, suggesting pathways to positive identity change. The present study aims to elucidate other key constructs differentiating recovery and non-recovery to comprehensively model interactive narrative processes. Methods: The LAAF procedure was used to collect personal narratives in a cohort of 32 active or recovering substance users. Narratives were coded for themes of interest and an inventory was used to assess recovery. Results: Analysis revealed two narrative structures: the first, comprising self-mastery, unity, redemption, healer, and happy ending, was significantly correlated with recovery outcomes, representing a Victory story; the second, comprising compulsion, avoidance, contamination, escapist, and sad ending, significantly correlated with non-recovery outcomes, representing a Defeat story. Conclusions: Findings build on previous observations to reveal constellations of interrelated self-story themes distinguishing activity or recovery from substance misuse. This enriches understanding of psychological processes associated with ongoing addiction and recovery, developing a meaningful framework of opposing narrative structures using the LAAF model, with proposed integrated pathways to positive identity and behavioral change.
(Edited publisher abstract)
Subject terms:
recovery, substance misuse, addiction, life story work;
Community Mental Health Journal, 56(2), 2020, pp.196-205.
Publisher:
Springer
... of recovery. Implications regarding intervention to support individuals to explore VHE are discussed.
(Publisher abstract)
This study aimed to explore how adults with lived experiences of voice hearing, who have participated in hearing voices groups based on approaches of the Hearing Voices Movement, understand their voice hearing experiences (VHE). A phenomenological approach guided the study design. In-depth semi-structured interviews were conducted with five participants who attended a hearing voices group. Participants experienced a journey of understanding VHE. The overarching theme ‘tension and recalibration’ permeated five themes: beliefs about voices; navigating the relationship with my voices; learning to live with my voices; rediscovering myself with my voices; and, influences to understanding my voices. This study highlights how voice hearers’ understanding can evolve over time and throughout phases of recovery. Implications regarding intervention to support individuals to explore VHE are discussed.
(Publisher abstract)
Subject terms:
schizophrenia, psychoses, service users, recovery;
Journal of Substance Use, 25(2), 2020, pp.163-172.
Publisher:
Taylor and Francis
Background: Research in the field of substance misuse shows that identity change is key to recovery. Theories typically focus on either personal or social factors in this process; however, a framework encompassing agency and communion has proved useful in understanding narratives in similar populations. Objectives: The study proposes that agency and communion provide useful constructs through which to examine substance misuse and recovery. Method: The Life As A Film\(LAAF) and repertory grids were used to explore agency and communion in a sample of 32 participants. Results: Smallest Space Analysis of LAAF content revealed four narrative structures according to elements of agency and communion. Case examples indicated that agency and communion themes related to a recovery identity, and an absence of themes was associated with substance misuse. Repertory grid analysis revealed a pattern of fixed low agency and communion constructs in cases of substance misuse, and a transformed high agency-communion construct system in cases of recovery. Transformation from a low agency and communion substance-using identity toward a high agency and communion recovery identity was illustrated. Conclusions: The exploratory results highlight the centrality of agentic and communal growth in identity-transformative recovery from substance misuse.
(Publisher abstract)
Background: Research in the field of substance misuse shows that identity change is key to recovery. Theories typically focus on either personal or social factors in this process; however, a framework encompassing agency and communion has proved useful in understanding narratives in similar populations. Objectives: The study proposes that agency and communion provide useful constructs through which to examine substance misuse and recovery. Method: The Life As A Film\(LAAF) and repertory grids were used to explore agency and communion in a sample of 32 participants. Results: Smallest Space Analysis of LAAF content revealed four narrative structures according to elements of agency and communion. Case examples indicated that agency and communion themes related to a recovery identity, and an absence of themes was associated with substance misuse. Repertory grid analysis revealed a pattern of fixed low agency and communion constructs in cases of substance misuse, and a transformed high agency-communion construct system in cases of recovery. Transformation from a low agency and communion substance-using identity toward a high agency and communion recovery identity was illustrated. Conclusions: The exploratory results highlight the centrality of agentic and communal growth in identity-transformative recovery from substance misuse.
(Publisher abstract)
Journal of Substance Use, 24(3), 2019, pp.265-272.
Publisher:
Taylor and Francis
Background: Narrative research shows that identity change is key to recovery from substance misuse. Theories have focused on either personal or social factors in this process. A framework encompassing Agency and Communion has been useful in understanding narratives in similar populations. Objectives: The study proposes that substance misuse and recovery can be understood from an Agency-Communion perspective. Method: The Life As A Film Task (LAAF) and repertory grids were used to explore Agency and Communion in a sample of 32 participants. Results: Smallest Space Analysis of LAAF items revealed four different narratives according to themes of Agency and Communion. Case examples indicated that Agency and Communion predicted a recovery identity, and the absence of Agency and Communion predicted substance misuse. Analysis of repertory grids showed fixed low Agency/Communion construct systems in cases of substance misuse and transformed high Agency/Communion construct systems in cases of recovery. Transformation from a low Agency/Communion substance-using identity toward a high Agency/Communion recovery identity was highlighted. Conclusions: These preliminary findings illustrate the role of Agency and Communion processes in identity-transforming recovery from substance misuse.
(Publisher abstract)
Background: Narrative research shows that identity change is key to recovery from substance misuse. Theories have focused on either personal or social factors in this process. A framework encompassing Agency and Communion has been useful in understanding narratives in similar populations. Objectives: The study proposes that substance misuse and recovery can be understood from an Agency-Communion perspective. Method: The Life As A Film Task (LAAF) and repertory grids were used to explore Agency and Communion in a sample of 32 participants. Results: Smallest Space Analysis of LAAF items revealed four different narratives according to themes of Agency and Communion. Case examples indicated that Agency and Communion predicted a recovery identity, and the absence of Agency and Communion predicted substance misuse. Analysis of repertory grids showed fixed low Agency/Communion construct systems in cases of substance misuse and transformed high Agency/Communion construct systems in cases of recovery. Transformation from a low Agency/Communion substance-using identity toward a high Agency/Communion recovery identity was highlighted. Conclusions: These preliminary findings illustrate the role of Agency and Communion processes in identity-transforming recovery from substance misuse.
(Publisher abstract)
Social Work in Mental Health, 16(6), 2018, pp.679-692.
Publisher:
Taylor and Francis
Place of publication:
Philadelphia, USA
The Mental Health Recovery Model is an empowering service philosophy which has been transforming the field of mental health. An important service approach to actualising this model is hiring peer support workers (PSWs) who are peers advanced in recovery and employed to assist other peers in their recovery process. This study reports on factors hypothesised to affect PSW job satisfaction. Using
(Edited publisher abstract)
The Mental Health Recovery Model is an empowering service philosophy which has been transforming the field of mental health. An important service approach to actualising this model is hiring peer support workers (PSWs) who are peers advanced in recovery and employed to assist other peers in their recovery process. This study reports on factors hypothesised to affect PSW job satisfaction. Using multiple regression analyses, organisational culture and relationship with peers predicted 29% of job satisfaction. Based on these findings, suggestions are offered to assist social work administrators in effectively integrating and supporting PSWs in the workplace.
(Edited publisher abstract)
Subject terms:
job satisfaction, peer support, mental health problems, recovery;
British Journal of Clinical Psychology, 56(3), 2017, pp.310-328.
Publisher:
Wiley
Background: Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.
Design: Cross-sectional online survey.
Method: People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.
Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models, being employed and recent experience of depression predicted recovery.
Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.
Conclusions: Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy.
(Edited publisher abstract)
Background: Personal recovery is recognized as an important outcome for individuals with bipolar disorder (BD) and is distinct from symptomatic and functional recovery. Recovery-focused psychological therapies show promise. As with therapies aiming to delay relapse and improve symptoms, research on the psychological mechanisms underlying recovery is crucial to inform effective recovery-focused therapy. However, empirical work is limited. This study investigated whether negative beliefs about mood swings and self-referent appraisals of mood-related experiences were negatively associated with personal recovery.
Design: Cross-sectional online survey.
Method: People with a verified research diagnosis of BD (n = 87), recruited via relevant voluntary sector organizations and social media, completed online measures. Pearson's correlations and multiple regression analysed associations between appraisals, beliefs, and recovery.
Results: Normalizing appraisals of mood changes were positively associated with personal recovery. Depression, negative self-appraisals of depression-relevant experiences, extreme positive and negative appraisals of activated states, and negative beliefs about mood swings had negative relationships with recovery. After controlling for current mood symptoms, negative illness models, being employed and recent experience of depression predicted recovery.
Limitations: Due to the cross-sectional design, causality cannot be determined. Participants were a convenience sample primarily recruited online. Power was limited by the sample size.
Conclusions: Interventions aiming to empower people to feel able to manage mood and catastrophize less about mood swings could facilitate personal recovery in people with BD, which might be achieved in recovery-focused therapy.
(Edited publisher abstract)
Subject terms:
bipolar disorder, depression, recovery, therapy and treatment;