The experience of psychosis and recovery from consumers' perspectives: An integrative literature review

'To loosen up and talk': Patients´ and facilitators´ experiences of discovery group sessions from the Tidal Model as an introduction before engaging in a person-centred group intervention

WHAT IS KNOWN ABOUT THE SUBJECT

Treatment groups in Mental Health Service is cost-effective, increases patients´ self-understanding and stimulate change Research shows that people with mental illness have different barriers to attend group sessions which often originates from a lack of trust in other people, but it is known that the possibility to build gradual trust among the participants encourages attendance.

WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE

This study is based on the experience from outpatients and illuminates how discovery groups from the Tidal Model can be used as introductory sessions to build gradual trust among people with mental illness before engaging in a person-centred group intervention. The study fills a research gap in methods to create a safe and trusting environment in treatment groups for people with mental illness working with recovery-oriented person-centred interventions.

WHAT ARE THE IMPLICATIONS FOR PRACTICE

This study emphasizes the importance of meeting concerns about social interactions in persons with mental illness when joining treatment groups. It presents a recovery-oriented method which meets this requirement and is easy to implement in practice.

ABSTRACT

INTRODUCTION: Recovery-oriented interventions delivered individually or in groups are more and more common within mental health nursing. However, persons with mental illness may be cautious about engaging in groups. Therefore, it is important to provide a trusting basis in the group to allow for the best opportunities to promote engagement, attendance and impact of treatment.

AIM

The aim was to explore how discovery group sessions were experienced as introductory sessions from the perspectives of participants and facilitators before engaging in a person-centred group intervention.

METHOD

A qualitative interview study was conducted, involving four group facilitators and 16 participants with mental illness from five completed groups. Data were analysed with Ricoeur's theory of interpretation.

RESULTS

The findings showed that the two discovery group sessions were experienced as useful and meaningful to all and created a safe atmosphere and a trusted relationship among group participants and facilitators.

DISCUSSION

Feeling safe and sharing experiences and emotions contribute to the relational climate in a group.

IMPLICATION FOR PRACTICE

Addressing concerns about social interactions in persons with mental illness is important in group treatment. This study proved that engaging patients in designing or adapting interventions for mental health services is important to improve quality.

Multifamily therapy in the community mental health network: A pragmatic randomized and controlled study

Multifamily therapy (MFT) is a psychotherapeutic group intervention for patients with severe mental disorders (SMDs) and their families. The present study is a multicenter, randomized, and controlled trial that analyzes the benefit of MFT during outpatient treatment. The recruited patients were randomly assigned to the experimental group (n = 26), which received 24 MFT sessions in addition to their treatment as usual (TAU), or to the control group (n = 29), which received only TAU (individual and family sessions). Six months after the inclusion in the MFT, the experimental group showed a significant decrease in number of visits to the psychiatric emergency services, number of psychiatric admissions, and the days of admission. The need for hospital care 6 months after recruitment was also lower in the experimental group compared to the control group. These results suggest that the implementation of MFT during outpatient treatment facilitates community management of people diagnosed with mental health problems.

A Systematic Review and Meta-Analysis of the Effectiveness of Adherence Therapy and Its Treatment Duration in Patients with Schizophrenia Spectrum Disorders

BACKGROUND

Adherence therapy (AT) is an intervention for improving medication adherence of people with schizophrenia spectrum disorders, but no systematic reviews have yet summarized the effectiveness and minimum treatment duration of AT. We here aimed to systematically examine the effectiveness of AT in improving outcomes versus treatment as usual (TAU) and its minimum effective duration for people diagnosed with schizophrenia spectrum disorders.

PATIENTS AND METHODS

Eligible randomized controlled trials were identified from four databases (Web of Science, PubMed, CINAHL and Cochrane Library) for the period 1 January 2006 to 1 January 2023. Of 1087 retrieved candidate studies, five studies with a total of 726 participants met the inclusion criteria. The search terms consisted of adherence therapy, compliance therapy, schizophrenia, schizoaffective disorder, schizophrenic disorder, medication adherence, and medication compliance (combined with OR and AND). Two investigators independently selected studies, extracted data, and conducted bias risk assessments. Random-effects models were used to analyze the pooled data.

RESULTS

Meta-analysis of the five selected studies showed that AT had a significantly greater positive effects than TAU on psychiatric symptoms, but no significant effects on adherence behaviors and attitudes.

CONCLUSION

The AT had limited effects in terms of improving the attitudes and behaviors of people with schizophrenia spectrum disorders with respect to medication adherence, but did improve patients' psychiatric symptoms. The therapy should be performed by trained staff for maximum benefit, and the recommended duration of the intervention is 12 hours.

A systematic review and thematic synthesis of qualitative literature on personal recovery and voice hearing

BACKGROUND

Personal recovery literature has been influential in the conceptualization of emotional distress and service provision. While personal recovery in psychosis has been well-studied, voice hearing literature has not been reviewed to elucidate recovery processes.

METHOD

Five databases were systematically searched to identify relevant qualitative recovery literature. Twelve eligible studies were included in this review, and an appraisal tool was applied to assess quality. Thematic synthesis was used to examine the results.

RESULTS

Three superordinate themes were found relating to 'Recovery Phases', 'Recovery Facilitators' and 'Barriers to Recovery'. Papers included descriptions of finding voices distressing initially yet moving towards integrating and accepting voices. Searching for meaning versus seeking distance from voices were pivotal processes to recovery pathways. Enabling and disrupting recovery experiences are discussed within a proposed model.

CONCLUSIONS

Recovery in voice hearing is an individual and potentially ongoing process. Future research should seek to examine recovery factors in voice hearing longitudinally and add further evidence to the supportive role services can play in recovery and voice hearing.

Psychological Resilience to Suicidal Experiences in People with Non-Affective Psychosis: A Position Paper

It is important to understand the psychological factors which underpin pathways to suicidal experiences. It is equally as important to understand how people develop and maintain resilience to such psychological factors implicated in suicidal experiences. Exploring optimal routes to gaining this understanding of resilience to suicidal thoughts and acts in people with severe mental health problems, specifically non-affective psychosis, was the overarching aim of this position paper. There are five central suggestions: 1. investigating resilience to suicidal experiences has been somewhat over-looked, especially in those with severe mental health problems such as schizophrenia; 2. it appears maximally enlightening to use convergent qualitative, quantitative and mixed research methods to develop a comprehensive understanding of resilience to suicide; 3. relatedly, involving experts-by-experience (consumers) in suicide research in general is vital, and this includes research endeavours with a focus on resilience to suicide; 4. evidence-based models of resilience which hold the most promise appear to be buffering, recovery and maintenance approaches; and 5. there is vast potential for contemporary psychological therapies to develop and scaffold work with clients centred on building and maintaining resilience to suicidal thoughts and acts based on different methodological and analytical approaches which involve both talking and non-talking approaches.