William Bradshaw, University of Minnesota
David Roseborough, University of Minnesota
Marilyn Armour, Ph.D
The purpose of this hermeneutic phenomenological study was to examine the lived experience of persons recovering from serious and persistent mental illness (SPMI). This study reports results from the first six months of treatment and is part of a two-year longitudinal study.
Forty adults with SPMI referred to county case management services were recruited for the study. A semi-structured interview was conducted for 1hour to elicit client narratives of their experience in recovery. The interviews were transcribed, read and coded to cluster thematic aspects in each case and across cases. Atlas was used to recode transcripts and retrieve quotes to dimensionalize each essential theme. Transcripts were reread for confirming and disconfirming evidence for each theme.
Life goals were expressed as a desire for greater independence and a return to a sense of normalcy. Therapeutic effects focused on relational issues: “being known” by the case manager and seeing the worker as “someone in there with me.” Significant areas for therapeutic attention focused on making realistic assessments: “contemplation of what I can do,” pacing recovery, seeking an optimal degree of challenge, attempting to transcend their own concerns, and working with ambivalence. Accompanying obstacles included a sense of constricted life choices, “living at a different speed,” and the impact of the illness on their sense of self.
IMPLICATIONS FOR PRACTICE:
Findings delineate critical factors in early stage recovery as identified by persons with SPMI. They highlight the need for clients to be an active collaborator in determining areas of therapeutic attention and emphasize the importance of relational factors in developing experiences of mastery and a more functional sense of self. Obstacles described by clients in early phase recovery provide new insight and meaning into problems of motivation and non-compliance in treatment.
Analysis of the data from T2 (12 months) and T3 (18 months) is in process.
Center for Social Work Research, The University of Texas at Austin
Keywords: health care