Priscilla Ridgway

An analysis of the definitions and elements of recovery: a review of the literature.

As mental health recovery gains traction, many people have put forward varying definitions. Few attempts have been made to create a dimensional analysis of the recovery literature that assesses the growing consensus about what recovery is or what its definition should entail. This paper incorporates an ecological framework to take the individuals life context into account while emphasizing both the reestablishment of ones mental health (i.e., first order change) and the mitigation of the oppressive nature of barriers imposed by the greater community (i.e., second order change) so that people may experience social integration and community inclusion.

Self-Efficacy and Self-Care: Missing Ingredients in Health and Healthcare among Adults with Serious Mental Illnesses

To help inform the design of a self-management intervention for improving the physical health of adults with serious mental illnesses, we conducted focus groups about their perceived medical care and physical health needs. Adults with serious mental illnesses participated in four semi-structured focus groups conducted at a transitional living facility, a social club, and a Hispanic outpatient mental health clinic. Questions included their recent experiences of seeking medical care, the effect of having a mental illnesses diagnosis, strategies for active self-care, and perceived barriers to better physical health. In addition to various systemic barriers to better medical care, participants articulated limited knowledge and self-efficacy regarding active self-management of their physical health. Despite their interest in learning more about health promotion, most participants expressed a sense of personal futility and powerlessness in improving their health. These data suggest that any effort to improve the wellbeing of these adults will need to address self-efficacy in the hope of improving self-care for their physical health needs.

Life Is Not an “Outcome”: Reflections on Recovery as an Outcome and as a Process

It is has repeatedly been said within the recovery movement that the term ‘‘recovery’’ may refer both to a process as well as to an outcome (cf., e.g., Anthony, 1993; Bellack, 2006; Davidson & Roe, 2007; Deegan, 1988; Jacobson, 2001; Spaniol & Koehler, 1994). What has not been fully clarified, though, is the nature of the relationship between the two. That is, does recovery as a process lead to recovery as an outcome, does recovery as an outcome preclude the need for recovery as a process, or is there necessarily any relationship between the two at all? This paper attempts to clarify at least one position on the nature of the relationship between recovery as a process and recovery as an outcome. We acknowledge that this is not the only position possible, and that others within this movement might have very different ideas about this issue. In fact, we were stimulated into thinking about our own position on the topic by a publication of Roe, Rudnick, and Gill (2007), who first brought this issue to our attention by suggesting that the concept of being in recovery may be a potentially problematic notion unless it is tied more explicitly to the process of recovering from mental illness. We offer our thoughts below in the hope of eliciting further debate on this important but relatively unacknowledged issue.

Considering DSM-5: the personal experience of schizophrenia in relation to the DSM-IV-TR criteria

Previous analyses have suggested that the personal experience of schizophrenia might be different from its depiction in the DSM-IV-TR. In this study, 17 people with schizophrenia or schizoaffective disorder were interviewed about their experiences of the DSM-IV-TR diagnostic criteria for schizophrenia. Descriptive phenomenological analysis was used to analyze the ways in which the personal experiences of the people in this study were similar to or different from the depiction of schizophrenia in the DSM-IV-TR. The personal experience of schizophrenia was similar in some way to each of the five diagnostic criteria for schizophrenia. Participants’ personal experiences also went beyond the DSM-IV-TR criteria. Specifically, participants described strong emotional reactions to their symptoms, including fear, sadness, embarrassment, and alienation. Also, participants described intense interest but severe disruptions in goal-directed behavior due to their hallucinations being engrossing, confusing, and distracting. Further, participants described not sharing their experiences in order to avoid social stigma. These findings suggest that the description of schizophrenia in DSM-5 may benefit from a change to DSM-IV-TR criteria to incorporate more of the personal experience of schizophrenia. Further research is needed to establish the representativeness, reliability, and validity of the qualitative findings described here.