Browsing by Subject "Recovery"
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Item A pilot study of participatory video in early psychosis: Qualitative findings(PAGEPress, 2022-10-04) MacDougall, Arlene G.; Price, Elizabeth; Glen, Sarah; Wiener, Joshua C.; Kukan, Sahana; Powe, Laura; Bird, Richelle; Lysaker, Paul H.; Anderson, Kelly K.; Norman, Ross M. G.; Psychiatry, School of MedicineFor people with psychotic disorders, developing a personal narrative about one’s experiences with psychosis can help promote recovery. This pilot study examined participants’ reactions to and experiences of participatory video as an intervention to help facilitate recovery-oriented narrative development in early psychosis. Outpatients of an early psychosis intervention program were recruited to participate in workshops producing short documentary-style videos of their collective and individual experiences. Six male participants completed the program and took part in a focus group upon completion and in an individual semistructured interview three months later. Themes were identified from the focus group and interviews and then summarized for descriptive purposes. Prominent themes included impacts of the videos on the participants and perceived impacts on others, fulfilment from sharing experiences and expressing oneself, value of collaboration and cohesion in a group, acquiring interpersonal and technological skills, and recommendations for future implementation. Findings of this study suggest that participatory video is an engaging means of self-definition and self-expression among young people in recovery from early psychosis.Item A qualitative exploration of stakeholders' perspectives on the experiences, challenges, and needs of persons with serious mental illness as they consider finding a partner or becoming parent(Frontiers Media, 2023-01-11) Dubreucq, Marine; Lysaker, Paul H.; Dubreucq, Julien; Psychiatry, School of MedicineBackground: While many persons with serious mental illness (SMI) consider intimate relationships and becoming parent as central parts of their lives deeply affecting wellbeing and recovery, others anticipate facing multiple challenges in these life domains. This qualitative study sought to explore the perspectives of persons with SMI and mental health providers (MHPs) with diverse backgrounds and practices on the experiences, challenges, needs and expectations of persons with SMI as they consider finding a partner or becoming parent. Methods: For this qualitative study, we conducted five focus groups between March and December 2020 for a total number of 22 participants (nine persons with SMI and thirteen MHPs) recruited from a center for psychiatric rehabilitation and a community mental health center in France. We used the inductive six-step process by Braun and Clarke for the thematic analysis. Results: Participants reported some challenges related to intimate relationships, stigma/self-stigma, disclosure and decision-making about start a family. Their expectations included: (i) psychoeducation about decision-making about finding a partner and starting a family; (ii) support in making empowered decisions about finding a partner, starting a family or disclosure to a prospective partner or their child; (iii) peer-support interventions; (iv) enhancing coping strategies; (v) integrated service provision including home treatment interventions, training to recovery-oriented practices and access to dedicated resources for providers. Conclusion: In short, intimate relationships and desire to start a family for persons with SMI should be more considered in psychiatric rehabilitation and additional support and interventions should therefore be provided.Item A Recovery-Oriented Approach: Application of Metacognitive Reflection and Insight Therapy (MERIT) for Youth with Clinical High Risk (CHR) for Psychosis(MDPI, 2024-04-15) Leonhardt, Bethany L.; Visco, Andrew C.; Hamm, Jay A.; Vohs, Jenifer L.; Psychiatry, School of MedicineClinical High Risk for psychosis (CHR) refers to a phase of heightened risk for developing overt psychosis. CHR often emerges during adolescence or early adulthood. CHR has been identified as a group to target for intervention, with the hope that early intervention can both stave off prolonged suffering and intervene before mental health challenges become part of an individual’s identity. However, there are few treatment modalities that can address some of the specific needs of CHR. Metacognitive Reflection and Insight Therapy (MERIT) is an integrative psychotherapy that can be applied to the CHR population. MERIT offers unique advantages to working with the CHR population as it aims to improve self-direction and recovery through stimulation of metacognitive capacity, a phenomenon that has been associated with recovery. This paper explores unique aspects of the CHR population and how MERIT can address barriers to recovery for individuals experiencing psychosis-like symptoms. Several case examples and a clinical vignette using MERIT to support patients with CHR are offered to exemplify this approach. MERIT offers a way to assist persons with CHR to address barriers to their personal recovery and to develop nuanced understandings of ways to master challenges.Item Adolescent Substance Use and Occupational Therapy Interventions: A Rapid Systematic Review(2021-05-05) Byrn, Hannah; Davila, Danielle; Green, Samantha; Kendall, Mary; Larson, Sydney; Prentice, Alexandra; Chase, Anthony; Petrenchik, Terry; Department of Occupational Therapy, School of Health and Human SciencesThis rapid systematic review analyzes the evidence for substance use reduction through therapeutic interventions and activities in adolescents between the ages of 13-25, along with the potential for implementation in the field of occupational therapy. Adolescents with substance use disorders (SUDs) often have specific challenges regarding their family interactions, cultural beliefs, school engagement, and community support. It can be difficult for adolescents with SUDs to successfully navigate their ever changing lives, as they may also present with comorbid psychiatric conditions. It is noted that throughout this review, many interventions were the first of their kind and focused on targeting adolescents within the contexts of their environment. Many studies utilized specific techniques aimed at improving adolescents’ intrinsic beliefs regarding their substance use. Overall, low to moderate evidence was found for the effectiveness of various interventions to reduce adolescent substance use. More exhaustive research is needed to evaluate the usefulness of these interventions, as many were done in very specific settings with very individualized populations. Moreover, occupational therapists should be cautious before implementation into practice, as none of the studies evaluated explicitly examined the role of occupational therapy. More investigation is required to determine how these interventions can be applied to the field of occupational therapy.Item Age, 12-Step Group Involvement, and Relapse Affect Use of Sobriety Date as Recovery Start Date: A Mixed Methods Analysis(Sage, 2023) Cyders, Melissa A.; Fry, Melissa; Fox, Taylor; Shircliff, Katherine; Jacobs, Molly; Scott, Hannah; Psychology, School of ScienceThe purpose of this paper is to explore the use of sobriety date as recovery start date, from the perspective of those in recovery, using a mixed methods approach. We report findings from 389 individuals who identify as being in recovery from a substance and/or alcohol use disorder concerning how they define their recovery start date. We report findings from logistic regression examining how the use of a sobriety date as a recovery start date differs across age, 12-step group engagement, and previous relapse occurrence. We complement these findings with qualitative data from focus groups discussions of how 44 individuals who identify as in recovery define what "recovery" means, how and why people choose their recovery start date, and the significance of sobriety in recovery start date definitions. About 50% (n = 182) of the quantitative sample defined their recovery start date as their date of last substance use or their first day of sobriety. Individuals who were younger, engaged in 12-step groups, and did not report a relapse had significantly greater odds of using a sobriety date as their recovery start date. Focus groups revealed nuances around sobriety date and, what for some was, a broader concept of recovery. The current findings prioritize the views of those in recovery to understand and define their own recovery start date. How those in recovery think about and define their recovery start date may have particular meaning. Research and clinical work would benefit from inquiring about recovery and sobriety dates separately.Item An Investigation of Employment Hope as a Key Factor Influencing Perceptions of Subjective Recovery among Adults with Serious Mental Illness Seeking Community Work(MDPI, 2024-03-19) Kukla, Marina; McGuire, Alan B.; Weber, Kenneth C.; Hatfield, Jessi; Henry, Nancy; Kulesza, Eric; Rollins, Angela L.; Psychology, School of ScienceIntroduction: Employment is an important contributor to recovery in people with serious mental illness (SMI), yet studies have not explored how subjective elements of employment hope contribute to perceptions of global recovery in this population. Methods: The current study examined the relationship between employment hope and subjective recovery in 276 unemployed adults with SMI participating in a multi-site clinical trial of a cognitive behavioral group intervention tailored toward work and combined with vocational rehabilitation. Participants had diagnoses of schizophrenia spectrum, bipolar, depressive, and posttraumatic stress disorders, and were receiving services at three Veterans Affairs healthcare facilities in the United States. Data were collected at study baseline. Linear regression analysis examined the relationship between employment hope (Short Employment Hope Scale; EHS-14) and subjective recovery (Recovery Assessment Scale; RAS) after controlling for psychiatric symptom severity and mental-health-related burden on daily life. Results: After accounting for covariates, employment hope significantly contributed to the regression model explaining subjective recovery. The overall model of predictor variables explained 52.5% of the variance in recovery. The results further explore the relationships between EHS-14 and RAS subscales. Conclusions: The findings suggest that employment hope is a key intervention target to bolster subjective recovery in this vulnerable population.Item Collaborate, Review Data and Change; Repeat(2022-09-27) Walton, Betty; Wendy, HarroldContext. The ANSA and TCOM framework, in conjunction with related information, can support data-informed policy planning and funding initiatives. One state’s collaborative data-informed recovery strategies provide an example. The concept of recovery from mental health and substance use disorders evolved from a deficit focus to include functional and personal recovery. Through a collaborative process SAMHSA, the federal behavior health authority, developed recovery’s working definition: “a process of change through which individuals improve their health and wellness, live a self- directed life, and strive to reach their full potential” in four dimensions (Health - overcoming or managing one’s diseases or symptoms, Home – a stable and safe place to live, Purpose - meaningful daily activities, and Community - relationships and social networks that provide support, friendship, love, and hope. Recently, SAMHSA acknowledged that the 2012 framework needs to evolve and issued a Recovery Challenge to community-based organizations to highlight innovative recovery strategies and practices. The challenge requires active, meaningful involvement of individuals with lived experience. Recovery and TCOM frameworks were cross walked to support training and to inform the state’s recovery support strategies. One strategy was to create a Recovery Support Workgroup (RSW) comprised of a dozen state agencies and community stakeholders. More than 51% of RSW members have lived experience with mental health and/or substance use. This group makes data-informed recommendations to state’s Mental Health and Addiction Planning and Advisory Council. Following a statewide 2019 gap analysis, which identified recovery support needs, the RSW created subgroups to address five recovery support needs: Personal support networks, Peer support services, Hobbies and interests, Prevention and wellness, and Safe and affordable housing. Data Collection Methodology. Multiple data sources informed the subgroups’ efforts: a consumer satisfaction survey, social determinants of health survey a Lived Experience Survey distributed through recovery groups, Medicaid claims diagnoses, recovery data collected at recovery organizations, and ANSA data. All data were associated with recovery dimensions: Health, Home, Community and Purpose. For ANSA data, the process required collaboration among the state’s data management, recovery support services, and the IU CANS/ANSA technical assistance teams. Enhancing ANSA Outcome Management Reports. Outcome Management reports, available to the state team, providers, and the IU CANS/ANSA team, were modified to inform the RSW subgroups by formatting reports by recovery dimensions and additional concerns. Building on existing reports (Resolved Actionable Needs, and item level metrics (Actionable, Continuing, Clinical Progress, Newly Identified, and Worsening), three new recovery focused reports were developed. Sharing and using the data. This collaborative, data-informed recovery initiative has received national attention. A variety of strategies to disseminate and to use the results for planning and managing change will be discussed: What has worked? What has been challenging? What has not work? What are the implications for quality improvement, program evaluation, and research?Item Community Mental Health Practice in the United States: Past, Present and Future(Eco-Vector, 2020-12-04) Hamm, Jay A.; Rutherford, Samuel; Wiesepape, Courtney N.; Lysaker, Paul N.; Psychiatry, School of MedicineSimilar to trends in Europe, approaches to mental illness in colonial America and recorded in early United States history were commonly characterized by incarceration and the removal of individuals from communities. In the mid-20th century, a major shift began in which treatment was offered in the community with the aim of encouraging individuals to rejoin their communities. In this paper, we will provide a brief history of community mental health services in the United States, and the forces which have influenced its development. We will explore the early antecedents of community-based approaches to care, and then detail certain factors that led to legislative, peer and clinical efforts to create Community Mental Health Centers. We will then provide an overview of current community mental health practices and evolving challenges through to the present day, including the development of services which remain focused on recovery as the ultimate goal.Item Comparison of Psychological Response between Concussion and Musculoskeletal Injury in Collegiate Athletes(American Psychological Association, 2017) Turner, Samantha; Langdon, Jody; Shaver, George; Graham, Victoria; Naugle, Kelly; Buckley, Thomas; Kinesiology, School of Physical Education and Tourism ManagementThe psychological response to musculoskeletal injuries has been well documented, however, research on the psychological response to concussion is limited. The Profile of Mood States (POMS) and the State-Trait Anxiety Inventory (STAI) have recently been used to assess the psychological recovery of concussions. Although some studies indicate that psychological response is different for musculoskeletal injuries and concussion, there is currently not enough information to indicate this difference occurs at specific clinical milestones. The purpose of this study was to compare the psychological responses of student-athletes who have been diagnosed with a concussion to those of athletes diagnosed with musculoskeletal injuries with similar recovery duration. Fifteen collegiate athletes who sustained a musculoskeletal injury were recruited and matched with 15 previously collected concussion participants. The main outcome measures were the scores of POMS constructs: tension-anxiety, anger-hostility, fatigue-inertia, depression-dejection, vigor-activity, confusion-bewilderment, and total mood disturbance and STAI (state anxiety only). Two-way MANOVAs was run to determine the effects of group and time on POMS and STAI constructs. There were no significant interactions identified, but follow-up ANOVAs identified a main effect for time for most POMS subscales, with POMS scores improving over time in both groups. Analyses also revealed that tension-anxiety, vigor-activity and the STAI were not affected by time or group. The findings of this study, that both groups' psychological response to injury improves over time and at similar clinical milestones suggests reduction in sports and team related activities may play a substantial role in the psychological response to either concussion or musculoskeletal injury.Item Detailed description of Division I ice hockey concussions: Findings from the NCAA and Department of Defense CARE Consortium(Elsevier, 2021-03) Van Pelt, Kathryn L.; Caccese, Jaclyn B.; Eckner, James T.; Putukian, Margot; Brooks, M. Alison; Cameron, Kenneth L.; Houston, Megan N.; Posner, Matthew A.; Jackson, Jonathan C.; McGinty, Gerald T.; Hillis, Cameron J.; McAllister, Thomas W.; McCrea, Michael A.; Broglio, Steven P.; Buckley, Thomas A.; Psychiatry, School of MedicineObjective: Since concussion is the most common injury in ice hockey, the objective of the current study was to elucidate risk factors, specific mechanisms, and clinical presentations of concussion in men's and women's ice hockey. Methods: Ice hockey players from 5 institutions participating in the Concussion Assessment, Research, and Education Consortium were eligible for the current study. Participants who sustained a concussion outside of this sport were excluded. There were 332 (250 males, 82 females) athletes who participated in ice hockey, and 47 (36 males, 11 females) who sustained a concussion. Results: Previous concussion (odds ratio (OR) = 2.00; 95% confidence interval (95% CI): 1.02‒3.91) was associated with increased incident concussion odds, while wearing a mouthguard was protective against incident concussion (OR = 0.43; 95%CI: 0.22‒0.85). Overall, concussion mechanisms did not significantly differ between sexes. There were specific differences in how concussions presented clinically across male and female ice hockey players, however. Females (9.09%) were less likely than males (41.67%) to have a delayed symptom onset (p = 0.045). Additionally, females took significantly longer to reach asymptomatic (p = 0.015) and return-to-play clearance (p = 0.005). Within the first 2 weeks post-concussion, 86.11% of males reached asymptomatic, while only 45.50% of females reached the same phase of recovery. Most males (91.67%) were cleared for return to play within 3 weeks of their concussion, compared to less than half (45.50%) of females. Conclusion: The current study proposes possible risk factors, mechanisms, and clinical profiles to be validated in future concussions studies with larger female sample sizes. Understanding specific risk factors, concussion mechanisms, and clinical profiles of concussion in collegiate ice hockey may generate ideas for future concussion prevention or intervention studies.