Last updated on February 2018

Representations and Strategies for Recovery


Brief description of study

In the recent context of deinstitutionalization and longitudinal studies pointing to a large number of positive long-term outcommes for people affected by a psychiatric disorder (schizophrenia, bipolar disorder, eating disorder, severe personality disorder, etc.), the possibility of overcoming the consequences of a psychiatric pathology emerges as a solid fact. Therefore, the existence of this possibility calls for the identification of the determinants underlying of the various outcomes over time of those affected by a severe psychiatric disorder, in particular those likely to underpin the most positive developments.

While it is well known from a medical point of view that certain dimensions affect the prognosis of persons affected by a severe psychiatric disorder (such as the persistence of negative symptoms or cognitive disorders in schizophrenic disorders), prognosis from a purely medical perspective (and putting aside the role of the person and his environment) seems to be able to account only for a modest proportion of the prognosis of people affected by a serious psychiatric disorder.

It is this fact that has gradually led to the emergence of complementary models capable of enriching the understanding of the determinants of the future of people affected by a severe psychiatric disorder, in particular models inviting to separate "becoming of the person" from the " psychiatric disorder "to take into account the" personal role of the person "in his or her own healing. This perspective is the "recovery" perspective.

Recovery process is defined as a personal trajectory which includes the person's experiences and the reactions of his / her environment following the installation of a psychiatric disorder, which can support a mode of release of the status of "psychiatric patient". Recovery thus implies an "approach underpinned by the understanding of the human response to pathology" (Noiseux) and, one might add, of its environment.

This definition of "recovery" is also subjective because it is tied to very personal experiences and related to the person's own norms as to what it means to be "re-established". The subject engages in a long, progressive process, without return to the previous state. In a dynamic response to an equilibrium perturbed by the disease, we are interested in restoring a new equilibrium rather than the factor triggering its loss. Recovery is seen as a trajectory punctuated by decisive moments on a background of progressive change, this process oscillates between awareness, ambivalence and forward shift.

However, while these studies point to a number of crucial dimensions involved in the recovery of a severe psychiatric disorder, one of the important limitations of these studies is the distance from any psychopathological consideration, thus setting aside the possibility of specific processes of recovery depending of the pathology. The identification of recurrent experiential logics specific to the various psychiatric disorders therefore appears to be an important field of investigation. It would potentially be able to guide the development of new therapeutic devices based on the recovery model.

Detailed Study Description

  1. Elaboration of a semi directed grid (exploratory phase)
  2. Collection of individual narratives
  3. Data analysis, according to IPA method (interpretative phenomenological analysis)
    • On the basis of individual narratives
    • On the basis of a focus group 4. Publication of results

Clinical Study Identifier: NCT03028545

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MARTIN BRICE, PH

Vial Veronique
Bron, France
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