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Background: The lack of social and material perspectives in descriptions of recovery processes is almost common in recovery research. Aim: Consequently, we investigated recovery stories and how people with mental health and/or addiction challenges included social and material aspects in these stories. Method: We conducted focus group and individual interviews. We investigated how the participants narrated their stories and how they assembled places and people in their recovery stories. Results: We found that narratives of recovery became assemblages where humans and their environments co-exist and are interdependent. Conclusion: As such, narratives about recovery are about everyday assemblages of well-being into which stories of insecurity are interwoven, without a start or stop point. [ABSTRACT FROM AUTHOR]

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The concept of recovery is commonly described as multifaceted and contested in the field of mental health and substance abuse. The aim of this study is to explore how understandings of recovery and recovery orientation of services are developed through daily practices and collaboration between service users and professionals. Eight pairs of participants were interviewed together, in accordance with the dyadic interview method. The dyads/pairs consisted of service users and professional helpers. A collaborative hermeneutic-phenomenological analysis was used to analyse data. Data were analysed into three overarching and entangled themes, exploring how recovery-oriented collaboration and knowledge encompasses (a) recovery as relational processes. These processes are entangled with (b) recovery as situated in time and place. Furthermore, relational processes and dimensions of time and place are situated in and supported or hindered by (c) recovery orientation as part of the municipal policies, understood as the regulations, frameworks and decisions guiding mental health and substance abuse services in the municipality. The further development of recovery-oriented services should focus on facilitating open-ended and flexible ways of developing practices and relationships. This involves recognizing how relationships contribute to the development of knowledge and practices. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Recovery‐oriented studies show that the quality of the professional relationship plays an essential role in the recovery from mental illness. Within mental health care in general, previous studies show that helpful professional relationships are characterized by several reciprocal aspects, such as friendship resemblance and self‐disclosure.The literature is scarce on in‐depth explorations of professional relationships within the often long‐lasting and intimate help context of institutional supportive housing. Explorations of staff members' experiences are absent. The scientific rationale of this study was to expand the current knowledge about professional relationships in mental health care by exploring staff members' descriptions of helpful professional relationships in supportive housing institutions. What this paper adds to existing knowledge: The study shows that helpful relationships may involve staff experiences of reciprocity in terms of both a two‐way influence between staff and residents and a reciprocal gain from being part of the helpful relationships.A conceptualization of reciprocity that complements existing concepts is suggested and connected to a "good match" between staff and residents. What are the implications for practice?: When support and care are intended to be provided within a dyadic relationship, both parties' preferences should be considered when pairing service users and professionals.Practitioners should get involved in ways that open up for being influenced and inspired by the service user's characteristics, such as personality and attitude. Furthermore, they should dare to enjoy and make use of the company of the service user in ways that promote multifaceted reciprocity. Introduction: In the aftermath of the deinstitutionalization in western countries, new community‐based mental health services have been established. An essential object of studies in this new institutional landscape has been helpful professional relationships, but we still lack knowledge about helpful relationships in community‐based institutional supportive housing. Aim: To explore how staff members describe their relationships with residents who have identified them as helpful. Methods: Qualitative interviews with nine staff members were analysed using thematic analysis. Results: "Reciprocity" was identified as the main theme, and two subthemes were developed: "Something influential about the resident" and "Value for the staff member." Discussion: The findings are discussed and related to existing conceptualizations of reciprocity in professional relationships, and an additional conceptualization is suggested. Implications for practice: To promote reciprocity, managers should consider both parties' personal preferences when matching professionals and service users. Further, professionals should get involved in ways that open up for being influenced and inspired by several of the service user's characteristics. They should allow themselves to enjoy the company of the service user in ways that promote multifaceted reciprocity. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore how material things might become involved in the recovery process of people with mental health difficulties. Empirical material from three different studies on various aspects concerning mental health issues that each of the authors had conducted was reanalysed through a phenomenological item analysis. We discovered that mundane objects such as a mobile phone, a bench, a door and a key have agency to contribute to peoples' recovery and wellbeing. Things became agents that created contexts that initiated physical, social and emotional movements. By giving attention to materiality we might become aware of the importance of things as agents in living in general and in recovery processes for people with mental health difficulties in particular. [ABSTRACT FROM AUTHOR]

Our daily lives and sense of self are partly formed by material surroundings that are often taken for granted. This materiality is also important for people with mental health problems living in supported housing with surroundings consisting of different healthcare services, neighbourhoods, buildings or furniture. In this study, we explored how understandings of tenants are expressed in the materialities of supported housing. We conducted ethnographic fieldwork in seven different supported accommodations in Norway and analysed the resultant field notes, interviews, photographs and documents using Situational Analysis. The analysis showed that supported housing materialities expressed a blurry picture comprising widening and narrowing understandings of tenants, both by others and by themselves. Widening understandings concerned how tenants were living their lives in their own ways in private rooms while maintaining a social life in common areas. Narrowing understandings pertained to understand the tenants based solely on their diagnosis and need for care and control in hospital‐like buildings. The following discussion focusses on the ideas that underlie narrowing materialities and on the importance of striving for atmospheres that entail a sense of belonging. [ABSTRACT FROM AUTHOR]

Background: User involvement, based on respect and carried out through dialogue, has been shown to lead to increased self-respect, self-confidence and positive identity. In Sweden, the Social Service Act requires that interventions be designed and implemented together with the individual concerned. The basic criterion for social support is prolonged severe mental illness (usually at least 6 months), with no criteria for specific diagnosis or institutional history. The most common form of social support is 'support in daily living', a community care intervention for people aged 18 years or older who have their own homes and living arrangements. Aim: This article aims to deepen our understanding of user involvement at the individual level in the provision of an ongoing social work intervention. What elements of user involvement can be found in users' and support workers' descriptions of helpful support in daily living? Method: Qualitative interviews were conducted with 18 users, who had experienced support in daily living as helpful, and 16 interviews with the users' support workers. Results: Three major, interconnected themes emerged: Constant dialogue; Framing the flexibility, in relation to formalized intervention plans and regulations; The importance of 'small things', decisions concerning daily life. Conclusion: Both users and support workers described user involvement at the individual, micro-level to be an integral part of helpful support in daily living. It was possible to create a space for dialogue and co-creation in which users were involved in formulating and deciding the contents of their support at an informal level, to influence their own everyday lives. While a formal framework of rules, restrictions and plans surrounds meetings between users and professionals, a facilitating factor may be the absence of too detailed plans and regulations, leaving trust to users and professionals and their capacity to manage most of the choices they have to make. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to explore the ways in which "small things" may be of importance for people with mental health difficulties. Method: Empirical material from three different studies was reanalysed through a phenomenological, dialogical, approach. Results: We discovered some paradoxical aspects of small things: i.e., they could be about "something" that was difficult or even impossible to identify. The unidentifiable could be about bodily, sensual experiences that are superficial (i.e., belonging to the surface). The interaction with others highlighted as significant could be about doing something fun, talking nonsense or kidding around, and hence not at all about making sense of something—a kind of important nonsense. We summarize these aspects in three themes: the importance of the unidentifiable, the superficial and nonsense. These aspects can be regarded as small things—even "nothings"—that make it possible "to stay in the world". Conclusion: We elaborate on the findings in relation to the following: Gumbrecht's critique of the prevailing hermeneutic world-view with its idea that "interpretation is humankind's exclusive way of relating to the world", Ingold's idea that social life is lived in relations of "interfacility" and hence a turn to surfaces is needed for a "restoration of social life", and Biesta's idea of existence as "coming into the world in the presence of others". [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate the internal and social factors that persons with experience from severe mental illness and alcohol and other drugs problems, and who have received treatment for these problems, describe as important for initiating and maintaining a recovery process.Design/methodology/approach In total, 40 persons were interviewed and asked to describe factors they perceived as important for initiating and maintaining recovery. The software Nvivo was used to categorise data in internal and social factors with subcategories.Findings There is significant variation in how recovery emerged but involved in general having a proper social situation and finding meaning in life. Initially, the majority had a marginalised situation with need of assistance with housing, employment, financial and social support.Research limitations/implications The change process in the investigated group is interpreted as related to individual resources rather than belonging to a group defined as having “double trouble”.Practical implications The study implies that in addition to professional help to handle diagnosed problems, the group in focus also need support and interventions that address individual complex needs.Social implications Supporting activities/peer support seem to be important for those lacking support from family. At the same time, it is important to recognise the risk of being forced into a recovery identity which might lead to worsening the situation for those who do not fit into this.Originality/value By using the same design as in previous studies, comparisons with other groups are possible while still keeping the qualitative meaning of the investigated factors. [ABSTRACT FROM AUTHOR]

Purpose The possibility of recovery for persons with co-occurring addiction and mental health problems has been contested. Though, recent studies show that recovery might happen, but without connection to specific treatment interventions. The purpose of this paper is to analyse professionals’ perceptions of their contribution to improvement.Design/methodology/approach In all, 15 experienced professionals were interviewed. The interviews were analysed using thematic analysis.Findings Recovery processes were dependent of the persons’ access to different forms of recovery capital (RC). Lack of RC was often associated with lack of trust in one’s self and others (identity and personal capital). Professionals had to be accepted as trustful agents through co-creating changes in the person’s life. Trusting a professional might be a basis for trusting one’s self as an agent in one’s recovery process and develop a social network (identity and relationship capital). Other aspects stressed by the professionals were to manage their own fragmentized organisations and societal shortcomings (economic capital).Practical implications Recovery has been described as a profoundly individual journey. However, it is also deeply social, involving other persons and contextual factors. Focusing on just one level might counteract the complex work behind double recovery.Originality/value Improvement was described as dependent on the presence of personal, inter-personal, organisational and societal factors. The findings give a deep and concrete understanding of the process constituting the development of a working alliance and its dependence on factors outside the direct relation between the staff member and the person. [ABSTRACT FROM AUTHOR]

During a 9-month period, 100 persons with SMI were given approx. 73 USD per month above their normal income. Sixteen of the subjects were interviewed. The interviews were analysed according to the methods of thematic analysis. The money was used for personal pleasure and to re-establish reciprocal relations to others. The ways in which different individuals used the money at their disposal impacted their sense of self through experiences of mastery, agency, reciprocity, recognition and security. The findings underline the importance of including social circumstances in our understanding of mental health problems, their trajectories and the recovery process. [ABSTRACT FROM AUTHOR]

Background:Although being personal in relationships with service users is commonly described as an important aspect of the way that professionals help people with severe mental problems, this has also been described to bring with it a need to keep a distance and set boundaries.Aims:This study aims to explore how professionals working in psychiatric care view being personal in their relationships with users.Method:Qualitative interviews with 21 professionals working in three outpatient psychiatric units, analyzed through thematic analysis.Results:Being personal in their relationships with users was described as something that participants regarded to be helpful, but that also entails risks. Participants described how they balanced being personal by keeping a distance and maintaining boundaries in their relationships based on their “experience-based knowledge” to counter these risks. While these boundaries seemed to play an important part in the way that they act and behave, they were not seen as fixed, but rather as flexible and dynamic. Boundaries could sometimes be transgressed to the benefit of users.Conclusions:Being personal was viewed as something that may be helpful to users, but that also entails risks. Although boundaries may be a useful concept for use in balancing these risks, they should be understood as something complex and flexible. [ABSTRACT FROM AUTHOR]

Psychotropic drugs, particularly antipsychotic types, are a cornerstone of the treatment of people with psychosis. Despite numerous studies showing that drug treatment with psychotropic drugs initially alleviates psychiatric symptoms, the proportion of people with mental health problems and symptoms that do not follow doctors' prescriptions, thus exhibiting so-called non-adherence, is considerable. Non-adherence is predominantly seen as a clinical feature and as a patient characteristic that is especially due to patients' poor understanding that they are ill. There is also a widespread notion that non-adherence is of great disadvantage to the patient. This article is based on interviews with 19 persons diagnosed with psychosis. It challenges the notion of patients being either adherent or non-adherent to the doctor's orders. The findings show that persons with psychosis are active agents when it comes to adjusting medication. The interviewees created their own strategies to gain power over treatment with psychotropic drugs. The most common strategies were to adjust the doses or take breaks of varying lengths from the medication. These deviations from prescriptions were important to conceal, not only from their own psychiatrists, but from all psychiatric staff. [ABSTRACT FROM AUTHOR]

The relationship with professionals is an important factor in relation to the outcome of interventions directed to persons with severe mental problems. However, the current knowledge regarding the development of helpful relationships within Individual Placement and Support (IPS) services is limited. The aim of the study was to investigate how participants in IPS services described their relationship with their IPS coach. The article is based on interviews from a Swedish government evaluation of IPS services, thematically analyzed. The results showed that the relationship with the coach is central for the participants’ success in the service. The main theme, “something different - as a human being” highlighted that the conditions for the relationship are different within IPS as compared to traditional services. The other themes were “here and now action,” “closer to wish-fulfilment – impact on the self,” and “from role to person.” The principles of IPS parallel the results from research about helpful relationships and offers good preconditions for the occurrence of such relationships. This can represent a bridge between evidence based methods and research on helpful relationships, and should be possible to implement in the development of evidence based methods as well as of treatment as usual. [ABSTRACT FROM AUTHOR]

People with severe mental illness (SMI) are often described as lonely and socially incapable – an inability resulting from the mental illness. The aim of this article is to explore experiences of being alone among persons with SMI. The article is based on interviews with 19 persons diagnosed with psychosis who were interviewed between four and nine times over a period of three years. The findings show that experiences of being alone can be identified bytwoconcepts: aloneness and loneliness. The persons in the study appeared as socially able and active in relation to their social lives. However, a social agent does not operate in a void but in interaction with specific living conditions; the experiences of aloneness and loneliness may be viewed as the result of the interplay between the individual and the social and material environment. [ABSTRACT FROM PUBLISHER]

Being in recovery from bipolar disorder involves work-related concerns. The specific aims of this study are to: 1) understand the role of work in recovery from bipolar disorders, and 2) understand how people with such disorders deal with work-related challenges. These topics are examined from the stance of the recovery process, in which work-related activities were explored. Semi-structured, qualitative interviews were conducted with persons who had experienced recovery from bipolar disorder. Analysis was performed through thematic and phenomenological analysis, with hermeneutic phenomenology and reflexive methodology as a framework. The findings are presented through the following themes: 1) many types of work – finding meaning and a focus; 2) helpful roles and contexts – to be much more than a person with an illness; 3) making work possible – the role of supportive relationships and supportive medications, and 4) the costs of working too much – finding a meaningful and healthy balance. [ABSTRACT FROM PUBLISHER]

Research has shown the importance of the relationship between professionals and users for the outcome of interventions in psychiatry. The aim of this study is to analyze time as one factor in the development of working alliances. Fifty-eight persons in recovery from diagnosis of severe mental illness were interviewed about helping factors in their recovery process. Two aspects of time were considered to be of importance for the construction of working alliances: the quantity of time, that is, getting more time than expected during, between, and after the sessions; and the quality of time, that is, having undisturbed and focused time, the experience of being in the professional thoughts between the sessions and timing in one's life. Those experiences give the person a sense of being a real-life person and not an abstract patient, and this lays the groundwork for establishing a working alliance. The management of time is an important factor in the creation of a working alliance and should be given greater attention in the development of experience- and evidence-based practice. [ABSTRACT FROM AUTHOR]

Background: The quality of the relationship between professional and user is one of the important factors in the recovery process. However, more knowledge is needed concerning the components of helping relationships and characteristics of the helping professional. The aim of this study was to explore users' experiences of helping relationships with professionals. Data and methods: This was a grounded theory analysis of 71 qualitative interviews to explore users' experience of helping relationships and their components, in psychiatric care in Sweden. Discussion: Within the three main categories - interpersonal continuity, emotional climate and social interaction - two core themes were found that described vital components of helping relationships: a non-stigmatizing attitude on the part of the professionals and their willingness to do something beyond established routines. Conclusions: The focus in psychiatric treatment research needs to be broadened. In addition to research on the outcome of particular methods and interventions, the common factors also need to be investigated, above all, what is the effect of the quality of the relationship between user and professional. Greater attention needs to be paid, as well, to how helping respective obstructive relationships in psychiatric services arise, are maintained or are modified. [ABSTRACT FROM AUTHOR]

As part of a growing literature describing processes of recovery in psychotic disorders, this report presents findings of an intensive, international study. Open-ended qualitivite interviews were conducted in Italy, Norway, Sweden, and the United States with a total of twelve individuals who have experience of recovery in psychosis. All interviews were translated into English and transcribed. Investigators from each of these countries collaborated in analyzing the interviews and identifying common elements across the twelve narratives. Themes were identified in each of the following areas: 1) how the individual deals with his or her difficulties; 2) the role of material resources; 3) the various roles of formal and informal health systems; 4) the roles, and absence, of significant others; and 5) the roles of social and cultural factors. Salient themes included the person's determination to get better, establishing a degree of self–control, and struggling to achieve a normal life; the need for material resoures and a sense of home, and the importance of going out and engagging in normal activities; the benifits, and costs, of medication, involvement in mutual support/user groups, and participation in various psychosocial interventions; the need to be accepted as, and to accept oneself as, a normal person who exists beyond the psychosis; the impact of stigma and discrimination, and the imortance of having one's rights respected and returning to a meaningful social role through work and/or positive relationships outside of the formal mental health system. Cultural differences between participants from each country were noted primarily in the nature of the opportunities and supports offered rather than in the nature of the processes described. In closing, implications of these findings are considered both for future research on processes of recovery and for making clinical practice more recovery-oriented. [ABSTRACT FROM AUTHOR]