Psychological Recovery

Retta Andresen is a Research Fellow at the University of Wollongong, Australia. Her research into the process of recovery and its measurement has received national and international recognition and interest. Lindsay Oades is a Clinical and Health Psychologist and Director of the Australian Institute of Business Wellbeing at the University of Wollongong, Australia. He has been awarded numerous national awards for his mental health research. Peter Caputi is an Associate Professor in the School of Psychology at the University of Wollongong, Australia. He is a consulting editor for the Journal of Constructivist Psychology and The Journal of Psychology: Interdisciplinary and Applied.

About the authors xi Foreword by Jon Strang xiii Preface xvii Acknowledgements xix Part I Recovery in Historical Context 1 Introduction: Recovery from schizophrenia 3 Overview 3 Early conceptualizations of schizophrenia 4 Diagnostic systems and prognostic pessimism 6 Empirical evidence for recovery 7 The persistence of a pessimistic prognosis 13 The real possibility of recovery 17 The emergence of the 'recovery' movement 18 What do we mean by 'recovery'? 20 Conclusion 22 Summary 22 2 Conceptualizing recovery: A consumer-oriented approach 23 Overview 23 Developing a consumer-oriented model of recovery 24 The search for common ground 25 Meanings of recovery in the literature 25 Consumer descriptions - psychological recovery 28 Diverse opinions on some aspects of recovery 31 Four component processes of recovery 34 A definition of psychological recovery 40 Steps along the journey of recovery 41 Five stages of psychological recovery 45 Conclusion 45 Summary 48 Appendices 48 Part II Elaboration of the Model: From Hopelessness to Flourishing 3 Moratorium: The first stage of psychological recovery 53 Overview 53 Negative symptoms or psychological sequelae? 53 Hope in the Moratorium stage: Hopelessness 54 Responsibility in the Moratorium stage: Powerlessness 57 Identity in the Moratorium stage: Loss of sense of self 59 Meaning in the Moratorium stage: Loss of purpose in life 63 Conclusion 65 Summary 66 4 Awareness: The second stage of psychological recovery 67 Overview 67 Hope in the Awareness stage: The dawn of hope 67 Responsibility in the Awareness stage: The need to take control 70 Identity in the Awareness stage: I am not the illness 72 Meaning in the Awareness stage: Need for a purpose in life 74 Conclusion 76 Summary 76 5 Preparation: The third stage of psychological recovery 77 Overview 77 Hope in the Preparation stage: Mobilizing resources 77 Responsibility in the Preparation stage: Taking autonomous steps 79 Identity in the Preparation stage: Taking an internal inventory 81 Meaning in the Preparation stage: Reassessing goals 83 Conclusion 85 Summary 85 6 Rebuilding: The fourth stage of psychological recovery 87 Overview 87 Hard work and hopefulness 87 Hope in the Rebuilding stage: Active pursuit of personal goals 88 Responsibility in the Rebuilding stage: Taking control 90 Identity in the Rebuilding stage: Self-redefinition 93 Meaning in the Rebuilding stage: Valued goals 96 Risk-taking, perseverance and resilience 99 Conclusion 100 Summary 101 7 Growth: The fifth stage of psychological recovery 103 Overview 103 Hope in the Growth stage: Optimism about the future 103 Responsibility in the Growth stage: In control of life and wellbeing 105 Identity in the Growth stage: An authentic self 107 Meaning in the Growth stage: Living a meaningful life 109 Resilience, personal growth and wisdom 111 Conclusion 113 Retrospective overview 114 Summary 114 8 Common questions regarding the stage model of psychological recovery 115 Overview 115 Ten questions that have been raised about the model 115 Conclusion 120 Summary 120 Part III Measuring Recovery 9 Recovery-oriented outcome measurement 123 Overview 123 Why the need for measures of recovery? 123 Approaches to operationalizing recovery in research 125 Assessing outcomes in routine clinical practice 126 Outcome measurement from the consumer perspective 127 Measuring consumer-defined recovery 128 Measures based on the stage model of psychological recovery 129 Concluding comment 135 Summary 135 Part IV Towards a Positive Future 10 Psychological recovery and positive psychology 139 Overview 139 A scientific approach to recovery 139 Hope 140 Meaning and purpose 140 Responsibility 141 Identity 142 Resilience 142 Strengths 143 Values 143 Autonomous goals 144 Growth 144 Wellbeing 145 Living with illness and flourishing 145 Summary 146 11 Reflections and future directions 147 From wellness to wellbeing 147 Applications of the model 148 Recovery measures in clinical work, evaluation and research 151 Current and future research directions 152 A word about words 153 Afterword 155 References 157 Index 179