Before Recovery – A Blind Spot in Recovery Research? : Users’ Narratives About the Origins and Development of their Mental Health and/or Addiction Problems (original) (raw)
Related papers
Recovery from alcohol problems in the absence of treatment: a qualitative narrative analysis
Addiction, 2020
Background and aims Recovery from alcohol problems in the absence of treatment or mutual-aid is very common, but under-researched. This study explores the lives of people who had resolved their alcohol problems without treatment, seeking to situate experiences of recovery in social contexts and broader life narratives. Design The in-depth qualitative interviews were aided by a life-history methodology that invited participants to account retrospectively for their lives. A narrative analysis was undertaken. Setting Two major cities (Sydney and Melbourne) in Australia. Participants People who had resolved an alcohol problem in the absence of treatment (n = 12) were recruited from the general community using convenience sampling. Measurements Eligible participants had received 'minimal treatment' for an alcohol use disorder: fewer than three sessions in an outpatient treatment programme or nine sessions with mutual-aid groups (e.g. Alcoholics Anonymous), or having accessed mental health treatment for problems other than drinking at least 2 years prior or 1 year after having resolved an alcohol problem. Participants were considered to have had an alcohol use disorder if they reported two or more symptoms (DSM-V) within a 1-year period prior to the past year, using questions endorsed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). People were considered to have resolved their alcohol use disorder by responding to the recruitment message calling for people who "used to have an alcohol problem but no longer do". The Alcohol Use Disorders Identification Test (AUDIT-C) was used to understand participant's drinking behaviours in the past 12 months. Findings Four different narratives were identified in the analysis. In the emancipation narrative, identity development and major changes across the life-curve were associated with separating oneself from an oppressive circumstance. In discovery narratives, art culture and other consciousness-expanding experiences were sources of identity development, but sometimes a barrier to alcohol recovery. In mastery narratives, life events were understood as failures or successes, and recovery was positioned as an individual journey accomplished through increased problem awareness. Finally, in coping narratives, changes were understood as a series of continuous struggles, and recovery was made sense of through diagnostic discourses. Conclusions People who resolve an alcohol use disorder in the absence of treatment or mutual-aid appear to explain their recovery in terms of at least four different life narratives: emancipation, discovery, mastery or coping. Social contexts and cultures outside the treatment setting, and the various identities and narratives they provide, shape change processes.
Recovery conversations provide space for consumers of mental health services to identify how life, post diagnosis, might be lived. Anthony (1993) notes that 'recovery is a simple but powerful vision' (p.13) however there is no universally accepted definition of recovery in a context of mental health. Conceptualising recovery as an individual journey, that has light and shade can provide an expansive view on consumers and their experiences. A recovery narratives study, recently conducted by The University of Sydney, identified that consumers of recovery services believed that their mental health needs were viewed separately, at times, to issues of physical health, culture, addiction issues and relationship stressors. Broad recovery narratives encourage consumers to be active participants in their own journey as 'opposed to passive recipients of their mental health care' (Allott and colleagues, 2002, p.15). Consumers understanding of the role of their physical health, culture and trauma may benefit notions of recovery. This paper identifies how consumers, practitioners and peer-workers, working in a recovery-oriented model, can be guided by participant stories that include factors on the periphery of mental health, and how they may assist in developing a recovery framework that offers both a process and an outcome.
Frontiers in Psychiatry
Aim:Enhancement of recovery-oriented care in psychiatry requires insight into the personal meaning and context of recovery. The Psychiatry Story Bank is a narrative project, designed to meet this need, by collecting, sharing and studying the narratives of service-users in psychiatry. Our study was aimed at expanding insight into personal recovery through contextual analysis of these first-person narratives.Methods:We analyzed 25 narratives, as collected through research interviews. To capture the storied context on both a personal, interpersonal and ideological level we combined several forms of qualitative analysis. A total of 15 narrative characteristics were mapped and compared.Results:Through comparative analysis we identified four narratives genres in our sample: Lamentation (narratives about social loss), Reconstruction (narratives about the impact of psychosis), Accusation (narratives about injustice in care), and Travelogue (narratives about identity transformation). Each ge...
The drug users experience: An exploration of the process of recovery
Recovery from drugs continues to be an ongoing concern. While recent studies shift their focus towards the individual in recovery and call for an implementation that includes the reduction of health and social risks caused by drug use, misuse of heroin remains a substantial global burden. Wanting to give voice to personal narratives and turning the attention towards the personal process of recovery, this research explores the question: what is the drug users’ experience of being in recovery? By turning the attention towards the individual rather than on the substance and the implications of misuse on society, this study aims to contribute to existing research that focuses on subjective experience and supports the notion that treatment could go beyond harm reduction and incorporate a more holistic approach to recovery tailored around individuals’ needs. Interpretative Phenomenological Analysis (IPA) has been employed to explore the personal process of recovery and examine needs and challenges faced within recovery. The resulting major themes address (1) feelings behind the motivation to use drugs; (2) how experienced stigma contributes to obstacles faced in the recovery process; (3) the experience of the long and gradual process of recovery versus the instant gratification of drugs; and (4) how human kindness and a sense of belonging have been experienced as fundamental to healing and growth within recovery. In light of the findings, broadening treatment options to provide an extended therapeutic component as part of recovery to address causality may offer individuals a better chance of reintegration to society and sustaining recovery.
Narrating the journey of sustained recovery from substance use disorder
Substance abuse treatment, prevention, and policy, 2018
The reported high rate of relapse in the context of an ever-increasing rate of substance abuse internationally and in South Africa together with the fact that the topic of sustained recovery from Substance Use Disorder (SUD) appears to be totally neglected in extant literature and research agendas motivated the researchers to conduct this investigation. The aim was to obtain an in-depth understanding of how individuals recovering from a SUD experience and sustain their recovery in order to fill the gap in the knowledge base. A qualitative research approach was followed, employing a narrative and phenomenological research design alongside an explorative, descriptive and contextual strategy of inquiry. Fifteen participants were purposefully recruited; and data were collected by means of individual, face-to-face interviews. Schlossberg's Transition Process Model (1981) (Schlossberg NK, The Counselling Psychologist 1981;9(2):2-18, Schlossberg NK, Journal of Employment Counselling 20...
Frontiers in Psychiatry
Background: Studies investigating the subjective experiences of long-term recovery from substance use disorder are scarce. Particularly, functional and social factors have received little attention. Objectives: To investigate what long-term recovered service users found to build recovery from substance use disorder. Material and Methods: The study was designed as a phenomenological investigation subjected to thematic analysis. We interviewed 30 long-term recovered adult service users. Results: Our thematic analysis resulted in five themes and several subthemes: 1) paranoia, ambivalence and drug cravings: extreme barriers to ending use; 2) submitting to treatment: a struggle to balance rigid treatment structures with a need for autonomy; 3) surrendering to trust and love: building a whole person; 4) a life more ordinary: surrendering to mainstream social responsibilities; and 5) taking on personal responsibility and gaining autonomy: it has to be me, it cannot be you. Conclusions: Our study sample described long-term recovery as a developmental process from dependency and reactivity to personal autonomy and self-agency. The flux of surrendering to and differentiating from authority appeared to be a driving force in recovery progression. Participants called for treatment to focus on early social readjustment.
Narratives of recovery from addictive behaviours
Addiction, 1999
Aims. The purpose of this study was to look for the ways in which people who have recovered from various addictions understand and present their change process. Materials. The research material consisted of 51 autobiographical stories of people who had been able to quit their addiction to alcohol, multiple drugs, binge eating, smoking, sex and gambling. Methods. The basic logic of each narrative was first defined. The narratives were then categorized according to what they presented as the key to recovery. Composite stories were then constructed and analysed mth regard to their emotional, causal, moral and ethical meanings. Findings. The analysis revealed five different story types among these self-narratives: the AA story, the growth story, the co-dependence story, the love story and the mastery story. All of them helped to make the addiction and recovery understandable, they released the protagonist from guilt and had a happy ending by which the values of the story were realized. Each story type was told predominantly by representatives of a panicular gender and addiction. Conclusions. As there are several ways out of addictive behaviours there are also several ways to construe the change. People who try to quit addictive behaviours could be encouraged to make full use ofthe cultural stock of stories in creating an account that fits their own experience of defeating their particular addiction.
International Journal of Environmental Research and Public Health
Recovery-oriented care has become a leading vision across countries. To develop services and communities in more recovery-oriented directions, enhanced understandings of recovery in terms of personal and social contexts are important prerequisites. The aim of this study is to explore the nature and characteristics of the experiences of recovery. The method used is a form of qualitative meta-synthesis that integrates the findings from multiple qualitative studies published by one research group. Twenty-eight empirical papers with a focus on recovery as personal and contextual experiences were included in this meta-synthesis. Five meta-themes were developed: (a) being normal, (b) respecting and accepting oneself, (c) being in control, (d) recovery as intentional, and (e) recovery as material and social. The themes describe how recovery encompasses dynamics between personal experiences and contextual dimensions. This meta-synthesis consolidated an understanding of recovery as dynamics ...
ProQuest, 2016
The purpose of this study is to discover the turning points women believe helped them stop abusing substances and subsequently maintain sobriety. The study is an examination of narrative responses collected from 25 semi-structured qualitative interviews of women who have remained abstinent from alcohol and drug use for three or more years. The theoretical structure for the current study is to find what cessation turning points taken from the narratives are congruous to Sampson and Laub’s age-graded informal social control theory turning points, in addition to other life-course perspective models and theories. The turning points discussed are employment, education, and other social relationships relative to self-discovery and cognitive change. Understanding what the user and offender comprehends about herself, at different phases in recovery, can illuminate the treatment correctional programs that will help prevent relapse and recidivism.