Personal Recovery for People Living with a Psychotic disorder | Reflective Essay
Introduction
According to Mentalhealth (2020), the term ‘recovery’ was defined as the capacity of an individual to live a meaningful life in the presence or absence of a mental illness or psychotic disorder (Mentalhealth 2020). According to a study carried out by Weeghel et al. (2019), the significance pertaining to personal recovery for people who experience psychotic disorders was emphasised. Psychotic disorders refer to conditions that negatively affect the cognitive functions and capabilities of an individual and leads to abnormal thinking and perceptions. The primary symptoms of psychotic disorders include delusions and hallucinations and major types comprise of schizophrenia and bipolar disorder. In order to treat these psychotic disorders, two primary treatment and recovery strategies are suggested. These include clinical recovery and personal recovery. Over the years, personal recovery has gained substantial significance and consists of an individual working towards something that is important to him or her. Personal recovery adheres to elements of hope, optimism and connectedness, thereby allowing an individual to live a meaningful life (Weeghel et al. 2019). This essay highlights the differences between clinical and personal mental health recovery and how personal recovery can enhance the wellbeing of people who experience psychotic disorders. Furthermore, the essay comprises of a reflection relating to how I, as a registered nurse (RN) can utilise effective communication strategies to assist a consumer living with the effects of a psychotic disorder.
Clinical recovery refers to the process proposed by health professionals such as psychologists and counselors, that aids the patients in reducing the symptoms related to psychotic disorders and achieve a balanced state of mental health. On the contrary, personal recovery refers to an individual adhering to his or her own decisions in order to live a meaningful life (Slade, 2016). According to a study carried out by Van Eck et al. (2018), the differences between clinical and personal mental health recovery were demonstrated in people experiencing schizophrenia. The results of the meta-analysis exhibited that there exists a small correlation between the clinical and personal mental health procedures and both should be considered for handling and nursing of patients suffering from psychotic disorders (Van Eck et al. 2018).
In similar study carried out by Rossi et al. (2018), the complex relationship between clinical and personal recovery in patients suffering from schizophrenia was determined. A cluster analysis was executed with the results showing patients suffering from higher levels of depression, stigma and lowered self-esteem. The primary reason for this were the inadequate treatment and recovery strategies being formulated and hence, there was a need for designing individualised and effective treatment regimes in order to cope with such conditions (Rossi et al. 2018).
However, in a study carried out by Chan et al. (2018), it was extensively argued that clinical and personal mental health recovery techniques adhere to different approaches and that the one which is most suitable for a patient suffering from a psychotic disorder should be applied. The clinical and personal mental health recovery processes applied for the well-being of patients suffering from schizophrenia were evaluated. One hundred and eighty-one people with schizophrenia spectrum disorders were recruited for this study and were observed in a total of two categories, including baseline and six months. The results exhibited that personal mental health recovery positively achieved the mental well-being of the individuals and was effective by more than 50% as compared to clinical mental health recovery (Chan et al. 2018).
In a similar study carried out by Dunne, Perich & Meade (2019), the significance pertaining to personal mental health recovery and how it serves as a better approach than clinical mental health recovery in dealing with patients of bipolar disorder was elaborated in depth. A survey was conducted with three hundred and twelve participants suffering from bipolar disorder. Factors including depression and hypomania were evaluated and the results were analysed. The results showed that people who adhere to personal mental health recovery regimen such as seeing family and friends had lower depression levels and hypomania. Hence, it can be deduced that personal mental health recovery leads to enhanced well-being of people who experience psychotic disorders. However, it was argued that there exists a dire need for understanding and formulating affective personal mental health recovery strategies (Dunne, Perich & Meade 2019).
According to a study carried out by O’Keeffe et al. (2019), a study referred to as iHOPE was executed and the differences between clinical and personal procedures of mental health recoveries were assessed. One hundred and seventy-one individuals who had experienced an initial episode of psychosis participated in the study. Following a follow-up session, 53.7% confirmed that they had completely improved by adhering to personal mental health recovery. Hence, the study highlighted the significance and effectiveness of personal recovery as compared to clinical practices (O’Keeffe et al. 2019). However, in a study carried out by Drake & Whitley (2014), it was argued that although personal mental health recovery has gained substantial attention in the past few years, there is still a need to draft systemic changes in recovery processes being employed for patients suffering from different mental illnesses and psychotic disorders. Personal mental health recovery is assumed to help individuals take part in events such as schooling, occupation and communal life (Drake & Whitley 2014).
According to the national framework for recovery-oriented mental health services, health professionals including, registered nurses, registered midwives, psychologists and neuro-physicians need to follow certain rules and legislations in order to optimise treatment of individuals who have experienced different psychotic disorder episodes (Nardella, Hooper & Barnes 2019). The national framework for recovery-oriented mental health services serves an essential guide for all the health professionals and encapsulates necessary capabilities that they should exhibit in order to support individuals with mental illness. Health professionals should be able recognise the aspirations and goals of their patients and implement a personal mental health recovery regime by formulating effective strategies and mechanisms (Nardella, Hooper & Barnes 2019).
National framework for recovery-oriented mental health services is a manuscript which elaborates the notions pertaining to recovery along with analysing a vast array of different practice fields and primary competences required by mental health workers in order to function in line with recovery oriented values. It can be used in making recovery oriented approaches that will aid health professionals including registered nurses (RN) to respond to a diversity of people with mental illness (Taylor, Moxham & Perlman 2018).
All people employed in mental health profession regardless of their role, discipline and seniority, are expected to follow the guidelines mentioned in the national framework for recovery-oriented mental health services. This framework has a dynamic role in the improvement and development of mental health service delivery in Australia. There are a total of seventeen aptitudes grouped into five practice fields of recovery oriented training which have been outlined in this framework. These comprise of communication exhibiting hope and optimism, a holistic practice approach, emphasis on personal mental health recovery, sincerity towards the profession and enhancing social determinants and factors (Taylor, Moxham & Perlman 2018)
Considering all these vital aspects of the national framework for recovery-oriented mental health services, I as a registered nurse (RN), would want to reflect on the importance of utilising two primary therapeutic communication strategies for treating individuals suffering from psychotic disorders such as schizophrenia and assess their strengths. According to a study carried out by Bifarin & Jones (2018), the importance of embedding recovery-oriented approaches into mental health nurse training was elaborated. In order for a registered nurse (RN) to practice safely and make use of his or her skills, effective therapeutic strategies should be formulated and put into effect. This will allow a registered nurse (RN) to optimise patient health care delivery and performing necessary actions in case of any unfortunate event (Bifarin & Jones 2018),
I, as a future registered nurse (RN) can adhere to using therapeutic communication techniques such as active listening and encouraging descriptions of perceptions. By using these techniques of therapeutic communication, I as a future registered nurse (RN) will be able to establish trust with my patients by prioritising their physical, emotional and mental well-being. According to a study carried out by Blake & Blake (2019), emphasis was placed on improving therapeutic active listening skills exhibited by both a registered nurse (RN) as well as student nurses. Active listening expects a registered nurse (RN) to show keen interest in what a patient might have to say and engage with them effectively throughout the communication. As a future registered nurse (RN), I can optimise active listening by using nonverbal and verbal cues such as agreeing and saying “I see” (Blake & Blake 2019).
Apart from active listening, I should also prioritise to encouraging patient descriptions of perceptions. According to a study carried out by Koskenniemi et al. (2018), the significance pertaining to measuring and analysing older patient’s perceptions was demonstrated. It can be helpful to adhere to an encouraging dialogue when asking about patient hallucinations and sensory issues. However, it was argued that there still lies a need for improving respect towards patients, particularly older patients and to show interest in their views when executing nursing practice (Koskenniemi et al. 2018). As a future registered nurse (RN), I should comply to using phrases like “What do you hear now?” and “What does it look like to you”? so that adequate nursing care can be delivered to the patients. I should also make sure not to cast their individual perceptions in negative light. Adhering to encouraging the descriptions of patient perceptions also in turn encourages nurses to take adequate decisions that tend to enhance patient care (French‐Bravo et al. 2020).
Conclusion
Psychotic disorders refer to conditions that negatively affect the cognitive functions and capabilities of an individual and leads to abnormal thinking and perceptions. The primary symptoms of psychotic disorders include delusions and hallucinations and major types comprise of schizophrenia and bipolar disorder. Over the years, personal recovery has gained substantial significance and consists of an individual working towards something that is important to him or her. Personal recovery adheres to elements of hope, optimism and connectedness, thereby allowing an individual to live a meaningful life. National framework for recovery-oriented mental health services is a manuscript which elaborates the notions concerning to recovery along with analysing a vast array of different training areas and primary skills required by mental health workers in order to function in line with recovery oriented principles. It can be used in making recovery oriented methods that will aid health professionals including registered nurses (RN) to respond to people with mental illness. As a future registered nurse (RN), I can adhere to using therapeutic communication techniques such as active listening and encouraging descriptions of perceptions. By using these techniques of therapeutic communication, I as a future registered nurse (RN) will be able to establish trust with my patients by prioritising their physical, emotional and mental well-being.
References
Bifarin, O.O. & Jones, S., 2018, ‘Embedding recovery-based approaches into mental health nurse training’, British Journal of Mental Health Nursing, vol.7, no.5, pp.234-240.
Blake, T. & Blake, T., 2019, ‘Improving therapeutic communication in nursing through simulation exercise’, Teaching and Learning in Nursing, vol.14, no.4, pp.260-264.
Chan, R.C., Mak, W.W., Chio, F.H. and Tong, A.C., 2018, ‘Flourishing with psychosis: a prospective examination on the interactions between clinical, functional, and personal recovery processes on well-being among individuals with schizophrenia spectrum disorders’, Schizophrenia Bulletin, vol.44, no.4, pp.778-786.
Drake, R.E. & Whitley, R., 2014, ‘Recovery and severe mental illness: description and analysis’, The Canadian Journal of Psychiatry, vol.59, no.5, pp.236-242.
Dunne, L., Perich, T. & Meade, T., 2019, ‘The relationship between social support and personal recovery in bipolar disorder’, Psychiatric rehabilitation journal, vol.42, no.1, p.100.
French‐Bravo, M., Nelson‐Brantley, H.V., Williams, K., Ford, D.J., Manos, L. and Veazey Brooks, J., 2020, ‘Exploring nurses’ perceptions of nurse managers’ communicative relationships that encourage nurses’ decisions to buy‐in to initiatives that enhance patients’ experiences with care’, Journal of Nursing Management, vol.28, no.3, pp.567-576.
Koskenniemi, J., Leino‐Kilpi, H., Puukka, P., Stolt, M. and Suhonen, R., 2018, ‘Being respected by nurses: Measuring older patients’ perceptions’, International Journal of Older People Nursing, vol.13, no.3, pp.12197.
Mentalhealth, 2020. Mentalhealth.org.nz. viewed 24 August 2020, <https://www.mentalhealth.org.nz/assets/ResourceFinder/recovery-competencies-for-new-zealand-mental-health-workers-march-2001.pdf>
Nardella, N., Hooper, S. & Barnes, R., 2019. Development of the mental health passport.
O’Keeffe, D., Hannigan, A., Doyle, R., Kinsella, A., Sheridan, A., Kelly, A., Madigan, K., Lawlor, E. and Clarke, M., 2019, ‘The iHOPE-20 study: relationships between and prospective predictors of remission, clinical recovery, personal recovery and resilience 20 years on from a first episode psychosis’, Australian & New Zealand Journal of Psychiatry, vol. 53, no. 11, pp.1080-1092.
Rossi, A., Amore, M., Galderisi, S., Rocca, P., Bertolino, A., Aguglia, E., Amodeo, G., Bellomo, A., Bucci, P., Buzzanca, A. and Carpiniello, B., 2018, ‘The complex relationship between self-reported ‘personal recovery’and clinical recovery in schizophrenia’. Schizophrenia research, vol.192, pp.108-112.
Slade, M., 2016. International differences in understanding recovery: systematic review.
Taylor, E.K., Moxham, L. & Perlman, D., 2018, ‘Self-determination and therapeutic recreation: Implications for personal recovery among people living with mental illness’, Australian Nursing and Midwifery Journal, vol. 25, no. 10, p.34.
Van Eck, R.M., Burger, T.J., Vellinga, A., Schirmbeck, F. and de Haan, L., 2018. The relationship between clinical and personal recovery in patients with schizophrenia spectrum disorders: A systematic review and meta-analysis. Schizophrenia Bulletin, vol.44, no.3, pp.631-642.
van Weeghel, J., van Zelst, C., Boertien, D. and Hasson-Ohayon, I., 2019, ‘Conceptualizations, assessments, and implications of personal recovery in mental illness: A scoping review of systematic reviews and meta-analyses’, Psychiatric rehabilitation journal, vol.42, no.2, p.169.
