Challenges to assisting with the recovery of personal identity and wellness for persons with serious mental illness: Considerations for mental health professionals

Buck, Kelly D.; Roe, David; Yanos, Philip T.; Buck, Benjamin; Fogley, Rebecca L.; Grant, Megan; Lubin, Fabrice; Lysaker, Paul H.

doi:10.1080/17522439.2012.699544

Cited by 81 publications

(52 citation statements)

References 27 publications

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“…A metaanalysis of 50 cross-sectional studies found a weak relationship between clinical insight and depression, but reported that longitudinal studies suggested a stronger, more complex relationship which plays out differently depending upon the circumstances of the individual person's life 87 . This is consistent with clinical observations that, with insight, persons may discover negative things about their lives which are surprising and affect each individual differently 88 .…”

Section: Good Clinical Insight Is Associated With Depression and Poorsupporting

confidence: 76%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

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Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

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Section: Good Clinical Insight Is Associated With Depression and Poorsupporting

confidence: 76%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

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“…It was challenging to accept what they lost, to face psychosis, overcome ongoing hurdles, and to re-establish their identity. The difficulties that accompanied adaptation and growth concurred with other research [21,58]. Nevertheless, most participants demonstrated resilience to face these challenges.…”

Section: Adaptation and Posttraumatic Growthsupporting

confidence: 60%

“…The current research shows that pain is still present amidst the gains and growth of adaptation. Buck et al [58] and Dunkley and Bates [21] encourage professionals to be aware of this and to support service users through both the challenges and gains of recovery. Accepting the inevitability of pain can enable individuals to work towards a meaningful and valued life [64].…”

Section: Clinical and Research Implicationsmentioning

confidence: 99%

Understanding Adaptation to First Episode Psychosis Through the Creation of Images

Attard

Larkin

Boden

et al. 2017

J. Psychosoc. Rehabil. Ment. Health

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This article aims to understand and explore the meaning of adaptation to First Episode Psychosis (FEP). An innovative method of data collection was used with ten participants who experienced FEP which integrated drawings of their lived experience within semi-structured interviews. The data were analysed through Interpretative Phenomenological Analysis and hermeneutic-phenomenological image analysis. Participants' experience was captured in four superordinate themes which identified that adaptation to FEP entailed: 'Finding out how psychosis fits into my story', 'Breaking free from psychosis', 'Fighting my way through psychosis', and 'Finding a new way of being 'me''. The participants' path of adaptation to FEP was an interplay of pains, challenges, and gains, and there was resonance with posttraumatic growth in their accounts. This article illustrates that creating images may offer a powerful way of conveying the multifaceted aspects of adaptation to FEP and could help individuals in communicating and processing their experience.

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“…Contemporary research has suggested that meaningful recovery from schizophrenia is possible and requires that persons actively make sense of their condition and lives and direct their own recovery (Lysaker and Buck 2006;Buck et al 2013). This suggests that treatment may need to go beyond advice giving or teaching of skills and instead offer opportunities for patients to reflect and then make decisions based on those reflections.…”

Section: Introductionmentioning

confidence: 98%

Metacognitive Reflective and Insight Therapy for a Person Who Gained Maximal Levels of Metacognitive Capacity and Was Able to Terminate Therapy

Buck

George

2016

J Contemp Psychother

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Schizophrenia often involves a loss of metacognitive capacity, or the ability to form a complex and integrated sense of self and others. Independent of symptoms and impairments in neurocognition, metacognitive deficits are a barrier to the formation and sustenance of goal-directed activities of daily life and ultimately to recovery. Metacognitive reflective and insight therapy (MERIT) is a form of psychotherapy intended to assist patients to recover metacognitive capacity through intensive individual therapy. This paper presents a case illustration of how MERIT assisted a patient with prolonged schizophrenia and significant metacognitive deficits to develop a robustly complex understanding of himself and others and then to use that knowledge to agentically monitor his own experiences and effectively respond to life challenges. The eight elements of MERIT that stimulate and promote metacognitive capacity are presented with an emphasis on how they were implemented when the patient had reached some of the higher levels of metacognitive function.

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Challenges to assisting with the recovery of personal identity and wellness for persons with serious mental illness: Considerations for mental health professionals

Cited by 81 publications

References 27 publications

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

Understanding Adaptation to First Episode Psychosis Through the Creation of Images

Metacognitive Reflective and Insight Therapy for a Person Who Gained Maximal Levels of Metacognitive Capacity and Was Able to Terminate Therapy

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