Profiles of Recovery from Mood and Anxiety Disorders: A Person-Centered Exploration of People's Engagement in Self-Management

Abstract

Context: A shift toward person-centered care has been occurring in services provided to people with mood and anxiety disorders. Recovery is recognized as encompassing personal aspects in addition to clinical ones. Guidelines now recommend supporting people's engagement in self-management as a complementary recovery avenue. Yet the literature lacks evidence on how individualized combinations of self-management strategies used by people relate to their clinical and personal recovery indicators.Objectives: The aims of this study were to identify profiles underlying mental health recovery, describe the characteristics of participants corresponding to each profile, and examine the associations of profiles with criterion variables.Method: 149 people recovering from anxiety, depressive, or bipolar disorders completed questionnaires on self-management, clinical recovery (symptom severity), personal recovery (positive mental health), and criterion variables (personal goal appraisal, social participation, self-care abilities, coping).Results: Latent profile analysis (LPA) revealed three profiles. The Floundering profile included participants who rarely used self-management strategies and had moderately severe symptoms and the lowest positive mental health. The Flourishing profile was characterized by frequent use of self-empowerment strategies, the least severe symptoms, and the highest positive mental health. Participants in the Struggling profile engaged actively in several self-management strategies focused on symptom reduction and healthy lifestyle. They concomitantly reported high symptom severity and moderately high positive mental health. The study revealed that Floundering was associated with higher probabilities of being a man, being single, and having a low income. People in the Flourishing profile had the most favorable scores on criterion variables, supporting the profiles' construct validity.Discussion: The mixed portrait of Struggling participants on recovery indicators suggests the relationship between health engagement and recovery is more intricate than anticipated. Practitioners should strive for a holistic understanding of their clients' self-management strategies and recovery indicators to provide support personalized to their profile. While people presenting risk factors would benefit from person-centered support, societal efforts are needed in the long term to reduce global health inequalities. The integration of constructs from diverse fields (patient-centered care, chronic illness, positive psychology) and the use of person-oriented analysis yielded new insights into people's engagement in their health and well-being.

Connection, meaning, and distraction: A qualitative study of video game play and mental health recovery in veterans treated for mental and/or behavioral health problems

“…Clinical best practices to promote these aspects of recovery and wellness include working with patients to identify appropriate and effective strategies—the “personal medicine” that empowers them to live the life of their choosing (Deegan, 2005; MacDonald-Wilson et al, 2013). While some strategies focus primarily on coping with symptoms, others focus on goals such as identifying and pursuing valued activities, social and community participation, recognizing strengths, and proactively managing psychological and cognitive resources (Coulombe et al, 2016; Deegan, 2005; Villaggi et al, 2015). VA clinical practice guidelines strongly support shared decision making to support veterans’ recovery from behavioral health conditions (Department of Veterans Affairs, Department of Defense, 2017, 2016, 2015), and emerging practices within the VA and the private sector include online and mobile-based mindfulness interventions, PTSD coaching, therapy support, and social connection (Bush et al, 2015; Department of Veterans Affairs, Veterans Health Administration, 2017; Objective Zero Foundation, 2018; Spijkerman et al, 2016).…”

Routine Cognitive Behavioural Therapy for Anxiety and Depression is More Effective at Repairing Symptoms of Psychopathology than Enhancing Wellbeing

“…An alternative perspective is that symptoms and wellbeing represent orthogonal dimensions (the dual-continua model: Tudor 1996; Provencher and Keyes 2011), based on findings that the two constructs are only moderately correlated in some samples and are best accounted for as two latent dimensions rather than a single latent dimension (Keyes 2005(Keyes , 2006(Keyes , 2007. Irrespective of which of these positions is adopted, treatment for anxiety and depression should aim to move individuals from a position of 'languishing' (low wellbeing, high mental illness) to one of 'flourishing' (high wellbeing, low mental illness) (Keyes and Lopez 2002;Coulombe et al 2016). Moreover, regardless of which of these frameworks is correct, it is likely that different intervention strategies will be required to develop wellbeing as opposed to reduce symptoms.…”

A Theory on the Components of Depression Self-Management in Older Adults

“…By drawing on the internal and external resources available to them as individuals—not simply as members of a group of older adults or people with depression—participants demonstrated a sense of empowerment in their efforts to achieve mastery over their own lives (Polacsek et al, 2018, 2020a). Self-empowerment is strongly associated with self-determination and self-management (Coulombe et al, 2016), both of which were embraced by participants as preferred approaches to meeting their own needs and preferences as older adults living with depression.…”