The Concept of Recovery as Experienced by Persons with Dual Diagnosis: A Systematic Review of Qualitative Research From a First-Person Perspective

Abstract

In this review, the participants pleaded for "flexibility" in mental health care, i.e., an approach that allows for both successes and failures. However, in order to come to a more comprehensive theoretical model of recovery in persons with dual diagnosis, future research is necessary to gain insight into the underlying mechanisms of recovery processes.

Dual diagnosis: A systematic review of the organization of community health services

“…Only a Canadian review (Torchalla et al, 2012) reports that using a parallel model or an integrated model of taking care is indifferent in terms of outcome, although it admits that IT decreases substance use and symptoms of mental disorder and that in no study the IT has proved harmful or less effective than other non-integrated programs. Only four studies do not consider a specific treatment model (Baldacchino et al, 2011; Deady et al, 2014; De Ruysscher et al, 2017; Edland-Gryt & Skatvedt, 2013; Edward & Robins, 2012), but they focus on two issues that can be considered implicit (or essential component) within an integrated model: low threshold and personalization of the treatment plan. A study (Kortrijk et al, 2013) proposed the trans-theoretical stages of change model, generally used successfully in the field of addiction (Di Clemente & Prochaska, 1998).…”

Dilemmas in recovery-oriented practice to support people with co-occurring mental health and substance use disorders: a qualitative study of staff experiences in Norway

“…While studies on first-person experiences of recovery in mental health have stressed the right to live well “within or despite symptoms” [ 30 ], first-person perspectives on substance use problems tend to stress at least some sort of control over substance use in order to enable recovery [ 3 , 33 ]. This also appears in first-person experiences of co-occurring disorders [ 21 , 34 – 36 ]. Importantly, there seems to be considerable individual variation in how substance use relates to recovery among people with co-occurring disorders [ 37 ], as well as in reasons for quitting substance use [ 38 ], and a categorical total abstinence approach seems to be at odds with recovery principles of supporting each individual’s goals and interests.…”

“…Previous studies suggest that the usefulness and necessity of directiveness may be perceived differently by practitioners and service users. Coercion and paternalism have been seen as incompatible with recovery-oriented practice in qualitative studies with a service user perspective [ 8 , 34 ]. Yet studies of practitioners’ accounts show that recovery-oriented practice and directiveness are not always seen as opposed to each other [ 14 ] and that authoritative behaviour by community mental health professionals may negatively affect therapeutic interactions, even when the professionals adopt a person-centred, recovery-oriented approach to practice [ 15 ].…”

Narratives of recovery in people with coexisting mental health and alcohol misuse difficulties

“…People may make specific identity shifts in recovery from alcohol and mental health difficulties compared with those who use other substances. Though the experiences of people with co-existing mental health and alcohol difficulties are present in the existing literature, a survey of the papers reviewed by Ness, Borg andDavidson (2014) andDe Ruysscher et al (2017) shows that in many cases the particular substances used by the participants are not specified, and even when they are, there is no exploration of what impact this has on their recovery. This paper aims to address this in the case of alcohol, by recruiting specifically people who misused alcohol and exploring the role of alcohol in their recovery narratives.…”