Recovery and self-identity development following a first episode of psychosis
| Date | 05 September 2019 |
| DOI | https://doi.org/10.1108/JPMH-01-2019-0013 |
| Published date | 05 September 2019 |
| Pages | 169-179 |
| Author | Nicola Ann Cogan,Matthias Schwannauer,Sean Harper |
| Subject Matter | Health & social care,Mental health,Public mental health |
Recovery and self-identity development
following a first episode of psychosis
Nicola Ann Cogan, Matthias Schwannauer and Sean Harper
Abstract
Purpose –The onset of psychosis typically develops during adolescence, a crucial period for beginning the
transition from family to independence and developing a stable sense of self. Recovery amongst adolescents
experiencing early onset psychosis has not yet been investigated with reference to its influence on
self-identity. The purpose of this paper is to explore the impact living with early onset psychosis has on
self-identity for adolescents in recovery.
Design/methodology/approach –A purposive sample of ten adolescents aged between16 and 18 years
from an Early Intervention Service in the Scottish National Health Service were recruited. All had experienced
at least one episode of psychosis and were within three years of first contact with the service.
Semi-structured interviews were adopted to capture adolescents’perspectives concerning their experiences
of recovery from psychosis and the impact on self-identity. All interviews were audio-recorded, transcribed
and thematically analysed.
Findings –Qualitative analysis of adolescents’accounts revealed how recovery from psychosis involves
working with individual explanatory frameworks concerning uncertain identities and status ambiguity, a
decrease in referent points and unfavourable social comparisons (emphasising loss, grief and self-criticism).
Research limitations/implications –Supporting adolescents experiencing early psychosis involves
education, rebuilding relationships with self and others and providing access to psychotherapeutic
interventions to aid self-identity development when needed.
Originality/value –The originality of this paper lies in the importance of identity, recovery, human
reconnection, advocacy and community reintegration for adolescents experiencingpsychosis. Public mental
health campaigns to tackle the stigma surrounding psychosis are essential to assisting adolescents in
developing their sense of self through their recovery journeys.
Keywords Self-identity, Citizenship, Adolescence, Psychosis, Mental health, Recovery
Paper type Research paper
Introduction
Research on recovery in the early phase of psychosis has risen dramatically in recent years
(Santesteban-Echarri et al., 2017). A growing interest in understanding and treating the early
phase of psychosis has brought forth a sense of optimism and hope of altering its course
(Bonnett et al., 2018; Lower et al., 2015). The onset of psychosis typically develops during
adolescence or early adulthood; a crucial period for forming peer networks, beginning the
transition from family to independence and developing a stable sense of self (Harrop and Trower,
2003). Chronicity of psychosis is often conceived of as a loss of self and of positive social roles
and identity (McCarthy-Jones et al., 2012). Experiencing a psychotic episode in early
adolescence often disrupts developmental tasks of establishing an identity and becoming more
autonomous (Gumley and MacBeth, 2014).
Recovery from psychosis includes both symptomatic and functional components. Functional
recovery has been found to lag behind symptomatic remission with many individuals remaining
socially isolated with poor functional outcomes (Norman et al., 2017). Systematic review and
meta-analysis of longitudinal studies of predictors of functional recovery emphasise the
importance of early intervention and the use of novel treatments targeting cognitive deficits to
Received 22 January 2019
Revised 2 April 2019
Accepted 11 April 2019
Nicola Ann Cogan is based at
the Department of Psychology,
University of Strathclyde,
Glasgow, UK.
Matthias Schwannauer is
based at the Department of
Clinical Psychology, University
of Edinburgh, Edinburgh, UK.
Sean Harper is based at Royal
Edinburgh Hospital,
Edinburgh, UK.
DOI 10.1108/JPMH-01-2019-0013 VOL. 18 NO. 3 2019, pp. 169-179, © Emerald Publishing Limited, ISSN 1746-5729
j
JOURNAL OF PUBLIC MENTALHEALTH
j
PAG E 16 9
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