An Exploratory Analysis of Correlates of Recovery
Abstract
OBJECTIVE: The concept of recovery has received increasing emphasis in the delivery of services to persons with schizophrenia. This study was an initial effort to develop an empirically based model of factors associated with a recovery orientation. METHODS: The authors reanalyzed data from 825 persons with schizophrenia who were assessed in the Schizophrenia Patient Outcomes Research Team (PORT) client survey. Multiple regression models were used to identify client and service use variables associated with each of four domains identified as important to a recovery orientation: life satisfaction, hope and optimism, knowledge about mental illness and services, and empowerment. RESULTS: In each regression model, the strongest relationship was observed between recovery orientation and lower severity of depressive symptoms. Both receipt of family psychoeducation and fewer side effects of medications were significantly and positively related to three of the four recovery domains. Psychotic symptoms were associated with less life satisfaction. Receipt of various services, including day treatment and legal services, was positively associated with knowledge about illness and services. CONCLUSIONS: Severity of psychiatric symptoms, a core feature of the biomedical perspective of mental illness, was negatively associated with a recovery orientation, and use of a variety of standard services were positively associated with a recovery orientation. Thus a polarized view of biomedical and recovery perspectives on mental illness may be unfounded, given that these perspectives appear to be mutually reinforcing.
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Sole reduction of symptoms does not necessarily result in higher personal recovery.
“Furthermore, studies have shown that sole reduction of symptoms (i.e. clinical recovery) does not necessarily result in higher personal recovery [6, 7].”
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“Different studies found a significant correlation between personal recovery and severity of symptoms (Corrigan et al., 2004, Resnick et al., 2004, Jørgensen et al., 2015), although such finding has not been replicated elsewhere (Roe et al., 2011).”
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Tse, S., Davidson, L., Chung, K.-F., Ng, K. L., & Yu, C. H. (2014) · Psychiatry: Interpersonal and Biological Processes · doi:10.1521/psyc.2014.77.1.41 · Cited by 53 · see citing works
“Therefore, clinicians, caregivers, and researchers alike should use both personal recovery and functional recovery indicators (Resnick et al., 2004; Roe et al., 2011; Silverstein & Bellack, 2008) as a form of triangulation to improve our understanding of the multifaceted nature of recovery and to demonstrate our commi…”
BackgroundMethodLysaker, P. H., Roe, D., & Buck, K. D. (2010) · Journal of the American Psychiatric Nurses Association · doi:10.1177/1078390309353943 · Cited by 53 · see citing works
“Resnick et al. (2004) have used a range of standardized self-report assessments of quality of life and future opportunities with acceptable levels of internally consistent and significant correlations with other relevant assessments.”
BackgroundSchennach, R., Obermeier, M., Seemüller, F., Jäger, M., Schmauß, M., Laux, G., Pfeiffer, H., Naber, D., Schmidt, L., Gäebel, W., et al. (2012) · Psychopathology · doi:10.1159/000336729 · Cited by 53 · see citing works
Alameda, L., Golay, P., Baumann, P., Progin, P., Mebdouhi, N., Elowe, J., Ferrari, C., Kim, Q., & Conus, P. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbw163 · Cited by 53 · see citing works
Monitoring the dissemination of peer support in the VA Healthcare System
Barber, J. A., Rosenheck, R. A., Armstrong, M., & Resnick, S. G. (2008) · Community Mental Health Journal · doi:10.1007/s10597-008-9146-7 · Cited by 68 · see citing works
“To assess general Veteran Recovery, items were selected that represent four distinct categories derived from the Patient Outcomes Research Team (PORT) client survey ( Resnick et al. 2004b, 2005 ): (1) general life satisfaction— rated on a 7-point Likert scale (1 = ‘‘terrible’’ to 7 = ‘‘delighted’’); (2) hope—rated on…”
MethodSelf-citationTALKING ABOUT HOPE: THE USE OF PARTICIPANT PHOTOGRAPHY
Miller, G. S., & Happell, B. (2006) · Issues in Mental Health Nursing · doi:10.1080/01612840600943697 · Cited by 49 · see citing works
O'Dwyer, S., Davoren, M., Abidin, Z., Doyle, E., McDonnell, K., & Kennedy, H. G. (2011) · BMC Research Notes · doi:10.1186/1756-0500-4-229 · Cited by 49 · see citing works
“Our current clinical practice is to assess the HCR-20 and S-RAMM, PANSS and GAF, DUNDRUM-3 and DUNDRUM-4 every six months prior to case conferences and when recommending leave or moves to less secure settings We believe these two structured professional judgement instruments fulfil many of the criteria set out for per…”
MethodJørgensen, R., Zoffmann, V., Munk‐Jørgensen, P., Buck, K. D., Jensen, S. O. W., Hansson, L. I., & Lysaker, P. H. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.03.013 · Cited by 48 · see citing works
“Resnick et al. (2004) and Silverstein and Bellack (2008), have proposed that recovery may involve objective phenomena, including the absence or remission of symptoms and psychosocial deficits and subjective phenomena, which involve changes in how persons feel about themselves.”
InfluentialHamm, J., Hasson-Ohayon, I., Kukla, M., & Paul H Lysaker, P. (2013) · Psychology Research and Behavior Management · doi:10.2147/prbm.s47891 · Cited by 64 · see citing works
“Recovery may also include persons developing the ability to experience themselves as agentic individuals with rich histories and the potential to influence their own futures and successfully navigate life’s challenges, regardless of fluctuations in level of dysfunction or symptoms.(36,38,42,43) In this regard, a centr…”
Piat, M., & Sabetti, J. (2009) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2009-0020 · Cited by 45 · see citing works
“, 2009 ; Smith, 2000; Sullivan, 1994). Pilgrim (2008) distinguishes three positions adopted by mental health consumers in relation to the discourse around recovery: (a) acceptance of the biomedical or “recovery from” perspective, (b) a “social recovery” perspective where consumers reject psychiatry altogether, and (c)…”
BackgroundMethodDavoren, M., Hennessy, S., Conway, C. M., Marrinan, S., Gill, P., & Kennedy, H. G. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0433-x · Cited by 45 · see citing works
“described four key aspects to recovery: life satisfaction, hope and optimism, empowerment and knowledge about mental illness and services [9] – akin to a rights based empowerment.”
BackgroundMaintenance of Recovery From Schizophrenia at 20-Year Follow-Up: What Happened?
Torgalsbøen, A., & Rund, B. R. (2010) · Psychiatry · doi:10.1521/psyc.2010.73.1.70 · Cited by 45 · see citing works
Factors involved in recovery from schizophrenia: A qualitative study of Thai mental health nurses
Kaewprom, C., Curtis, J., & Deane, F. P. (2011) · Nursing and Health Sciences · doi:10.1111/j.1442-2018.2011.00621.x · Cited by 43 · see citing works
The Recovery Process Utilizing Erikson’s Stages of Human Development
Vogel-Scibilia, S., McNulty, K. C., Baxter, B., Miller, S., Dine, M., & Frese, F. J. (2009) · Community Mental Health Journal · doi:10.1007/s10597-009-9189-4 · Cited by 41 · see citing works
“Multiple authors have endorsed the instillation of hope as one of the key concepts of recovery (Resnick et al. 2004, 2005; Jacobson and Greenley 2001; Mead and Copeland 2000).”
BackgroundHope, recovery and symptoms: the importance of hope for people living with severe mental illness
Hayes, L., Herrman, H., Castle, D. J., & Harvey, C. A. (2017) · Australasian Psychiatry · doi:10.1177/1039856217726693 · Cited by 41 · see citing works
Drapalski, A. L., Leith, J. E., & Dixon, L. B. (2009) · Clinical Schizophrenia & Related Psychoses · doi:10.3371/csrp.3.1.4 · Cited by 38 · see citing works
Hasson‐Ohayon, I., Roe, D., & Kravetz, S. (2006) · Psychological Services · doi:10.1037/1541-1559.3.4.262 · Cited by 38 · see citing works
Argentzell, E., Hultqvist, J., Neil, S., & Eklund, M. (2017) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2017.1346144 · Cited by 37 · see citing works
“ing increased quality of life (8) and taking control of one’s life (9,10).”
BackgroundCorrelates of subjective recovery in an early intervention program for psychoses
Norman, R. M. G., Windell, D., Lynch, J., & Manchanda, R. (2012) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2012.00371.x · Cited by 36 · see citing works
The Scale to Assess Narrative Development
Lysaker, P. H., Taylor, A. C., Miller, A. B., Beattie, N. L., Strasburger, A. M., & Davis, L. W. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000202512.54587.34 · Cited by 36 · see citing works
“Summarized by Resnick et al. (2004), recovery can involve changes in any of a number of domains of function that can be grouped into at least two larger sets: objective assessments of the absence of illness (e.g., symptom remission and good psychosocial function) and subjective experiences related…”
BackgroundA substantive theory of recovery from the effects of severe persistent mental illness
Henderson, A. R. (2010) · International Journal of Social Psychiatry · doi:10.1177/0020764010374417 · Cited by 36 · see citing works
Patients’ perspectives on what works in psychoeducational groups for schizophrenia
Sibitz, I., Amering, M., Gößler, R., Unger, A., & Katschnig, H. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0245-5 · Cited by 35 · see citing works
“It is evident from the present study that participation in the seminar promoted self-confidence and empowerment, key elements in the recovery of individuals with schizophrenia [31].”
BackgroundArgentzell, E., Bäckström, M., Lund, K., & Eklund, M. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02924-2 · Cited by 34 · see citing works
Subjective Recovery in Patients with Schizophrenia and Related Factors
İpçi, K., Yıldız, M., İncedere, A., Kiras, F., Esen, D., & Gürcan, M. B. (2020) · Community Mental Health Journal · doi:10.1007/s10597-020-00616-5 · Cited by 33 · see citing works
Concept analysis of recovery in mental illness in young adulthood
McCauley, C. O., McKenna, H., Keeney, S., & McLaughlin, D. F. (2015) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12245 · Cited by 32 · see citing works
Is there a science of recovery and does it matter?
Holloway, F. A. (2008) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.108.005488 · Cited by 31 · see citing works
Piat, M., Sabetti, J., & Bloom, D. (2009) · Issues in Mental Health Nursing · doi:10.1080/01612840802509452 · Cited by 31 · see citing works
“…internal and external recovery processes (Jacobson & Greenley, 2001; Ochocka, Nelson, & Janzen, 2005); and two large descriptive studies by Resnick et al. (2005; 2004), based on data from 825 recovering consumers, which developed an empirical model based on four recovery domains:…”
BackgroundNakajima, S., Takeuchi, H., Fervaha, G., Plitman, E., Chung, J. K., Caravaggio, F., Iwata, Y., Mihashi, Y., Gerretsen, P., Remington, G. J., et al. (2014) · Schizophrenia Research · doi:10.1016/j.schres.2014.12.024 · Cited by 31 · see citing works
“schizophrenia, including quality of life and subjective well-being, which in turn increases risk of suicide, relapse, and psychiatric hospitalization (Kim et al., 2014; Reine et al., 2003; Resnick et al., 2004; Sands and Harrow, 1999; Tollefson et al., 1999).”
Coaching for recovery: a quality improvement project in mental healthcare
Burhouse, A., Rowland, M., Niman, H. M., Abraham, D., Collins, E., Matthews, H., Denney, J., & Ryland, H. (2015) · BMJ Quality Improvement Reports · doi:10.1136/bmjquality.u206576.w2641 · Cited by 30 · see citing works
“[29] Resnick et al [30] believe the key elements of recovery for people with long-term mental illness are: - Satisfaction with life - Hope and optimism -”
BackgroundRecovery and its correlates in patients with schizophrenia
Singla, N., Avasthi, A., & Grover, S. (2020) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2020.102162 · Cited by 32 · see citing works
Implications of evidence-based practice for mental health nursing.
Fisher, J. E., & Happell, B. (2009) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2009.00607.x · Cited by 35 · see citing works
“This conflicts with the recovery model that is currently being promoted in the mental health arena (Borg & Kristiansen 2004; Davidson et al. 2006; Rebeiro Gruhl 2005; Resnick et al. 2004).”
MethodPharmacological strategies for the management of comorbid depression and schizophrenia
Češková, E. (2020) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2020.1717466 · Cited by 29 · see citing works
“However, evidence suggests that depression is linked to poorer outcomes [9,10].”
BackgroundLim, M., Li, Z., Xie, H., Tan, B. L., & Lee, J. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2238-9 · Cited by 28 · see citing works
The burden of depressive symptoms in people with schizophrenia
Conley, R. R. (2009) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2009.09.001 · Cited by 28 · see citing works
Riedel, M. J., Mayr, A. J., Seemüller, F., Maier, W., Klingberg, S., Heuser, I., Klosterkötter, J., Gastpar, M., Schmitt, A., Sauer, H., et al. (2011) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2011.552633 · Cited by 28 · see citing works
“Depressive symptoms have been associated with an impaired social and vocational functioning, poor quality of life and an increased risk of relapse (Tollefson and Andersen 1999; Resnick et al. 2004).”
BackgroundDavidsen, A. S., Davidsen, J., Jønsson, A. B. R., Nielsen, M. H., Kjellberg, P. K., & Reventlow, S. D. (2020) · International Journal of Mental Health Systems · doi:10.1186/s13033-020-00419-x · Cited by 27 · see citing works
Cross-Validation of Mental Health Recovery Measures in a Hong Kong Chinese Sample
Ye, S. S., Pan, J., Wong, D. F. K., & Bola, J. R. (2013) · Research on Social Work Practice · doi:10.1177/1049731512471861 · Cited by 27 · see citing works
Predictors of Mental Health Recovery in Homeless Adults with Mental Illness
Kerman, N., Sylvestre, J. C., Aubry, T., Distasio, J., & Schütz, C. G. (2018) · Community Mental Health Journal · doi:10.1007/s10597-018-0356-3 · Cited by 27 · see citing works
López, J. E., Orrell, M. W., Morgan, L., & Warner, J. P. (2009) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181b2090b · Cited by 27 · see citing works
The Recovery Process and People with Serious Mental Illness Living in the Community
Merryman, M. B., & Riegel, S. K. (2007) · Occupational Therapy in Mental Health · doi:10.1300/j004v23n02_03 · Cited by 26 · see citing works
“Resnick, Rosenheck, and Lehman (2004) developed a model of factors associated with a recovery orientation.”
BackgroundThe Wellness Planner: Empowerment, Quality of Life, and Continuity of Care in Mental Illness
Marchinko, S., & Clarke, D. (2010) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2010.10.003 · Cited by 26 · see citing works
Depression in schizophrenia: Comparison of first- and second-generation antipsychotic drugs
Mauri, M. C., Moliterno, D., Rossattini, M., & Colasanti, A. (2007) · Schizophrenia Research · doi:10.1016/j.schres.2007.10.020 · Cited by 25 · see citing works
“Most recent research has shown that they indicate a poor prognosis in terms of recovery and reintegration into the community (Resnick et al., 2004), and they clearly play a part in the devastating long-term nature of schizophrenia.”
Compensation of Veterans with Psychiatric or Substance Abuse Disorders and Employment and Earnings
Greenberg, G. A., & Rosenheck, R. A. (2007) · Military Medicine · doi:10.7205/milmed.172.2.162 · Cited by 25 · see citing works
Self-citationYıldız, M., Erim, R., Soygür, H., Tural, Ü., Kiras, F., & Güleş, E. (2017) · Psychiatry and Clinical Psychopharmacology · doi:10.1080/24750573.2017.1405579 · Cited by 24 · see citing works
“Studies on recovery have found that two-, fouror five-factor structures of recovery [25,27,28,36,37].”
BackgroundBuonocore, M., Bosia, M., Baraldi, M. A., Bechi, M., Spangaro, M., Cocchi, F., Bianchi, L., Guglielmino, C., Mastromatteo, A. R., & Cavallaro, R. (2017) · Psychiatry and Clinical Neurosciences · doi:10.1111/pcn.12605 · Cited by 24 · see citing works
What are depressive symptoms in acutely ill patients with schizophrenia spectrum disorder?
Schennach, R., Riedel, M. J., Obermeier, M., Seemüller, F., Jäger, M., Schmauß, M., Laux, G., Pfeiffer, H., Naber, D., Schmidt, L., et al. (2014) · European Psychiatry · doi:10.1016/j.eurpsy.2014.11.001 · Cited by 23 · see citing works
“Depressive symptoms are associated with impairments in social and vocational functioning, poor quality of life and an increased risk of relapse [32,40] also contributing to the alarmingly high rates of suicide [28].”
Background
- Authors
- Resnick, S. G., Rosenheck, R. A., & Lehman, A. F.
- Affiliations
- United States Department of Veterans Affairs (US)
- Venue
- Psychiatric Services
- Published
- 2004-05
- Volume
- 55
- Issue
- 5
- Pages
- 540-547
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2096587241
- Semantic Scholar
- 1a18ae6d5bb6c95da489ad8491fde5a3f58f1604
- Cited by
- 251
- References
- 36
- Citations by year
- 2025: 3 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 5 · 2020: 9 · 2019: 12 · 2018: 10 · 2017: 11 · 2016: 8 · 2015: 10 · 2014: 18 · 2013: 13 · 2012: 21
- FWCI
- 26.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mental Health and Patient Involvement
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- recovery orientation, schizophrenia, life satisfaction, hope and optimism, empowerment, depressive symptoms, family psychoeducation, antipsychotic adverse effects, psychotic symptoms, day treatment, legal services, service utilization, biomedical model of mental illness
- MeSH terms
- Adult, Depression, Female, Humans, Male, Mental Health Services, Middle Aged, Personal Satisfaction, Power, Psychological, Psychotic Disorders, Quality of Life, Surveys and Questionnaires, Schizophrenia, Comorbidity, Recovery of Function
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