11 General introduction process of changing one’s attitudes, values, feelings, goals, skills, and/or roles. It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness (14).” Manuscripts with first person accounts on recovery have been published in scientific journals, which illustrate the individual character of recovery (15-18). Recent qualitative research shows that recovery narratives of people with different diagnoses show similar themes. This suggests that personal recovery is a transdiagnostic concept, i.e. not only applicable to patients with psychosis (19). In addition, Anthony mentions another interesting aspect: “Recovery transcends illness and the disability field itself. Recovery is a truly unifying human experience. Because all people (helpers included) experience the catastrophes of life (death of a loved one, divorce, the threat of severe physical illness, and disability), the challenge of recovery must be faced.” This implies that the concept of recovery is not limited to people with mental illness, but is universal. After that, Anthony writes: “Successful recovery from a catastrophe does not change the fact that the experience has occurred, that the effects are still present, and that one’s life has changed forever. Successful recovery does mean that the person has changed, and that the meaning of these facts to the person has therefore changed. They are no longer the primary focus of one’s life.” This suggests that recovery is not, as described in the classical dictionary definition above, a return to the same state as before, but an adaptation to disruptive circumstances. Like stated in the quote of a research participant at the beginning of this thesis, a volcano might be a good metaphor: after an eruption, the volcano will never be like it was before, and you don’t know if and when it will erupt again. This is in line with Deegan’s description of recovery as “a transformative process in which the old self is gradually let go of and a new sense of self emerges (15).” ‘To overcome’, rather than ‘to recover’, might have been a better word for this process. Efforts have been made to develop conceptual frameworks for personal recovery. A systematic review and narrative synthesis resulted in an, often cited, acronym CHIME, which stands for five core recovery processes: Connectedness; Hope and optimism about the future; Identity; Meaning in life; and Empowerment (20). Also, different phases of recovery have been defined: Overwhelmed by, struggling with, living with and living beyond the disability (21). There is a debate whether personal recovery is measurable in a quantitative manner, because it is highly individual (22). A ‘golden standard’ is difficult, if not impossible, to define. This also relates to the question whether personal recovery is an outcome or a process (23, 24). An outcome measure is a tool that can be used to assess the effectiveness of a treatment, usually by comparing scores before and after an intervention. Personal recovery as an outcome may be compared with other 1
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