87 Clinical treatment interventions and personal recovery than the time needed for the previously administered quantitative questionnaires). In total, 26 patients with a severe mental disorder (SMI) were interviewed. Data collection The interviews took place between March 2017 and August 2019. A trained researcher (AJ, JB, KW, JZ) conducted the interviews face-to-face at the local treatment facility, or, if requested by the participant, at their own home. 3 interviewers were medical students (AJ, JB, JZ) and KW had a background in health and life sciences. Interviews took approximately 30-90 minutes (mean: 56 minutes). Interviews were audiorecorded, for which participants gave consent before the interview. For the semi-structured interviews, a topic list was used that started with questions that are considered appropriate to discover one’s personal recovery story because of their open, yet personal character: what has happened, what are strengths and weaknesses and what are future hopes or goals (32). Following that, respondents were queried about helping and hindering factors in their recovery process. A substantial part of the interview time was spent on establishing rapport and giving the respondents space to tell their recovery story in their own way. Getting a global picture of the overall recovery story first was considered necessary to enable the interviewer to ask in more depth about the impact of clinical interventions on recovery. If clinical treatment was not spontaneously mentioned by respondents, participants were further prompted about the influence of specific interventions on their personal recovery: Receiving a diagnosis, Medication, Hospitalization, Coercive treatment, Psychological treatment. The two researchers that conceptualized the study (RVE and AV), both psychiatrists, based the choice for asking about these specific interventions on their own clinical experience and medical training and on the existing literature on this subject, as mentioned in the introduction. We felt that these categories of treatment are applied in clinical practice from a mainly ‘medical’ point of view in line with a goal of clinical remission/recovery. The interview guide was not pilot tested, but the opening questions of the recovery-oriented interview have been used before in research (33). Data analysis The interviews were transcribed verbatim with all identifiers removed and uploaded to the MAXQDA Qualitative Data Analysis Software package to facilitate analysis. Thematic analysis enables the generation of new insights derived from the data (34). Exploring the data on how clinical treatment interventions impact personal recovery, we openly and inductively coded the experiences in the interviews, staying attentive towards potential other themes of clinical treatment apart from the above mentioned ones (diagnosis, medication, hospitalization, coercion, psychological treatment). The pre-defined categories that were explicitly asked for during the interviews, were used as a deductive framework for the results. The subthemes were 5
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