93 Clinical treatment interventions and personal recovery R: “[What I want to work on] are the compulsions […] with the help of the psychologist, so we’re discontinuing medication, I’m happy to say. We’re doing it verbally now, with training, or therapy.” ~ P004 DISCUSSION The current study aimed to explore the subjective experience of clinical treatment interventions in personal recovery stories of patients with severe mental illness. The role that specific clinical treatment interventions play for personal recovery appears to differ widely among SMI patients, ranging from very helpful to very hindering. The following clinical treatment interventions were discussed in the personal recovery stories of the participants: 1. Receiving a diagnosis It was found that receiving a diagnosis can function as an important step towards personal recovery, while it can also hinder this process. A diagnosis may provide an explanation for complaints and can give access to treatment options. Also, it can endorse the idea that not the patient, but the illness is to blame for the symptoms. Conversely, receiving the diagnosis of a mental illness can lead to a negative selfimage because of a stigma that can accompany the diagnosis. This negative influence on self-identity may be an extra obstacle for patients in their personal recovery process, which is in line with findings from previous studies (35, 36). The impact of a diagnosis of psychosis has been described before as a ‘means of access’ as well as a ‘cause of disempowerment’. It can help by ‘naming the problem’ and hinder by ‘labelling the person’. It can also be a ‘cause of social exclusion’ (37). Perceived and experienced stigma, also from mental health providers, predicts self-stigma (38). It is important that health care workers are aware of the fact that a diagnosis can have these different consequences for patients. Furthermore, it is advisable to have a conversation about the impact of the diagnosis on the patient’s personal recovery process and to be alert about (self-)stigma (39). ‘Stigma resistance’, defined as ‘one’s ability to deflect or challenge stigmatizing beliefs’ was found to be associated with advanced stages of personal recovery in serious mental illness patients (40). Moreover, when clinicians give someone a diagnosis, a hopeful attitude and discussing the potential for recovery, are important. 2. Medication Medication can be of great help for patients’ personal recovery process by reducing symptoms. It can give a sense of control and can make patients able to function 5
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