95 Clinical treatment interventions and personal recovery that the perception of the use of these coercive measures tends to differ between patients. While some patients perceived coercive measures as negative, others did not share this view. As found in an earlier study, a sense of safety, agency, control and empowerment is important for coercive treatment to aid, rather than disrupt recovery (53). Also, shame, self-contempt and stigma stress as a reaction to involuntary hospitalization showed poorer recovery after 2 years (54). Due to the negative impact coercive measures can have, they should be used as a last resort and good communication with the patient is extremely important (55, 56). If coercive measures are used, evaluation on the impact is essential with the patient and family, also to explore whether traumatic experiences need support or treatment. 5. Psychological treatment Psychological interventions are perceived by respondents to have a positive effect on personal recovery and no clear downsides were indicated. Patients consider it helpful to treat specific symptoms, such as depressive mood, anxiety, trauma related and psychotic symptoms with for instance Cognitive Behavioral Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR). Hancock and Perich already found in their review that recovery-focused interventions based on principles of CBT showed significant improvement in personal recovery of patients with bipolar disorder (57). Participants of the current study also underscore the importance of paying attention to resilience factors, such as having a positive self-image/selfesteem. This is in line with earlier research, indicating that improving resilience contributes to personal recovery (58-61). The finding that no participants reported negatively about psychological interventions, may have to do with the fact that in order to start a psychotherapy there has to be some kind of mutual agreement about the problem to address and the relevance and purpose of the chosen psychological treatment. This differs from the other categories of interventions, because the latter can also be performed without consent of the specific patient (e.g. administer medication, hospitalization). Limitations and future research A limitation of this study might be that patients who agreed and were able to participate in an interview of 30 to 90 minutes are relatively well-functioning and may have more positive views concerning their treatment. In trying to make statements concerning the impact of factors on personal recovery there should be kept in mind the substantial differences between individual patients. We should be aware of potential over or under interpreting the meaning of a topic for someone’s personal recovery process. 5
RkJQdWJsaXNoZXIy MTk4NDMw