Investigating Recovery in Psychosis: a Personal Construct Repertory Grid Study
Chadwick, Sarah Louise
Research regarding the potential value of using a personal construct psychology (PCP) framework to explore recovery in psychosis has been minimal. Mental health policy guidelines (Shepherd et al., 2008) recommend that recovery in mental health is an important area that needs further research. This study aims to further understanding of recovery in service users with psychosis, by examining personal constructs elicited from participants, in contrast to the researcher supplying constructs (Bell and McGorry, 1992). Further, it attempts to define the degree of recovery using the Recovery Assessment Scale (RAS, Corrigan et al., 1999). Thirty two adults from the NHS and voluntary sector participated in the study; each completed a repertory grid (Kelly, 1955). The RAS enabled recovery to be defined by splitting the sample, and comparisons made between low to moderate and high recovery groups. The main findings of the study show that participants in the high recovery group showed less differentiation between their different selves; greater self-esteem; an experienced sense of control over their environment; a higher degree of quality and quantity of support; and a higher degree of hope and goal setting than participants in the low to moderate recovery group. In addition, content analysis (Landfield, 1971) of current self constructs showed that participants in high recovery construed themselves as being more self-sufficient, more active socially, and displayed higher tenderness compared to those in low to moderate recovery. Findings show how repertory grid methods can be applied clinically in order to help with case assessment and formulation, and help facilitate individually tailored therapeutic interventions to enhance recovery. For example, self differentiation findings suggest that to help an individual move towards a higher degree of recovery involves firstly loosening, and then tightening up their construing system. Secondly, self-esteem measures enabled identification of personal goals to strive towards in terms of an individual’s conception of their current and ideal self, and thus steps to take to progress toward recovery. Thirdly, the Pawn and Origin Scale (Westbrook and Viney, 1980) highlighted the degree of control over one’s external and internal world, thus highlighting areas that could be worked on to progress toward higher recovery. Clinical interventions addressing implicative dilemmas were also identified as enabling a change in behaviour, and therefore movement toward recovery. Limitations of the study are discussed, including using HICLAS (De Boeck, 1992) to measure self elaboration in recovery; and future research outlined, including exploring recovery in psychosis through a longitudinal study, and sampling across different mental health populations.