“I Didn't See It as a Problem, I Thought It Was Going to Be Taken Away”: Narratives From Family Members of Users in Rehab

There are multiple discourses on addictions that influence the way in which relatives interpret the substance use of a family member. The purpose of this study is to understand the influence of these discourses on the construction of use as a problem by relatives of people in recovery. Narratives were obtained on the path of the illness to identify the phases in the construction of use as a problem and the influence of the discourses on each phase. The process has four successive phases: normalization, impasse, exasperation, and adoption of the treatment ideology. This process goes from the legitimization of use to its moral interpretation and subsequently to the transition to medical discourse. It is concluded that it is important to reduce the influence of the moral discourse in order to facilitate timely detection and early care, as well as to design interventions focused on the reconstruction of use as a problem.

Can we mend fences? A model of recovery processes of SME business-to-business relationships

Purpose This paper aims to develop a process model of business-to-business (B2B) relationship recovery after a transgression has placed the future of the relationship in doubt. The research questions ask, How are relationships recovered? and How does the relationship strength pre-transgression influence the recovery process? Design/methodology/approach The process model is empirically grounded with first-hand narratives of owner managers (OMs) and key personnel of Irish small and medium-sized enterprises (SMEs). Using the critical incident technique, 25 owner and manager interviews in 23 SMEs resulted in 48 recovery narratives. Findings The findings identify four types of outcomes flowing from two potential recovery process paths. The strength of the relationship pre-transgression and the desire to maintain the relationship influence the parties’ actions during the recovery process and the status of the relationship subsequently. Research limitations/implications The authors acknowledge that each narrative in the data are the informants’ construction of the phenomenon. The B2B relationship recovery process model offers OMs and SMEs a blueprint of what to expect, and how they might reach for recovery instead of the relationship ending. Originality/value Prior studies either treat recovery as a minor part of an ending process or focus on a single sub-process, leaving the overall process under-researched. This study contributes to the B2B relationship dynamics discussion with a processual view of the overall recovery process, including recovery sub-processes, paths and temporal outcomes in different types of relationships and takes into account the pre-transgression relationship.

Where Do We Go After Surviving the Virus? Cross-Country Documentary Analysis of the Social Consequences Faced by COVID-19 Survivors

In this study, we attempted to move beyond the skewed discussions on stigma to unravel other social consequences that are experienced by persons who have recovered from COVID-19. We conducted a documentary review of published news reports from 14 highly ranked news portals in Ghana and Malaysia (published between 1st January 2020 and 30th August 2020) that contained personal accounts from the recovered patients about their lived experiences with the virus and social consequences encountered after recovery. Narratives from the recovered patients were extracted and analyzed following the narrative thematic analysis procedure. Common themes identified from the narratives included: 1) Stigma impacting mental health, 2) Assault and abuse 3) Experiences of treatment. The findings show the need for interprofessional collaboration between social and health care professionals such as social workers, community health workers, medical practitioners and psychologists to prevent and address issues of abuse and other social consequences experienced by COVID-19 survivors.

Recorded Mental Health Recovery Narratives as a Resource for People Affected by Mental Health Problems: Development of the Narrative Experiences Online (NEON) Intervention

Background The internet enables sharing of narratives about health concerns on a substantial scale, and some digital health narratives have been integrated into digital health interventions. Narratives describing recovery from health problems are a focus of research, including those presented in recorded (eg, invariant) form. No clinical trial has been conducted on a web-based intervention providing access to a collection of Recorded Recovery Narratives (RRNs). Objective This study presents knowledge produced through the development of the Narrative Experiences Online (NEON) Intervention, a web-based intervention incorporating the algorithmic recommendation of RRNs. Methods Knowledge was gathered through knowledge integration (KI) activities. KI1 synthesized previous studies to produce the NEON Impact Model describing how accessing RRNs produces health-related outcomes. KI2 developed curation principles for the NEON Collection of RRNs through consultation with the NEON Lived Experience Advisory Panel and the curation of a preliminary collection. KI3 identified harm minimization strategies for the NEON Intervention through consultation with the NEON International Advisory Board and Lived Experience Advisory Panel. The NEON Intervention was finalized through 2 research studies (RS). In RS1, mental health service users (N=40) rated the immediate impact of randomly presented narratives to validate narrative feedback questions used to inform the recommendation algorithm. In RS2, mental health service users (n=25) were interviewed about their immediate response to a prototype of the NEON Intervention and trial procedures and then were interviewed again after 1 month of use. The usability and acceptability of the prototype and trial procedures were evaluated and refinements were made. Results KI1 produced the NEON Impact Model, which identifies moderators (recipient and context), mechanisms of connection (reflection, comparison, learning, and empathy), processes (identification of change from narrative structure or content and internalization of observed change), and outcomes (helpful and unhelpful). KI2 identified 22 curation principles, including a mission to build a large, heterogeneous collection to maximize opportunities for connection. KI3 identified seven harm minimization strategies, including content warnings, proactive and reactive blocking of narratives, and providing resources for the self-management of emotional distress. RS1 found variation in the impact of narratives on different participants, indicating that participant-level feedback on individual narratives is needed to inform a recommender system. The order of presentation did not predict narrative feedback. RS2 identified amendments to web-based trial procedures and the NEON Intervention. Participants accessed some narratives multiple times, use reduced over the 4-week period, and narrative feedback was provided for 31.8% (105/330) of narrative accesses. Conclusions RRNs can be integrated into web-based interventions. Evaluating the NEON Intervention in a clinical trial is feasible. The mixed methods design for developing the NEON Intervention can guide its extension to other clinical populations, the design of other web-based mental health interventions, and the development of narrative-based interventions in mental health.

Management of a High-Performing Mental Health Recovery Research Group

A personal perspective is given on the processes involved in managing and sustaining a high-performing mental health recovery research group. The broader context of scholarship in the United Kingdom is outlined, in which academic productivity is commodified specifically in relation to peer-reviewed journal papers. Four leadership choices in developing a high-performing research group are discussed: optimal group size; sharing the workload; maintaining a programmatic focus; and performance expectations. Approaches to maximising innovation are identified, including emotional and intellectual engagement of team members, working with diverse stakeholders and convening communities of practice. We use a highly managed approach to publications from inception to acceptance, which is described in detail. The use of these approaches is illustrated in relation to the Recovery Research Team which was formed in 2009. Specific recovery-related issues covered include demonstrating the ability to develop a significant recovery research portfolio (our four current large [>UK£2 m] studies relate to recovery narratives, global mental health peer support work, digital interventions and Recovery Colleges); the positive implications of actively recruiting researchers with mental health lived experience; how performance issues are managed; our approach to involving lived experience co-authors in papers; and our decision to conduct mixed-methods rather than solely qualitative studies.

For whom the bell CHIMEs: a synthesis of remarkable student lives

Purpose The purpose of this paper is to review the 20 remarkable lives of student accounts published in this journal. These recovery narratives (RNs) are examined first in terms of whether they meet the five elements of the connectedness, hope, identity, meaning and empowerment (CHIME) model of recovery and then in terms of what makes each account remarkable. Design/methodology/approach Two Excel spreadsheets were created. One had each author’s name and the five elements of the CHIME model, the other the features of a remarkable life. Findings All 20 accounts fulfilled the criteria for the CHIME model, independently validating this model of recovery. Hence, each account showed evidence of connectedness, hope, identity, meaning and empowerment. A number of additional characteristics stood out from the accounts such as the importance of motherhood and of education. Research limitations/implications All 20 accounts were only reviewed by the two authors, who may be subject to bias. To reduce this, the first author did the bulk of the ratings. This paper shows the importance of education for recovery. Practical implications Some 15/20 accounts reported problems with mental health services, mainly around waiting lists. Must mental health always remain a Cinderella service? Originality/value This is the first attempt to synthesise this particular set of recovery narratives, entitled remarkable lives. These accounts show the richness of the recovery journeys embarked on by many sufferers and these are just drawn from one University. Like the authors of these stories, we too as recovery specialists have much to learn from their inspiring accounts.