The Role of Self–efficacy in Recovery from Serious Psychiatric Disabilities: A Qualitative Study with Fifteen Psychiatric Survivors

This qualitative analysis applied the theory of self–efficacy to results from a study that used grounded theory to identify the factors that influenced the recoveries of 15 psychiatric survivors. Participants identified the development of a more competent and efficacious sense of self as a central aspect contributing to their recoveries. Analysis also revealed four factors related to this development: meaningful activities, supportive professional relationships, peer-support and choice among a variety of treatment alternatives. Participants' description of the recovery process and how they were able to develop a competent sense of self, possessed several parallels with Bandura's social cognitive theory of self–efficacy. This article argues that self–efficacy may provide practitioners with a useful guide for creating the contexts that facilitate the recovery process. Implications for practice and research will be explored.

[1]  R. Rosenheck,et al.  An empirical conceptualization of the recovery orientation , 2005, Schizophrenia Research.

[2]  O. Timm Psychiatric rehabilitation. , 1959, Military medicine.

[3]  Anselm L. Strauss,et al.  Qualitative Analysis For Social Scientists , 1987 .

[4]  A. S. Soydan Supported Education: A Portrait of a Psychiatric Rehabilitation Intervention , 2004 .

[5]  G. Clum,et al.  A meta-analysis of self-help treatment approaches , 1993 .

[6]  S. Estroff Self, identity, and subjective experiences of schizophrenia: in search of the subject. , 1989, Schizophrenia bulletin.

[7]  A. Bandura Social cognitive theory: an agentic perspective. , 1999, Annual review of psychology.

[8]  P. Solomon,et al.  The state of knowledge of the effectiveness of consumer provided services. , 2001, Psychiatric rehabilitation journal.

[9]  N. Tarrier,et al.  Illness management and recovery: a review of the research. , 2002, Psychiatric services.

[10]  T. Marrelli Mental health: A report of the surgeon general , 2000 .

[11]  Claudio Barbaranelli,et al.  Role of affective self-regulatory efficacy in diverse spheres of psychosocial functioning. , 2003, Child development.

[12]  P. Solomon Peer support/peer provided services underlying processes, benefits, and critical ingredients. , 2004, Psychiatric rehabilitation journal.

[13]  D. Fisher A new vision of healing as constructed by people with psychiatric disabilities working as mental health providers , 1994 .

[14]  F. Frese Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia , 2004 .

[15]  P. Solomon,et al.  One-year outcomes of a randomized trial of consumer case management , 1995 .

[16]  L. J. Tenney It has to be about choice. , 2000, Journal of clinical psychology.

[17]  O. Cohen How do we Recover? An Analysis of Psychiatric Survivor Oral Histories , 2005 .

[18]  G. Girolamo WHO Studies on Schizophrenia , 1996 .

[19]  D. Pettie,et al.  Illness as evolution: The search for identity and meaning in the recovery process. , 1999 .

[20]  A. Bengtsson-tops Mastery in patients with schizophrenia living in the community: relationship to sociodemographic and clinical characteristics, needs for care and support, and social network. , 2004, Journal of psychiatric and mental health nursing.

[21]  L. Kurtz Mutual aid for affective disorders: the manic depressive and depressive association. , 1988, The American journal of orthopsychiatry.

[22]  Michael A. Mancini,et al.  Making sense of it all: consumer providers' theories about factors facilitating and impeding recovery from psychiatric disabilities. , 2005, Psychiatric rehabilitation journal.

[23]  A. Watson,et al.  A Social-Cognitive Model of Personal Responses to Stigma. , 2005 .

[24]  P. Ridgway,et al.  Restorying psychiatric disability: learning from first person recovery narratives. , 2001, Psychiatric rehabilitation journal.

[25]  Larry Davidson,et al.  Peer Support Among Individuals with Severe Mental Illness , 2006 .

[26]  J. Strauss,et al.  Sense of self in recovery from severe mental illness. , 1992, The British journal of medical psychology.

[27]  Carlo C. DiClemente,et al.  Self-Efficacy and Addictive Behaviors , 1995 .

[28]  M. Cardaci,et al.  Relations among Perceived Self-Efficacy, Self-Esteem, and School Achievement , 2003, Psychological reports.

[29]  N. Jacobson,et al.  Who (or What) Can Do Psychotherapy: The Status and Challenge of Nonprofessional Therapies , 1994 .

[30]  R. Hayward,et al.  In sickness and in health: dilemmas of the person with severe mental illness. , 1998, Psychiatry.

[31]  J. Strauss,et al.  The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later. , 1987, The American journal of psychiatry.

[32]  P. Solomon,et al.  The efficacy of a consumer case management team: 2-year outcomes of a randomized trial , 2006, The journal of mental health administration.

[33]  P. Deegan Recovery: The lived experience of rehabilitation. , 1988 .

[34]  J. Marley Return To Community: Building Support Systems for People With Psychiatric Disabilities , 1995 .

[35]  J. E. Maddux,et al.  Self-efficacy theory: potential contributions to understanding cognitions in depression , 1986 .

[36]  S. Segal,et al.  Characteristics of new clients at self-help and community mental health agencies in geographic proximity. , 2002, Psychiatric services.

[37]  J. Strauss,et al.  The Vermont longitudinal study of persons with severe mental illness, II: Long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. , 1987, The American journal of psychiatry.

[38]  A. Bandura Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[39]  Michael F. Green,et al.  Self-efficacy and neurocognition may be related to coping responses in recent-onset schizophrenia , 2004, Schizophrenia Research.

[40]  K. Mueser,et al.  The role of work in the recovery of persons with psychiatric disabilities. , 2002, Psychiatric rehabilitation journal.

[41]  William A. Anthony,et al.  Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. , 1993 .

[42]  K. Mueser,et al.  Coping with negative symptoms of schizophrenia: patient and family perspectives. , 1997, Schizophrenia bulletin.

[43]  G. Nelson,et al.  Moving forward: negotiating self and external circumstances in recovery. , 2005, Psychiatric rehabilitation journal.

[44]  S. Mead,et al.  What Recovery Means to Us: Consumers' Perspectives , 2000, Community Mental Health Journal.

[45]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[46]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[47]  P. Deegan Recovery as a journey of the heart. , 1996 .

[48]  E. Corin,et al.  From Symptoms to Phenomena: The Articulation of Experience in Schizophrenia , 1994 .

[49]  Pamela Jordan Basics of qualitative research: Grounded theory procedures and techniques , 1994 .

[50]  C. Mowbray,et al.  Consumer-operated drop-in centers: Evaluation of operations and impact , 2006, The journal of mental health administration.

[51]  P. Corrigan,et al.  Introduction: Recovery as Consumer Vision and Research Paradigm. , 2005 .

[52]  J. Chamberlin On Our Own: Patient-Controlled Alternatives to the Mental Health System , 1979 .

[53]  T. Payne,et al.  The Smoking Self-Efficacy Questionnaire (SSEQ): preliminary scale development and validation , 1985 .

[54]  Nora Jacobson,et al.  What is recovery? A conceptual model and explication. , 2001, Psychiatric services.

[55]  F. Dickerson Evidence Based Mental Health Practice: A Textbook , 2007 .

[56]  Matthew B. Miles,et al.  Qualitative Data Analysis: An Expanded Sourcebook , 1994 .

[57]  Thomas E. Smith,et al.  Self-efficacy and psychosocial functioning in schizophrenia: A mediational analysis , 2005, Schizophrenia Research.

[58]  L. Davidson,et al.  The person in recovery from acute and severe psychosis: the role of dependency, self-criticism, and efficacy. , 2004, The American journal of orthopsychiatry.

[59]  M. Kelly,et al.  Exploring the concept of recovery in schizophrenia. , 2005, Journal of psychiatric and mental health nursing.

[60]  E. Corin,et al.  Positive withdrawal and the quest for meaning: the reconstruction of experience among schizophrenics. , 1992, Psychiatry.

[61]  N. Jacobson,et al.  Experiencing recovery: a dimensional analysis of recovery narratives. , 2001, Psychiatric rehabilitation journal.