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Psychotic Disorder Reflective Essay

Psychotic Disorder Reflective Essay

Reflective essay regarding the personal recovery for people living with a psychotic disorder

In this assessment, you will learn about the differences between clinical and personal recovery and therapeutic communication that fosters personal recovery for people who experience psychotic disorders
Task:
Part one: explain the differences between clinical and personal mental health recovery and discuss how personal recovery can enhance the wellbeing of people who experience psychotic disorders.
Part two: reflect on how you, as a future registered nurse, can use therapeutic communication skills (e.g. active listening, probing, empathic responding) to assist a consumer living with the effects of a psychotic disorder identify their strengthens and embark on a personal recovery journey. Include no more than two examples of communication skills in your answer.

Psychotic Disorder Reflective Essay Example 

Recovery for People Experiencing Psychotic Disorders and Therapeutic Communication

Traditionally, it was believed that people with psychotic disorders rarely recovered. Healthcare providers only focused on the clinical aspects of the disorders. Currently, there is an increasing emphasis on personal recovery procedures and care policies, and laws have been developed to safeguard this aspect of recovery (Thomas et al., 2016). Personal recovery in patients suffering from psychotic disorder promotes their general health and well-being. It helps individual patients to define their recovery goals, improves their resilience, self-esteem and confidence, promotes the establishment and maintenance of meaningful social relationships, improves their dignity and shapes the sense of purpose (Thomas et al., 2016).  Personal recovery is a vital pillar of people with persistent psychotic disorders which helps them to lead meaningful lives either with or without the symptoms of the disorders. The main difference between personal recovery and clinical recovery is the focus of the treatment. While clinical recovery encompasses the mitigation of the clinical symptomatology, personal recovery entails the development of identity and valued goals (Chan et al., 2018). Registered nurses have a critical role in the recovery processes of patients who suffer from psychotic disorders. Apart from ensuring that the patients are adherent to the prescribed medication meant to address their clinical symptoms, the nurses ought to use therapeutic communication skills to help the patients attain some level of well-being with or without the psychotic disorder symptoms. Regular therapeutic communication with patients helps them to manage their symptoms, develop coping strategies and structure their lives. Personal recovery is a treatment intervention which nurses may engage in to help patients living with psychotic disorders to lead meaningful lives, as defined by themselves, even in the presence of the mental health condition.

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Part 1: Differentiating Between Clinical and Personal Mental Health Recovery

Recovery refers to the ability of an individual to lead a meaningful life either in the presence or absence of mental illness (O’Hagan, 2001). The definition of recovery is highly subjective and varies widely among different patients who suffer from psychotic disorders. Thus, it is the role of each patient to define their status as to whether they are living well. In the past, recovery in mental health was narrowly conceptualized as the absence of psychiatric symptoms or relapse (Chan et al., 2018). This narrow conceptualization of recovery came to be referred to as clinical recovery. The meaning of recovery has evolved to encompass a broader range of aspects, including functionality and personal recovery. Functional recovery in mental health encompasses an individual’s ability to actively engage in functional, occupational and social domains which include learning, working and caring for self (Chan et al., 2018). Personal recovery refers to the individual sense of well-being beyond patient hood and must be defined by the patients themselves. Personal recovery is a journey which an individual patient commits to whether they are experiencing the symptoms of psychotic disorders or not. In mental health, personal and clinical recovery are mostly differentiated by the kind of interventions taken, the roles of the patients and healthcare providers and the indicators of the recovery process.

The conceptualization of clinical recovery is based on the biomedical model of health, which views recovery as a state of absence of the illness symptoms that a patient was exhibiting (OíHagan, 2001). This conceptualization necessitates the administration of various drugs to treat the symptoms of the disease. Clinical recovery requires the presence of medical personnel who apply clinical procedures to boost the psychological well-being of the patient and mitigate the occurrence of symptoms (Frost et al., 2017). It entails the application of systematic procedures by psychiatrists, counsellors and other medical practitioners to reduce symptoms. Personal recovery is highly individualized and does not require, and medical interventions (Winsper et al., 2020). While the care team may offer support which might be crucial to personal recovery, the process is highly individualized. Personal recovery is aided by the efforts that a person makes towards their own well-being. The process of personal recovery underpins the individual focus on in identifying the causes of the psychotic disorder, evaluation and the application of established strategies in addressing the mental condition and realizing a new self which contributes positively to individual growth and development.

Personal recovery and clinical recovery are characterized by different indicators of health. Patients who have recovered clinically can be differentiated from those who have had a personal recovery. The recovery processes in clinical recovery lead to the disappearance or a significant decline in the symptoms that the patient was exhibiting before (Slade et al., 2014). For instance, a clinically recovered patient is likely to have a significant reduction of delusions and hallucinations. The reduction of these symptoms is largely attributed to medical interventions. Personal recovery, on the other hand, entails individuals becoming more independent, building social relations a change in attitudes and feelings and living a purposeful life (Slade et al., 2014). Personal recovery has close links with learning coping skills regardless of whether an individual is experiencing mental problems or not. It helps individuals to live fulfilling lives even amidst the limitations caused by psychotic disorders. The major themes in personal recovery, which could also be indicators of well-being are optimism, purposeful living, identity formation and greater social connectedness.

In clinical recovery, the degree of well-being is usually determined by the healthcare practitioner, whereas in personal recovery, the degree of well-being is usually determined by the patients themselves. In clinical psychology, the healthcare provider has the role of examining the patient to determine the presence or absence of psychotic disorders symptoms (Roosenschoon et al., 2019). It is the role of a healthcare provider to provide care services to mitigate psychosis disorder symptoms. Similarly, it is their role to assess the functionality of the care services offered, which are mostly medication (Ewart et al., 2016). The healthcare providers are tasked with the duty to determine the responsiveness of a certain patient following the administration of a particular drug (Brown & Kandirikirira, 2007). In personal recovery, patients are allowed to give their opinions about their level of well-being. Even though healthcare practitioners can offer support for personal recovery, they cannot determine the level of personal well-being. It is the role of patients to self-determine and reflect on their lives to know their levels of well-being (Eck et al., 2018). Patients who still have the symptoms for psychotic disorders may have high self-esteem, a positive identity, meaningful relationships and purposeful lives (Brown & Kandirikirira, 2007). Without the patient’s narration, the healthcare providers are unable to establish the patient’s gains towards personal recovery.

Personal recovery is mainly focused on achieving something important to the individual and developing hope for the future. Personal recovery is an option in recovery that helps a patient to lead a satisfying life even when experiencing the symptoms of psychotic disorder. The journey towards personal recovery helps psychotic disorder patients to develop goals and work towards achieving them (Leamy et al., 2011). This gives them an increased control of their lives which helps them not only to manage the symptoms of the psychotic disorder but also to develop resilience. Personal recovery entails the assumption of various strategies to improve personal well-being. These strategies include hope, control, lifestyle changes., acceptance and stability. These strategies are vital in the enhancement of individual dignity, self-esteem and social relationships (Bejerholm & Roe, 2018). These aspects of life increase the chances of living a normal life with the reoccurring symptoms of psychotic disorder. Personal recovery, for instance, enables an individual to lead a more dignified life whereby their views, concerns, needs and feelings are recognized. Psychotic disorder patients who have not undergone personal recovery are much likely to face dismissal, disregard, indifference, condescension and diminishment (Jacobson, 2009). Overall, personal recovery increases an individual’s social visibility, control over their lives and the chances of leading a purposeful life.

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Part 2: Reflection on Therapeutic Communication Skills

Communication, in nursing, is not only a tool of expression but also a means of creating trust between the nurse and patient. Therapeutic communication is particularly a critical aspect of the personal recovery of patients suffering from a psychotic disorder. Therapeutic communication encompasses a wide range of techniques which mainly prioritize the well-being of the patients emotionally, physically and mentally (Australian Ministers’ Advisory Council, 2013). Therapeutic communication helps nurses to objectively support patients to embark on their journey of personal recovery. Even though personal recovery is an individualized process, nurses play a critical role in triggering it and offering continued support. As a future registered nurse, I will use various therapeutic techniques to help patients living with the symptoms of the psychotic disorder to accept themselves, discover a purpose in life and embark on a personal recovery journey. Patients exhibiting the symptoms of psychotic disorders are often overlooked in society, which might lead to the loss of their identity and stigmatization (Australian Ministers’ Advisory Council, 2013). As a result, I feel that the essential therapeutic communication skills to support their personal recovery would be active listening and emphatic responding.

Active listening is a therapeutic communication skill which requires the listener not only to hear what the speaker is saying but also to show it through actions. It is highly engaging and requires self-discipline. In the future, as a registered nurse, I will always ensure that I actively listen to patients living with a psychotic disorder. I believe that listening actively takes in a certain amount of effort from the listener, which helps to boost the self-esteem of the patient. The skill indicates that a nurse is interested in what the patient is saying (Bifarin & Jones, 2018). It gives the nurse an opportunity to guide the conversation, which enables the patient to open up more on their experiences. Active listening in all contexts implies that a nurse or healthcare provider is keeping the patient at the centre of the care (Bifarin & Jones, 2018). This practice empowers the patients to gain more autonomy over their lives which forms a basis personal recovery.

Emphatic responding in nursing encompasses the ability of a nurse to accept and show an understanding of the patient’s reality and respond to him or her without any form of judgment. To respond emphatically, a nurse must accurately perceive the experiences and feelings of the patient. In my future practice, I will employ this skill when working with consumers living with the effects of psychotic disorder to help them achieve decreased levels of anxiety, distress and depression. Empathy enables a healthcare provider to figure out the diversity of consumers as well as their personal recovery journeys (Kezelman & Stavropoulos, 2012). Showing empathy implies that a nurse is determined to resolve the individual mental problems of a consumer. It allows the nurse to give the patient hope and reinforce their identity. Responding emphatically creates an impression to the patient that their lives are just different and that they can create new normal lives that suit their needs. It enables a client to have an increased sense of self-esteem, autonomy, self- confidence, and to develop a strong sense of identity (Pehrson et al., 2016). The impact created by emphatic listening contributes positively to personal recovery.

Conclusion

The scope of interpretation of recovery in the field of psychotic disorders has evolved gradually to involve not only the absence of symptoms but also the state of well-being of the patient. Although the treatment of symptoms is vital, there is an increasing emphasis on general well-being as patients of psychotic disorders may not always fully recover from the symptoms of the conditions. The treatment of symptoms of psychotic disorders constitutes clinical recovery, whereas the focus on improving individual well-being results in personal recovery. Personal recovery is very vital among the people who experience psychotic disorders because it enables them to lead meaningful and purposeful life even in the midst of the symptoms of the disorders. The variations between clinical recovery and personal recovery mainly emanate from the type of interventions taken, the roles of the healthcare provider and the consumer and the indicators of recovery. Although personal recovery is, to a great extent, individualized, nurses play a critical role in facilitating the journey and offering support. The role played by nurses in personal recovery is boosted by therapeutic communication skills. Active listening and emphatic responding, particularly, lead to improved self-esteem, autonomy, sense of identity and recognition which facilitate the process of personal recovery.

References

Australian Ministers’ Advisory Council. (2013). A national framework for recovery-oriented mental health services: Guide for practitioners and providers. Commonwealth of Australia. Retrieved from https://www1.health.gov.au/internet/main/publishing.nsf/content/67D17065514CF8E8CA257C1D00017A90/$File/recovgde.pdf

Bejerholm, U., & Roe, D. (2018). Personal recovery within positive psychiatry. Nordic Journal of Psychiatry, 72(6), 420-430. doi:10.1080/08039488.2018.1492015

Bifarin, O. O., & Jones, S. (2018). Embedding recovery-based approaches into mental health nurse training. British Journal of Mental Health Nursing, 7(5), 234-240. doi:10.12968/bjmh.2018.7.5.234

Brown, W., & Kandirikirira, N. (2007). Recovering Mental Health in Scotland: Report on Narrative Investigation of Mental Health Recovery. Glasgow: Scottish Recovery Network. Retrieved from https://scottishrecovery.net/wp-content/uploads/2008/03/Recovering_mental_health_in_Scotland_2007.pdf

Chan, R. C., Mak, W. W., Chio, F. H., & Tong, C. A. (2018). Flourishing With Psychosis: A Prospective Examination on the Interactions Between Clinical, Functional, and Personal Recovery Processes on Well-being Among Individuals with Schizophrenia Spectrum Disorders. Schizophrenia Bulletin, 44(4), 778-786. doi:10.1093/schbul/sbx120

Eck, R. M., Burger, J. T., Vellinga, A., & Schirmbeck, F. (2018). The Relationship Between Clinical and Personal Recovery in Patients With Schizophrenia Spectrum Disorders: A Systematic Review and Meta-analysis. Schizophrenia Bulletin, 44(3), 631–642. doi:10.1093/schbul/sbx088

Ewart, S. B., Bocking, J., Happell, B., Platania-Phung, C., & Stanton, R. (2016). Mental Health Consumer Experiences and Strategies When Seeking Physical Health Care: A Focus Group Study. Global Qualitative Nursing Research, 3, 1-10. doi:10.1177/2333393616631679

Frost, B. G., Tirupati, S., Johnston, S., Turrell, M., & Lewin, T. J. (2017). An Integrated Recovery-oriented Model (IRM) for mental health services: evolution and challenges. BMC Psychiatry, 17(22), 1-17. doi:10.1186/s12888-016-1164-3

Jacobson, N. (2009). A taxonomy of dignity: a grounded theory study. BMC International Health and Human Rights, 9(3), 1-9. doi:10.1186/1472-698X-9-3

Kezelman, C., & Stavropoulos, P. (2012). ‘The Last Frontier’- Practice Guidelines for Treatment of Complex Trauma and Trauma-Informed Care and Service Delivery. Adults Surviving Child Abuse. Retrieved from https://www.childabuseroyalcommission.gov.au/sites/default/files/IND.0521.001.0001.pdf

Leamy, M., Bird, V., Boutillier, C. L., Williams, J., & Slade, M. (2011). 10.1093/schbul/sbx088. The British Journal of Psychiatry, 199, 445-452. doi:10.1093/schbul/sbx088

OíHagan, M. (2001). Recovery Competencies for New Zealand Mental Health Workers. Wellington: Mental Health Commission. Retrieved from https://www.mentalhealth.org.nz/assets/ResourceFinder/recovery-competencies-for-new-zealand-mental-health-workers-march-2001.pdf

Pehrson, C., Banerjee, S. C., Manna, R., Shen, M. J., Hammonds, S., & Coyle, N. (2016). Responding empathically to patients: Development, implementation, and evaluation of a communication skills training module for oncology nurses. Patient Education and Counseling, 99(4), 610-616. doi:10.1016/j.pec.2015.11.021

Roosenschoon, B.-J., Kamperman, A. M., Deen, M. L., Weeghel, J., & Mulder, C. L. (2019). Determinants of clinical, functional and personal recovery for people with schizophrenia and other severe mental illnesses: A cross-sectional analysis. PLoS One, 14(9), 1-12. doi:10.1371/journal.pone.0222378

Slade, M., Amering, M., Farkas, M., Hamilton, B., & O’Hagan, M. (2014). Uses and abuses of recovery: implementing recovery-oriented practises in mental health systems. World Psychiatry, 13(1), 12-20. doi:10.1002/wps.20084

Thomas, N., Farhall, J., Foley, F., & Leitan, N. D. (2016). Promoting Personal Recovery in People with Persisting Psychotic Disorders: Development and Pilot Study of a Novel Digital Intervention. Frontiers in Psychiatry, 7(196), 1-10. doi:10.3389/fpsyt.2016.00196

Winsper, C., Docherty, C. A., & Weich, S. (2020). How do recovery-oriented interventions contribute to personal mental health recovery? A systematic review and logic model. Clinical Psychology Review, 76, 1-10. doi:10.1016/j.cpr.2020.101815

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