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The mechanisms and processes of connection: developing a causal chain model capturing impacts of receiving recorded mental health recovery narratives

Ng, Fiona; Charles, Ashleigh; Pollock, Kristian; Rennick-Egglestone, Stefan; Cuijpers, Pim; Gillard, Steve; Van Der Krieke, Lian; Bongaardt, Rob; Pomberth, Scott; Hui, Ada; Repper, Julie; Roe, James; Llewellyn-Beardsley, Joy; Yeo, Caroline; Hui, Ada; Hare-Duke, Laurie; Manley, David; Slade, Mike


Research Assistant on Theneon Study

Ashleigh Charles

Kristian Pollock

Stefan Rennick-Egglestone

Pim Cuijpers

Steve Gillard

Lian Van Der Krieke

Rob Bongaardt

Scott Pomberth

Ada Hui

Julie Repper

James Roe

Joy Llewellyn-Beardsley

Caroline Yeo

Ada Hui

Laurie Hare-Duke

David Manley

Mike Slade


Background: Mental health recovery narratives are a core component of recovery-oriented interventions such as peer support and anti-stigma campaigns. A substantial number of recorded recovery narratives are now publicly available online in different modalities and in published books. Whilst the benefits of telling one's story have been investigated, much less is known about how recorded narratives of differing modalities impact on recipients. A previous qualitative study identified connection to the narrator and/or to events in the narrative to be a core mechanism of change. The factors that influence how individuals connect with a recorded narrative are unknown. The aim of the current study was to characterise the immediate effects of receiving recovery narratives presented in a range of modalities (text, video and audio), by establishing the mechanisms of connection and the processes by which connection leads to outcomes.
Method: A study involving 40 mental health service users in England was conducted. Participants were presented with up to 10 randomly-selected recovery narratives and were interviewed on the immediate impact of each narrative. Thematic analysis was used to identify the mechanisms of connection and how connection leads to outcome. Results: Receiving a recovery narrative led participants to reflect upon their own experiences or those of others, which then led to connection through three mechanisms: comparing oneself with the narrative and narrator; learning about other's experiences; and experiencing empathy. These mechanisms led to outcomes through three processes: the identification of change (through attending to narrative structure); the interpretation of change (through attending to narrative content); and the internalisation of interpretations. Conclusions: This is the first study to identify mechanisms and processes of connection with recorded recovery narratives. The empirically-based causal chain model developed in this study describes the immediate effects on recipients. This model can inform selection of narratives for use in interventions, and be used to support peer support workers in recounting their own recovery narratives in ways which are maximally beneficial to others.

Journal Article Type Article
Publication Date Dec 21, 2019
Journal BMC Psychiatry
Electronic ISSN 1471-244X
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 19
Article Number 413
APA6 Citation Ng, F., Charles, A., Pollock, K., Rennick-Egglestone, S., Cuijpers, P., Gillard, S., …Slade, M. (2019). The mechanisms and processes of connection: developing a causal chain model capturing impacts of receiving recorded mental health recovery narratives. BMC Psychiatry, 19,
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