“Why shouldn’t I expect a lot from life?” – a qualitative study of what facilitates long-term recovery in first-episode psychosis

Åsbø, Gina; Haavind, Hanne; Kruse, Sindre Hembre; Wold, Kristin Fjelnseth; Ten, Wenche; Hegelstad, Velden; Romm, Kristin Lie; Slade, Mike; Ueland, Torill; Melle, Ingrid; Simonsen, Carmen

Abstract

Background

Qualitative research frequently characterises recovery, but more knowledge on subjective experiences of facilitators of long-term recovery in psychosis is needed. This interview study aimed to explore what people with first-episode psychosis (FEP) highlight as important for their long-term recovery.

Methods

Interviews with 20 individuals in recovery (personal and/or clinical) participating in two follow-up studies, 10 and 20-years after treatment start for a first episode schizophrenia or bipolar spectrum disorder. Interviews were thematically analysed by a research team that included a peer researcher.

Results

The analysis generated that personal resources and agency were experienced as the overarching facilitators of recovery, with five themes: (1) Doing recovery in everyday life, involving agency in daily life; (2) Re-evaluating risk, involving re-evaluating limitations and stress reduction; (3) Becoming a caregiver, involving development from being cared for to taking care of others; (4) Negotiating normality, involving identity and social inclusion; (5) Owning and sharing your story, involving accepting lived experience and overcoming stigma.

Discussion

All participants described themselves as the main facilitators of their own recovery, and treatment as secondary to their efforts. Gradually testing limitations and taking risks, providing social support to others, as well as owning and sharing your story were crucial for promoting long-term recovery in FEP. Clinical implications include supporting service users’ agency with strength- based interventions and shared-decision making, as well as refining psychoeducation on stress reduction in a long-term perspective.

Citation

Åsbø, G., Haavind, H., Kruse, S. H., Wold, K. F., Ten, W., Hegelstad, V., Romm, K. L., Slade, M., Ueland, T., Melle, I., & Simonsen, C. (2025). “Why shouldn’t I expect a lot from life?” – a qualitative study of what facilitates long-term recovery in first-episode psychosis. BMC Psychiatry, 25, Article 423. https://doi.org/10.1186/s12888-025-06681-y

• Journal Article Type: Article
• Acceptance Date: Mar 4, 2025
• Online Publication Date: Apr 28, 2025
• Publication Date: Apr 28, 2025
• Deposit Date: Mar 6, 2025
• Publicly Available Date: Mar 6, 2025
• Journal: BMC Psychiatry
• Electronic ISSN: 1471-244X
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 25
• Article Number: 423
• DOI: https://doi.org/10.1186/s12888-025-06681-y
• Public URL: https://nottingham-repository.worktribe.com/output/46191107
• Publisher URL: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-025-06681-y