Year

2019

Degree Name

Doctor of Philosophy (Psychology)

Department

School of Psychology

Abstract

Background: Understanding of recovery in mental health has evolved to include clinical definitions and personal recovery models. However, knowledge surrounding personal recovery have been predominately derived from qualitative studies of individuals with severe mental illness such as psychosis. This thesis by compilation presents four studies which explored the concept of personal recovery in the context of Borderline Personality Disorder (BPD) to describe the lived experience of recovery.

Method: The thesis provides an introduction to the literature (Chapter One) and the methodology undertaken in the research (Chapter Two). The research consists of five components. Firstly, a systematic review (19 studies representing 1122 individuals) to examine the current state of the literature and identify gaps to guide the direction of the thesis (Chapter Three). Chapter Four presents archival data from clinical interviews to identify the treatment and recovery goals of individuals seeking treatment for BPD. Chapter Five presents a mixed-methods study which uses bivariate and multivariate analysis to examine the role of an individual’s self-identified recovery status and diagnostic status on clinical and personal recovery outcomes in 349 individuals who completed an online survey. To further understand one’s self-identified recovery status, thematic analysis was conducted on individual’s personal definition of recovery in BPD. Chapter Six draws upon data from participants in Chapter Five and consists of an interpretative phenomenological analysis of 14 in-depth interviews investigating recovery stages and processes in individuals at opposite ends of the recovery continuum.

Results: Of the 19 studies in the systematic review, only three examined personal (versus clinical) recovery through the perspective of people with lived experience of BPD (Chapter Three). Whilst treatment and recovery goals of individuals seeking treatment for BPD indicate that symptom reduction was an important goal, 88.2% of individuals reported goals of a psychosocial nature, indicating that goals extend beyond clinical realms (Chapter Four). The importance of an individual’s evaluation of progress and personal definition of recovery was highlighted by findings that individuals who self-identified with being recovered, regardless of whether they met diagnostic criteria, did not differ on clinical or personal recovery outcomes. Definitions of recovery in BPD was seen to take on two definitions; recovery as self-management or recovery as not possible (Chapter Five). Identification of the stages and processes of recovery identified that recovery occurred across three stages and involved four processes, with the interaction between stages and processes promoting change (Chapter Six).

Conclusion: Taken together, the research has provided evidence to broaden recovery perspectives of individuals with BPD to be more personally meaningful and provides recommendations for how services and treatment incorporate more recovery-focused goals.

FoR codes (2008)

110319 Psychiatry (incl. Psychotherapy), 111714 Mental Health, 170106 Health, Clinical and Counselling Psychology

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.