Year

2019

Degree Name

Doctor of Philosophy

Department

School of Psychology

Abstract

Narrative identity reconstruction is complex and a key process in mental health recovery. Recovery processes are individual and nonlinear with unique developmental pathways that characterise this human adaptive growth. The nonlinear dynamic change processes are the least-understood aspects of recovery and the most difficult to harness in recovery-oriented healthcare. A need exists for novel approaches that focus on investigating those processes. As a nonlinear phenomenon, narrative identity reconstruction is suited to investigation from a complex adaptive system (CAS) perspective. The purpose of this thesis is to explore participants’ narrative identity reconstruction as part of their mental health recovery, using a CAS perspective. This research project was guided by a constructivist (interpretive) research paradigm. It uses a conceptual framework that is informed by CAS, the life story model of identity (LSMI), intentional change theory (ICT), and the hero’s journey. These are integrated into a narrative coaching approach. A two-study, exploratory mixed methods design was used to generate knowledge regarding participants’ narrative identity reconstruction in recovery. In Study 1 interviews examined the recovery stories of 17 mental health peer workers in order to qualitatively explore the main elements of their narrative identity reconstruction in recovery. Participants’ self-mastery (as part of personal agency), especially at redemptive story turning points, was found to be a crucial aspect of their narrative identity reconstruction. In Study 2, the findings from Study 1 were operationalised in a narrative coaching serious boardgame designed to improve participants’ sense of self-mastery as a part of narrative identity reconstruction. The study aimed to quantitatively explore the boardgame intervention outcomes amongst a sample of 31 individuals (people in recovery) living with mental disorders and 31 participants (psychology students and psychologists) without mental disorders. It was considered a meaningful comparison as the clinical group, by virtue of participants’ training and work, would likely have a relatively higher pre-intervention level of sense of self-mastery than the clinical group. Both groups demonstrated significant improvement in self-mastery, with the clinical group improvement reaching the preintervention level of the non-clinical group. The findings from the two studies were integrated. Participants’ narrative identity reconstruction, characterised by sense of selfmastery, was understood as a causal narrative in which the individual is an agentic story protagonist within an agentic recovery journey story. In CAS terms, participants’ selfmastery was understood as actualisation of their adaptive capacity (inherent potential), especially at bifurcation points (choice of alternative developmental pathways). This occurred as part of a shift from an illness attractor (habitual pattern of functioning) to a recovery attractor. Using a CAS perspective to explore the reconstruction of narrative identity responds to the call for complexity approaches to recovery-related healthcare. A better understanding of narrative identity reconstruction as adaptive growth in recovery could advance theory (i.e., offers domain specific applications and deeper understanding of LSMI, ICT, CAS), research (i.e., offers a more nuanced understanding of agency as a key aspect of recovery), and practice (i.e., offers a way for mental health professionals to practically assist their clients to reconstruct narrative identity). Future research should include randomised controlled trials to assess the effectiveness of the boardgame in supporting narrative identity reconstruction amongst individuals with a range of mental health disorders and at different stages of recovery.

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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.