University of Brighton, UK.
Aston University, Birmingham, UK.
Psychol Psychother. 2021 Sep;94(3):646-666. doi: 10.1111/papt.12337. Epub 2021 Mar 27.
Most existing research on the family context of psychosis focuses on the 'burden' of caring for people experiencing psychosis. This research is the first to ask young people experiencing early psychosis to 'map' and describe their experiences and understandings of their family relationships, and how they have related to their psychosis and recovery.
The research took an inductive, multimodal hermeneutic-phenomenological approach (Boden, Larkin & Iyer, 2019, Qual. Res. Psychology, 16, 218-236; Boden & Larkin, 2020, A handbook of visual methods in psychology, 358-375).
Ten young adults (18-23), under the care of early intervention in psychosis services in the UK, participated in an innovative relational mapping interview (Boden, Larkin & Iyer, 2018), which invited participants to draw a subjective 'map' of their important relationships. This visual methodology enables subtle, complex, ambivalent, and ambiguous aspects of the participants' experiences to be explored.
Findings explore the participants' accounts of how they love, protect, and care for their families; how they wrestle with family ties as they mature; and their feelings about talking about their mental health with loved ones, which was typically very difficult.
This paper advances understanding of recovery in psychosis through consideration of the importance of reciprocity, and the identification and nurturance of relational strengths. The capacity of a young person to withdraw or hold back when trying to protect others is understood as an example of relational agency. The possibility for extending strengths-based approaches and family work within the context of early intervention in psychosis services is discussed.
Young adults experiencing early psychosis may benefit from support to identify their relational strengths and the opportunities they have for reciprocity within their family structures, where appropriate. Relational motivations may be important for a range of behaviours, including social withdrawal and non-communication. Services may benefit from exploring the young person's relational context and subjective meaning-making in regard to these actions. Young adults experiencing early psychosis may benefit from opportunities to make sense of their family dynamics and how this impacts on their recovery. Attachment-based and relationally oriented interventions that increase trust and openness, and reduce feelings of burdensomeness are likely to support family functioning as well as individual recovery.
大多数关于精神病家庭环境的现有研究都集中在照顾精神病患者的“负担”上。这项研究首次要求经历早期精神病的年轻人“绘制”和描述他们对家庭关系的体验和理解，以及他们如何与精神病和康复相关。
该研究采用了归纳、多模态解释学-现象学方法（Boden、Larkin & Iyer，2019，Qual. Res. Psychology，16，218-236；Boden & Larkin，2020，A 手册 of visual methods in psychology，358-375）。
10 名 18-23 岁的年轻人（18-23 岁）参加了英国早期精神病干预服务的创新关系映射访谈（Boden、Larkin & Iyer，2018），该访谈邀请参与者绘制他们重要关系的主观“地图”。这种视觉方法可以探索参与者体验中微妙、复杂、矛盾和模糊的方面。
研究结果探讨了参与者如何爱、保护和照顾他们的家庭；他们在成熟过程中如何与家庭关系作斗争；以及他们与所爱的人谈论心理健康的感受，这通常非常困难。
本文通过考虑相互性的重要性以及识别和培养关系优势，推进了对精神病康复的理解。当年轻人试图保护他人时，他们撤回或保留的能力被理解为关系代理的一个例子。在早期精神病干预服务的背景下，扩展基于优势的方法和家庭工作的可能性将被讨论。
经历早期精神病的年轻人可能会受益于支持，以确定他们的关系优势以及在适当情况下他们在家庭结构中互惠的机会。关系动机可能对包括社会退缩和非沟通在内的各种行为很重要。服务可能会受益于探索年轻人的关系背景和对这些行为的主观意义。经历早期精神病的年轻人可能会受益于了解他们的家庭动态以及这如何影响他们的康复的机会。增加信任和开放性、减少负担感的基于依恋和关系导向的干预措施可能会支持家庭功能以及个人康复。
