Resilience in youth recently diagnosed with psychosis : a qualitative inquiry

BACKGROUND: Psychotic disorders are among the most disabling health issues affecting young people today. Clinical and psychosocial interventions are considered to have the most potential for preventing the disabling consequences of this illness during the first two to five years following the onset of a psychotic disorder. The development of interventions for this stage of the illness is partially dependent upon understanding how young people build resilience within the context of their daily lives. Yet, little research has been conducted on resilience particularly based on the narrative accounts of youth themselves. OBJECTIVE: To better understand how youth recently diagnosed with a psychotic disorder restore, sustain, and enhance their resilience (capacity to cope with adversity), and how aspects of the environment, and the activities they engage in, support and/or hinder this process. METHODS: Using a qualitative approach, combining grounded theory, narrative, and arts-based methods at different stages of the research process, 17 young people, between the ages of 18 to 24, diagnosed with psychosis within the past three years, were recruited from two Canadian mental health care settings: a specialized early psychosis intervention program and a general psychiatric service for street youth. Over the duration of 1 year, 36 individual interviews and three focus group meetings were conducted, supplemented by participants’ creation of biographical, literary and visual accounts. Prolonged engagement, methodological crystallization, transparency, and reflexivity enhance the rigour and trustworthiness of the findings. RESULTS: Data analysis led to the explication of normalizing-identity work, a psychosocial process that involves navigation towards and engagement in narrative practices and highly valued activities to enhance one’s normal sense of self and identity, in conjunction with the social, structural, and technological environment’s capacity to facilitate access to this process in meaningful ways. CONCLUSION: The findings illustrate that a key pathway through which participants sustain, restore, and enhance their resilience is engagement in identity work. The findings contribute to theoretical and empirical knowledge that further understanding of the phenomena of resilience, well-being, and psychosocial recovery in relation to youth recently diagnosed with psychosis, as well as offer practical implications for the specialized field of early psychosis intervention.Medicine, Faculty ofGraduat