Recovery in Telling Life Stories (RETELL): Testing a Narrative Identity Intervention for Personal Recovery in Individuals With Severe Mental Illness
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Intervention feasibility: Change from pre-intervention throughout the intervention to post-intervention and follow-up in personal recovery
研究概览
简要总结
This project tests the Recovery In Telling Life Stories (RETELL) intervention, aimed at supporting personal recovery in people with severe mental illness (SMI). While many of those with SMI experience symptom control, their quality of life often remains low due to social loss, negative self-perceptions, and identity-related challenges not addressed by standard treatments. Through a process of narrative repair, the RETELL intervention helps participants explore the personal consequences of mental illness while supporting the enhancement of narratives that strengthen identity and foster well-being. The intervention is delivered across 8-12 sessions and will be assessed for feasibility of both the intervention and study procedures. We will also explore its preliminary impact on recovery, quality of life, symptoms, functioning, self-stigma, and personality, using a multiple single-case A-B-A design. We expect the intervention and study procedures to show acceptable feasibility. We further hypothesize that participants' scores on recovery and well-being will be low at baseline, improve during the intervention, and remain higher after the intervention ends and at 3-month follow-up. This study will provide a foundation for future randomized controlled trials.
详细描述
This project tests the Recovery In Telling Life Stories (RETELL) intervention, an intervention developed to support personal recovery in individuals with severe mental illness (SMI).
Research shows that many people with SMI experience low quality of life even when their symptoms are in remission and functional level, e.g. cognitive remediation. This is not only due to the illness itself but also to the consequences that often accompany it, such as the loss of social and occupational roles and the development of negative self-perceptions. These challenges are only to a limited extent addressed by existing treatments, which typically focus on symptom reduction.
Personal recovery is about living a satisfying and meaningful life despite the potential constraints associated with mental illness. A major barrier to this process can arise when a person develops an understanding of themself (a narrative identity) characterized by shame, low self-esteem, and self-stigmatization. When negative identity conclusions dominate, it can be difficult to experience well-being, meaning in life, or hope for the future.
Despite an increasing focus on personal recovery in mental health care systems globally, evidence-based methods to support the recovery process are limited. In this project, we develop and test the RETELL intervention, designed to support personal recovery by helping participants process the personal consequences of mental illness and identify and cultivate positive identity conclusions and personal strengths. In RETELL, the participants are guided through this process, which we refer to as narrative repair, over a structured sequence of 8-12 sessions. Across these sessions, participants are guided in telling their life story and in constructing preferred and empowering narratives about themselves and their future.
The intervention will be tested in a mixed methods study using a one-arm multiple single-case intervention design with an A-B-A structure. This includes a pre-intervention phase (T1) with four weeks of outcome measurements, an intervention phase (T2) continuing with the same measures every second week, 4 weeks of post-intervention measurements (T3), and 4 weeks of follow-up measurements starting 3 months after intervention completion (T4). Data will be collected in electronic surveys and qualitative interviews. The primary aim is to assess intervention feasibility including potential to improve recovery and quality of life. It is aimed to recruit 20 participants diagnosed with SMI within the timeframe allowed by the study plan.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adults between the ages of 18 and 65 years
- •A self-reported principal diagnosis of one or more of the following: schizophrenia (F20), bipolar disorder (F31), personality disorders (F60), obsessive-compulsive disorder (F42), anxiety disorders (F41), recurrent depressive disorder (F33), eating disorders (F50), hyperkinetic disorders (F90), post-traumatic stress disorder (F43.1), Asperger syndrome (F84.5)
- •Not in full recovery (Brief INSPIRE-O < 50)
- •Danish language proficiency
- •Medication stabilized (i.e., same type and dosage for a minimum of 8 weeks)
- •Ability and willingness to give informed consent
排除标准
- •Self-reported diagnosis of mental retardation (F70-79) and/or organic mental disorder (F00-09)
- •Psychiatric symptoms, thoughts of self-harm and/or substance abuse of self-reported severity which are likely to prevent one or all of the following: attendance at scheduled sessions, completion of questionnaires before, during and after the intervention, meaningful engagement in the therapeutic process
- •Psychiatric hospitalization in the past 4 weeks
- •Prior conviction of violent crime
- •Currently homeless
- •Currently in psychotherapy initiated within the past 6 months.
研究组 & 干预措施
RETELL
Narrative therapy to support personal recovery, delivered individually over 8-12 sessions.
干预措施: Narrative therapy (Behavioral)
结局指标
主要结局
Intervention feasibility: Change from pre-intervention throughout the intervention to post-intervention and follow-up in personal recovery
时间窗: Pre-intervention (T1), intervention (T2), post-intervention (T3) and follow-up (T4)
Recovery will be assessed using the Brief INSPIRE-O, consisting of 5 items reflecting five dimensions of personal recovery: connectedness with others, hope and optimism for the future, positive identity, meaning in life, and empowerment, with a score range of 0-100. Feasibility will be indicated by stability or increase throughout the study period compared to pre-intervention.
Intervention feasibility: Satisfaction with treatment (quantitative)
时间窗: Post-intervention (T3)
Participant-reported treatment satisfaction using the using the Client Satisfaction Questionnaire (CSQ), a brief, standardized self-report measure designed to assess clients' overall satisfaction with healthcare or psychological services. It consists of 8 items rated on a Likert scale, covering aspects such as service quality, perceived helpfulness, and whether the service met the client's needs. Total score range: 8-32, with higher numbers indicating greater satisfaction. Feasibility will be indicated by a mean score of 20 or above.
Intervention feasibility: Treatment dropout rate
时间窗: Through intervention phase (T2), between 8-12 weeks
Treatment dropout is defined as participation in less than three out of the four therapeutic tasks of the intervention. Feasibility will be indicated by a dropout rate \< 30%.
次要结局
- Change from pre-intervention to post-intervention and follow-up in functioning and disability(Pre-intervention (T1), post-intervention (T3) and follow-up (T4))
- Study procedure feasibility: Study drop-out rate(Throughout study completion, an average of approximately 35 weeks.)
- Intervention feasibility: Satisfaction with the therapeutic alliance(Intervention phase (T2))
- Change from pre-intervention to post-intervention and follow-up in domain-specific recovery(Pre-intervention (T1), post-intervention (T3) and follow-up (T4))
- Study procedure feasibility: Acceptance rate(Study recruitment phase, approximately 15 months)
- Study procedure feasibility: Questionnaire response rate(Throughout study completion, an average of approximately 35 weeks.)
- Change from pre-intervention to post-intervention and follow-up in symptomatic status(Pre-intervention (T1), post-intervention (T3) and follow-up (T4))
- Intervention feasibility: Number of participants with treatment-related adverse events(From the beginning of the intervention (T2) to the final 3-month follow-up (T4))
- Intervention feasibility: Satisfaction with treatment (qualitative)(Post-intervention (T3))
- Change from pre-intervention throughout the intervention to post-intervention and follow-up in well-being(Pre-intervention (T1), intervention (T2), post-intervention (T3) and follow-up (T4))
- Change from pre-intervention to post-intervention and follow-up in self-stigmatization(Pre-intervention (T1), post-intervention (T3) and follow-up (T4))
- Change from pre-intervention to follow-up in Big 5 personality traits(Pre-intervention (T1) and post-intervention (T3))
研究者
Dinne Christensen
Principal Investigator ,Postdoc, PhD
University of Aarhus