The psychosocial rehabilitation of patients with early psychosis: Insights on spirituality and coping in recovery

Abstract

OBJECTIVES: This study aims to draw a closer linkage between spirituality and mental health. The purpose is to conceptualise ways through which spirituality and religion play a role in coping throughout the illness and recovery processes. DESIGN: The study adopts qualitative inquiry using interpretive phenomenological analysis. This enables in-depth patient and professional accounts of the meanings and roles of spirituality. METHODS: Purposive sampling of five patients and five psychiatrists or therapists was conducted at psychiatric clinics in Hong Kong. Semi-structured interviews were recorded, transcribed verbatim and analysed based on emerging codes according to interpretive phenomenological analysis. RESULTS: Spirituality exerts a significant role throughout rehabilitation: (a) Attributing and reacting to symptoms: Patients’ own thought systems, including personal, religious/supernatural and cultural beliefs influence intensities of distress. Secondary symptom manifestations like isolation and mistrust can further impair their sense of connectedness. (b) Help seeking behaviours: Strong religious/supernatural attribution of symptoms often delays seeking appropriate treatment. (c) Coping with residual symptoms: Religion offers relief and ways to cope with symptoms. Patients also cope by creating meaning for persistent residual symptoms such that it does not disrupt their sense of selves. (d) Sense making of illness, and recovery: This occurs as processes of internalisation, externalisation or religious-orientations. Patients attempt to reconcile with their personal identity, remove disabilities, strive for a sense of peace and rely on religion. Conclusion: Findings help establish theoretical understanding and clinical significance of spirituality in early psychosis. This supports further research to operationalise spirituality and designing measures for empirical studies. This study was supported by the Research Grants Council (GRF/HKU 745511H)