Title

An exploration of social participation for young adults following a first psychotic episode

Presenter Information

Valerie Fox, UNC Chapel Hill

Location

Merritt Room

Start Time

2-10-2015 9:00 AM

End Time

2-10-2015 11:00 AM

Session Type

Research Paper

Abstract

Statement of Purpose: The purpose of this study was to explore participation in social life for young adults following a first episode of psychosis (FEP). There were two study aims: 1) explore the sociocultural mechanisms that facilitated or hindered the engagement and experience of social participation for young adults following FEP; and 2) utilize discursive examples on mental illness to explore perceived opportunities for participation for young adults following FEP. Studies have recognized the importance of social participation for well-being (Eklund, Hermansson, & Hakansson, 2012; Orr, 2005; Schon, Denhov, & Topor, 2009; Wisdom et al., 2008), however, the factors influencing social participation following FEP have not been well-examined in FEP. This study fills a gap in occupational science research as occupational science had not explored the “occupational situation” (Humphry & Wakeford, 2013) of this particular population, which is critical in understanding the nature of occupation as it relates to health and well-being. The purpose of this presentation will be to present study findings, discuss avenues for application of study methodologies, and explore future avenues for translation of this research.

Description of Methods: This qualitative study combined collaborative ethnography and discourse elicitation to examine the impact of FEP on participation in social occupations. Five consultants between the ages of 18-30 who had experienced FEP within the last 5 years were recruited. Data were collected for a minimum of 6 months with each consultant. Study aims were met using semi-structured interviews, participant observations, and discourse elicitation. Photographs and quotes related to mental illness were used as a means to elicit discussion about broader social messages and assumptions. Interviews and fieldnotes were transcribed and coded using narrative analysis.

Report of Results: Preliminary findings show that the following factors influenced participation in social occupations: social norms and expectations, prior occupational histories, social media, relationships, underlying habits and routines, identities, and limitations in income and transportation. In addition, the need to manage the disease occasionally superseded engagement in occupations, although this engagement was noted to be vital to health and recovery.

Discussion/Implications as Related to Occupational Science: This research is important to occupational science for several reasons. First, it has extended understandings of sociocultural factors impacting occupational participation, while also expanding application of existing occupational concepts to new populations (i.e., occupational deprivation, occupational possibilities). Second, this research has provided preliminary data to support intervention development and offer new areas for clinical practice and policy improvement. Third, this study utilized several innovative methods that can be applied to future occupational science research. The combination of methodologies used in this study provided a holistic understanding of the occupational lives of the study consultants, while also garnering broader ideas about social perceptions related to psychosis and participation. Discourse elicitation is a novel approach that has wide implications for use with many different populations, especially in attempting to explore invisible, or taken-for-granted, assumptions that may not come to mind during more traditional interview formats.

Key Words: Ethnography, Social participation, Mental illness

Objectives:

  1. Present findings of the research study and the impact these findings have for occupational science and translation to clinical practice.
  2. Discuss a novel method for exploring underlying assumptions and perceptions related to occupational participation, while acknowledging the challenges of this type of method.
  3. Suggest future directions for research and application of proposed methods.

References

Eklund, M., Hermansson, A., & Hakansson, C. (2012). Meaning in life for people with schizophrenia: Does it include occupation? Journal of Occupational science, 19(2), 93- 105.

Humphry, R., & Wakeford, L. (2013) Educational Implications of Taking a Transactional Perspective of Occupation in Practice. In M. Cutchin & V. Dickie (eds), A transactional perspective of occupation. New York, NY: Springer.

Orr, S. (2005). Social exclusion and the theory of equality: The priority of welfare and fairness in policy. London, UK: University College, Centre for Transport Studies.

Schon, U., Denhov, A., & Topor, A. (2009). Social relationships as a decisive factor in recovering from severe mental illness. International Journal of Social Psychiatry, 55(4), 336-347.

Wisdom, J., Bruce, K., Saedi, G., Weis, T., & Green, C. (2008). ‘Stealing me from myself’: identity and recovery in personal accounts of mental illness. Australian and New Zealand Journal of Psychiatry, 42, 489-495.

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Oct 2nd, 9:00 AM Oct 2nd, 11:00 AM

An exploration of social participation for young adults following a first psychotic episode

Merritt Room

Statement of Purpose: The purpose of this study was to explore participation in social life for young adults following a first episode of psychosis (FEP). There were two study aims: 1) explore the sociocultural mechanisms that facilitated or hindered the engagement and experience of social participation for young adults following FEP; and 2) utilize discursive examples on mental illness to explore perceived opportunities for participation for young adults following FEP. Studies have recognized the importance of social participation for well-being (Eklund, Hermansson, & Hakansson, 2012; Orr, 2005; Schon, Denhov, & Topor, 2009; Wisdom et al., 2008), however, the factors influencing social participation following FEP have not been well-examined in FEP. This study fills a gap in occupational science research as occupational science had not explored the “occupational situation” (Humphry & Wakeford, 2013) of this particular population, which is critical in understanding the nature of occupation as it relates to health and well-being. The purpose of this presentation will be to present study findings, discuss avenues for application of study methodologies, and explore future avenues for translation of this research.

Description of Methods: This qualitative study combined collaborative ethnography and discourse elicitation to examine the impact of FEP on participation in social occupations. Five consultants between the ages of 18-30 who had experienced FEP within the last 5 years were recruited. Data were collected for a minimum of 6 months with each consultant. Study aims were met using semi-structured interviews, participant observations, and discourse elicitation. Photographs and quotes related to mental illness were used as a means to elicit discussion about broader social messages and assumptions. Interviews and fieldnotes were transcribed and coded using narrative analysis.

Report of Results: Preliminary findings show that the following factors influenced participation in social occupations: social norms and expectations, prior occupational histories, social media, relationships, underlying habits and routines, identities, and limitations in income and transportation. In addition, the need to manage the disease occasionally superseded engagement in occupations, although this engagement was noted to be vital to health and recovery.

Discussion/Implications as Related to Occupational Science: This research is important to occupational science for several reasons. First, it has extended understandings of sociocultural factors impacting occupational participation, while also expanding application of existing occupational concepts to new populations (i.e., occupational deprivation, occupational possibilities). Second, this research has provided preliminary data to support intervention development and offer new areas for clinical practice and policy improvement. Third, this study utilized several innovative methods that can be applied to future occupational science research. The combination of methodologies used in this study provided a holistic understanding of the occupational lives of the study consultants, while also garnering broader ideas about social perceptions related to psychosis and participation. Discourse elicitation is a novel approach that has wide implications for use with many different populations, especially in attempting to explore invisible, or taken-for-granted, assumptions that may not come to mind during more traditional interview formats.

Key Words: Ethnography, Social participation, Mental illness

Objectives:

  1. Present findings of the research study and the impact these findings have for occupational science and translation to clinical practice.
  2. Discuss a novel method for exploring underlying assumptions and perceptions related to occupational participation, while acknowledging the challenges of this type of method.
  3. Suggest future directions for research and application of proposed methods.