ASPECTS OF RECOVERY STYLES FROM PSYCHOSIS (SELF-REFLECTION, HELPING-ALLIANCE, INTEGRATION, SEALING OVER)

Abstract

This study investigated the nature of two main aspects of the integrating and sealing over recovery styles from psychosis. These aspects which distinguish between the recovery styles are quality of patients' awareness of the psychotic experience and interpersonal relatedness during the recovery process. In order to explore the clinical utility of this description of the recovery process from psychosis, the integration/sealing over continuum of recovery styles was correlated with self-reflection and patients' initial engagment in a helping alliance and self-exploration in group psychotherapy.;Sixteen day hospital and sixteen inpatients who had recently suffered an acute psychotic episode were subjects in the study. Based on a clinical interview patients' recovery styles were operationally defined by an Integration/Sealing Over Scale (McGlashan, Wadeson, Carpenter, & Levy, 1977). As expected, a significant amount of the variance in the integration/sealing over continuum was accounted for by the capacity for reflective self-awareness and the quality of the helping alliance as rated by therapists.;The Integration/Sealing Over Scale is positively correlated with self-reflection (r = .67, p < .001) and lack of defensiveness (r = .54, p < .01). The Integration/Sealing Over Scale and self-reflection remain positively correlated when lack of defensiveness is partialled out. Also, the Integration/Sealing Over Scale is positively correlated with the therapists' assessment of the helping alliance (r = .57, p < .001), patient involvement (r = .45, p < .01), and patient exploration (r = .60, p < .001) in group therapy sessions. Each of these relationships remains significant when the effects of premorbid social adjustment, thought disorder, paranoid diagnosis, gender of patient, and treatment milieu are partialled out.;The consistent pattern of highly significant correlations between recovery style and treatment related variables suggests that the integrating and sealing over terms provide rich, complex, and clinically useful descriptions of patients' orientation toward dealing with the psychotic experience. It was also suggested that the recovery styles may be treatment relevant in designating integrating patients as those patients who are most amenable for intensive, insight oriented psychotherapy.