Effect-study of participating in the Photo-instrument into self-experiences of patients recovering from a psychiatric crisis

One important findng from the pilot study was that being able to show what is
important to you and talk about it precedes acceptation and goalfinding. The
future wish that patients are asked to imagine and portray reflects a 'valued
life'. Goal finding may be too far-fetched for many patients. For them it may
be more important to realize that they have values in life that still hold
true. In the pilot study we could determine what the structure, the purpose and
the function was of the stories that patients told when interpreting their
photographs. Sometimes this seemed to be a facade behind suffering was
concealed to protect what they saw as important in their lives. In the recovery
movement one departures from 'being stuck' in suffering. Being stuck can be
overcome in the course of the recovery process. First prelimenary conclusions
from the pilot point at another direction than acceptation of suffering. What
seems to matter most is finding a way of realting to suffering that leaves room
for a 'valued life' or in any case a 'normal' functioning. This puts so-called
facades in another light.

The study aims at finding answers for the following questions:
-What changes develop in the perception of patients concerning their daily
functioning (inclusing the impact of mental disorders) and how are these
changes related to the photo-story they have presented in the photo group?
-How look nurses upon these outcomes and perceptions of patients ?
-How relate the answers to these questions to our understanding of empowerment
and recovery?

The design is a mixed one of quantitative and qualitative research. Using the
Sickness Impact Profile (SIP)-questionnaire data are aggregated that are used
as a basis for narrative explorative interviews with patients. In-depth
interviews are held with a limited number of patients and their caregivers to
contextualize and describe the patients 'perception in coherent cases.

The intervention is the photo-instrument, a structured group intervention that
enables participants to recount and share their subjective experiences
associated with photographs they made themselves. There is a process of
selectng and prioritizing of photos and adjoining texts for a presntation at a
photo exhibition. There are two rounds of 8 sessions. Both rounds result in an
exhibition.

The SIP is filled out by respondents on three moments in time: before, after
and 6 months after the intervention. Filling out the SIP takes 20 minutes and
can't be considered emotionally taxing. With a limited number (5) of patients
we'll have an in-depth interview that will last approximately one hour. This
may be emotionally taxing, although the focus will be on 'normal' functioning
and how respondente interpret this in the contact of their lives.