Interactions between mental illness recovery processes in the family

• Published date: 01 February 2022
• Author: Netta Galimidi,Michal Shamai
• Date: 01 February 2022
• DOI: http://doi.org/10.1111/fare.12594

RESEARCH

Interactions between mental illness recovery processes

in the family

Netta Galimidi

1

|Michal Shamai

2

1

Zefat Academic College, Zefat, Israel

2

University of Haifa, Haifa, Israel

Correspondence

Michal Shamai, University of Haifa, Haifa,

Israel.

Email: michals@research.haifa.ac.il

Abstract

Objectives: This study is designed to understand the experi-

ences of the recovery processes of people with schizophre-

nia and their parents and to explore the connections

between the processes of the different family members.

Background: There is extensive evidence in the professional

literature that understanding the recovery process of indi-

viduals with schizophrenia must include all family mem-

bers. However, there is a gap in the knowledge regarding

the way family members experience both their individual

process and its connection to the processes other family

members undergo.

Method: This research employed qualitative methodology in

which 15 families were interviewed through semistructured

interviews (i.e., 15 adult individuals with schizophrenia and

their parents). Thematic individual, dyadic, and triadic levels

analysis were employed.

Findings: Two main themes emerged: elements of the

recovery processes of family members that led toward fam-

ily recovery and connections among the recovery processes

of family members.

Conclusion: In spite of the predominance of the pharmaco-

logical paradigm in the area of mental health, the family

still plays an important role in the recovery process, which

is a systemic process involving all family members. As a

result, every family member undergoes some processes that

contribute to recovery of the others and of the entire

system.

Implications: The characteristics of the family system

interactions during the recovery process should be taken

into account in understanding and providing interven-

tions for people with schizophrenia, and should be inte-

grated into all types of interventions provided to these

families.

Received: 26 March 2020Revised: 6 January 2021Accepted: 27 February 2021

DOI: 10.1111/fare.12594

© 2021 National Council on Family Relations.

408 Family Relations. 2022;71:408–425.wileyonlinelibrary.com/journal/fare

KEYWORDS

family mental health, family recovery, schizophrenia, separation from

illness

INTRODUCTION

Since the 1970s, there has been a revolution in the concept of rehabilitating people coping with

mental illness—including schizophrenia—by using recovery as a major theoretical perspective

to understand the rehabilitation process of people coping with these illnesses and as a guide for

intervention with this population (Anthony, 2000; Slade & Longden, 2015). This revolution was

based on the great emphasis on the role of the family in the development and treatment of

schizophrenia during the 1960s and 1970s. At almost the same time, various family therapy

approaches were developed from observation and treatment of people with schizophrenia and

their families. These approaches viewed family dynamics as a source of illness onset and pro-

gression (Bateson, 1972; Bowen, 1993; Haley, 1997; Minuchin et al., 2007). In recent decades,

studies have pointed to a multifactorial etiology underlying schizophrenia, which includes bio-

logical, psychological, and environmental factors, thus challenging researchers and therapists to

better understand the role of the family in the coping and recovery processes (Caqueo-Urízar

et al., 2009; Noiseux & Ricard, 2008).

Since the late 1980s, along with research development regarding the recovery concept, there

has been growing interest not only in the recovery of people with schizophrenia but also in the

recovery of their families (Spaniol, 2010). Several models were developed to understand the

recovery processes of the family (Kates & Hastie, 1986; O’Grady & Skinner, 2012). At the same

time, researchers attempted to understand the family’s influence on and contribution to the

recovery process of people with schizophrenia (Davidson et al., 2010; Pernice-Duca, 2010;

Topor et al., 2006). However, all studies to date have examined either the person with schizo-

phrenia or the family members—especially parents—in relation to the person’s recovery.

There is a significant lacuna in examining the parents and the person with schizophrenia as

a unit and as a system. The purpose of this study was to examine the subjective experience of

the recovery processes of people who suffer from schizophrenia and their parents from a sys-

temic perspective, which includes the individual subsystems (the person with schizophrenia and

each parent), the parental and marital subsystem, and the family system unit (includes the

person with schizophrenia and the parents).

LITERATURE REVIEW

The concept of recovery

Recovery is defined as returning to the state that prevailed prior to the onset of the illness

(Davidson et al., 2010). Recovery is not cure—that is, eradication of the illness—and no cure

for severe mental illness, such as schizophrenia, has yet been found (Anthony, 2000). Despite

many attempts to define the concept of recovery, it is still vague, imposing difficulties on the

research and a practical approach to this concept (e.g., Gehart, 2012). There are three main

conceptions of recovery—clinical recovery, recovery as a result, and personal recovery—each

providing a different definition.

Clinical recovery occurs when a person with a psychiatric disorder reaches a state in which

the symptoms of the illness cease and disappear for a long and stable period. This approach,

which represents the medical model, focuses on recovery as a significant amelioration of symp-

tom intensity (Slade et al., 2017). Recovery as a result is an extension of clinical recovery and

MENTAL ILLNESS RECOVERY PROCESSES409