Module 2: Complex, Comorbid, and Chronic
Disorders
Clinical, Societal, and Personal Recovery in
SZ Spectrum Disorders Across Time
(Castelein et. al., 2021)
What is the difference between personal, clinical, and societal recovery, according to
Castelein et al. (2021)?
Clinical Recovery – refers to the aim to minimize clinical symptoms and the focus in mental
health
1. Clinical – or symptomatic – recovery was assessed with remission items, and a time
criterion of at least 6 months
2. The items included positive symptoms and negative symptoms
Societal Recovery – refers to regaining everyday functioning at work, in social relationships,
and in housing – also strongly influences the way patients restore their health
1. Societal recovery was assessed by observing three areas of functioning over the past 6
months
2. The areas included daily living and self-care, study and housekeeping, and social
contacts
Personal Recovery – refers to one’s own experience of recovery, reflecting hope, identity,
and meaning – i.e., living a meaningful life
1. Personal recovery is personal and subjective – can only be assessed by the patients
themselves
Which is more important?
All types of recovery are very important – however, even in the very best recovery state –the
greatest challenge was to improve patients’ outcome on societal recovery
, - Specifically, on the aspects of work, study, and housekeeping
Interestingly, patients with mostly negative symptoms scored higher on happiness –
compared to patients with positive symptoms – but experienced more societal problems
1. Patients with negative symptoms may be less aware of their mental health condition
2. Patients with positive symptoms experience a high burden of illness – due to
hallucinations and delusions
The fact that patients with negative symptoms were happier could potentially point to the fact
that although they are not symptom-free – have not experienced clinical recovery – they
were still subjectively happy
1. They also experienced more societal problems – yet were happy
2. It would appear that personal recovery – one’s subjective sense of well-being – is
most important
Personal Recovery in People with Psychotic
Disorder
(Leendertse, 2021)
Explain how the CHIME dimensions together facilitate personal recovery
CHIME – i.e., Connectedness, Hope, Identity, Meaning in life, and Empowerment
Treatment focus should be on affecting the elements of personal recovery itself
- Important dimensions to focus on in treatment include (1) meaning in life, (2)
empowerment, and (3) hope
There could be a bidirectional relationship between the CHIME dimensions and the
symptoms and their associated distress – unclear exactly how they influence each other
1. E.g., having hope may reinforce the effectiveness of treatment in reducing distress
associated with symptoms of psychosis
Disorders
Clinical, Societal, and Personal Recovery in
SZ Spectrum Disorders Across Time
(Castelein et. al., 2021)
What is the difference between personal, clinical, and societal recovery, according to
Castelein et al. (2021)?
Clinical Recovery – refers to the aim to minimize clinical symptoms and the focus in mental
health
1. Clinical – or symptomatic – recovery was assessed with remission items, and a time
criterion of at least 6 months
2. The items included positive symptoms and negative symptoms
Societal Recovery – refers to regaining everyday functioning at work, in social relationships,
and in housing – also strongly influences the way patients restore their health
1. Societal recovery was assessed by observing three areas of functioning over the past 6
months
2. The areas included daily living and self-care, study and housekeeping, and social
contacts
Personal Recovery – refers to one’s own experience of recovery, reflecting hope, identity,
and meaning – i.e., living a meaningful life
1. Personal recovery is personal and subjective – can only be assessed by the patients
themselves
Which is more important?
All types of recovery are very important – however, even in the very best recovery state –the
greatest challenge was to improve patients’ outcome on societal recovery
, - Specifically, on the aspects of work, study, and housekeeping
Interestingly, patients with mostly negative symptoms scored higher on happiness –
compared to patients with positive symptoms – but experienced more societal problems
1. Patients with negative symptoms may be less aware of their mental health condition
2. Patients with positive symptoms experience a high burden of illness – due to
hallucinations and delusions
The fact that patients with negative symptoms were happier could potentially point to the fact
that although they are not symptom-free – have not experienced clinical recovery – they
were still subjectively happy
1. They also experienced more societal problems – yet were happy
2. It would appear that personal recovery – one’s subjective sense of well-being – is
most important
Personal Recovery in People with Psychotic
Disorder
(Leendertse, 2021)
Explain how the CHIME dimensions together facilitate personal recovery
CHIME – i.e., Connectedness, Hope, Identity, Meaning in life, and Empowerment
Treatment focus should be on affecting the elements of personal recovery itself
- Important dimensions to focus on in treatment include (1) meaning in life, (2)
empowerment, and (3) hope
There could be a bidirectional relationship between the CHIME dimensions and the
symptoms and their associated distress – unclear exactly how they influence each other
1. E.g., having hope may reinforce the effectiveness of treatment in reducing distress
associated with symptoms of psychosis
