The process of posttraumatic growth in psychosis: A qualitative study

Introduction: People who experience psychosis can also experience post-traumatic growth (PTG); positive changes from difficult experiences. There is limited research into the specifics of how PTG occurs and manifests in people with psychosis. The PROSPER framework, developed from a systematic review, delineates seven domains of facilitating factors (Personal Identity and Strength, Receiving Support, Opportunities and Possibilities, Strategies for Coping, Perspective Shift, Emotional Experience, and Relationships). This study aimed to investigate 1) the process of growth in individuals with psychosis, 2) validate the PROSPER framework, and 3) identify additional mechanisms of growth.



Methods: A semi-structured interview schedule was produced with input from the Lived Experience Advisory Panel. Interviews were conducted with 25 people who had experienced psychosis and who self-reported positive changes. Data was analysed using both deductive and inductive thematic analysis.



Results: The findings from the analysis were utilised to develop a model of positive change for people with psychosis. In brief, psychosis was described as a disruption, which was influenced by determinants such as personal and trauma factors. Movement from disruption to positive change was described as a process of acceptance influenced by four mechanism categories (cognitive processes, social factors, personal well-being, and external factors). Indicators of positive change manifested through the PROSPER framework.



Conclusions: People who experience psychosis do indeed experience PTG, and a model has been developed to illustrate the process for these participants. This model can serve as the foundation for further research aiming to understand PTG in individuals with psychosis, and the identified mechanisms can be utilised in interventions to support PTG.