1. Participatory Approach To Qualitative
Advances in Qualitative Methods Conference
Banff, May 2-5, 2003
Participatory Approach To Qualitative
Research In Community Mental Health
The Place of Consumer Survivor Initiatives in Stories of Recovery
Rich Janzen, Joanna Ochocka and Geoffrey Nelson

2. Overview of Presentation
1) Background to Study
2) Alternatives Needed
3) Differences between Active/Nonactive
4) People’s Experiences of CSI’s
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3. Purpose of the Longitudinal Study of Consumer/Survivor Initiatives
To examine the activities and impacts of Consumer Survivors Initiatives on new members (individual level) and the communities within which they exist. (systems level)
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4. Methodology: Individual Qualitative
Baseline, 9, 18 month follow-up interviews
26 qualitative interviews (11 active and 15 non-active CSI members)
Open-ended interviews - asked about changes
in past 9 months, factors facilitating and
inhibiting changes, typical day in the life
Interviews transcribed and analyzed using content analysis and Nvivo
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5. Purpose of Paper
To understand the role of Consumer Survivor Initiatives in mental health recovery.
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6. Working Definition: Recoveryl
Self
External Circumstances
Positive Changes
Negative Changes
Negotiation
Drive Forward
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7. Process of Analysis
Coding of all 26 interviews in Nvivo using recovery framework categories (baseline and 9 months)
Analysis team discussion: Preliminary themes
Searching for CSI’s as a helping factor in recovery
Analysis team discussion: Major themes
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8. Alternatives Needed: An Unexpected Finding
Limits of psychiatric profession
Limits of hospitals
Challenges of medication adjustments
“It was like the psychiatrist felt like she diagnosed me and she knew what was best. I was to follow her instructions and so forth and then that would be my road to recovery. It felt like I gave most of my control and power to her and let it be in her hands”
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9. Alternatives Needed
“I never found the mental health profession helpful. Never. One of the big things I believe that are helpful is to believe in God, in a higher power, in something beyond yourself. They never talk about that and if you have a belief in God they kind of think you are delusional, so this isn’t helpful. I found that my belief in God, from Alcoholics Anonymous and places like that have increased my recovery. If I had been seeing a psychiatrist for forty years, a belief in God for two weeks would be far more helpful. That is my comparison because psychiatrists don’t give you that kind of strength.”
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10. Differences Between Active/ NonActive Participants
Few differences consistent with quantitative findings (quality of participation is a better predictor)
Strongest difference that exists triangulates well with quantitative findings
18-month and 36-month follow-up may expose more differences
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11. CSI’s Facilitate Social Support
Differences:
CSI’s Facilitate Social Support
Major difference between those active and those not active in CSI’s
Increased social support both through CSI itself and in other settings
“I felt isolated, I didn't have any contact with peers who were going through the same situation I have…It does make quite a difference for an individual to contact his peers and go through what they have gone through and give each other support.”
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12. CSI’s Facilitate Social Support
Differences:
CSI’s Facilitate Social Support
“It was an amazing group and I got close to these people and everything and then it ended. The last night that I was there we had a group hug and everything and it was wonderful. Then it ended up that the next day I couldn’t handle the group changing. I am not a person that deals with people going away or anything finishing and so I, that is the day that I actually started going downhill. From that day I have been doing progressively worse.”
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13. CSI’s Facilitate Community Participation
Differences:
CSI’s Facilitate Community Participation
Active CSI participants tend to be more active in a variety of community settings
Examples of community settings include churches, sports/fitness, bars/dance clubs, bingo, employment.
“I started going to the bars and that may sound stupid, but there is community in bars as well.”
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14. NonActive Accept Limits and Capacities
Differences:
NonActive Accept Limits and Capacities
“Yeah, it’s very difficult. It’s been a lesson that I’ve had to learn, is to tame it, control myself, you know... not get too involved in everything because otherwise you get sick. It’s really frustrating because you don’t know how much you can do and how much you can’t do and you see other people being able to take stress levels that you know that if you tried you wouldn't be able to do it. That was the frustrating thing for me. It always has been…”
“I am not really interested in having a job. I have enough to handle. What I need to do now is learn my limit.”
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15. People’s Experiences of CSI’s:
Helpful Processes
Social arena--a place to go
Welcoming place
Opportunity to talk with peers
Opportunity to participate in groups
Opportunity to contribute
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16. People’s Experiences of CSI’s:
Helpful Processes
“You feel at home here [at CSI]...It is somewhere to go.”
“When I talk to people I see that I am not the only one that it helps because I get down in the dumps sometimes…It helps to talk. It really does.”
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17. People’s Experiences of CSI’s:
Outcomes
More social support-made new friends, less social isolation
More accepted and can be yourself
Taking charge and taking responsibility
Challenging the system
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18. People’s Experiences of CSI’s:
Outcomes
“ I was very shy when I am in a group. I got a very good response from everybody in the group--very friendly and open and I felt comfortable quickly.”
“I have made some friendships…It was quite a change. The reason that I was so isolated in the community was that I just did not want to divulge my personal life anymore.”
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19. Thank you for your attention
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20. Future Contact Dr. Joanna Ochocka, Project Coordinator
Rich Janzen Senior Researcher
Centre for Research & Education in Human Services
73 King Street West, Suite 202
Kitchener, ON, Canada N2G 1A7
Phone: (519) Fax: (519)
Website:
Dr.Geoffrey Nelson, Principal Investigator
Wilfrid Laurier University
Department of Psychology
Waterloo, ON, Canada, N2L 3C5
Phone: , ext. 3314, Fax:
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