TY - JOUR
T1 - Theoretical model of recovery following a suicidal episode (COURAGE)
T2 - scoping review and narrative synthesis
AU - Sokol, Yosef
AU - Levin, Chynna
AU - Linzer, Mairav
AU - Rosensweig, Chayim
AU - Hubner, Shifra
AU - Gromatsky, Molly
AU - Walsh, Samantha
AU - Dixon, Lisa
AU - Goodman, Marianne
N1 - Funding Information:
We thank the lived experience, recovery and suicide experts, including: Peter Britton, PhD; Janne Damsgaard, PhD; Larry Davidson, PhD; Patricia Deegan, PhD; Amanda Gibley, MSc; Richard Goldberg, PhD; Mary Leamy, PhD; Ben Milbourn, PhD; Myra Piat, PhD; Terri Pogoda, PhD; Josephine Ridley, PhD; Theo Stickley, PhD; Jerry Tew, PhD; and Patricia Tran, PhD; as well as the Veterans Administration Health Services Research and Development Service (VA HSR&D) Suicide Prevention Research Impact NeTwork (SPRINT) Consortium of Research. Writing of this manuscript was supported by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs. None of those consulted were compensated for their feedback.
Publisher Copyright:
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.
PY - 2022/11/17
Y1 - 2022/11/17
N2 - Background Despite a significant need, there are currently no rigorously developed empirically based models for what personal recovery from a suicidal episode looks like. Aims To develop a theoretical model of personal recovery after a suicidal episode, based on a comprehensive literature review and stakeholder feedback. Method A scoping review of all empirical studies on this topic was conducted, followed by a thematic analysis to create a preliminary framework. Consultation-based revisions were then made based on feedback from a stakeholder panel to develop the final theoretical model. Results The final model comprised seven themes: choosing life, optimising identity, understanding oneself, rediscovering meaning, acceptance, growing connectedness and empowerment (acronym 'COURAGE'). Although there are some similarities between COURAGE and other models of personal recovery, there are components, such as 'choosing life' and 'understanding oneself', that are specific to recovery after an acute suicidal episode. Conclusions To our knowledge, this is the first study to use a comprehensive literature review with stakeholder feedback to develop a conceptual model of personal recovery after an acute suicidal episode. This model has important implications for both researchers and clinicians to consider. Looking ahead, COURAGE can inform the reconceptualisation of assessment, research and clinical care of individuals who have experienced a suicidal episode.
AB - Background Despite a significant need, there are currently no rigorously developed empirically based models for what personal recovery from a suicidal episode looks like. Aims To develop a theoretical model of personal recovery after a suicidal episode, based on a comprehensive literature review and stakeholder feedback. Method A scoping review of all empirical studies on this topic was conducted, followed by a thematic analysis to create a preliminary framework. Consultation-based revisions were then made based on feedback from a stakeholder panel to develop the final theoretical model. Results The final model comprised seven themes: choosing life, optimising identity, understanding oneself, rediscovering meaning, acceptance, growing connectedness and empowerment (acronym 'COURAGE'). Although there are some similarities between COURAGE and other models of personal recovery, there are components, such as 'choosing life' and 'understanding oneself', that are specific to recovery after an acute suicidal episode. Conclusions To our knowledge, this is the first study to use a comprehensive literature review with stakeholder feedback to develop a conceptual model of personal recovery after an acute suicidal episode. This model has important implications for both researchers and clinicians to consider. Looking ahead, COURAGE can inform the reconceptualisation of assessment, research and clinical care of individuals who have experienced a suicidal episode.
KW - Suicide
KW - individual psychotherapy
KW - personal recovery
KW - qualitative research
KW - recovery framework
UR - http://www.scopus.com/inward/record.url?scp=85143611549&partnerID=8YFLogxK
U2 - 10.1192/bjo.2022.599
DO - 10.1192/bjo.2022.599
M3 - Review article
AN - SCOPUS:85143611549
SN - 2056-4724
VL - 8
JO - BJPsych Open
JF - BJPsych Open
IS - 6
M1 - e200
ER -