A Narrative Exploration of In-patient Mental

Health Recovery

Presentedby:JaylynLeightonandShelaghKeesmaat

Committeemembers:Dr.KimberlyLopez&Dr.CoreyJohnson

UniversityofWaterloo

HomewoodHealthCentre

Agenda:– Thestorybehindtheresearchprojectandtheoutdoorexperiential

psychotherapyworkshop– Aconceptualframeworkforexploringtheliteraturereview– Findings

– Thestoriesoftheexperienceoftheworkshop– Anoverviewofthenarrativethreads

– Discussion:SoWhat…?– Implicationsforpracticeandresearch– Non-conclusion

The story behind the research project…– AddictionMedicineServices(AMS)- Addiction-traumarecoverystream,

HomewoodHealthCentre,GuelphON

Conceptual Framework

PTSD-SUDcomorbiddiagnosis

TheFieldofRecreationandLeisureAustinetal.,2015;

McCarville&MacKay,2007

TreatmentandHealingofaPTSD-SUDdiagnosis

Kofoed etal.,1993;StewartandConrod,

2003

SUDPTSD

MentalHealth

MarginalizationandStigmaofamentalhealthdiagnosis

Brown&Strega,2005;Clearyetal.,2004;Kreek,2011

GroupInterventionsShank&Coyle,2002HealingGriffin,2005;Scott&Ross,2006

TherapeuticRecreationAustinetal.,2015;Shank&Coyle,2002

RelationalandSensorimotorJordan,2015;Ogden&Fisher,2015

OutdoorExperientialTherapy

Ewert etal.,2001

TheroleoftheoutdoorsBerger&McLoed,2006;Jordan,2015

PsychotherapyBuzzell andChalquist,

2009

THEGAP…

DSM-5,2013

Guiding research question:

– 1.Howdoestheuseofoutdoorexperientialpsychotherapywithinanin-patientcaresetting,influenceindividualsexperiencesofearlyrecovery?

Methodology– NarrativeInquiry– “thebodyhaslived,felt,andbeenhurt,andthereforeithousesmemoriesofitsown”

(deMedeiros,2014,p.480)

– Experience-focusednarrativeinquiry– Chase,2005;Jackson&Mazzei.2005;Johnson&Parry,2015;Berbary &Boles,2014;Squire,2008)

The research context….

– ProgramContext:TheOutdoorExperientialPsychotherapyWorkshop(FridayFebruary16,2018)

– Targetedpopulation:PTSD-SUDco-morbiddiagnosis– Thesite:HomewoodHealthCentre(Addiction-PTSD

RecoveryStream,AddictionMedicineServices(AMS)unit)

– Theparticipants:6participants(3identifiedasmale,3identifiedasfemale)

Data collection and analysis procedures:– PhaseOne:TheOutdoorExperientialPsychotherapyWorkshop

– PhaseTwo:GroupDebrief(Audio-recorded)

– PhaseThree:Semi-structuredNarrativeLife-ExperienceInterviews– Lifehistoryblendedtolife-experiencenarrative

– PhaseFour:AnalysisandInterpretation– Collectionandanalysisof:audio-recordedfocusgroupandtranscriptsofnarrative

life-storyandexperienceinterviews

– Useofthematicanalysis(Braun&Clarke,2006;Creswell,2013)

– PhaseFive:Representation

Narratives

– TheStoryofOdin

TheGood: Clear,blueskies

TheBad:TheDarkClouds

TheUgly:TheHeavyRains

WeatheringtheStorm:Taking

Shelter

TheGood:Thesunpeakingthrough

The Perfect Storm: The good, the bad and the Ugly

Figure4. Figure5.

ThePerfectStorm

TheRoleofthe

Outdoors

Connectingwithothersthroughstories

WorkingthroughPast

Behaviours

The good: Clear, blue skies– “itfeltgoodtogetawayfromthebuilding,[itfeltlike]Iwasawayfrommyalcoholism

andIwasawayfromnottalkingaboutitsomuchanditjustgavemeapeaceofmind”(Joseph)

– “[itwas]nicetobeoutinnatureitsmoretranquil,youautomaticallyfeelabreathoffreshair,youfeelatpeace,youfeellikeyouareremovedfromschedule,routine,andstructure”(Liam)

The Bad: The dark clouds– “IhavebeensufferinginsideandnooneknowsontheoutsidethatIamsuffering.”(Odin)

– “Ineverhadmuchofachildhood…itbroughtoutthekid”(Joseph)

The Ugly: The heavy rains– “itthrewmeofffortheday…Ifeltemotionallyexhaustedandemotionally

drained.”(Brianna)

Weathering the Storm: Taking shelter– “thedebriefingwasnicebecausethenIgottounloadanyfeelingsIhadin

betweenandnotbuildupanyresentmentsorfrustrations.”(Brianna)

– “IfindthatwhenpeoplearetalkingabouttheirexperiencesthefirstthingItrytodoisrelatetotheirexperience,kindoflikewalkingintheirshoes…likehowhadmylifebeenaffectedinsimilarways.”(Odin)

The Good: The sun peaking through– “yeahitwasfunandgoofy,Idon’trememberdoingsomethingfunandgoofy

likethatsober.”(Ava)

Transferring the Storm into Recovery:

– “sometimestheanswerliesjustoutsideyourcomfortzone…IamgladIcametoday…Igottoworkatitslowlyandgetbacktobeingaroundotherpeopleandhavingfunwithoutdrinking.”(Odin)

– “eachoneofusisborndifferent…butbehindeveryoneisourstories.”(Joseph)

– “IfIcanhelpsomeonedowntheroad…changethingsforthebetterthereisalwaysprogresstobemade.”(Odin)

TheGood: Clear,blueskies

TheBad:TheDarkClouds

TheUgly:TheHeavyRains

WeatheringtheStorm:Taking

Shelter

TheGood:Thesunpeakingthrough

The Perfect Storm: The good, the bad, and the ugly

Discussion- So What?• TheRoleofOutdoorExperientialPsychotherapywithinanIn-patientSetting

– MedicalversusSocialApproachestoCare

– TheCycleofaPTSD-SUDDiagnosisinCare

– TheUnderstandingandRoleofTRinCare

– TheRoleoftheOutdoorsinCare

– TheRoleofFuninCare

Discussion• ProvidingaPlatformforthevoiceinthecrackstobehear

- Theroleofgroupinterventionsandprocessingtechniques- The‘VoiceintheCracks’

• ImplicationforResearchandPractice• BridgingtheGapbetweenResearchandPractice

Non conclusion: What’s next?

– “eachoneofusisborndifferent…butbehindeveryoneisourstories.”(Joseph)

Thank you!AspecialthankyoutoShelaghKeesmaat,andHomewoodHealthCentreforhelpingsupportthisresearchproject