The central role of self-agency in clinical recovery from first episode psychosis

Purpose: While there is accumulating evidence for clinical recovery in a significant proportion of people experiencing a first episode psychosis, the mechanisms facilitating this form of recovery are less well known. Thus, the aim of this study is to investigate mechanisms of recovery after a first-episode psychosis as perceived by clinically recovered service users. Methods: Thematic analytic approach within an interpretative–phenomenological framework. Twenty clinically recovered service users were interviewed. Analysis followed an established meaning condensation procedure. Results: Main theme: Establishment of subjective self-agency. Subordinate themes: (1) Environmental support and gentle pressure, (2) Individually tailored assistance, (3) Antipsychotic medication: relinquishing personal responsibility, and considerable side effects. Conclusions: We suggest that an increase in sense of personal agency is a core mechanism driving recovery for participants in the study sample. Findings indicate that interventions aiming to boost subjective and behavioral agency in service users might be of great benefit, particularly in combating negative symptoms of psychosis.