Psychosocial Intervention: Promoting Functional Recovery in Adult Patients with Early Psychosis: A Recovery-oriented Life Coaching Intervention

Abstract

Disruptions in functioning are commonly reported in patients with psychosis. Apart from symptomatic remission, functioning is one of the most important indicators of recovery. Recent studies have consistently revealed that achievement of adequate functioning is a critical element signifying recovery. Although the majority of first-episode psychosis (FEP) patients achieve symptomatic remission after adequate antipsychotic treatment, a significant proportion of them still exhibit prominent functional impairment. Jockey Club Early Psychosis (JCEP) project is a specialized early intervention program in Hong Kong that provides 2–4 year phase-specific case management for adults presenting with FEP. To facilitate their early functional recovery, JCEP has developed a psychosocial intervention based on life coaching approach. This intervention includes 10 weekly structured group-based sessions incorporating cognitive-behavioral, motivational, and solution-focused therapeutic components. The program facilitates patients to undergo active change process via identification of achievable goals, formulation of action plans, provision of feedback and progress monitoring for goal attainment. It is strength-oriented and aims to facilitate patients to gain a sense of agency and to achieve sustained functional improvement via firstly, enhancing motivation, self-regulation and competence by positive reinforcement obtained from successive accomplishments of self-determined goals; secondly, providing an autonomy-supportive treatment environment with a context of recovery expectations; and thirdly, facilitating formation of supportive social network in group-based setting. Owing to an unmet therapeutic need for functional recovery in patients with early psychosis, group-based life coaching intervention serves as an innovative yet potentially promising psychosocial therapeutic approach that deserves systematic evaluation of its effectiveness in functional improvement