Beyond early intervention: can we adopt alternative narratives like 'Woodshedding' as pathways to recovery in schizophrenia?
OBJECTIVE
To consider how early intervention in psychosis can support a recovery paradigm.


METHODS
Significant numbers of those developing a first episode of psychosis are on a path to a persisting and potentially life long condition. Constituting the schizophrenia spectrum disorders, such conditions demand the particular qualities and attitudes inherent within recovery-based practice. This paper explores some of these qualities and attitudes by examining the tension between a traditional 'clinical' narrative used by many health providers and a 'human' narrative of users of services and their families.


RESULTS
We draw out key features and constructs of recovery practice as they relate to the EI paradigm. These include: woodshedding, turning points, discontinuous improvement models, therapeutic optimism, gradualism and narratives of story telling. We also highlight the role of family members and other close supporters and believe their potential contribution requires greater consideration.


CONCLUSIONS
The early intervention (EI) paradigm can resonate and indeed offer a stronghold for recovery-based practice where traditional mental health services have sometimes struggled. Conversely, failure of caregivers to provide such an approach in the early phase of illness can cause unnecessary and sometimes disastrous consequences.
National Early Intervention Development Programme of the National Mental Health Development Unit, London, UK. david.shiers@nmhdu.org.uk
David
D
Shiers
Alan
A
Rosen
Ann
A
Shiers
D061345:Early Medical Intervention / Q000379:methods*; D006801:Humans; D008605:Mental Health Services; D011582:Psychological Theory; D012559:Schizophrenia / Q000628:therapy