title: How Occupationally High-Achieving Individuals With a Diagnosis of Schizophrenia Manage Their Symptoms.
abstract: OBJECTIVE
  The study objective was to elucidate coping strategies utilized by individuals recovered from schizophrenia.
  
  
  METHODS
  This qualitative study enrolled individuals with schizophrenia who had reached a level of recovery defined by their occupational status. Diagnosis of schizophrenia was confirmed with the Structured Clinical Interview for DSM-IV. Current symptoms were objectively rated by a clinician. Surveys gathered information on demographic characteristics, occupation, salary, psychiatric history, treatment, and functioning. Audio-recorded person-centered qualitative interviews gathered accounts of coping strategies. Transcripts were summarized and coded with a hybrid deductive-inductive approach.
  
  
  RESULTS
  Twenty individuals were interviewed, including ten men. The average age was 40 years. Sixty percent of participants were either currently in a master's-level program or had completed a master's or doctoral degree. Eight categories of coping strategies were identified: avoidance behavior, utilizing supportive others, taking medications, enacting cognitive strategies, controlling the environment, engaging spirituality, focus on well-being, and being employed or continuing their education. Some strategies were used preventively to keep symptoms from occurring; others were used to lessen the impact of symptoms. Strategies were flexibly utilized and combined depending on the context.
  
  
  CONCLUSIONS
  Use of strategies in a preventive fashion, the effectiveness of the identified strategies, and the comfort individuals expressed with using several different strategies supported these individuals in achieving their occupational goals. The findings contribute to an overall shift in attitudes about recovery from schizophrenia and highlight the importance of learning from people with lived experience about how to support recovery.
authors.affiliation: Dr. Cohen and Dr. Marder are with the Desert Pacific Mental Illness Research, Education and Clinical Center, Dr. Hamilton and Ms. Glover are with the Center for the Study of Healthcare Innovation, Implementation, and Policy, and Dr. Glynn is with the Research Service, all at the Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles (e-mail: ancohen@ucla.edu ). Dr. Cohen, Dr. Hamilton, Dr. Glynn, and Dr. Marder are also with the Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine, University of California, Los Angeles. Ms. Glover is also with the California School of Professional Psychology, Alliant International University, Alhambra, California. Dr. Saks is with the Gould School of Law and Dr. Brekke is with the School of Social Work, University of Southern California, Los Angeles.
authors.forename: Amy N
authors.initials: AN
authors.lastname: Cohen
authors.affiliation: Dr. Cohen and Dr. Marder are with the Desert Pacific Mental Illness Research, Education and Clinical Center, Dr. Hamilton and Ms. Glover are with the Center for the Study of Healthcare Innovation, Implementation, and Policy, and Dr. Glynn is with the Research Service, all at the Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles (e-mail: ancohen@ucla.edu ). Dr. Cohen, Dr. Hamilton, Dr. Glynn, and Dr. Marder are also with the Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine, University of California, Los Angeles. Ms. Glover is also with the California School of Professional Psychology, Alliant International University, Alhambra, California. Dr. Saks is with the Gould School of Law and Dr. Brekke is with the School of Social Work, University of Southern California, Los Angeles.
authors.forename: Alison B
authors.initials: AB
authors.lastname: Hamilton
authors.affiliation: Dr. Cohen and Dr. Marder are with the Desert Pacific Mental Illness Research, Education and Clinical Center, Dr. Hamilton and Ms. Glover are with the Center for the Study of Healthcare Innovation, Implementation, and Policy, and Dr. Glynn is with the Research Service, all at the Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles (e-mail: ancohen@ucla.edu ). Dr. Cohen, Dr. Hamilton, Dr. Glynn, and Dr. Marder are also with the Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine, University of California, Los Angeles. Ms. Glover is also with the California School of Professional Psychology, Alliant International University, Alhambra, California. Dr. Saks is with the Gould School of Law and Dr. Brekke is with the School of Social Work, University of Southern California, Los Angeles.
authors.forename: Elyn R
authors.initials: ER
authors.lastname: Saks
authors.affiliation: Dr. Cohen and Dr. Marder are with the Desert Pacific Mental Illness Research, Education and Clinical Center, Dr. Hamilton and Ms. Glover are with the Center for the Study of Healthcare Innovation, Implementation, and Policy, and Dr. Glynn is with the Research Service, all at the Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles (e-mail: ancohen@ucla.edu ). Dr. Cohen, Dr. Hamilton, Dr. Glynn, and Dr. Marder are also with the Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine, University of California, Los Angeles. Ms. Glover is also with the California School of Professional Psychology, Alliant International University, Alhambra, California. Dr. Saks is with the Gould School of Law and Dr. Brekke is with the School of Social Work, University of Southern California, Los Angeles.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Glover
authors.affiliation: Dr. Cohen and Dr. Marder are with the Desert Pacific Mental Illness Research, Education and Clinical Center, Dr. Hamilton and Ms. Glover are with the Center for the Study of Healthcare Innovation, Implementation, and Policy, and Dr. Glynn is with the Research Service, all at the Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles (e-mail: ancohen@ucla.edu ). Dr. Cohen, Dr. Hamilton, Dr. Glynn, and Dr. Marder are also with the Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine, University of California, Los Angeles. Ms. Glover is also with the California School of Professional Psychology, Alliant International University, Alhambra, California. Dr. Saks is with the Gould School of Law and Dr. Brekke is with the School of Social Work, University of Southern California, Los Angeles.
authors.forename: Shirley M
authors.initials: SM
authors.lastname: Glynn
authors.affiliation: Dr. Cohen and Dr. Marder are with the Desert Pacific Mental Illness Research, Education and Clinical Center, Dr. Hamilton and Ms. Glover are with the Center for the Study of Healthcare Innovation, Implementation, and Policy, and Dr. Glynn is with the Research Service, all at the Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles (e-mail: ancohen@ucla.edu ). Dr. Cohen, Dr. Hamilton, Dr. Glynn, and Dr. Marder are also with the Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine, University of California, Los Angeles. Ms. Glover is also with the California School of Professional Psychology, Alliant International University, Alhambra, California. Dr. Saks is with the Gould School of Law and Dr. Brekke is with the School of Social Work, University of Southern California, Los Angeles.
authors.forename: John S
authors.initials: JS
authors.lastname: Brekke
authors.affiliation: Dr. Cohen and Dr. Marder are with the Desert Pacific Mental Illness Research, Education and Clinical Center, Dr. Hamilton and Ms. Glover are with the Center for the Study of Healthcare Innovation, Implementation, and Policy, and Dr. Glynn is with the Research Service, all at the Greater Los Angeles Department of Veterans Affairs Healthcare System, Los Angeles (e-mail: ancohen@ucla.edu ). Dr. Cohen, Dr. Hamilton, Dr. Glynn, and Dr. Marder are also with the Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine, University of California, Los Angeles. Ms. Glover is also with the California School of Professional Psychology, Alliant International University, Alhambra, California. Dr. Saks is with the Gould School of Law and Dr. Brekke is with the School of Social Work, University of Southern California, Los Angeles.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Marder
mesh_terms: D000124:Achievement; D000223:Adaptation, Psychological; D000328:Adult; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012559:Schizophrenia / Q000628:therapy
keywords: Coping; Education; Qualitative methods; Recovery; Schizophrenia; Work