Coping and Growth in Psychosis: Positive Pathways Following Trauma

Objective(s): There are high rates of trauma in people who experience psychosis and a focus on the negative impact. The current study explores people’s perceptions of factors that facilitate positive adjustment and Post Traumatic Growth (PTG) following trauma, which is important for developing interventions to support resilience and well-being. Methods: Semi-structured interviews were completed by eleven people with experiences of both trauma and psychosis. Transcripts were subject to thematic analysis. Results: Participants welcomed the idea of growth and stressed the importance of hearing growth stories from other people with similar experiences and practitioners. However, growth was considered a sensitive topic that clinicians should introduce tentatively to not undermine the potential suffering caused by trauma. Participants effectively used various strategies to deal with their traumas, including some typically considered maladaptive by clinicians (e.g., avoidance and self-harm). Conclusion: When working with trauma in the context of psychosis, mental health professionals should formulate behaviours in terms of whether or not they are functional to a specific moment and environment, rather than routinely consider methods of coping as adaptive or maladaptive. Our findings also highlight the importance of assessing and supporting recovery from trauma rather than just from psychotic symptoms and suggest that clinicians should offer interventions for fostering PTG in psychosis, such as supporting access to a diverse range of narratives about adapting to life beyond trauma.