Using timelines as part of recovery-focused practice in psychosis

Abstract

Timelines are used as a way for people to track the development of mental health problems over time particularly factors from childhood, adolescence and early adulthood. They show what was happening in people's lives at the times when they became ill and also at the times when they were well. Timelines can be used by service users and mental health workers to make sense of experiences and facilitate coping, including making best use of medicines. For many people in recovery the aim will not be to eliminate experiences associated with psychosis and it is often possible to reduce their negative impact and lead a satisfying life. Further research is needed exploring links between timelines, concordance and recovery. The value of timelines is discussed with regard to the promotion of recovery, particularly emphasizing relapse signature and concordance in medicine-taking. Recovery approaches in contemporary mental health care rely on understanding motivations, aspirations and decision making. In the authors' experience timelines are a useful way of working together with people to make sense of experiences, of which they may only have partial or intermittent awareness. The mental health workers' philosophical approach, the tools available to them and their skills and attributes, shape the therapeutic relationship. Timelines are a useful tool in helping reach the kind of joint understanding within a therapeutic relationship which characterizes concordance. As this relationship develops, decision making including that around medicine-taking and relapse signature, can be based on this shared understanding. Timeline examples (Tables2 and 3) based on the fictitious experiences of Philip, a young man diagnosed with schizophrenia, show their application in recovery-focused practice. Further research is needed to enhance the limited evidence base underpinning timelines as a method of facilitating concordance. © 2011 Blackwell Publishing.