Determinants, self-management strategies and interventions for hope in people with mental disorders: Systematic search and narrative review

doi:10.1016/j.socscimed.2011.11.008

Social Science & Medicine

Volume 74, Issue 4, February 2012, Pages 554-564

https://doi.org/10.1016/j.socscimed.2011.11.008 Get rights and content

Abstract

Developing a recovery focus in mental health services is a policy goal internationally, and hope is a central component of recovery. Yet determinants of hope of people with mental disorders are not well known, nor are strategies and interventions that increase hope. This study aims to systematically summarise the available evidence to fill four relevant knowledge gaps: (1) hope scales used in psychiatric research, (2) determinants of hope, (2) hope-fostering self-management strategies, and (3) interventions to increase hope for people with mental disorders. We conducted a systematic literature search in April 2011 and a narrative synthesis of publications including qualitative and quantitative studies. Results for the first time provide a comprehensive overview of existing evidence and identify important scientific knowledge gaps: (1) Hope scales used do slightly vary in focus but are overall comparable. (2) Most published research used cross-sectional designs resulting in a high number of potential determinants of hope. No studies prospectively investigated the influence of these determinants. (3) Hope fostering self-management strategies of people with mental disorders were described in qualitative studies only with experimental studies completely missing. (4) While some recovery oriented interventions were shown to increase hope as a secondary outcome, there are no successful interventions specifically aimed at increasing hope. This review provides the basis for both practical and research recommendations: The five most promising candidate interventions to improve hope in people with mental disorders are (i) collaborative strategies for illness management, (ii) fostering relationships, (iii) peer support, (iv) helping clients to assume control and to formulate and pursue realistic goals, and (v) specific interventions to support multiple positive factors such as self-esteem, self-efficacy, spirituality and well-being. These may serve to directly improve care and to develop theory-based models and testable interventions to improve hope in mental health as well as in allied fields.

Highlights

►Identifies relevant determinants, self-management strategies and interventions to increase hope in psychiatric practice. ► Specific components of recovery oriented programmes and positive psychology interventions improve hope. ► Self-management strategies can be used as components of interventions to successfully increase and maintain hope. ► Hope can be improved successfully in people with mental illness.

Section snippets

Background

Hope has been a relevant topic in mythology, philosophy and religion for centuries. However, it was only in the 1950s when Menninger (1959) identified it as integral to the profession of psychiatry, important for initiating therapeutic change, willingness to learn and personal well-being. Since then, a wealth of research has been conducted investigating hope in various medical fields and different settings (Castañeda et al., 2010, Lalor et al., 2009, Rhodes et al., 2009), but particularly in

Data sources

We searched twelve bibliographic databases from inception (bracketed): AMED (1985); British Nursing Index (1985); EMBASE (1947); MEDLINE (1946); PsycINFO (1806); Social Science Policy (1890); CINAHL (1981); International Bibliography of Social Science (1951); British Humanities Index (1962); Sociological abstracts (1952); and Social Services abstracts (1979). The reference lists of all included studies, relevant reviews and opinion papers were hand searched for additional relevant papers.

Results

Study selection is shown in Fig. 1.

Characteristics of the 57 included studies are shown in Online Data Supplement 2. Eight were qualitative, and were used in all Aims. Of the 49 quantitative studies, 35 used cross-sectional designs (reported within review Aim 2) and 16 were prospective (9 fitting review Aim 2 and 8 review Aim 4). The 149 relevant review and opinion papers were used for hand search only and are summarised in Online Data Supplement 2.

Discussion

In this systematic review and narrative synthesis we bring together a wide range of quantitative and qualitative data on potential determinants of hope, self-management strategies and interventions that might serve to improve hope in people with mental disorders. Given the increasing theoretical importance of hope, particularly in positive approaches to mental health, research on this topic has substantially increased in recent years as reflected by the rising number of studies meeting our

Clinical implications

The results of this review suggest at least five promising elements that may be included in future interventions specifically designed to enhance hope of people with mental disorders: (i) collaborative strategies for illness management, including medication, (ii) a focus on fostering relationships both with staff and people outside the mental health system, (iii) facilitating connections with peers, particularly peer support, (iv) helping clients to assume control and to formulate and pursue

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Determinants, self-management strategies and interventions for hope in people with mental disorders: Systematic search and narrative review

Abstract

Highlights

Section snippets

Background

Data sources

Results

Discussion

Clinical implications

Journal of Substance Abuse Treatment

Personality and Individual Differences

Social Science & Medicine

International Journal of Nursing Studies

Social Science & Medicine

Psychiatry Research

Applied Nursing Research

Behaviour Research and Therapy

Social Science & Medicine

Social Science & Medicine

Archives of Psychiatric Nursing

Personality and Individual Differences

Social Science & Medicine

Social Science & Medicine

Social Science & Medicine

Stages of recovery instrument: development of a measure of recovery from serious mental illness

Australian and New Zealand Journal of Psychiatry

Classification in psychiatry: ICD-10 versus DSM-IV

Br J Psychiatry

A randomized controlled trial of the effectiveness of a modified recovery workbook program: preliminary findings

Psychiatric Services

Positive psychology. History in the remaking?

Theory & Psychology

Conventional wisdom on measurement: a structural equation perspective

Psychological Bulletin

Recovery and mental health: a review of the British literature

Journal of Psychiatric and Mental Health Nursing

Correlates of insider and outsider conceptualizations of recovery

Psychiatric Rehabilitation Journal

Exploring identity within the recovery process of people with serious mental illnesses

Psychiatric Rehabilitation Journal

Hope therapy in a community sample: a pilot investigation

Social Indicators Research

Reliability and validity of the Japanese version of the self-identified stage of recovery for people with long term mental illness

International Journal of Mental Health Nursing

The role of symptom distress and goal attainment in promoting aspects of psychological recovery for consumers with enduring mental illness

Journal of Mental Health

Initial outcomes of a mental illness self-management program based on wellness recovery action planning

Psychiatric Services

Religion and spirituality in the lives of people with serious mental illness

Community Mental Health Journal

Examining the factor structure of the recovery assessment scale

Schizophrenia Bulletin

“Positive Psychology”: some plusses and some open issues

Journal of Community Psychology

Developing and evaluating complex interventions: the new medical research council guidance

BMJ

Hostility and hope in combat-related posttraumatic stress disorder: a look back at combat as compared to today

Cognitive Therapy and Research

The promise of positive psychology

Psychological Topics

Strategies for encouraging and maintaining hope among people living with serious mental illness

Australian Social Work

Patterns of current and lifetime substance use in schizophrenia

Schizophrenia Bulletin

Effect of wellness recovery action plan (wrap) participation on psychiatric symptoms, sense of hope, and recovery

Psychiatric Rehabilitation Journal

Predictors of hope among members of mental health self-help agencies

Social Work in Mental Health

Exploring hope: its meaning for adults living with depression and for social work practice

Advances in Mental Health

Hope and recovery from substance dependence in homeless veterans

Journal of Social and Clinical Psychology

Hope, coping, and social support in combat-related posttraumatic stress disorder

Journal of Traumatic Stress

Perception of illness as a barrier to work in consumers of supported employment services

Journal of Vocational Rehabilitation

Causal attributions for psychological illness among Turkish psychiatric in-patients and their relationships with hope

International Journal of Social Psychiatry

Risk and protective factors for suicidal behavior in abused African American women

Journal of Consulting and Clinical Psychology