Table 2

Final conceptual framework for post-traumatic growth in psychosis and other severe mental health conditions

Type of growthDefinition of the positively perceived change
1. Self-discoveryHaving a fuller and deeper understanding of oneself.
 1.1 Emotional lifeDiscovering or re-discovering how to access, accept and be mindful of inner emotional life and difficult feelings.
 1.2 Self-knowledgeKnowing oneself better, being more authentic and not being as shaped by the expectations of others.
 1.3 Self-acceptanceGrieving and letting go of the past, and developing self-compassion.
 1.4 Self-responsibilityTaking (back) responsibility for one’s own life.
2. Sense of selfDevelopment of a more positive sense of self, including integration and valuing of illness experiences.
 2.1 Pride in selfTaking pride in oneself, including personal strengths and achievements.
 2.2 Integration of experiencesIllness experiences become an accepted part of one’s sense of self.
 2.3 Valuing of experiencesFinding positives in the experience of illness.
3. Life perspectiveNew or renewed appreciation of or gratitude about aspects of life.
 3.1 Appreciation of lifeAppreciation for life and the importance of hopefulness.
 3.2 Appreciation of supportGratitude for support received from services.
 3.3 Meaningful sufferingGratitude that suffering was meaningful and not in vain.
 3.4 Survivor missionNew growth of political consciousness or use of illness experiences to benefit others.
4. Well-beingMore active engagement in, and management of, one’s own well-being and lifestyle.
 4.1 MotivationIncreased determination to stay well, self-manage and not return to a bad situation.
 4.2 Being activeMore engagement in the arts, music, sport, nature and learning.
5. RelationshipsMore actively choosing and valuing relationships with others.
 5.1 Choosing relationshipsActively choosing relationships to continue, to re-start or to end.
 5.2 Valuing relationshipsPlacing more value on relationships with others.
 5.3 EmpathyEnhanced ability to empathise with others.
6 SpiritualityDeeper engagement with spirituality, religious and existential endeavours.
 6.1 Spiritual awarenessIncreased awareness of the presence of something greater than oneself making a positive contribution by providing meaning.
 6.2 Spiritual engagementNew or renewed engagement with spiritual or religious practices, helping with meaning-making and providing comfort and security.