"Flourish": A Recovery-Based Self-Development Program
"Flourish" is a new type of self-help program for people with long-term mental illness, developed by researchers at the Illawarra Institute for Mental Health at the University of Wollongong. In collaboration with NSW CAG, a trial of the program is now almost complete. The results so far have been very positive.
Flourish focuses on the positive and working towards the future, rather than focusing on problems. It is called a "self-development" program, because it is designed to enable people to take responsibility for making the positive changes they want to see in their lives. In that way, it encourages personal growth.
Flourish is based on the principles of the positive psychology movement, which advocates that more effort should be invested in studying what makes people thrive, rather than focusing solely on what makes things go wrong. The concept of "flourishing" holds that symptoms of mental illness do not preclude living a fulfilling and meaningful life, while absence of symptoms does not guarantee a flourishing life (Keyes, 2003).
While Flourish is sensitive to the unique problems that a person with serious mental illness faces, it acknowledges that everyone has a "core self" that strives to learn, grow and thrive. This core self is represented by a set of deeply held values that steer the person on their life journey. Flourish is designed to help people to tap into their core values and to move forward with a life that is meaningful to them.
The program is self-directed and comprises a Handbook, containing information and exercises that the person works through at home; an mp3 player with recordings which complement the material in the handbook; fortnightly peer-led discussion meetings; and reminder calls during the alternate fortnight. It has eight self-learning modules covering: recovery and "flourishing"; identifying my strengths and my values; life vision and goal planning; how positive emotions can help us to grow; how "mindfulness" can help us deal with anxiety; the process of change and overcoming resistance to change; and obtaining social support for goals.
The trial of the program is almost complete, with groups having been held in Wollongong, Nowra, Sydney and Gippsland (Vic). Thirty-eight people took part in the first round of the trial, while twenty-three people took part in the second round.
Positive outcomes...
The research has found that people who completed the program showed increases in psychological well-being in the areas of self acceptance, environmental mastery, and relationships with others; they had improved recovery outcomes in the areas of personal confidence and hope, goal orientation and trusting others and felt less dominated by their symptoms. They also reported lower levels of depression and anxiety than people who had been on a waiting list for the program.
"Just what is needed..."
Feedback received from those who have finished the program is that the positive focus was very welcome and "just what is needed." Interviews with some of the participants have shown that individual people gain more from different parts of the program. Some participants have said that the program had given them a structure that had helped them to make progress in getting on with their lives - something that is missing when they leave hospital. They felt they could continue to use the ideas in the Handbook after completing the course.
Below is an excerpt from an interview with a participant in the Flourish program:
Sara:*
Sara described her ‘light bulb' moment in the Flourish project as the module on ‘willingness to change and resistance to change'. Before undertaking the Flourish project she describes life as a ‘constant cycle of negative energy and bad moods.'
‘Before Flourish I had literally got to the point where I just didn't care. I was just really withdrawn and depressed'
Sara had goals, but had no idea how to get there, and felt her life lacked direction. She was unable to recognise her barriers, her confidence was low and her internal thoughts and feelings about herself were very negative. She found herself putting up barriers to everything, which she just could not get through because she ‘just didn't know how.'
Breaking down some barriers took weeks but seeing written down on paper the things she was resisting made her realise how ‘ridiculous' they were and she couldn't believe how the ‘tiniest things were holding her back'. She describes this as a ‘massive change', which was challenging.
Although she still has bad days, she is now far more positive, can recognise her strengths and describes a ‘huge change' for the better in her interaction with other people.
The researchers are very pleased with the results so far, and are hoping to obtain funding to expand the program and to make materials available online in the future.
*Names have been changed.
The project is being coordinated from the Illawarra Institute for Mental Health at the University of Wollongong in conjunction with NSW Consumer Advisory Group-Mental Health Inc. The research is funded by the Australian Rotary Health Research Fund.
Reference:
Keyes, Corey L. M., and Jonathan Haidt. 2003. Flourishing: Positive Psychology and the Life Well-Lived. Washington D.C.: American Psychological Association