Livshistorier og førstegangspsykose — en klinisk metode for systematisk narrativt arbeid: Hvordan vurderer pasienten nytten av Kronologisk livsløpsdiagram (KLD) i utredning av førstegangspsykose?

Abstract

Aim.

To gain knowledge about first-episode psychosis patients' experience with and judgements of a specific narrative method, as part of initial assessment.

Background.

Subjective illness insight is an important yet underfocused goal for psychosis treatment and should be aided as early as possible, even during assessments. No study, to our knowledge, has explored psychotic patients' experience with specific clinical methods to promote insight.

Methods.

Psychosis is often associated with difficulties in telling coherent life stories. Chronological Lifespan Chart (CLC) is a means to systematically recreate parts of the patients' subjective life story. Through semi-structured interviews, 19 patients were asked to describe and quantify the experienced value of using this narrative tool, with particular reference to recognition, participation and self-understanding. The study has a qualitative, phenomenological, and hermeneutic approach.

Findings and conclusions.

The patient-therapist cooperative work with CLC gave the majority of the patients a strong sense of being recognized, clearly encouraging the dialogue. They further experienced being active participants during initial assessments, and the felt ownership of their narratives increased. The patients' self-understanding was strengthened by raising the consciousness about own coping strategies and consequences of the illness in daily life.