The Contribution of Individual, Dyadic and Social Factors, to the Personal Recovery of People with Mental Illness in Spousal Relationship

The present research is based on the modern approach to recovery, in the process of coping with mental illness. The recovery process involves changes in the individual's attitudes, beliefs, values and abilities. This approach emphasizes the need of building personal resources and meaning in the process of recovery. This is, therefore, a  very personalized approach. However, its inclusion of a discussion of spousal and other intimate relationships and recognition of the resources found in such relationships has just far been limited. As a result, the present research is also based on the Dyadic coping model, developed by Bodenman ( Bodenman, 1995), which completes the recovery model relavant to couples. According to Bodenman, one should view the coping process with mental illness as a process shared both by the individual with the mental illness and his or her spouse (or significant other).

The purpose of this study is to explore the process of "Personal Recovery" of individuals with mental illness, from a perspective that has not yet been considered. Thus, we have focused on the contribution of relationships with a spouse (or significant other) - and the important resources existing within them. To do this, a theoretical model that interacts three groups was tested for the first time. These three groups include: individual variables including personal coping strategies; spousal variables including dyadic coping and marital adjustment; and social variables including social recognition of loss and social support. In addition, we have made a comparison between men and women, and between those who have participated in couple therapy and those who have not.

The research population included 127 individuals coping with serious mental illness - major depression, schizophrenia, and bi-polar disorder - who are in a spousal relationship. Sampling of the research population was randomized, and was carried out according to the method of convenience and "snow ball" sampling. All the variables were checked by using structured scales, which included the following questionnaire: Personal details, recovery assessment, dyadic adjustment, individual coping, disenfranchised loss and grief, dyadic coping, and perception of social support.

The hypotheses of the research include: 1. The personal recovery of women will be rated higher than men. 2. The rating of the following variables will be higher among the participants in this research who experienced couple therapy - than for those not involved in couple therapy: social support, personal coping, recognition of loss, dyadic coping, marital adjustment, and personal recovery. 3. The greater the social support, the greater will be the personal coping, the recognition of loss, the dyadic coping, the marital adjustment, and the personal recovery. 4. The greater the positive personal coping strategies and the fewer the negative personal coping strategies, the higher will be the recognition of loss, the dyadic coping, the marital adjustment, and the personal recovery. 5. The greater the recognition of loss of the participants in this reach, the greater will also be their dyadic coping, marital adjustment, and their personal recovery. 6. As the dyadic coping increases so will the marital adjustment and personal recovery. 7.  As the marital adjustment increases so will the extent of the personal recovery.

Most of the hypotheses of this research were indeed confirmed. The major results of this research point to the contribution of personal coping, social support, marital adjustment, dyadic coping, and recognition of loss to the process of personal recovery of an individual with mental illness. What's more, relationships were discovered between the various research variables, the most important of them being: a direct relationship between dyadic coping and both personal coping and marital adjustment. An additional central result is that recognition of loss has a positive contribution on marital adjustment and dyadic coping. Also shown was that amongst women, personal recovery was greater than observed by men. Furthermore, participants in this research that were involved in couple therapy rated their personal recovery greater than those who were not in couple therapy. A further interesting result regarding couple therapy is that the men who took part in couple therapy rated their involvement in the variable of marital adjustment as greater than men who were not involved in couple therapy. These results emphasize the importance of a holistic approach of the individual coping with mental illness. According to this approach, it is desirable that treatment should focus on personal elements, as well on the couple or family element- because these aspects or inseparable. In addition, the research results prove and emphasize the importance of couple resources and couple therapy to personal recovery, and as factors which enable one to carry out the recovery approach.

This research is groundbreaking in that it explores for the first time, the connection between dyadic coping and the recognition of loss, to personal recovery and marital adjustment.  More importantly, this study examined, for the first time, the contribution of couple therapy to all variables in the study. On the basis of the above findings, we can expand the existing intervention methods that were heretofore based primarily on individualistic perceptions, to interventions which include the couple element. Such interventions, will aid in a more effective manner, those individuals who are coping with mental illness, to maintain their intimate relationships, and to draw strength from their personal resources and from the couple relationship. To do this, we must develop a therapeutic model that includes the spousal or significant other relationship, and view the coping process with mental illness as a dyadic process. Similarly, the therapeutic model should be cognizant that the “recognition of loss”, that people with mental illness endure, is a dyadic process in which spouses or significant others share.

Key words: Personal coping; Dyadic coping; Recognition of loss; Personal recovery