Recovery in Telling Life Stories

NCT ID: NCT07082777

Last Updated: 2025-08-14

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-07-21
• Study Completion Date: 2027-04-01

Brief Summary

This project tests the Recovery In Telling Life Stories (RETELL) intervention, aimed at supporting personal recovery in people with severe mental illness (SMI). While many of those with SMI experience symptom control, their quality of life often remains low due to social loss, negative self-perceptions, and identity-related challenges not addressed by standard treatments. Through a process of narrative repair, the RETELL intervention helps participants explore the personal consequences of mental illness while supporting the enhancement of narratives that strengthen identity and foster well-being. The intervention is delivered across 8-12 sessions and will be assessed for feasibility of both the intervention and study procedures. We will also explore its preliminary impact on recovery, quality of life, symptoms, functioning, self-stigma, and personality, using a multiple single-case A-B-A design. We expect the intervention and study procedures to show acceptable feasibility. We further hypothesize that participants' scores on recovery and well-being will be low at baseline, improve during the intervention, and remain higher after the intervention ends and at 3-month follow-up. This study will provide a foundation for future randomized controlled trials.

Detailed Description

This project tests the Recovery In Telling Life Stories (RETELL) intervention, an intervention developed to support personal recovery in individuals with severe mental illness (SMI).

Research shows that many people with SMI experience low quality of life even when their symptoms are in remission and functional level, e.g. cognitive remediation. This is not only due to the illness itself but also to the consequences that often accompany it, such as the loss of social and occupational roles and the development of negative self-perceptions. These challenges are only to a limited extent addressed by existing treatments, which typically focus on symptom reduction.

Personal recovery is about living a satisfying and meaningful life despite the potential constraints associated with mental illness. A major barrier to this process can arise when a person develops an understanding of themself (a narrative identity) characterized by shame, low self-esteem, and self-stigmatization. When negative identity conclusions dominate, it can be difficult to experience well-being, meaning in life, or hope for the future.

Despite an increasing focus on personal recovery in mental health care systems globally, evidence-based methods to support the recovery process are limited. In this project, we develop and test the RETELL intervention, designed to support personal recovery by helping participants process the personal consequences of mental illness and identify and cultivate positive identity conclusions and personal strengths. In RETELL, the participants are guided through this process, which we refer to as narrative repair, over a structured sequence of 8-12 sessions. Across these sessions, participants are guided in telling their life story and in constructing preferred and empowering narratives about themselves and their future.

The intervention will be tested in a mixed methods study using a one-arm multiple single-case intervention design with an A-B-A structure. This includes a pre-intervention phase (T1) with four weeks of outcome measurements, an intervention phase (T2) continuing with the same measures every second week, 4 weeks of post-intervention measurements (T3), and 4 weeks of follow-up measurements starting 3 months after intervention completion (T4). Data will be collected in electronic surveys and qualitative interviews. The primary aim is to assess intervention feasibility including potential to improve recovery and quality of life. It is aimed to recruit 20 participants diagnosed with SMI within the timeframe allowed by the study plan.

Feasibility will be assessed in terms of both intervention and study procedure feasibility, as this study will form the basis for larger randomized controlled trials. Intervention feasibility will be evaluated based on treatment dropout, treatment satisfaction and trajectory of self-reported recovery compared to pre-intervention. Feasibility will be indicated by < 30% dropout, a mean sum score of ≥ 20 on the Client Satisfaction Questionnaire, and increase or stability of self-reported recovery throughout the study period compared to pre-intervention. Study procedure feasibility includes recruitment acceptance rate, questionnaire response rate and study dropout rate. We tentatively propose a ≥ 50% recruitment acceptance rate, ≥ 75% questionnaire response rate and ≤ 25% study dropout rate as indicating acceptable study feasibility.

Secondary outcomes include well-being, domain-specific recovery, overall functioning, symptom levels, and self-stigmatization. In addition, changes from pre- to post-intervention in personality trait scores will be explored. Statistical analyses will include dependent t-tests to examine effect sizes and changes in quantitative outcomes, and these will be interpreted with attention to clinical significance. Finally, interviews about participants' experiences with the intervention will be thematically analyzed to identify perceived helpful elements, potential mechanisms of change and to inform the refinement of the programme theory.

Conditions

Schizophrenia Disorders; Personality Disorders; Obsessive - Compulsive Disorder; Anxiety Disorders; Recurrent Depressive Disorder; PTSD - Post Traumatic Stress Disorder; Hyperkinetic Disorders; Eating Disorders; Bipolar Disorders; Aspergers Syndrome

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

RETELL

Narrative therapy to support personal recovery, delivered individually over 8-12 sessions.

Group Type: EXPERIMENTAL

Narrative therapy

Intervention Type: BEHAVIORAL

The intervention is structured around 4 central tasks focusing on different aspects of narrative repair. Task 1: Introduction to life story exploration and building alliance. Task 2: Explore and process the impact of mental illness on identity, externalizing negative narratives, and making sense of emotional responses such as guilt, grief, or shame. Task 3: Identify positive identity conclusions (e.g., strengths, values, skills) from past or current life experiences, and support their integration into the personal narrative. Task 4: Support the imagining of a realistic and hopeful future narrative, grounded in insights of previous sessions. Tasks 1-4 are addressed in a total of 8-12 sessions, depending on the specific user needs. Sessions will have an app. duration of 45-60 mins and will be delivered by the PI who is a trained therapist and psychologist (MSc. Psych.), receiving ongoing supervision. The intervention manual will be made freely available in relation to study publication.

Interventions

Narrative therapy

The intervention is structured around 4 central tasks focusing on different aspects of narrative repair. Task 1: Introduction to life story exploration and building alliance. Task 2: Explore and process the impact of mental illness on identity, externalizing negative narratives, and making sense of emotional responses such as guilt, grief, or shame. Task 3: Identify positive identity conclusions (e.g., strengths, values, skills) from past or current life experiences, and support their integration into the personal narrative. Task 4: Support the imagining of a realistic and hopeful future narrative, grounded in insights of previous sessions. Tasks 1-4 are addressed in a total of 8-12 sessions, depending on the specific user needs. Sessions will have an app. duration of 45-60 mins and will be delivered by the PI who is a trained therapist and psychologist (MSc. Psych.), receiving ongoing supervision. The intervention manual will be made freely available in relation to study publication.

Intervention Type: BEHAVIORAL

Other Intervention Names

Recovery in Telling Life Stories (RETELL)

Eligibility Criteria

Inclusion Criteria

• Adults between the ages of 18 and 65 years
• A self-reported principal diagnosis of one or more of the following: schizophrenia (F20), bipolar disorder (F31), personality disorders (F60), obsessive-compulsive disorder (F42), anxiety disorders (F41), recurrent depressive disorder (F33), eating disorders (F50), hyperkinetic disorders (F90), post-traumatic stress disorder (F43.1), Asperger syndrome (F84.5)
• Not in full recovery (Brief INSPIRE-O < 50)
• Danish language proficiency
• Medication stabilized (i.e., same type and dosage for a minimum of 8 weeks)
• Ability and willingness to give informed consent

Exclusion Criteria

• Self-reported diagnosis of mental retardation (F70-79) and/or organic mental disorder (F00-09)
• Psychiatric symptoms, thoughts of self-harm and/or substance abuse of self-reported severity which are likely to prevent one or all of the following: attendance at scheduled sessions, completion of questionnaires before, during and after the intervention, meaningful engagement in the therapeutic process
• Psychiatric hospitalization in the past 4 weeks
• Prior conviction of violent crime
• Currently homeless
• Currently in psychotherapy initiated within the past 6 months.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Aarhus

OTHER

Sponsor Role: lead

Responsible Party

Dinne Christensen

Principal Investigator ,Postdoc, PhD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Dorthe K. Thomsen, PhD

Role: STUDY_CHAIR

University of Aarhus

Locations

Aarhus Univerity

Aarhus C, , Denmark

Site Status: RECRUITING

Countries

Denmark

Central Contacts

Dinne S. Christensen, PhD

Role: CONTACT

dsc@psy.au.dk

+4522317461

Dorthe K. Thomsen, PhD

Role: CONTACT

dorthet@psy.au.dk

+45 4189 3206

Facility Contacts

Dinne S. Christensen, PhD

Role: primary

dsc@psy.au.dk

004522317461

References

Thomsen, D. K., et al. (2023). Storying Mental Illness and Personal Recovery. Cambridge, Cambridge University Press.

Reference Type: BACKGROUND

Other Identifiers

1-10-72-56-25

Identifier Type: OTHER

Identifier Source: secondary_id

2022-0367531, 3878

Identifier Type: -

Identifier Source: org_study_id