Chapter 7 170 to age-appropriate role expectations, the performance of daily living tasks without supervision, engagement in social interactions (16), and the degree of independence with regard to housing (9, 17). The third recovery type is personal recovery, a term that emerged from people with a lived experience of mental illness and also emphasizes the personal nature of the recovery process (18, 19). Personal recovery includes several components summarized in the word CHIME (20): connectedness; hope and optimism about the future; identity; meaning in life; and empowerment. Changes in illness management scores may be related to changes in personal recovery. Previously, a close relationship between illness management and personal recovery was suggested because the improved management of symptoms, relapses, and stresses of everyday life is critical to developing hope and reaching personal recovery goals (5). IMR is a structured psychosocial program fostering illness self-management in people living with schizophrenia and other SMIs (4). It was created based on an empirical literature review on teaching strategies for illness self-management (5). The aim of IMR training is to improve illness management skills and thereby improve clinical recovery which improves personal and functional recovery. This working of IMR is suggested in a conceptual framework (4, 21). Based on this conceptual framework, in a previous study, we cross-sectionally analyzed the association of the components of illness management with the three types of recovery (10). The results showed that one illness management component—coping—was associated with clinical, functional, and personal recovery. The direct associations between coping and functional and personal recovery were stronger than the indirect associations via clinical recovery. One conclusion of this study is that clinical recovery appears to not be a prerequisite for functional and personal recovery (10). This study was conducted in the context of a randomized controlled trial (RCT) investigating the effects of IMR training + care as usual versus care as usual alone in outpatients with SMI (11, 21). In this RCT we found a significant effect of IMR + care as usual versus care as usual alone in self-reported overall illness management, as well as in personal recovery over an 18 month period (11). Moreover, in this RCT, clinical and functional recovery over time significantly improved about as much in both the IMR training group as in the care as usual group (11).
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