Posttraumatic Growth

A first episode of psychosis is often a highly traumatic experience. However, a first episode of psychosis may also present an opportunity for posttraumatic growth (i.e., positive changes following the struggle with adversity). While posttraumatic growth has been reported following various physical illnesses (e.g., HIV) or traumatic events (e.g., war), very little research has investigated posttraumatic growth following a first episode of psychosis. This knowledge gap prevents us from having a fuller understanding of the aftermath of psychosis. To address this knowledge gap, this body of research has thus far addressed two research questions: 1) what are the ways that people experience posttraumatic growth following a first episode of psychosis, and 2) what facilitates such growth?

These research questions were answered using knowledge synthesis and empirical mixed methods research approaches.

Findings from our studies revealed that perceptions of having experienced posttraumatic growth are common, and that such growth is perceived to occur at an individual-level (e.g., experiencing a stronger sense of self), interpersonal-level (e.g., developing closer relationships with family) and spiritual level (e.g., developing greater spirituality). Facilitators of posttraumatic growth include personal (e.g., finding ways to see the good in the bad), social (e.g., having support from loved ones), cultural (e.g., knowing of colloquial approaches to seeing what tragedy spawns) spiritual (e.g., prayer), and institutional (e.g., receiving high-quality mental health services) factors.

Together, these findings validate the experiences of persons who have experienced posttraumatic growth following a first episode of psychosis, and can inform the delivery of positive, hopeful, strengths-based services to persons experiencing mental health and substance use problems.

This research was funded by a Canadian Institutes of Health Research Doctoral award; a Fonds de recherche du Québec – Santé Doctoral Award; and a McGill University Department of Psychiatry Graduate Student Award.


One aspect of posttraumatic growth following a first episode of psychosis reported by study participants entailed finding ways to give back and make positive contributions to society. One framework for describing how people give back to society is that of generativity, which is a multidimensional construct that, at its core, refers to one’s concern for and contributions towards the betterment of others, including future generations. Generativity may be expressed in a variety of ways, such as through caregiving, mentoring, teaching, or engaging in civics, and it may add purpose and meaning to one’s own life while also benefiting society at large. In addition, generativity has been shown to improve satisfaction with and quality of life; integration with one’s community; and psychological well-being.

Despite the potential importance of generativity to persons with mental health or substance use problems, few studies have been conducted on this topic. This knowledge gap precludes the development of interventions to more fully support people’s recovery and potential within their communities and society. This research topic is currently being addressed using knowledge synthesis, questionnaires and focus groups. Persons with mental health and substance use problems are involved in the conception, design, implementation and evaluation of the study.

This research is funded by a Canadian Institutes of Health Research Fellowship award and a Fonds de recherche du Québec – Santé Postdoctoral Award.


Mental health problems typically begin between during the critical developmental phase of adolescence and young adulthood, and affect approximately 18.5% of young Canadians. In addition to disrupting important and emerging educational and occupational milestones, mental health problems may disrupt young people’s sense of belonging and citizenship within their communities.

The most well-established model of citizenship defines it as the strength of a person’s access to the rights (e.g., freedom to associate), responsibilities (i.e., actions that are important to people), roles (i.e., positions occupied in society), and resources (e.g., money) needed to live a full and meaningful life; as well as their relationships (e.g., support networks, close ties, and community connections) and socially validated sense of belonging. Supporting people with mental health problems to live as full citizens is crucial for their recovery; yet, the very aspects of citizenship that promote recovery (e.g., social inclusion, financial autonomy) are frequently absent for persons with mental health problems.

By intervening early, youth mental health services can prevent mental health problems from progressing into more severe disorders and protect youth from the negative consequences of mental health problems. However, lack of attention to citizenship may prevent youth mental health services from supporting youths’ full integration and participation in their communities and may thus hinder their capacity to recover, grow and to give back to society, a desired goal for many.

To address these knowledge gaps, my colleagues and I have worked with youth with mental health problems to identify 1) the meaning of, and perceived facilitators and barriers to, citizenship among youth with mental health problems, as well as the role citizenship plays in recovery; and examine 2) rates and predictors of citizenship among a larger sample of youth with mental health problems, and the degree to which citizenship predicts recovery.