Table 2.

Final conceptual framework for post-traumatic growth in psychosis and other severe mental health conditions

Type of growth	Definition of the positively perceived change
1. Self-discovery	Having a fuller and deeper understanding of oneself.
1.1 Emotional life	Discovering or re-discovering how to access, accept and be mindful of inner emotional life and difficult feelings.
1.2 Self-knowledge	Knowing oneself better, being more authentic and not being as shaped by the expectations of others.
1.3 Self-acceptance	Grieving and letting go of the past, and developing self-compassion.
1.4 Self-responsibility	Taking (back) responsibility for one’s own life.
2. Sense of self	Development of a more positive sense of self, including integration and valuing of illness experiences.
2.1 Pride in self	Taking pride in oneself, including personal strengths and achievements.
2.2 Integration of experiences	Illness experiences become an accepted part of one’s sense of self.
2.3 Valuing of experiences	Finding positives in the experience of illness.
3. Life perspective	New or renewed appreciation of or gratitude about aspects of life.
3.1 Appreciation of life	Appreciation for life and the importance of hopefulness.
3.2 Appreciation of support	Gratitude for support received from services.
3.3 Meaningful suffering	Gratitude that suffering was meaningful and not in vain.
3.4 Survivor mission	New growth of political consciousness or use of illness experiences to benefit others.
4. Well-being	More active engagement in, and management of, one’s own well-being and lifestyle.
4.1 Motivation	Increased determination to stay well, self-manage and not return to a bad situation.
4.2 Being active	More engagement in the arts, music, sport, nature and learning.
5. Relationships	More actively choosing and valuing relationships with others.
5.1 Choosing relationships	Actively choosing relationships to continue, to re-start or to end.
5.2 Valuing relationships	Placing more value on relationships with others.
5.3 Empathy	Enhanced ability to empathise with others.
6 Spirituality	Deeper engagement with spirituality, religious and existential endeavours.
6.1 Spiritual awareness	Increased awareness of the presence of something greater than oneself making a positive contribution by providing meaning.
6.2 Spiritual engagement	New or renewed engagement with spiritual or religious practices, helping with meaning-making and providing comfort and security.