Peer Relationships Within The Recovery Journey: Perspectives Of Forensic Dual Diagnosis Clients

Many forensic patients are diagnosed with both a ‘serious mental illness’, such as ‘schizophrenia’ and a ‘substance use disorder’. This is referred to as dual diagnosis, and is socially situated: distress, substance use and recovery appear linked to interpersonal and social context.

Forensic services aim to facilitate patients’ recovery from mental health difficulties, substance use and offending, historically from a biomedical perspective. However, recently they have moved towards a ‘recovery model’ approach. Peer support is a cornerstone of the recovery model: Those with shared experiences of mental distress, treatment and recovery can help reduce stigma and foster recovery in each other.
This study aimed to explore the role of naturally occurring peer relationships in recovery for forensic patients. Ten male forensic patients were interviewed across fifteen interviews which were analysed using constructivist grounded theory.

The analysis constructed a model of recovery as an individual journey intertwined with an interpersonal journey, comprising four stage-categories, and a fifth category representing social processes between peers. Participants actively negotiated peer relationships in different ways throughout recovery. Constructing oneself in relation to peers influenced participants’ sense of self and recovery. Some features of the forensic environment complicated recovery, and stigma was reproduced between peers.

Building on patients’ use of comparison, effective peer relationships and coping strategies could help facilitate recovery. Continuing to shift towards a recovery approach within forensic services could reduce some of the identified barriers to recovery for forensic patients. Recommendations for forensic services, Counselling Psychologists and Counselling Psychology training programmes are made.