The double-edged nature of recovery in first-episode psychosis

Growing research has highlighted that the first few years of psychotic illnesses constitute a “critical period” in which (i) the majority of the functional deterioration that accompanies these illnesses occurs, and (ii) individuals are most responsive to both pharmacological and psychosocial treatments for psychosis and its deleterious sequelae. Clinical interest in intervening earlier in psychotic episodes, and what early intervention might mean for a person’s symptom reduction and social functioning, has emerged within a decades-long history of social science research on the concept of recovery. In this article, we describe the intersection between that long-standing interest in recovery and the more recent attention to first-episode psychosis to explore conundrums that may arise as clinicians engage with their clients following a first episode of psychosis. We suggest ways of addressing these situations by highlighting several complementary or alternative approaches to traditional psychiatric treatment and conclude with a call to rethink ways of doing research on recovery in first-episode psychosis.