Caroline da Cunha Lewin

Thesis Title: Understanding and supporting self-harm recovery through qualitative survivor research: development and refinement of the Self-Harm Recovery Model

Abstract: In UK clinical practice and national guidance, self-harm is conceptualised as any self-injury carried out by an individual, with recovery predicated on behavioural cessation. In contrast, personal recovery approaches emphasise the influence of other salient factors, such as positive change in understanding oneself in living a fulfilling life despite mental distress. A preliminary conceptual model, called the Self-Harm Recovery Model (SHRM), grounded in lived experience perspectives, has been developed. It conceptualises self-harm recovery as an embodied experience influenced by relational, psychological, and cognitive components, acknowledging the function and meaning a person ascribes to it. However, there are research gaps on the impact of self-ideation, self-identity and meaning in self-harm experience. Therefore, further research is required to maximise SHRM’s validity and application. This study will refine the SHRM within an ethical survivor-controlled framework, to ground self-harm recovery in the experiential knowledge of young adults aged 18-35 years. This qualitative study will employ semi-structured interviews with young adults aged 18-35 years with current or historical self-harm engagement. Data will increase understanding of lived experiences of self-harm recovery and support refinement of the SHRM. This will be discussed with clinicians in interviews to establish applicability to clinical practice. Interpretative Phenomenological Analysis (IPA) will enable exploration of lived self-harm experience. Thematic analysis will be employed to critically analyse data relating to refinement of the SHRM. A trauma-informed, ethical approach to the research will be adhered to. This study will employ PPI by forming a Lived Experience Advisory Panel (LEAP) with adults with lived experience of self-harm recovery. The LEAP will be consulted at strategic points, contributing to every research stage. They will be reimbursed for their time.

First Supervisor:

Publications: Fusar-Poli. P., Estradé. A., Stanghellini. G., Esposito. C.,, Rosfort., R., Mancini. M., Norman. P., Cullen. J., Adesina. M., Benavides Jimenez. G., da Cunha Lewin. C., Drah. E. A., Julien. M., Lamba. M., Mutura. E., Prawira. B., Sugianto. A., Teressa. J., White. L. A., Damiani. S., Vasconcelos. C., Bonoldi. I., Politi. P., Vieta. E., Radden. J., Fuchs. T., Ratcliffe. M. & Maj. M. (2023). The lived experience of depression: a bottom-up review co-written by experts by experience and academics. World Psychiatry 22(3), 352-365. doi: 10.1002/wps.21111

Da Cunha Lewin. C., Leamy. M., & Palmer. L (2023). How do people conceptualise self-harm recovery and what helps in adolescence, young and middle adulthood? A qualitative meta-synthesis. Journal of Clinical Psychology (2023), 1-26. doi: 10.1002/jclp.23588

Da Cunha Lewin. C., Hudson, G. & Parri. L. (2023). “Anorexia-lite”: the dangers of weight classification in diagnosis. The Lancet Psychiatry. doi: 10.1016/s2215-0366(23)00263-8.

Da Cunha Lewin. C. (2022). Living with self-harm: Advice on offering compassionate, non-judgemental care to people who self-harm from nurse Caroline da Cunha Lewin, who has personal experience of this behaviour. Emergency Nurse 30, (2), 16-18.

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Twitter – @cdacunhalewin