- Objective: To explore patient perspectives on the role of personal growth-related risk taking in
the recovery process, and to identify social stigma’s role when consumers approach and evaluate
new endeavors. Methods: 177 Kaiser Permanente Health Plan members participated in a mixedmethods
study of recovery among individuals with serious mental illness (schizophrenia,
schizoaffective disorder, bipolar disorder, affective psychosis). Participants completed 4 in-depth
interviews over 24 months. Data were analyzed using a modified grounded theory approach.
The author sub-coded and analyzed interview content, then extracted major themes to identify
relevant text. Results: The most helpful discussions about risk-taking occurred in the context of
healthy, collaborative, mutually trusting clinician-patient relationships. Advice was accepted
when clinicians listened well, knew patients’ capabilities and interests, and pushed gently at a
pace that was comfortable for patients. Concerns about social stigma were not observed
commonly in this sample, however two participants independently discussed stigma despite not
being directly asked about it. Conclusions: Enduring, strong, collaborative relationships provide
a healthy framework for discussions between patients and clinicians about taking on new
activities, roles or responsibilities. The importance of clinicians’ awareness of social stigma is
underscored by decades of research findings that correlate with the author’s results.