Recovery in Telling Life Stories (RETELL):Development and pilot study of a narrative identity intervention to support personal recovery in severe mental illness

Background and objectives: Personal recovery is increasingly emphasized in mental health care and by service users. Identity is an important dimension of recovery, and (re)constructing life narratives is an approach to helping individuals connect their experiences with meaning, purpose, and value. Structured, evidence-based interventions targeting identity-related aspects of personal recovery remain few. This study presents the development of such an intervention, Recovery in Telling Life Stories (RETELL), a narrative identity intervention for individuals with severe mental illness.<br/>Methods: The development process comprised three stages: conceptualization, stakeholder feedback and piloting. Stakeholder panels included persons with lived experience of severe mental illness (n=9), mental health professionals (n=3), and international experts in narrative therapy, personal recovery, and intervention development (n=2). The resulting intervention consists of 12 individual sessions structured around four key tasks of narrative repair. To examine feasibility and inform refinement, RETELL was piloted in a case study using an A-B-A design with repeated outcome assessments of personal recovery (Brief INSPIRE-O) and well-being (WHO-5), alongside measures of therapeutic alliance (Session Rating Scale, SRS) and treatment satisfaction (Client Satisfaction Questionnaire, CSQ). A qualitative interview at post-intervention further explored the participant’s experiences.<br/>Results: Piloting indicated good feasibility and acceptability. No adverse events occurred, satisfaction with treatment was very high (CSQ = 31; mean SRS = 36.8), and mean self-reported recovery and well-being increased by 42% and 45%, respectively, from baseline to post-intervention follow-up. The participant described meaningful changes in self-understanding and perspective, stating the intervention had “…changed something – the way I think, how I view myself, and how I view my life.”<br/>Conclusions: Findings suggest RETELL to be a promising and feasible intervention with the potential to enhance personal recovery and well-being. Insights from this pilot will guide refinement of the intervention manual before more extensive feasibility testing and future trials, contributing to the growing evidence base for recovery-oriented interventions in psychiatry.