Mental Disorders; Mental Processes; Psychological Phenomena and Processes; Psychological Theory; Substance-Related Disorders; Schizophrenia and Disorders with Psychotic Features; Psychiatry and Psychology
My training, research, and policy interests focus on the interface of recovery in psychiatric and substance use disorders with membership in society. I have investigated processes of recovery in psychosis, using peer support and other social engagement strategies in engaging people with co-occurring disorders and/or who are homeless into care, the development of qualitative and participatory research methods, the development and evaluation of innovative, community-based psychosocial interventions, and the promotion of collaborative relationships between people with behavioral health disorders and their healthcare providers. Much of this work has been oriented toward articulating a disability and civil rights perspective on psychiatric disorders, attempting to create an array of pathways into community life for people with psychiatric disabilities. Throughout this work, my colleagues and I also have attempted to identify and redress social, political, and economic disparities as they relate to healthcare, opportunities for recovery, and the participation of persons with disabilities in the activities, and communities, of their choice.
Extensive Research Description
There have been three major foci to my developing program of research: understanding processes of recovery in psychosis; developing and evaluating community-based and psychosocial interventions to promote recovery, and; designing and analyzing policies to foster community integration among people with psychosis. First, in collaboration with John Strauss I was able to articulate, develop, and apply empirical-qualitative methods to the study of psychosis and processes of recovery. Initially through a series of longitudinal interviews with people living with, and at times recovering from, psychosis I identified a number of common elements in the processes involved in improvement. These findings led to a series of papers beginning in 1992 in which my colleagues and I described the various roles the person with the disorder can play in his or her own recovery as well as in the recovery of his or her peers. Primary among the elements involved in these processes were (re-) establishing a sense of efficacy as a social agent and a sense of belonging among one's non-disabled peers.
These appeared to provide cornerstones of recovery, especially for a population that had developed a secondary disability due to prolonged symptoms, impairment, demoralization, and social isolation. Beginning in 1995, we then began to apply these insights, through a participatory research approach, in the development and evaluation of psychosocial interventions designed collaboratively with people with prolonged psychosis. Through studies of individual and groups forms of peer support, we identified a number of potential avenues of access for people with disabilities to exit the psychiatric ghettos of community-based systems of care and return to the broader community. This research initially was taken up by the Mental Health Consumer Movement both in the U.S. and elsewhere, and then began to impact clinical psychiatry when we were able to demonstrate the effectiveness of this approach in enhancing participants' social functioning and decreasing their use of intensive and costly services. These studies also have since served as the impetus for large-scale, controlled studies funded by the National Institutes of Health and Substance Abuse and Mental Health Services Administration assessing the effectiveness of peer-based and culturally-responsive interventions in increasing access to care and improving functional outcomes among people with psychosis.
On somewhat of a parallel track, my work in public policy has been devoted to developing systems of care that promote the recovery and community integration of people with psychiatric disabilities. These efforts at the local, state, and federal level have involved introducing evidence-based, recovery-oriented, and culturally responsive services and structures across systems of care, and evaluating their effectiveness in improving patient and service system outcomes. Examples of our contributions include peer engagement as an alternative to mandated outpatient treatment and the use of psychiatric advance directives to extend a person's capacity to make his or her own healthcare-related decisions during times of distress or disorganization.
NIMH #MH099012, “Person Centered Care Planning and Service Engagement,” M. Desai, Principal Investigator, L. Davidson, Primary Mentor, 5% effort, $371,022 total, $125,000 direct costs per year, 3/1/2015-2/28/2017.
PCORI #IH-0043, “Broadening Stakeholder Involvement in Behavioral Health Research,” L. Davidson, Principal Investigator, 5% effort, $250,000 total, $125,000 per year, 2/1/15-1/31/17.
SAMHSA #H79SM061708, “Transforming Lives through Supported Employment,” J. Girard, Principal Investigator, L. Davidson, Co-Investigator, 2%, $4,000,000 total, $800,000 per year, $480,000 direct costs per year, 10/14-9/19.
NIMH R01 #MH097796, “Recovery-oriented Structures, Practices, and Outcomes in CMHCs: A National Study,” M. O’Connell, Principal Investigator, L. Davidson, Co-Investigator, 10%, $2,827,065 total costs, $1,822,000, 9/14-8/18.
PCORI #IH-1304-7294, “Increasing Health Care Choices and Improving Health Outcomes Among Persons with Serious Mental Illness,” C. Bellamy, Principal Investigator, L. Davidson, Co-Investigator, 5% effort, $2,080,935 total costs, $1,485,000 direct costs, 10/13-9/16.
NIMH R01 #MH099012, “Implementing Person-Centered Care Planning in Clinical Practice,” V. Stanhope, Principal Investigator, L. Davidson, Co-Investigator, 10% effort, $2,821,216 total costs, $1,733,563 direct costs, 11/13-10/17.
- The roots of the recovery movement: Lessons learned. Davidson, L.; Rakfeldt, J.; & Strauss, J.S. London: Wiley-Blackwell, 2010.
- Practical guide to recovery-oriented practice: Tools for transforming mental health care. Davidson, L.; Tondora, J.; O’Connell, M.J.; Lawless, M.S.; & Rowe, M.: ANew York: Oxford University Press, 2009.
- Recovery from severe mental illnesses:Research evidence and implications for practice. Davidson, L.; Harding, C.M.; & Spaniol, L.: Volumes 1 and 2. Boston, MA: Center for Psychiatric Rehabilitation of Boston University, 2005 and 2006.
- Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia. Davidson, L.: New York: New York University Press, 2003.
Remission and recovery in schizophrenia: practitioner and patient perspectives.
Davidson, L.; Schmutte, T.; Dinzeo, T.; & Andres-Hyman, R. Schizophrenia Bulletin, 2008, 34(1):5-8.
Full List of PubMed Publications
- Flanagan EH, Greig A, Tharnish S, Boynton E, Cruza-Guet MC, Davidson L, Delphin-Rittmon ME: An Evaluation of Racial and Ethnic Health Differences in State Mental Health Inpatient Services: 2002-2005 Versus 2010-2011. J Behav Health Serv Res. 2016 Dec 20; 2016 Dec 20. PMID: 28000013
- Tang JP, Tse S, Davidson L: The big picture unfolds: Using photovoice to study user participation in mental health services. Int J Soc Psychiatry. 2016 Dec; 2016 Oct 26. PMID: 27798049
- Kidd SA, Virdee G, Mihalakakos G, McKinney C, Feingold L, Collins A, Davidson L, Weingarten R, Maples N, Velligan D: The welcome basket revisited: Testing the feasibility of a brief peer support intervention to facilitate transition from hospital to community. Psychiatr Rehabil J. 2016 Dec; 2016 Oct 27. PMID: 27786523
- Steiner JL, Anez-Nava L, Baranoski M, Cole R, Davidson L, Delphin-Rittmon M, Dike C, DiLeo PJ, Duman RS, Kirk T Jr, Krystal J, Malison RT, Rohrbaugh RM, Sernyak MJ, Srihari V, Styron T, Tebes JK, Woods S, Zonana H, Jacobs SC: The Connecticut Mental Health Center: Celebrating 50 Years of a Successful Partnership Between the State and Yale University. Psychiatr Serv. 2016 Dec 1; 2016 Oct 3. PMID: 27691379
- Biringer E, Davidson L, Sundfør B, Ruud T, Borg M: Experiences of support in working toward personal recovery goals: a collaborative, qualitative study. BMC Psychiatry. 2016 Nov 25; 2016 Nov 25. PMID: 27887587
- Díaz E, Añez LM, Silva M, Paris M, Davidson L: Using the Cultural Formulation Interview to Build Culturally Sensitive Services. Psychiatr Serv. 2016 Nov 1; 2016 Nov 1. PMID: 27799018
- Bjornestad J, Joa I, Larsen TK, Langeveld J, Davidson L, Ten Velden Hegelstad W, Anda LG, Veseth M, Melle I, Johannessen JO, Bronnick K: "Everyone Needs a Friend Sometimes" - Social Predictors of Long-Term Remission In First Episode Psychosis. Front Psychol. 2016 Oct 4; 2016 Oct 4. PMID: 27757090
- Ljungqvist I, Topor A, Forssell H, Svensson I, Davidson L: Money and Mental Illness: A Study of the Relationship Between Poverty and Serious Psychological Problems. Community Ment Health J. 2016 Oct; 2015 Oct 3. PMID: 26433374
- Rozanova J, Noulas P, Smart K, Roy A, Southwick SM, Davidson L, Harpaz-Rotem I: "I'm Coming Home, Tell the World I'm Coming Home". The Long Homecoming and Mental Health Treatment of Iraq and Afghanistan War Veterans. Psychiatr Q. 2016 Sep. PMID: 26566926
- Biringer E, Davidson L, Sundfør B, Ruud T, Borg M: Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery. Scand J Caring Sci. 2016 Aug 3; 2016 Aug 3. PMID: 27486028
- Davidson L: The Recovery Movement: Implications For Mental Health Care And Enabling People To Participate Fully In Life. Health Aff (Millwood). 2016 Jun 1. PMID: 27269027
- Desai MU, Pavlo AJ, Davidson L, Harpaz-Rotem I, Rosenheck R: "I Want to Come Home": Vietnam-Era Veterans' Presenting for Mental Health Care, Roughly 40 Years After Vietnam. Psychiatr Q. 2016 Jun. PMID: 26156261
- Flanagan EH, Buck T, Gamble A, Hunter C, Sewell I, Davidson L: "Recovery Speaks": A Photovoice Intervention to Reduce Stigma Among Primary Care Providers. Psychiatr Serv. 2016 May 1; 2016 Jan 14. PMID: 26766754
- Flanagan E, Farina A, Davidson L: Does Stigma Towards Mental Illness Affect Initial Perceptions of Peer Providers? Psychiatr Q. 2016 Mar. PMID: 26115742
- Wilkinson ST, van Schalkwyk GI, Davidson L, D'Souza DC: The Formation of Marijuana Risk Perception in a Population of Substance Abusing Patients. Psychiatr Q. 2016 Mar. PMID: 25982082
- Stratford A, Brophy L, Castle D, Harvey C, Robertson J, Corlett P, Davidson L, Everall I: Embedding a Recovery Orientation into Neuroscience Research: Involving People with a Lived Experience in Research Activity. Psychiatr Q. 2016 Mar. PMID: 25969424
- Van Schalkwyk GI, Bhalla IP, Griepp M, Kelmendi B, Davidson L, Pittenger C: Toward understanding the heterogeneity in obsessive-compulsive disorder: Evidence from narratives in adult patients. Aust N Z J Psychiatry. 2016 Jan; 2015 Apr 8. PMID: 25855685
- Biringer E, Davidson L, Sundfør B, Lier HØ, Borg M: Coping with mental health issues: subjective experiences of self-help and helpful contextual factors at the start of mental health treatment. J Ment Health. 2016; 2015 Oct 20. PMID: 26484831
- van Schalkwyk GI, Davidson L, Srihari V: Too Late and Too Little: Narratives of Treatment Disconnect in Early Psychosis. Psychiatr Q. 2015 Dec. PMID: 25663602
- Barbic SP, Kidd SA, Davidson L, McKenzie K, O'Connell MJ: Validation of the brief version of the Recovery Self-Assessment (RSA-B) using Rasch measurement theory. Psychiatr Rehabil J. 2015 Dec; 2015 Jun 15. PMID: 26075526
- Castelein S, Bruggeman R, Davidson L, van der Gaag M: Creating a Supportive Environment: Peer Support Groups for Psychotic Disorders. Schizophr Bull. 2015 Nov; 2015 Aug 20. PMID: 26297694
- Sklar M, Aarons GA, O'Connell M, Davidson L, Groessl EJ: Mental Health Recovery in the Patient-Centered Medical Home. Am J Public Health. 2015 Sep; 2015 Jul 16. PMID: 26180945
- Delphin-Rittmon ME, Flanagan EH, Andres-Hyman R, Ortiz J, Amer MM, Davidson L: Racial-ethnic differences in access, diagnosis, and outcomes in public-sector inpatient mental health treatment. Psychol Serv. 2015 May. PMID: 25961650
- Stanhope V, Tondora J, Davidson L, Choy-Brown M, Marcus SC: Person-centered care planning and service engagement: a study protocol for a randomized controlled trial. Trials. 2015 Apr 22; 2015 Apr 22. PMID: 25897762
- Pelletier JF, Davidson L: [At the very roots of psychiatry as a new medical specialty: the Pinel-Pussin partnership]. Sante Ment Que. 2015 Spring. PMID: 26355477
- Pelletier JF, Corbière M, Lecomte T, Briand C, Corrigan P, Davidson L, Rowe M: Citizenship and recovery: two intertwined concepts for civic-recovery. BMC Psychiatry. 2015 Mar 4; 2015 Mar 4. PMID: 25885779
- Tse S, Davidson L, Chung KF, Yu CH, Ng KL, Tsoi E: Logistic regression analysis of psychosocial correlates associated with recovery from schizophrenia in a Chinese community. Int J Soc Psychiatry. 2015 Feb; 2014 May 27. PMID: 24869851
- Davidson L: Peer support: coming of age of and/or miles to go before we sleep? An introduction. J Behav Health Serv Res. 2015 Jan. PMID: 24217993
- Ben-David S, Birnbaum ML, Eilenberg ME, DeVylder JE, Gill KE, Schienle J, Azimov N, Lukens EP, Davidson L, Corcoran CM: The subjective experience of youths at clinically high risk of psychosis: a qualitative study. Psychiatr Serv. 2014 Dec 1; 2014 Nov 17. PMID: 25179420
- Davidson L, Arrigo BA: Managing risk and marginalizing identities: on captivity and citizenship. Introduction. Int J Offender Ther Comp Criminol. 2013 Jun. PMID: 23648639
- Davidson L: Do events have effects? A commentary on Polizzi and Draper. Int J Offender Ther Comp Criminol. 2013 Jun; 2013 Mar 31. PMID: 23545400
- Kirk TA, Di Leo P, Rehmer P, Moy S, Davidson L: A case and care management program to reduce use of acute care by clients with substance use disorders. Psychiatr Serv. 2013 May 1. PMID: 23632578
- Delphin-Rittmon ME, Andres-Hyman R, Flanagan EH, Davidson L: Seven essential strategies for promoting and sustaining systemic cultural competence. Psychiatr Q. 2013 Mar. PMID: 22581030
- Delphin-Rittmon M, Andres-Hyman R, Flanagan EH, Ortiz J, Amer MM, Davidson L: Racial-ethnic differences in referral source, diagnosis, and length of stay in inpatient substance abuse treatment. Psychiatr Serv. 2012 Jun. PMID: 22422017
- Davidson L, Bellamy C, Guy K, Miller R: Peer support among persons with severe mental illnesses: a review of evidence and experience. World Psychiatry. 2012 Jun. PMID: 22654945
- Flanagan EH, Solomon LA, Johnson A, Ridgway P, Strauss JS, Davidson L: Considering DSM-5: the personal experience of schizophrenia in relation to the DSM-IV-TR criteria. Psychiatry. 2012 Winter. PMID: 23244014
- Sledge WH, Wieland M, Sells D, Walden D, Holmberg C, Zhenqiu Lin, Davidson L: Qualitative study of high-cost patients in an urban primary care centre. Chronic Illn. 2011 Jun; 2011 Jan 27. PMID: 21273219
- Sledge WH, Lawless M, Sells D, Wieland M, O'Connell MJ, Davidson L: Effectiveness of peer support in reducing readmissions of persons with multiple psychiatric hospitalizations. Psychiatr Serv. 2011 May. PMID: 21532082
- David DH, Styron T, Davidson L: Supported Parenting to Meet the Needs and Concerns of Mothers with Severe Mental Illness. Am J Psychiatr Rehabil. 2011 Apr. PMID: 22180730
- Davidson L, Mezzina R, Rowe M, Thompson K: "A life in the community": Italian mental health reform and recovery. J Ment Health. 2010 Oct. PMID: 20836690
- Tondora J, O'Connell M, Miller R, Dinzeo T, Bellamy C, Andres-Hyman R, Davidson L: A clinical trial of peer-based culturally responsive person-centered care for psychosis for African Americans and Latinos. Clin Trials. 2010 Aug; 2010 Jun 22. PMID: 20571133
- Davidson L, Shaw J, Welborn S, Mahon B, Sirota M, Gilbo P, McDermid M, Fazio J, Gilbert C, Breetz S, Pelletier JF: "I don't know how to find my way in the world": contributions of user-led research to transforming mental health practice. Psychiatry. 2010 Summer. PMID: 20557219
- Davidson L, Roe D, Andres-Hyman R, Ridgway P: Applying stages of change models to recovery from serious mental illness: contributions and limitations. Isr J Psychiatry Relat Sci. 2010. PMID: 21149986
- Flanagan EH, Davidson L, Strauss JS: The Need for Patient-Subjective Data in the DSM and the ICD. Psychiatry. 2010 Winter. PMID: 21198379
- Davidson L: PORT through a recovery lens. Schizophr Bull. 2010 Jan; 2009 Dec 3. PMID: 19959705
- Davidson L, Drake RE, Schmutte T, Dinzeo T, Andres-Hyman R: Oil and water or oil and vinegar? Evidence-based medicine meets recovery. Community Ment Health J. 2009 Oct; 2009 Aug 2. PMID: 19649708
- Schmutte T, O'Connell M, Weiland M, Lawless S, Davidson L: Stemming the tide of suicide in older white men: a call to action. Am J Mens Health. 2009 Sep; 2008 Apr 30. PMID: 19477749
- Flanagan EH, Davidson L: Passing for "normal": features that affect the community inclusion of people with mental illness. Psychiatr Rehabil J. 2009 Summer. PMID: 19592375
- Sells D, Sledge WH, Wieland M, Walden D, Flanagan E, Miller R, Davidson L: Cascading crises, resilience and social support within the onset and development of multiple chronic conditions. Chronic Illn. 2009 Jun. PMID: 19474232
- Flanagan EH, Miller R, Davidson L: "Unfortunately, we treat the chart:" sources of stigma in mental health settings. Psychiatr Q. 2009 Mar; 2009 Feb 4. PMID: 19191027
- Schmutte T, Flanagan E, Bedregal L, Ridgway P, Sells D, Styron T, Davidson L: Self-efficacy and self-care: missing ingredients in health and healthcare among adults with serious mental illnesses. Psychiatr Q. 2009 Mar; 2008 Dec 2. PMID: 19048375
- Davidson L: 'Recovery' as a response to oppressive social structures. Chronic Illn. 2008 Dec. PMID: 19091939
- Sells D, Black R, Davidson L, Rowe M: Beyond generic support: incidence and impact of invalidation in peer services for clients with severe mental illness. Psychiatr Serv. 2008 Nov. PMID: 18971409
- Davidson L, Ridgway P, Kidd S, Topor A, Borg M: Using qualitative research to inform mental health policy. Can J Psychiatry. 2008 Mar. PMID: 18441659
- Davidson L, Schmutte T, Dinzeo T, Andres-Hyman R: Remission and recovery in schizophrenia: practitioner and patient perspectives. Schizophr Bull. 2008 Jan; 2007 Nov 5. PMID: 17984297
- Davidson L, Tondora J, O'Connell MJ, Kirk T Jr, Rockholz P, Evans AC: Creating a recovery-oriented system of behavioral health care: moving from concept to reality. Psychiatr Rehabil J. 2007 Summer. PMID: 17694712
- Rowe M, Bellamy C, Baranoski M, Wieland M, O'Connell MJ, Benedict P, Davidson L, Buchanan J, Sells D: A peer-support, group intervention to reduce substance use and criminality among persons with severe mental illness. Psychiatr Serv. 2007 Jul. PMID: 17602012
- Flanagan EH, Davidson L: "Schizophrenics," "borderlines," and the lingering legacy of misplaced concreteness: an examination of the persistent misconception that the DSM classifies people instead of disorders. Psychiatry. 2007 Summer. PMID: 17661537
- Davidson L, White W: The concept of recovery as an organizing principle for integrating mental health and addiction services. J Behav Health Serv Res. 2007 Apr; 2007 Mar 10. PMID: 17351758
- Andres-Hyman RC, Strauss JS, Davidson L: Beyond parallel play: Science befriending the art of method acting to advance healing relationships. Psychotherapy (Chic). 2007 Mar. PMID: 22122170
- Bedregal LE, O'Connell M, Davidson L: The Recovery Knowledge Inventory: assessment of mental health staff knowledge and attitudes about recovery. Psychiatr Rehabil J. 2006 Fall. PMID: 17076052
- Davidson L, Flanagan E, Roe D, Styron T: Leading a horse to water: an action perspective on mental health policy. J Clin Psychol. 2006 Sep. PMID: 16810670
- Sells D, Davidson L, Jewell C, Falzer P, Rowe M: The treatment relationship in peer-based and regular case management for clients with severe mental illness. Psychiatr Serv. 2006 Aug. PMID: 16870970
- Davidson L: What happened to civil rights? Psychiatr Rehabil J. 2006 Summer. PMID: 16881240
- Davidson L, Shahar G, Lawless MS, Sells D, Tondora J: Play, pleasure, and other positive life events: "non-specific" factors in recovery from mental illness? Psychiatry. 2006 Summer. PMID: 16822194
- Davidson L, Chinman M, Sells D, Rowe M: Peer support among adults with serious mental illness: a report from the field. Schizophr Bull. 2006 Jul; 2006 Feb 3. PMID: 16461576
- Davidson L, O'Connell M, Tondora J, Styron T, Kangas K: The top ten concerns about recovery encountered in mental health system transformation. Psychiatr Serv. 2006 May. PMID: 16675756
- Davidson L, Lawless MS, Leary F: Concepts of recovery: competing or complementary? Curr Opin Psychiatry. 2005 Nov. PMID: 16639093
- Davidson L: More fundamentally human than otherwise. Psychiatry. 2005 Fall. PMID: 16253111
- Añez LM, Paris M Jr, Bedregal LE, Davidson L, Grilo CM: Application of cultural constructs in the care of first generation Latino clients in a community mental health setting. J Psychiatr Pract. 2005 Jul. PMID: 16041232
- O'Connell M, Tondora J, Croog G, Evans A, Davidson L: From rhetoric to routine: assessing perceptions of recovery-oriented practices in a state mental health and addiction system. Psychiatr Rehabil J. 2005 Spring. PMID: 15895922
- Shahar G, Trower P, Iqbal Z, Birchwood M, Davidson L, Chadwick P: The person in recovery from acute and severe psychosis: the role of dependency, self-criticism, and efficacy. Am J Orthopsychiatry. 2004 Oct. PMID: 15554809
- Sells DJ, Stayner DA, Davidson L: Recovering the self in schizophrenia: an integrative review of qualitative studies. Psychiatr Q. 2004 Spring. PMID: 14992305
- Shahar G, Davidson L: Depressive symptoms erode self-esteem in severe mental illness: a three-wave, cross-lagged study. J Consult Clin Psychol. 2003 Oct. PMID: 14516237
- Sells DJ, Rowe M, Fisk D, Davidson L: Violent victimization of persons with co-occurring psychiatric and substance use disorders. Psychiatr Serv. 2003 Sep. PMID: 12954942
- Rowe M, Falzer P, Berryhill J, Thomas L, Delphin M, Vargas V, Styron T, Davidson L: New forms of outreach in community psychiatry: a report from the field. Adm Policy Ment Health. 2003 May. PMID: 12940687
- Bizub AL, Joy A, Davidson L: "It's like being in another world": demonstrating the benefits of therapeutic horseback riding for individuals with psychiatric disability. Psychiatr Rehabil J. 2003 Spring. PMID: 12739908
- Shahar G, Chinman M, Sells D, Davidson L: An action model of socially disruptive behaviors committed by persons with severe mental illness: the role of self-reported childhood abuse and suspiciousness-hostility. Psychiatry. 2003 Spring. PMID: 12710229
- Rowe M, Fisk D, Frey J, Davidson L: Engaging persons with substance use disorders: lessons from homeless outreach. Adm Policy Ment Health. 2002 Jan. PMID: 12033671
- Hoge MA, Tebes JK, Davidson L, Griffith EE: The roles of behavioral health professionals in class action litigation. J Am Acad Psychiatry Law. 2002. PMID: 11931368
- Styron TH, Pruett MK, McMahon TJ, Davidson L: Fathers with serious mental illnesses: a neglected group. Psychiatr Rehabil J. 2002 Winter. PMID: 11859994