Politicising Recovery: Why Early Intervention Must Move Beyond the Imperative of Functioning

To articulate the politicisation of recovery as a conceptual and clinical framework for early intervention in psychosis and to argue why the field must move beyond the imperative of functioning.

Early intervention for ultra-high-risk states and first-episode psychosis has improved symptomatic outcomes, yet a persistent gap remains between remission and functional recovery, while social and environmental determinants shape both onset and course. This gap partly reflects an implicitly autoplastic model of recovery, helping young people adjust to social conditions that remain unexamined, a drift intelligible within cognitive capitalism, where functioning itself becomes the imperative.

Conceptual and narrative analysis drawing on critical and survivor-led accounts of the recovery movement, Langer's autoplastic/alloplastic dialectic, Pichon-Rivière's grupo operativo and eco-phenomenological accounts of selfhood.

We define the politicisation of recovery as the expansion of clinical and institutional practices that support the young person's capacity to act within, interpret and sometimes transform the conditions shaping their lived world; the restoration of agency, not collective social change, is the criterion. We describe three levels at which early intervention, a field born as a reform movement, already enacts this politics without naming it: the therapeutic relationship and case management, the group as a small-scale world and the institution through peer involvement and reflexivity.

We discuss three tensions the framework must navigate, responsibility, stratification and dependency and their implications for outcome measurement and research, where instruments sensitive to perceived control, empowerment and meaningful participation should complement functional indicators such as NEET status.