Psychosocial recovery

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Psychosocial recovery, or the Recovery Model, refers to the process of recovery from mental disorder or substance dependence, and/or from being labeled in those terms. Recovery has been defined as "an individual’s journey of healing and transformation to live a meaningful life in a community of his or her choice while striving to achieve maximum human potential” (U.S. Department of Health and Human Services, 2005). It incorporates a philosophy of support, respect, empowerment, choice, hope, and social inclusion. Originating in programs to overcome substance dependency, the concept of recovery in mental health usage emerged from deinstitutionalization resulting in more individuals living in community settings but there being a perceived failure to support full recovery or enable proper integration into the community in a meaningful manner. The recovery model is a form of social model of disability by contrast to a medical model of disability and may involve "consumers" and "survivors" of mental health service as well as mental health professionals.

History

In general medicine or psychiatry, recovery has long been used to refer to the end of a particular experience of illness. In the context of long-term conditions, it might refer to a period of remission and therefore potentially relapse.

The concept of full 'recovery' as a general philosophy was first popularised in relation to substance use programs, including 12-step approaches.

Application of full recovery concepts to psychiatric disorders is comparatively recent and stems largely from two interrelated sources: the consumer/survivor movement, a grassroots self-help and advocacy initiative, and psychiatric rehabilitation, a professional approach to mental health services provision.

The concept of full recovery has emerged as a significant paradigm in the field of mental health and became increasingly implemented in the policies and practices of mental health systems.

Approaches to recovery

For many, “recovery” has a political as well as personal implication, where to recover is to find meaning, to challenge prejudice, to reclaim a chosen life and place within society, to validate the self. Recovery can thus be viewed as one manifestation of empowerment. Recovery is an individual expierince of the consumer; it is a fundamental change in the consumers concept of self. It is important to recognise that an important feature of recovery from mental illness is that a consumer must be open to failure, disappointment and possible relaspe; that having a realistic allowance for such allows for a greater potential for a successful progress in the reduction of symptoms. ^[3]

In psychiatric rehabilitation terms, by contrast, recovery refers in large part to functional criteria and reduction of psychosocial disability. To recover is to improve and maintain personal capacity in one or more of the major domains of life, whether it be work, housing, relationships, or recreation.

Evidence and Policy

The psychosocial recovery model has been supported by evidence from both quantitative and qualitative research. Long term (longitudinal) studies have shown that a psychiatric disorder does not necessarily take a course of inevitable deterioration and that, for a significant number of people, a return to full potential is possible. Other research, including studies of reports by consumers/survivors of mental health services, has identified resilience and resourcefullness, diverse and individual pathways of healing, and factors which can enhance or detract from recovery. Increasingly, recovery has become both a subject of mental health services research and a term that is emblematic of many of the goals of the consumer/survivor movement. Specific policy and clinical strategies are currently being used to implement recovery principles although key questions remain.

Attempts are being made by some people and organizations to transform the mental health system to a recovery-based one, with expanded choices of recovery-based services and supports. This is occurring in the United States through plans by the US Department of Health and Human Sciences to develop a National Recovery Initiative (NRI) and State Recovery Initiatives (SRI) involving a shift to consumer-centred or consumer-led planning, with financing mechanisms that support increased consumer control, and creating roles for consumers in service delivery and support. Specific subcommittees are planned to: launch a nationwide pro-recovery, anti-stigma education campaign; develop and synthesize model recovery policies as well as materials for training consumers in board participation; develop materials and train consumers in carrying out evaluations of the performance of mental health systems; supply networking and technical assistance to help further the development of peer-run services

See also

• Rehabilitation
• Psychotherapy
• Soteria
• Therapeutic community
• Social work
• Social firm
• Social psychiatry
• Clinical psychology
• Psychiatry
• Anti-psychiatry
• Recluse

Further reading

• Ahern, L. & Fisher, D. (2001) Recovery at your own PACE. Journal of psychosocial nursing and mental health services. 39 (4) pp.22-32
• Allott, P. et al. (2005) Recovery, Values and e-learning The Mental Health Review 10 (4) pp.
• Borg, M. & Kristiansen, K. (2004) Recovery-orientated professionals: Helping relationships in mental health services. Journal of Mental Health 13(5) pp.493-505
• Buchanan-Barker, P. & Barker, P. (2006) The TEN Commitments: A value Based for Mental Health Recovery Journal of Psychosocial Nursing & Mental health Services 44(9) pp. 29-33
• Carolan, S., (2005) Recovery and all that Jazz: A Vision for Adult Mental Health Services, UK: CSIP. England
• CCAWI (2006) ESC Recovery Training: A 2-Day training programme for the Mental Health Workforce. NIMHE. England
• Dinniss, S. (2006) Recovery-orientated mental healthcare British Journal of Psychiatry 189(4), pp.384
• Fisher, D & Chamberlin, J. Consumer-Directed Transformation to a Recovery-Based Mental Health System. USA: National Empowerment Centre. USA
• Glover, H. (2005) – Recovery Based Service Delivery: are we ready to transform the words into a paradigm shift. Australian eJournal for the Advancement of mental Health 4 (3)34-38
• Happell, B. & Roper, C (2003) The role of a mental health consumer in the education of postgraduate psychiatric nursing students’ evaluation Journal of Psychiatric and Mental Health Nursing 10 (3) pp. 343-350
• Kingdon, D. & Ramon, S. & Perkins, R. & Morris, D. (2005) Social Inclusion for Psychiatrists, NIMHE. England
• Royal College of Psychiatrists (2004) Report: Rehabilitation and Recovery Now.UK
• Slade, M., Knowles, L. & Luke, G. (2007) Recovery Training Programme: Final Report Document. England
• The American Psychiatric Association (2005) Use of the Concept of Recovery: A Position Statement, APA. USA
• Wood, A.L. & Wahl, O.F. (2006) Evaluating the effectiveness of a consumerprovided

mental health recovery education presentation Psychiatric Rehabilitation Journal 30 (1) pp. 46-53

External links

• Fostering Recovery from Life-transforming Mental Health Disorders: A Synthesis and Model
• NASW Practice Snapshot: The Mental Health Recovery Model
• Recovery as a Journey of the Heart (PDF). Conference Talk (1995) by Patricia Deegan, PhD.
• Consumer Council recommendation (Word Doc) for a policy on transforming the service system to a Recovery Oriented Service System, produced by the US New Freedom Initiative
• Identifying and Overcoming Mentalism (Word Doc) by Coni Kalinowski, M.D. and Pat Risser. InforMed Health Publishing & Training.
• Lit review and policy for NHS Scotland