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Recovery Model

During the past few years the “Recovery Model” of change has been introduced as a way to understand how persons with a severe mental illness make progress over time. The model elaborately describes many stages that mentally ill persons go through; from being totally dependent on mental health practitioners and other care givers to becoming aware of their illness to learning to manage the symptoms and take an active role in the treatment process. Perhaps the most exiting aspect of the “Recovery Model” is the underlying principle that hope fuels the engine of recovery. The idea that persons with a mental illness should have hope for recovering is a radical departure from traditional views that have been part of the behavioral healthcare field. According to traditional views, mental illnesses are debilitating chronic conditions that do not change and if anything grow worse over time. Treatments based on this view have been designed to assist mentally ill persons and their families to “get in touch” with this most bitter reality.

The “Recovery Model” is based on the premise that persons with a mental illness do improve over time. Although the improvement may be slow and have downturns, the overall picture is positive. Research not only supports the contention that mentally ill persons improve but also demonstrates the importance of hope as the fuel that drives the recovery process. Bruce Wampold recently published a book entitled, The Great Psychotherapy Debate. In this book he provides strong research evidence that supports an understanding of change that has been offered by the famous psychologist Jerome Frank. Frank has argued that in the world of psychiatric symptoms demoralization plays a major role in what makes psychiatric symptoms worse. He argues further that a critically important part of what helps people change or recover is the discovery of hope. This may seem too simple to be true. However, when more carefully examined this seemingly simple truth has many complex ramifications. The idea that persons who suffer from a mental illness should become in touch with the reality that change is unlikely supports demoralization and creates a self-fulfilling prophecy. It is this demoralization that makes illness chronic.

On the other hand, hope for future recovery reverses the effects of demoralization and starts the ball of change rolling. When persons with mental illnesses have hope they will be more likely to take medication. They will want to play an active role in their treatment and will have goals that they wish to achieve. Research also shows that goals work like a magnet in the recovery process. Goals create a future vision. When a person has a positive vision of what he or she wants to be like in the future, the positive future vision attracts the behaviors and attitudes that make the vision come true. This is a positive self-fulfilling prophecy. Positive behaviors and attitudes actually influence the chemistry of the brain. This all begins with hope. More simply stated, we become who we wish to be. Who we wish to be is influenced by hope that we can be better people tomorrow than we are today.

Andy Solovey, Associate Director for Clinical Services, Scioto Paint Valley Mental Health Center

Click The Recovery Model on Left for more information.
 
Advisory
SAMHSA Issues Consensus Statement on Mental Health Recovery

The Substance Abuse and Mental Health Services Administration today unveiled a consensus statement outlining principles necessary to achieve mental health recovery. The consensus statement was developed through deliberations by over 110 expert panelists representing mental health consumers, families, providers, advocates, researchers, managed care organizations, state and local public officials and others.

“Recovery must be the common, recognized outcome of the services we support,” SAMHSA Administrator Charles Curie said. “This consensus statement on mental health recovery provides essential guidance that helps us move towards operationalizing recovery from a public policy and public financing standpoint. Individuals, families, communities, providers, organizations, and systems can use these principles to build resilience and facilitate recovery.”

The 10 Fundamental Components of Recovery include:

• Self-Direction: Consumers lead, control, exercise choice over, and determine their own path of recovery by optimizing autonomy, independence, and control of resources to achieve a self-determined life. By definition, the recovery process must be self-directed by the individual, who defines his or her own life goals and designs a unique path towards those goals.

• Individualized and Person-Centered: There are multiple pathways to recovery based on an individual’s unique strengths and resiliencies as well as his or her needs, preferences, experiences (including past trauma), and cultural background in all of its diverse representations. Individuals also identify recovery as being an ongoing journey and an end result as well as an overall paradigm for achieving wellness and optimal mental health.

• Empowerment: Consumers have the authority to choose from a range of options and to participate in all decisions—including the allocation of resources—that will affect their lives, and are educated and supported in so doing. They have the ability to join with other consumers to collectively and effectively speak for themselves about their needs, wants, desires, and aspirations. Through empowerment, an individual gains control of his or her own destiny and influences the organizational and societal structures in his or her life.

• Holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. Recovery embraces all aspects of life, including housing, employment, education, mental health and healthcare treatment and services, complementary and naturalistic services (such as recreational services, libraries, museums, etc.), addictions treatment, spirituality, creativity, social networks, community participation, and family supports as determined by the person. Families, providers, organizations, systems, communities, and society play crucial roles in creating and maintaining meaningful opportunities for consumer access to these supports.

• Non-Linear: Recovery is not a step-by step process but one based on continual growth, occasional setbacks, and learning from experience. Recovery begins with an initial stage of awareness in which a person recognizes that positive change is possible. This awareness enables the consumer to move on to fully engage in the work of recovery.

• Strengths-Based: Recovery focuses on valuing and building on the multiple capacities, resiliencies, talents, coping abilities, and inherent worth of individuals. By building on these strengths, consumers leave stymied life roles behind and engage in new life roles (e.g., partner, caregiver, friend, student, employee). The process of recovery moves forward through interaction with others in supportive, trust-based relationships.

• Peer Support: Mutual support—including the sharing of experiential knowledge and skills and social learning—plays an invaluable role in recovery. Consumers encourage and engage other consumers in recovery and provide each other with a sense of belonging, supportive relationships, valued roles, and community.

• Respect: Community, systems, and societal acceptance and appreciation of consumers —including protecting their rights and eliminating discrimination and stigma—are crucial in achieving recovery. Self-acceptance and regaining belief in one’s self are particularly vital. Respect ensures the inclusion and full participation of consumers in all aspects of their lives.

• Responsibility: Consumers have a personal responsibility for their own self-care and journeys of recovery. Taking steps towards their goals may require great courage. Consumers must strive to understand and give meaning to their experiences and identify coping strategies and healing processes to promote their own wellness.

• Hope: Recovery provides the essential and motivating message of a better future— that people can and do overcome the barriers and obstacles that confront them. Hope is internalized; but can be fostered by peers, families, friends, providers, and others. Hope is the catalyst of the recovery process.

The National Consensus Statement on Mental Health Recovery is available at SAMHSA’s National Mental Health Information Center at
www.mentalhealth.samhsa.gov or
1-800-789-2647.