Recovery: a journey of the
heart
Patrick Mundy
Physiotherapist
Learning Outcomes
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No Health without Mental health (2011)
Principles of Recovery
REFOCUS: Model of Recovery
Supporting Recovery
Physiotherapy and Recovery
No Health without mental health
(2011)
The Vision:
1.More people will have good mental health
2.More people with mental health problems will recover
3.More people with mental health problems will have good physical health
4.More people will have a positive experience of care and support
5.Fewer people will suffer avoidable harm
6.Fewer people will experience stigma and discrimination
Recovery Supporting
Organisations
• Implementing Recovery organisational
change (ImROC)
• Recovery colleges
– Both for service users and Staff
– Courses lead by both a Practitioner teacher
and a Peer teacher
– Non-clinical
• Promoting trusts and organisations to
hiring Peer support workers
Clinical Recovery
– Evidence based practice and skilful
use of interventions
– Getting rid of symptoms
– Restoring social functioning
– “Getting back to normal”
“…. A deeply personal, unique process of
changing one’s attitudes, values, feelings,
goals, skills &/or roles. It is a way of living a
satisfying, hopeful, & contributing life even
within the limitations caused by illness.
Recovery involves the development of new
meaning & purpose in one’s life as one grows
beyond the catastrophic effects of mental
illness.” (Anthony 1993)
Personal Recovery
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Physical, mental and spiritual journey
Spontaneous and Natural
Deeply Personal
Can occur with or with out professional help
Involves growth and setbacks, periods of rapid
and little change
• Can occur with continuing symptoms
• http://youtu.be/jhK-7DkWaKE
Core concepts of Recovery
Hope – Sustains motivation and
supports expectations of an
individually fulfilled life
Sense of control – Service
users taking control of their own
problems, the services they
receive and their lives
Opportunity – Participation in a
wider society. To be valued, to
contribute and have access to
the opportunities that exist
within those communities
Recovery
Vs. Rehabilitation
The goal of the recovery process is
not to become normal. The goal is
to embrace the human vocation of
becoming more deeply, more fully
human. (Deegan, 1995)
Def: restore (someone) to health or
normal life by training and therapy
after imprisonment, addiction, or
illness (Oxford Dictionary)
The process whereby a disabled
A person with paraplegia can
person is enabled to use their
recover even though the spinal
residual abilities to function
cord has not. Similarly, a person
effectively in as normal a social
with mental illness can recover
situation as possible (Bennet 1978)
even though the illness is not
“cured”. (Anthony, 1993)
Recovery is what people with
disabilities do. Treatment and
case management and
Rehabilitation are what helpers
do to facilitate recovery.
(Anthony, 1993)
Stages of Recovery
• Moratorium Denial, confusion, hopelessness, identity
confusion, self-protective withdrawal
• Awareness The first glimmer of hope for a better life,
that recovery is possible. Can emerge from within or be
triggered by significant other, role model, clinician
• Preparation The person resolves to start recovery work,
taking stock of personal resources, values, limitations
• Rebuilding Forging a more positive identity, setting &
striving towards personal goals, reassessing old values
• Growth Whether or not symptom-free, can manage
illness & stay well (resilience, self-confidence, optimism)
Andresen R et al (2003) The experience of recovery from schizophrenia: towards an
empirically-validated stage model, Australian and New Zealand Journal of Psychiatry, 37,
586-94
REFOCUS: Model of Recovery
Recovery-promoting Relationships
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Relationship between staff and service users is
central to personal Recovery
Exploring team understanding of Recovery and
team values
Skill training in Coaching
Working Practices
1. Understanding
values and treatment
preferences:
Care planning is
centred around
person
2. Assessing strengths:
Focussed on amplifying
a person’s strengths
and ability
3. Supporting goalstriving:
Oriented around
personally valued goals
and that staff support
active goal-striving
Supporting Recovery
Download:
www.rethink.org/100ways
Recovery-promoting
Relationships
• Valuing people for who they are – seeing beyond a
diagnosis/set of symptoms
• “Listening” & believing in the authenticity
• Seeing & having confidence in their skills, abilities &
potential
• Recognising that problems or set backs are part of the
recovery process
Recovery-promoting
Relationships
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Tipping points for successful recovery:
Insights and acceptance in the person being supported
Allowance of risk taking
Co-development of social opportunities and knowledge
Positive relationships with formal services based on
good communication
• Carers involved in self-recovery and respite
Parr H (2009) Carers and supporting recovery,
Glasgow: Scottish Recovery Network.
Mental Health Life Coaching
• Established from sport and Business
• Non-clinical
• Defined as a holistic orientation to working
with people, to find balance, enjoyment
and meaning in their lives as well as
improving performance, skills and
effectiveness.
Coaching Continued
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Goal: Setting clear goals
Reality: Exploring the current situation
Options: Alternative strategies or courses of action
Way forward: What is to be done, when, by whom and
the will to do it.
Social Inclusion
• Supporting people regain their place in
their communities where they live
• Restitution – Regaining something that
was lost or taken away
Peer Support
• Mutual self-help groups
• Peer support specialists
– Is a role in the mental system for which
personal experience of mental illness is a job
requirement
– Their own lived experience is valued
– Act as Role models
• Peer run programmes
Physiotherapy and Recovery
• Currently no research in the role of
Physiotherapy in Recovery
• Currently little involvement in Recovery
• Is there a place for physiotherapy in
Recovery?
• Natural Coaches!
• Goal-striving practice
Online Recovery Resources
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www.rethink.org
www.scottishrecovery.net
www.iop.kcl.ac.uk/recovery
www.researchintorecovery.com
Further Reading/information
• Slade, M (2009) 100 ways to support recovery. Rethink
Recovery Series Vol. 1. London: Rethink Mental Illness
• Bora R, Leaning L, Moores A, Roberts G (2010): Life
coaching for mental health recovery: the emerging
practice of recovery coaching. Advances in Psychiatric
Treatment, Vol 16, 459-467
• Gallwey T (1974), The Inner Game of Tennis. Random
house, New York.