Recovery: How to support this
journey as a practitioner
Joanna Fox
Anglia Ruskin University
1
Presentation outline
•
•
•
•
•
•
•
What the recovery experience might be like
A personal journey of recovery
How to practise from a recovery based position
An exercise
What recovery means in practical support
Difficulties of recovery
Recovery is a life long journey
2
1. What is recovery?
• Recovery is defined as a personal process of
overcoming the negative impact of diagnosed
mental illness / distress despite its continued
presence.
• NIMHE (2004) Emerging Best Practices
in Mental Health Recovery
3
2. Recovery – a personal
journey
•
•
•
•
•
•
•
•
•
•
Breakdown at university
Friendship
Re-building
Faith – there must be a reason?
Family members
Mentorship
Something to do
Direction
Personal steel
Career
4
3. What ‘services’ helped me
•
•
•
•
•
•
•
•
Holistic understanding
Challenging at my level
Enabling with support
Looking at my strengths
Being positive
Being meaningfully occupied
Always stretching me
Full time education as a student then returning
to further training as a social work student
• Cognitive Behaviour Therapy to re-construct my
5
‘negative’ ways of thinking
4. Elements affecting the
recovery experience
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Hope, confidence and optimism
Diagnosis
Self-acceptance, responsibility, belief and esteem
Self-efficacy
Self-awareness
Negative identity and low expectations
Stigma – spoiled identity
Thriving – growth beyond the label
Powerlessness – removal of identity
Reclaiming power and self-determination
Physical image
Sexual Identity
Creative identity
Cultural, social and community identity
Group identity – activism
Spiritual identity
Brown, Wendy. and Kandirikirira, Niki. (2006). Recovering mental health in Scotland. Report on
narrative investigation of mental health recovery.
Glasgow, Scottish Recovery Network.
http://www.scottishrecovery.net/content/mediaassets/doc/Recovering%20Identity.pdf
accessed on line 27.10.06
6
5. The recovery model
Anthony (1993. p. 13) defines recovery as:
“a deeply personal, unique process of changing one’s
attitudes, values, feelings, goals, skills and/ or roles. It is
a way of living a satisfying, hopeful and contributing life
even with limitations caused by the illness. Recovery
involves the development of new meaning and purpose
in one’s life as one grows beyond the catastrophic effects
of mental illness”.
Anthony WA (1993) Recovery from mental illness:
the guiding vision of the mental health service system in the
1990s, Psychosocial Rehabilitation Journal, 16, 11-23
7
6. In England: what does
recovery mean in professional
practice?
• Focusing on the core significance of hope and optimism
• A shift of professional role from authority to coach
• Medication: more than compliance
• Moving from risk avoidance to risk-sharing
• Promoting self-management
• Hospital as a springy safety-net
• Making recovery worth it – what to recover for?
• Developing a common language
Roberts G, Wolfson P (2004) The rediscovery of recovery,
Advances in Psychiatric Treatment, 10, 37-47
(Acknowledgements to Mike Slade, SLAM NHS Trust)
8
7. Building a support package as a
recovery based practitioner
Coleman (2004) suggests the following are the
types of questions that may be asked (ibid p.
62/63)
•
•
•
•
What areas of your life do you consider have gone
particularly well over the last six months?
What can be done by yourself or others to build on
your successes?
What areas of your life have not gone so well in the
last six months?
Have there been any particular barriers, difficulties or
problems that have caused these parts of your life not
to go so well?
9
Building a support package 2
• What can you do by yourself to resolve these
problems?
• What can others do to help you resolve these
problems?
• What do you want to achieve over the next six
months?
• Which of these goals can you achieve on your
own?
• Which of these goals do you require help to
achieve?
• Who can help you achieve these goals?
10
Exercise – The WRAP flower
• Working from a strengths perspective…
11
What were key elements of
practical support for me?
FROM MY EXPERIENCE:
12
1. In the beginning…
• Underlining any positive changes that you see to the
service user
– You have been happier today
– You couldn’t have done that last year
• Keeping the person occupied in things they want to do,
sometimes things that take up time
– Going out shopping
– Going out for a walk
• Providing structure
– Finding a balance between ‘organising me’ and encouraging me
13
2. In the middle…
• Enabling me to discover what might lead
me to recovery
• Not setting the bar too high
– Challenging at my level but not too high
• Keeping focused on hope and optimism
– But trying to avoid being patronising
14
3. Moving towards recovery…
• Enabling problem solving
• Enabling me to discover my own recovery
journey but helping me to remember and
discover this optimism
15
Difficulties in recovery work as a
practitioner…
• Control and care “Mental health law”
• Duty of care and risk management
– How far can you enable but still protect
• Enabling and empowering but not taking
that power away from the service user
– Learned helplessness
– How much to support?
– How much to get them to do it for
themselves?
16
Recovery is a shared life long
journey
• Recovery is a journey just as Life is a journey
• Recovery is about optimism
– Sometimes you have to help find the optimism and
hope
• Recovery is a journey of self-discovery
– Sometimes you get lost and need help to find yourself
• Recovery is a hard journey
– We need help and encouragement along that road
• Recovery is a life long journey
– We need to remember it takes a life time to live
recovery and we all live a journey of recovery
17
Recovery belongs
to us all
• “Recovery is not a gift from doctors but the
responsibility of us all… We must become
confident in our own abilities to change our lives;
we must give up being reliant on others doing
everything for us. We need to start doing these
things for ourselves. We must have the
confidence to give up being ill so that we can
start becoming recovered”. Coleman 1999[1]).
•
[1] Coleman R (1999) Recovery: An alien
concept. Gloucester: Hansell
18