[NYAPRS Enews] RTP: Recognizing Recovery-Oriented Practice, Webinar Viewing Available

[Harvey Rosenthal]

NYAPRS Note: In addition to the following weekly post from SAMHSA's
Recovery to Practice initiative, please note that the RTP Webinar
recording for the June 8 Webinar, "Emerging Trends in Program and
Workforce Development" that featured presenters from NYAPRS (Chacku
Mathai and Gail Smith) and the Annapolis Coalition (John Morris and Sue
Bergeson) is now available at
http://www.dsgonline.com/rtp/resources.html.   

 

 

A Few Tips For Recognizing A Recovery-Oriented Practice

Recovery to Practice  June 18, 2010

 

                One response that some mental health practitioners have
when they are encouraged to adopt recovery-oriented practices is that
they "do it" already. Such a response is often based, though, on the
assumption that recovery is something that they (i.e., practitioners)
can "do" themselves, with little attention paid to how the people
themselves (i.e., the patients or consumers) are engaged in or
responding to these efforts. With recovery being the responsibility of
the person, and with recovery-oriented practice being the complementary
responsibility of the practitioner, what is at issue in the
transformation to recovery-oriented care is how the two are working
together to enable the person with the illness to manage his or her
condition and pursue his or her aspirations for a full life. In this
respect, the recovery orientation of mental health practitioners is
reflected in how they utilize their expertise, skills, and accumulated
knowledge in engaging and supporting people in their own recovery
journey. In this vein, we offer the following beginning list of criteria
by which practices might be assessed in terms of their recovery
orientation.     

 

Does the care being offered center on the person as a unique individual?
Is it based on his or her unique and self-defined life goals and
informed by his or her personal needs, values, and preferences?
Recovery-oriented practice is carried out at the level of each
individual, unique person within the context of his or her family and
ongoing life. Each person's recovery plan therefore should look
different from anyone else's, and be based squarely on each person's
self-expressed particular goals, needs, values, and preferences. Does
the plan provide the person with a roadmap for where he or she is headed
and what he or she is trying to do in his or her life? Does the plan
address a life outside of or beyond formal mental health services, or
does it remain within the boundaries of the mental health system? Can
you tell from the plan what the care team is trying to accomplish, not
just what they are trying to get rid of or avoid? If medication is part
of the plan, can you tell what the medication is to be used for? Is
adherence an end in itself, or is it viewed as a route to some other,
personally desirable end? Will the services offered lead the person to
some worthwhile and wished for changes in his or her life? 

 

Does the care being offered focus on what the person will be doing
between appointments with mental health practitioners? Is there more for
the person to do, and more expected of the person, than for him or her
simply to receive treatment or attend meetings with practitioners? Is it
clear to the person the benefits or costs of certain treatments, or the
value of attending meetings or groups? Is it clear to the person how
these activities will help him or her to get to where he or she wants to
in life, or do they simply seem to aim to keep the person "busy"? Do
practitioners have concrete suggestions for activities or strategies the
person might try out in the community, or do they expect the person only
to participate in mental health-related activities?  

 

Does the care being offered encourage and support the person in assuming
increasing control over his or her life, including the power to make his
or her own decisions? As a result of being the recipient of care that
has not been oriented to promoting recovery, some people may need to be
encouraged to take back control of certain parts of their lives, the
responsibility for which may have been assumed by other people. Do
practitioners encourage the person to view him or herself as capable and
as having intact domains of functioning beyond the reach of the illness?
Do practitioners remind the person, or introduce the person perhaps for
the first time, to his or her personal strengths and gifts? Do
practitioners help the person to focus on achieving some small
successes, or easy wins, in order to rebuild his or her self-confidence
and sense of personal efficacy? Do practitioners encourage and support
the person in taking risk and trying new things-perhaps even gently
encouraging the person to get unstuck, to re-invest in life, or to be
liberated from the inertia of chronic illness?  

 

Does the care being offered help the person to feel better, or does it
make the person feel worse? Is the care offered in a dignified setting
and in a respectful manner? Seeking and receiving health care is
intended to help people feel better rather than worse. While being told
that you have an illness or a disability is sure to be distressing, when
offered compassionately, such care should also help the person to
understand his or her situation better and to feel confident that he or
she is doing what he or she can to make things as better as possible.
Does the person find attending mental health appointments to feel
humiliating or demeaning? Does the person leave the practitioner's
office feeling better or worse about him or herself and his or her
prospects for recovery? Are the services offered in a relatively safe,
clean, pleasant, and uplifting setting, or does the setting look run
down and not cared for? 

 

How will practitioners know whether or not receiving care helps the
person to feel better or worse, or whether or not the person experiences
the care offered as being responsive to him or her as a unique
individual? For these, and other, reasons, the last criterion to be
mentioned is eliciting the person's feedback and input on an ongoing
basis.

                                          

Do practitioners instill a sense of hope and possibility of recovery in
those they work with?  Do practitioners encourage the use of peer
supports?  Do practitioners ask the person for his or her feedback? Do
practitioners ask the person if the care he or she is receiving is
helpful? Does the practitioner inform the person what he or she can do
should the care not be experienced as helpful? Often a first step in
becoming an empowered consumer or user of mental health services is
being able to tell practitioners whether or not they are being helpful.
Do the practitioners welcome feedback about the care they provide? Do
the practitioners ask the person for his or her suggestions or ideas
about how the care they provide can be improved? When the person gives
feedback to practitioners, do they listen to and take the person
seriously? Do they make changes based on the person's feedback? Do
practitioners suggest what the person can do if he or she remains
dissatisfied with the care receives? Do they suggest how the person
might go about changing practitioners or services if they are not
helpful? When the person complains or files a grievance, do
practitioners treat the person respectfully, and does the person receive
a timely response to his or her concerns? 

 

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