Chapter 43 Recovery Model Terry Krupa

Objectives Define recovery in the context of mental illness Identify common elements of recovery Consider how recovery is evaluated Describe intervention tools to support recovery Discuss the relationship between occupational therapy and recovery

Defining recovery Recovery has gained prominence internationally as a guiding vision for the development of mental health systems and services Yet, there can be confusion and a lack of shared agreement about the definition of recovery

Conflicting Perspectives on Recovery Clinical perspective * Personal perspective

Defining Recovery – Conflicting Perspectives A clinical definition of recovery – Focuses on reducing mental illness, symptom reduction Recovery as cure Illness management as determined by experts is central to recovery

Defining Recovery – Conflicting Perspectives (Continued) A personal perspective on recovery Recovery as a personal life journey Living a life of meaning and purpose beyond the illness People with mental illness do the “recovering” service providers and others can enable or interfere with recovery process

The importance of the definition The personal perspective on recovery has gained influence as the guiding vision for mental health service delivery systems It has required a significant transformation of mental health services and systems which historically have been predominantly medical and clinical

Elements of the recovery process

Elements of the Recovery Process Hope – Believing in possibilities and potentials Redefining self – mental illness as one aspect of a multi- dimensional identity Incorporating illness – acknowledging and accepting limitations of illness but moving beyond to discover personal potentials, strengths, capacities

Elements of The Recovery Process Being involved in meaningful activities – engaging in social roles and making contributions Overcoming stigma – developing resilience to stigma Assuming control – taking responsibility for the personal transformations of recovery

Elements of the Recovery Process (Continued) Becoming empowered and exercising citizenship Managing symptoms – active participation in approaches and treatments to control symptoms Being supported by others – being autonomous but connected to others

The Recovery Process Applied Think of people who have mental illness you have met or somehow had contact with. Did they experience any of these elements of the recovery process? Describe this experience.

How can service providers enable the recovery process? Support self-direction Identify and build individual strengths, potentials while attending to illness Provide and support access to options, opportunities, resources Communicate hope Enable access to peer support Support well-being across all aspects daily life

Enabling Recovery What practices meant to enable recovery have you heard about or witnessed? Are there any recovery-enabling practices that you would like to learn more about?

Recovery Tools Evidence-based interdisciplinary intervention approaches The Recovery Workbook (Spaniol, Koehler & Hutchinson, 1994) Wellness Recovery Action Plan (WRAP; Copeland, 1997) Illness Management and Recovery (Gingerich & Mueser, 2005)

Recovery and Occupational Therapy How can OT contribute to the knowledge and practice base of recovery? Knowledge related to occupation and well-being Expanding understanding of the relationship between engagement in activity/occupation and elements of recovery Ensuring that the focus on meaningful activities is maintained in services and service systems Client-centred tools Others??

Recovery and Occupational Therapy How can OT be informed by recovery? Remaining sensitive to the factors that constrain the ability to practice in a recovery enabling way