Background Principles of the Recovery Approach Agored Study Day 11 th November 2010

Overview BackgroundBackground DefinitionDefinition Policy and GuidelinesPolicy and Guidelines Key ConceptsKey Concepts The Ten Essential Shared CapabilitiesThe Ten Essential Shared Capabilities

Background The Recovery Model originated in the service user/survivor movement in 80’s and 90’s.The Recovery Model originated in the service user/survivor movement in 80’s and 90’s. Based on self help empowerment and advocacy (re Civil Rights movement and ‘AA’).Based on self help empowerment and advocacy (re Civil Rights movement and ‘AA’). The term refers to recovering hope for living full and purposeful life whatever the circumstances.The term refers to recovering hope for living full and purposeful life whatever the circumstances. Recovery approach values treatment, but focus is on living with ongoing symptoms/difficulties.Recovery approach values treatment, but focus is on living with ongoing symptoms/difficulties.

Policy and Guidelines The Department of Health consider that recovery is broadly applicable to all long term conditions.The Department of Health consider that recovery is broadly applicable to all long term conditions. Recovery is fully consistent with current health and social care policiesRecovery is fully consistent with current health and social care policies Eg - NICE/SCIE 42 on dementia (2006) - Our health, our care, our say (DoH, 2006) - Our health, our care, our say (DoH, 2006) - Commissioning framework for health and well being (DoH, 2007) - Commissioning framework for health and well being (DoH, 2007) - NSF for Older People in Wales (2006) - NSF for Older People in Wales (2006)

Policy and Guidelines (Continued) Recovery is seen as being relevant to all professionals in mental health services.Recovery is seen as being relevant to all professionals in mental health services. Shares the ethos of progressive social care practice (re ‘personalisation’).Shares the ethos of progressive social care practice (re ‘personalisation’). Resonates with Human Rights Act.Resonates with Human Rights Act.

Defining Recovery Emphasis upon living a satisfying, hopeful and contributing life, even with the limitations caused by illness.Emphasis upon living a satisfying, hopeful and contributing life, even with the limitations caused by illness. An individual process, ‘owned’ by the user.An individual process, ‘owned’ by the user. Developing a personal identity that is not defined by illness.Developing a personal identity that is not defined by illness. Development of new meaning and purpose in one’s life.Development of new meaning and purpose in one’s life. ‘…a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles.’‘…a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles.’

Recovery and Person Centred Care Common themes:Common themes: –Importance of valuing the individual. –Choice, control and agency. –Social inclusion and meaningful life. Recovery – identity: me and mental illness. ILLNESS (me) >>>>>>>>>ME (illness) Identity: Person and Dementia DEMENTIA (me) >>>>>>>>ME (dementia)

Key Concepts Finding and maintaining hope.Finding and maintaining hope. - Believing in one’s self; having a sense of personal agency; optimistic about the future. - Believing in one’s self; having a sense of personal agency; optimistic about the future. Re-establishment of a positive identity.Re-establishment of a positive identity. - Finding a new identity which incorporates illness but retains a core, positive sense of self. Building a meaningful life.Building a meaningful life. - Making sense of illness; finding a meaning in life, despite illness; engaged. Taking responsibility and control.Taking responsibility and control. - Feeling in control of illness and life.

Key Concepts (Continued) Active coping rather than passive adjustment: self manage condition, as much as possible.Active coping rather than passive adjustment: self manage condition, as much as possible. A process of increasing understanding and acceptance.A process of increasing understanding and acceptance. Moving towards a sense of meaning and purpose – being involved in meaningful activities.Moving towards a sense of meaning and purpose – being involved in meaningful activities. Re-assessing goals and values (often life goals may no longer be available).Re-assessing goals and values (often life goals may no longer be available).

The Five Stages of Recovery Moratorium – a time of withdrawal and a profound sense of loss and hopelessness.Moratorium – a time of withdrawal and a profound sense of loss and hopelessness. Awareness – realisation that all is not lost.Awareness – realisation that all is not lost. Preparation – Taking stock of strengths/weaknesses and starting to work on developing recovery skills.Preparation – Taking stock of strengths/weaknesses and starting to work on developing recovery skills. Rebuilding – actively working towards a positive identity, setting meaningful goals and taking control of one’s life.Rebuilding – actively working towards a positive identity, setting meaningful goals and taking control of one’s life. Growth – living a meaningful life, characterised by self management of illness, resilience and a positive sense of self.Growth – living a meaningful life, characterised by self management of illness, resilience and a positive sense of self.

Putting it into Practice Supporting people to develop skills to manage and live with symptoms.Supporting people to develop skills to manage and live with symptoms. Supporting people to build active and meaningful lives within their communities.Supporting people to build active and meaningful lives within their communities. Promoting a sense of hope.Promoting a sense of hope. Valuing individual life experiences (re links with person centred care/life history).Valuing individual life experiences (re links with person centred care/life history).

10 Essential Shared Capabilities Working in PartnershipWorking in Partnership Respecting DiversityRespecting Diversity Practising EthicallyPractising Ethically Challenging InequalityChallenging Inequality Promoting RecoveryPromoting Recovery

10 Essential Shared Capabilities (Continued) Identifying People’s Needs and StrengthsIdentifying People’s Needs and Strengths Providing Service User Centred CareProviding Service User Centred Care Making a DifferenceMaking a Difference Promoting Safety and Positive Risk TakingPromoting Safety and Positive Risk Taking Personal Development and LearningPersonal Development and Learning

References Making Recovery a Reality – Sainsbury Centre for Mental Health.Making Recovery a Reality – Sainsbury Centre for Mental Health. Recovering Ordinary Lives: The Strategy for Occupational Therapy in Mental Health (2007).Recovering Ordinary Lives: The Strategy for Occupational Therapy in Mental Health (2007). A Common Purpose: Recovery in Mental Health Services RCP/CSIP/SCIE.A Common Purpose: Recovery in Mental Health Services RCP/CSIP/SCIE. Recovery and Older People – (Lynn Read/Kevin Sole).Recovery and Older People – (Lynn Read/Kevin Sole). Repper, J and Perkins, R (2003) Social Inclusion and Recovery. Balliere Tindall. Edinburgh.Repper, J and Perkins, R (2003) Social Inclusion and Recovery. Balliere Tindall. Edinburgh. Social Exclusion Unit Report (2004) Mental Health and Social Exclusion. Exclusion Unit Report (2004) Mental Health and Social Exclusion. National Institute of Mental Health (2005) Guiding Statement on Recovery. Institute of Mental Health (2005) Guiding Statement on Recovery.