Copyright © F.A. Davis Company The Recovery Model Chapter 21

Copyright © F.A. Davis Company Introduction Research has indicated that the striving for and achievement of recovery is realistic for many individuals. Recovery began in the addictions field when referring to a person recovering from a substance use disorder. The term has recently been adopted by mental health professionals who believe that recovery from mental illness is also possible.

Copyright © F.A. Davis Company What Is Recovery? Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. SAMHSA 2011

Copyright © F.A. Davis Company Recovery is supported by four major dimensions: 1.Health 2.Home 3.Purpose 4.Community What Is Recovery? (cont.)

Copyright © F.A. Davis Company The basic concept of a recovery model is empowerment of the consumer. What Is Recovery? (cont.)

Copyright © F.A. Davis Company Guiding Principles of Recovery Recovery: – Emerges from hope – Is person-driven – Occurs via many pathways – Is holistic – Is supported by peers and allies – Is supported through relationship and social networks – Is culturally-based and influenced – Is supported by addressing trauma – Involves individual, family, and community strengths and responsibilities – Is based on respect

Copyright © F.A. Davis Company The Tidal Model A mental-health-nursing recovery model that may be used as the basis for interdisciplinary mental health care A person-centered approach to help people deal with their problems of human living Focus is on the individual’s personal story.

Copyright © F.A. Davis Company The Ten Tidal Commitments and Practitioner Competencies: 1.Value the voice. Actively listen to the person’s story and help the person record it in his or her own words. 2.Respect the language. Help individuals express in their own language their understanding of personal experiences through use of stories, anecdotes, and metaphors. 3.Develop genuine curiosity. Show interest in the person’s story. The Tidal Model (cont.)

Copyright © F.A. Davis Company The Ten Tidal Commitments and Practitioner Competencies (cont.): 4.Become the apprentice. Develop a plan of care and help the individual identify specific problems and ways to address them. 5.Use the available toolkit. Help individuals identify what efforts may be successful in solving the identified problems. 6.Craft the step beyond. Help the individual determine what kind of change would represent a step toward recovery. The Tidal Model (cont.)

Copyright © F.A. Davis Company The Ten Tidal Commitments and Practitioner Competencies (cont.): 7.Give the gift of time. Dedicate the time to address needs and plan and implement care. 8.Reveal personal wisdom. Help individuals develop self-confidence in the ability to help themselves. 9.Know that change is constant. Help the individual become aware of changes that are occurring. 10.Be transparent. Ensure that the individual is aware of the significance of all interventions and gets copies of the plan of care. The Tidal Model (cont.)

Copyright © F.A. Davis Company The Wellness Recovery Action Plan (WRAP) A step-wise process through which an individual is able to monitor and manage distressing symptoms that occur in daily life Others may be included in the process to assist the individual, but individual empowerment comes from self- administration of the plan.

Copyright © F.A. Davis Company Steps in the WRAP process include: – Developing a wellness toolbox – Daily maintenance list – Triggers – Early warning signs – Things are breaking down or getting worse. – Crisis planning WRAP is highly individualized and addresses the unique needs of the person and his or her situation. The Wellness Recovery Action Plan (WRAP) (cont.)

Copyright © F.A. Davis Company The Psychological Recovery Model Psychological recovery is defined as “the establishment of a fulfilling, meaningful life and positive sense of identity founded on hopefulness and self-determination.” (Andresen, Oades, and Caputi, 2011) Four components of the recovery process: – Hope – Responsibility – Self and identity – Meaning and purpose

Copyright © F.A. Davis Company Five Stages of Recovery: – Stage 1. Moratorium – Stage 2. Awareness – Stage 3. Preparation – Stage 4. Rebuilding – Stage 5. Growth The Psychological Recovery Model (cont.)

Copyright © F.A. Davis Company Nursing Interventions That Assist with Recovery The Tidal Model The WRAP Model The Psychological Recovery Model — Assessment — Interventions — Outcomes

Copyright © F.A. Davis Company 1.The nurse is assisting a client with mental illness recovery using the WRAP model. Which of the following interventions would be included? A.Assisting the individual to tell his personal story. B. Helping the client examine his philosophy of life in search of meaning and purpose. C.Taking control of the recovery process for the client. D.Helping the client craft a psychiatric advanced directive for when he can no longer care for himself. Nursing Interventions That Assist with Recovery (cont.)

Copyright © F.A. Davis Company Correct answer: D – Helping the client craft a psychiatric advanced directive for when he can no longer care for himself is part of the WRAP model of recovery. The client makes decisions (in writing) about treatment issues (what type, who will provide, and who will represent his interests). Nursing Interventions That Assist with Recovery (cont.)