1. Recovery to Practice and American Association of
American Psychiatric Association
and
American Association of
Community Psychiatrists
Recovery to Practice

2. Presenter: Annelle B. Primm , MD, MPH Deputy Medical Director
Director, Office of Minority and National Affairs
American Psychiatric Association

3. Recovery to Practice - Psychiatrists
The goal of the Recovery to Practice Project is to equip psychiatrists with the knowledge, skills and attitudes to provide recovery-oriented psychiatric care in which they will work in partnership with people in recovery to assist them in achieving their goals and living a fulfilling life in the community.
Recovery to Practice - Psychiatrists

4. Recovery to Practice - Psychiatrists
Project Partners
Advisory Group
people in recovery
psychiatrists in recovery
psychiatrists
other mental health professionals
Work Group – APA staff and community psychiatrists
Recovery to Practice - Psychiatrists

5. Information Gathering – Year 1
Literature review
Face-to-face Dialogues
Consumers and psychiatrists
Psychiatrists and family members
Psychiatrists and other mental health professionals
Facilitated conference calls
Consumers
Targeted groups of psychiatrists (16)

6. Facilitated Conference Calls (psychiatrists)
Community psychiatrists
Inpatient psychiatrists
State mental health program directors
Psychiatry residents
Residency training directors
Addiction psychiatrists
Consumer-psychiatrists
VA psychiatrists
International medical graduates
Psychiatrists working with:
Women
African Americans
Asian Americans
American Indians
Hispanics
LGBT populations
Youth/young adults

7. “Hope is the catalyst of the recovery process and provides the
essential and motivating messages
of a positive future.”
(SAMHSA)

8. SAMHSA 10 Recovery Components
Hope
Self-direction
Individualized and
person-centered
Empowerment
Holistic
Non-linear
Strengths-based
Peer support
Respect
Responsibility
Recovery to Practice - Psychiatrists

9. From People in Recovery
Psychiatrists hinder recovery by “viewing crises as something to be medicated away or restrained away instead of opportunities for people to learn and grow.” “It’s no good when things feel clinical, when it is all about the medications and symptoms, and not about the rest of my life.” “Psychiatrists must not lose sight of how fearful it is for someone to lose control of their mind.” “The most powerful thing anyone said to me was ‘I have so much hope for you.’’’
Recovery to Practice - Psychiatrists

10. Recovery to Practice - Psychiatrists
From Psychiatrists
“Change the goal of services from treating illness to helping people rebuild lives.”
Recovery oriented practice for psychiatrists: “We’re talking about a fundamental change in values, not just a change in techniques.”
“Believing in the possibility of recovery is key;
I want psychiatrists to believe that consumers
can recover and to have a positive attitude.” (Consumer psychiatrist)
Recovery to Practice - Psychiatrists

11. System Challenges
Contrasting perceptions and separation of programs for addictions and mental health recovery
Psychiatrists and multi-disciplinary teams

12. Recovery Services Require Strong Teams
We need to integrate a range of quality of life services beyond any one person’s competence
People at different stages of recovery require different staff skills – engagement, building skills and support, moving on
To increase accessibility to “someone I know”
(Adapted from Mark Ragins, M.D.)

13. Recovery Services Require Strong Teams
A team can create a culture of acceptance, welcoming, engaging, and emotionally connecting to people who are often rejected because of stigma and discrimination
To adopt multiple roles we need to support and watch out for each other
To maintain staff morale and avoid burnout we need to stick together and take care of each other
Adapted from Mark Ragins, M.D.

14. Recommendations for Training
Connect to participants’ prior knowledge and experiences
Demonstrate recovery-oriented practices that address common clinical challenges
Focus on how to use recovery principles in real situations (e.g., within time/resource limitations); provide concrete exercises
Involve consumers as trainers, provide personal recovery stories

15. Target Audience
1) Direct service providers, including: psychiatry residents, medical students, and fellows
Very early career psychiatrists
Public/community psychiatrists
Inpatient psychiatrists and emergency psychiatrists (acute care settings)
2) Trainers/supervisors, including
Residency program supervisors and lecturers, and medical student educators
Case conference/grand rounds organizers
“Early adopter” local training providers

16. Recovery to Practice - Psychiatrists
Goals of Training
Familiarize psychiatrists with:
Principles of recovery oriented care
Benefits for individuals in recovery
Benefits for psychiatrists
Practical strategies for clinical settings
Recovery to Practice - Psychiatrists

17. Recovery to Practice - Psychiatrists
Training Modules
1. Introduction and Rationale
2. Engagement and Welcoming Environment
creating an environment of hope for recovery where all people feel valued and respected
3. Person-Centered Planning and Shared
Decision-Making
Recovery to Practice - Psychiatrists

18. Recovery to Practice - Psychiatrists
Modules, cont.
4. The Role of Medication in Recovery
collaborative medication management; discussing
options (including not taking medication)
5. Health and Wellness Focused Care
integrated approach to recovery and well-being
(mental, physical, spiritual, social, etc.)
6. Building Living Skills and Achieving Goals
self-sufficiency and meaningful activity; building emotional skills to deal with adversity
Recovery to Practice - Psychiatrists

19. Recovery to Practice - Psychiatrists
Modules cont.
7. Culturally Appropriate and Trauma Informed Care
incorporate understanding of beliefs, cultural identity
spirituality, and experiences into recovery planning
8. Developing Peer Supports and Working
with Peer Specialists
9. Developing Natural Supports and Facilitating
Community Integration
family members, peer support groups, strategies
to strengthen support systems
Recovery to Practice - Psychiatrists

20. Recovery Training for Psychiatrists
Online training – will provide CME,
approximately 1 hour/module 
Recovery Toolkit of materials for use of trainers during in-person training
All training presented jointly by a psychiatrist and a consumer

21. Recovery Toolkit An introductory discussion
A video vignette demonstrating several key points in the curriculum
A video of a panel discussion of the key points in the module
Suggested topics/questions for discussion
Summary discussion
Supplemental materials and resources

22. Ongoing opportunities for feedback
All of the materials will be pilot tested before they are finalized. We will seek review and comment from psychiatrists in various work settings and people in recovery as part of that process.
Recovery to Practice - Psychiatrists

23. Project Directors: Annelle Primm, MD, MPH American Psychiatric Association Wes Sowers, MD American Association of Community Psychiatrists Questions/comments, contact: Debbie Cohen,