1. RECOVERY IMPLICATIONS FOR STAFF How does it fit with CBT?

2. Recovery – Working for a service informed by service user priorities. Recovery is not the same as cure “A way of living a satisfying, hopeful and contributing life even within the limitations caused by the illness” (Anthony 1993) “ A key element to recovery is about people taking control.” (www.mentalhealthrecovery.org.uk)www.mentalhealthrecovery.org.uk

3. Contributing Factors identified by people who have recovered The ability to have hope Trusting my own thoughts Enjoying the environment Feeling alert and alive Increased self esteem Knowing I have a tomorrow Working with and relating to others Increased spirituality Having a job Having the ability to work

4. RECOVERY MEANS… ~ Giving service users ownership of the process. BY Making service user involvement meaningful Respecting the service user as the expert in their own situation Empowering the individual to voice their aspirations Taking those aspirations seriously, and finding out from them what support will be needed from us to make it happen. Making their priorities and choices more important than fitting into the system.

5. Self Management of Symptoms Wellness Recovery Action Planning.(Mary Ellen Copeland). ( fostered by NIMHE) People devise their own plan, first identifying “wellness”; then looking at signs of relapse. Devise a contract for when they are relapsing – get agreement from professionals.

6. Raising expectations: employment; meaningful activity; social integration Making employment a viable opportunity by providing adequate support to both employee and employer Smoothing the path towards gaining qualifications – pre NVQ and NVQ in supported settings Supported entry into FE. Fostering aspiration, and taking individual’s aspirations seriously.

7. Partnership with service users; beyond tokenism. Use of current services can be a deskilling and demoralising experience – at worst a traumatic one. We need to work in partnership with “the experts” to design services that are empowering and promote Recovery. We need to employ “experts” – those who have survived and thrived despite mental health setbacks in our services, with adequate support, should be integral to this.

8. The role of spirituality in Recovery. Breakdown, for those who experience it, is frequently perceived as a stage in life’s journey: The straight road ahead has become blocked, or fallen away: a gulf opens which can herald terrifying and disorienting experiences – but can also open the way to wider perspectives and new meanings. Hence spirituality is one of the routes to Recovery most frequently cited by service users, and most marginalised by dominant conceptualisations. This is a challenge that needs addressing.

9. For staff RECOVERY MEANS… ……..A change of role; NOT controlling, leading, persuading the person to conform NOT being the most important person in that individual’s life BUT facilitating individuality handing over responsibility for symptom management to the best of that person’s capacity Supporting the person in making and repairing relationships with friends and relatives and other community supports that often break or suffer in times of crisis taking the individual’s experience and concerns seriously – they are now central.

10. “BUT these people are ill – they cannot do all that. You are asking too much of them”. True, it will be more difficult if if they have not come to terms with what has happened If they do not accept that things are different and that there are obstacles to overcome Or if they feel powerless to tackle them Staff therefore have a vital role In facilitating the reaching of that point of acceptance - the “turning point” where the individual is ready to take responsibility. In instilling hope that things can be different.

11. In Summary, for you, Recovery means Giving service users ownership of the process. A change of role for staff – the service user is central. Plus a vital role in facilitating the reaching of the point of acceptance where they are ready to take responsibility.

12. Where does this fit with CBT? List elements of CBT that fit well with Recovery. List areas of possible challenge? How should CBT take account of Recovery?