Professional Accountability

          According to a 2009 SAMSHA study, professionals in the mental health field need to be trained in the recovery model. Most professionals have been introduced to recovery concepts and principles through federal program requirements or their agency’s administration policy. Sheedy and Whitter (2009) report that there is support for the principles of recovery, and after consulting 375 studies, their findings show that:

Extensive research has been conducted in the addictions field to support the following principles and systems elements: There are many pathways to recovery; Recovery exists on a continuum of improved health and wellness; Recovery is supported by peers and allies; Recovery is a reality; Inclusive of family and other ally involvement; Individualized and comprehensive services across the lifespan; Continuing care part of the continuity of care element; Partnership-consultant relationships; Responsiveness to personal belief systems; Commitment to peer recovery support services; Integrated services; and  Ongoing monitoring and outreach… (p. 39).

 

            With the current SAMSHA (2012) definition of recovery; the four dimensions that support a life in recovery; and the ten guiding principles of recovery, it is important for professionals to have  current, up-to-date education and training on practices that promote recovery. For example, as caregivers, the mental health care professional would want to work as a team with the consumer and take the time to listen and talk (Williams & Tufford, 2012). According to Gehart (2012), the goal of the Marriage and Family Therapist (MFT) should be to integrate the recovery principles into their practice; in fact, in order to reduce the confusion and resistance that the professional might feel Gehart introduces a “four-phase model for adopting a recovery orientation. Phase One: Horror, Outrage, and Righteous Indignation; Phase Two: Overconfidence; Phase Three: Integration and Balance; Phase Four: Creative Implementation” (Part.I, p.437-8). In Part II, Gehart (2012) insists that recovery can be facilitated between the MFT and the consumer when they “…develop a ‘reasonable’ course of action based on (a) what the therapist knows to be effective based on theory research, (b) what the consumer is willing to commit to, and (c) what is reasonably safe but not necessarily risk free” (p.451). In addition to consulting the consumer about their needs and wants, it is important to include families in the available resources of the mental health system and in the recovery process (President’s New Freedom Commission on Mental Health, 2003, p.9).

            Mental health care providers have many barriers to providing adequate and effective care, because there are many gaps between mental health care needs and actual services that are delivered; for instance, inadequate human resources for mental health (President’s New Freedom Commission on Mental Health, 2003, p.16; WHO, 10 facts on mental health); poverty and unemployment (Power, 2010); crime and violence in the community (Whitley, 2011); and the many facets of the recovery process (Gehart, 2012; Onken et al., 2007; Pilgrim, 2009; Segal, Silverman, & Tempkin, 2010). At times, these multiple facets of the recovery process and the nonlinear process of recovery cause individuals with a neurobiological disorder to fluctuate along the recovery process, thus making it challenging for mental health care professionals (Gehart, 2012; Onken et al., 2007; Pilgrim, 2009; Segal, Silverman, & Tempkin, 2010). In addition, professional have to maintain not only the health and safety of the individuals that are seeking treatment, but they have to maintain the health and safety of the community (Gehart, 2012).           

            Mental health care providers should provide support in a non-judgmental, non-stigmatizing, and supportive manner that follows ethical guidelines (American Counseling Association, 2010; Gotham, 2006; McHugh & Barlow, 2010). Most mental health care professionals have received training on evidence-based approaches, and they know that it is important to take into account individual client needs (Gotham, 2006; McHugh & Barlow, 2010; Kazak, Hoagwood, Weisz, Hood, Kratouchwill, Vargas, & Banez, 2010). Yet, some clinicians can find themselves unskilled or torn between the complexities involved in deviating from empirically supported approaches to meet the client’s needs; nevertheless, the APA Presidential Task Force (2006) defines ‘evidence-based practice of psychology (EBPP)’ as utilizing all available methodologies and focusing treatment on the client’s needs:

Evidence-based practice in psychology is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences…It is important to clarify the relation between EBPP and empirically supported treatments (ESTs). EBPP is the more comprehensive concept. ESTs start with a treatment and ask whether it works for a certain disorder or problem under specified circumstances. EBPP starts with a patient and asks what research evidence (including relevant results from RCTs) will assist the psychologist in achieving the best outcome (p.273).