Monday, September 22, 2014

Recovery Transformation


SAMSHA (2012) redefined its definition of recovery as “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential;” therefore, when individuals change the overall positive benefits to their mental, physical, and social health is their recovery. SAMSHA (2012) realized that recovery is multifaceted, so along with this definition they came up with the four dimensions that support recovery and the ten guiding principles of recovery. Consequently, the four major dimensions that support a life in recovery are: (1) taking care of one’s emotional and physical health; (2) a safe home or place to live; (3) a purpose to life through meaningful activities; and (4) community supports that create relationships and social networks (SAMSHA, 2012). In the article Working Definition of Recovery, SAMSHA (2012) defines the ten guiding principles of recovery as:

Recovery emerges from hope:  The belief that recovery is real provides the essential and motivating message of a better future – that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Recovery is person-driven:  Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s). Recovery occurs via many pathways:  Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds- including trauma experiences - that affect and determine their pathway(s) to recovery. Abstinence is the safest approach for those with substance use disorders. Recovery is holistic:  Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. The array of services and supports available should be integrated and coordinated. Recovery is supported by peers and allies: Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery. Recovery is supported through relationship and social networks:  An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change.  Recovery is culturally-based and influenced: Culture and cultural background in all of its diverse representations - including values, traditions, and beliefs - are keys in determining a person’s journey and unique pathway to recovery. Recovery is supported by addressing trauma: Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration. Recovery involves individual, family, and community strengths and responsibility:  Individuals, families, and communities have strengths and resources that serve as a foundation for recovery.  Recovery is based on respect:  Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems – including protecting their rights and eliminating discrimination – are crucial in achieving recovery (p.1-2). 

 

            Research suggests that as people progress through the recovery process their goals will change as their basic needs are met. According to humanist psychologist Abraham Maslow basic needs are vital for survival; for example, ‘physiological needs’ are water, food, and sleep; therefore, once these needs are met the individual would move onto meeting their ‘security needs’: safety, shelter, employment, and health care (1987). When setting goals it is important for consumers to have an understanding of the recovery process, because if they believe that recovery means a ‘cure’ to all their symptoms, then it might make recovery seem unreachable and be disheartening (Svanberg, Gumley, & Wilson, 2010). It is important to set appropriate and effective goals for each individual with a neurobiological disorder. If an appropriate and effective goal is set, then the individual will have a better chance of impacting their whole life (Clarke, 2012). Clarke, Oades, & Crowe (2012) explain that there are different stages of recovery goals; for example, “Avoidance goals aim to move or stay away from a negative or undesirable outcome (e.g. ‘to stop hearing voices’) whereas, approach goals aim to move towards or maintain a positive or desirable outcome (‘buy a car’) (p.298). Therefore, it is important to build on the individuals strengths when setting goals, and to acknowledge that “Individuals often experience setbacks within recovery which can lead to a few steps back before progressing again” and that is ok (Clark, p.303).            These recovery-oriented concepts are transforming the mental health care system (Clarke, 2012; Gehart, 2012; Onken et al., 2007; Pilgrim, 2009; Segal, Silverman, & Tempkin, 2010; Svanberg, Gumley, & Wilson, 2010).  

            This study is an analysis of the recovery system for individuals with a “neurobiological disorder,” [1] and it reveals that (1) there is not adequate funding for individuals with a neurobiological disorder; (2) there needs to be more education and training for individuals with a neurobiological disorder and professionals; as well as, accountability for professionals that do not promote recovery and follow the evidence based practices; and (3) society needs to reduce the stigma and fear that surrounds a neurobiological disorder, because evidence shows that change is possible.  




[1] In this paper, “Neurobiological disorder” refers to a diagnosis given to any person, who currently or at any time during the past year, have had a diagnosable mental, behavioral, or emotional disorder that would meet diagnostic criteria specified in the Diagnostic and Statistical Manual for Mental Disorders Fifth Edition (DSM - V). This term is not meant to be derogatory or demeaning to people who are dealing with mental health challenges.

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