Background Principles of the Recovery Approach

1. Background Principles of the Recovery Approach Agored Study Day 11th November 2010

2. Overview • Background • Definition • Policy and Guidelines • Key Concepts • The Ten Essential Shared Capabilities

3. Background • The Recovery Model originated in the service user/survivor movement in 80’s and 90’s. • Based on self help empowerment and advocacy (re Civil Rights movement and ‘AA’). • The term refers to recovering hope for living full and purposeful life whatever the circumstances. • Recovery approach values treatment, but focus is on living with ongoing symptoms/difficulties.

4. Policy and Guidelines • The Department of Health consider that recovery is broadly applicable to all long term conditions. • Recovery is fully consistent with current health and social care policies Eg - NICE/SCIE 42 on dementia (2006) - Our health, our care, our say (DoH, 2006) - Commissioning framework for health and well being (DoH, 2007) - NSF for Older People in Wales (2006)

5. Policy and Guidelines (Continued) • Recovery is seen as being relevant to all professionals in mental health services. • Shares the ethos of progressive social care practice (re ‘personalisation’). • Resonates with Human Rights Act.

6. Defining Recovery • Emphasis upon living a satisfying, hopeful and contributing life, even with the limitations caused by illness. • An individual process, ‘owned’ by the user. • Developing a personal identity that is not defined by illness. • Development of new meaning and purpose in one’s life. • ‘…a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills and roles.’

7. Recovery and Person Centred Care • Common themes: • Importance of valuing the individual. • Choice, control and agency. • Social inclusion and meaningful life. Recovery – identity: me and mental illness. ILLNESS (me) >>>>>>>>>ME (illness) Identity: Person and Dementia DEMENTIA (me) >>>>>>>>ME (dementia)

8. Key Concepts • Finding and maintaining hope. - Believing in one’s self; having a sense of personal agency; optimistic about the future. • Re-establishment of a positive identity. - Finding a new identity which incorporates illness but retains a core, positive sense of self. • Building a meaningful life. - Making sense of illness; finding a meaning in life, despite illness; engaged. • Taking responsibility and control. - Feeling in control of illness and life.

9. Key Concepts (Continued) • Active coping rather than passive adjustment: self manage condition, as much as possible. • A process of increasing understanding and acceptance. • Moving towards a sense of meaning and purpose – being involved in meaningful activities. • Re-assessing goals and values (often life goals may no longer be available).

10. The Five Stages of Recovery • Moratorium – a time of withdrawal and a profound sense of loss and hopelessness. • Awareness – realisation that all is not lost. • Preparation – Taking stock of strengths/weaknesses and starting to work on developing recovery skills. • Rebuilding – actively working towards a positive identity, setting meaningful goals and taking control of one’s life. • Growth – living a meaningful life, characterised by self management of illness, resilience and a positive sense of self.

11. Putting it into Practice • Supporting people to develop skills to manage and live with symptoms. • Supporting people to build active and meaningful lives within their communities. • Promoting a sense of hope. • Valuing individual life experiences (re links with person centred care/life history).

12. 10 Essential Shared Capabilities • Working in Partnership • Respecting Diversity • Practising Ethically • Challenging Inequality • Promoting Recovery

13. 10 Essential Shared Capabilities (Continued) • Identifying People’s Needs and Strengths • Providing Service User Centred Care • Making a Difference • Promoting Safety and Positive Risk Taking • Personal Development and Learning

14. References • Making Recovery a Reality – Sainsbury Centre for Mental Health. • Recovering Ordinary Lives: The Strategy for Occupational Therapy in Mental Health (2007). • A Common Purpose: Recovery in Mental Health Services RCP/CSIP/SCIE. • Recovery and Older People – www.londondevelopmentcentre.org (Lynn Read/Kevin Sole). • Repper, J and Perkins, R (2003) Social Inclusion and Recovery. Balliere Tindall. Edinburgh. • Social Exclusion Unit Report (2004) Mental Health and Social Exclusion. Http://www.publications.odpm.gov.uk • National Institute of Mental Health (2005) Guiding Statement on Recovery. www.nimhe.org.uk