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