Recent Projects: Recovery Dimensions
A National Study of the Policies and Practices That Promote Functional Recovery
The purpose of this study was to conduct quantitative and qualitative research guided by a participatory action research (PAR) approach to describe and evaluate the extent to which state mental health systems had implemented policies and practices that promote the recovery of persons with long-term mental illness. This project was conducted in collaboration with the National Association of State Mental Health Directors (NASMHPD), the National Association of Consumer/Survivor Mental Health Administrators (NAC/SMHA), and the Consumer Organization Networking and Technical Assistance Center (CONTAC).
Consumer-advisors described a variety of mental health services and practices that promote recovery, including: the explicit use of and endorsement of advanced directives; use of consumer advisors at all levels of state systems; services focused on role functioning in the areas of employment, education, residential; employment of consumers in meaningful roles within the mental health system; the use of person-first language; the elimination of seclusion and restraints; the elimination of forced treatments; training that promotes the notion of recovery; mission statements that promote the notion of recovery.
The majority of state Departments of Mental Health has adopted a mission/vision of recovery to guide their services. States list the following services as key to a recovery oriented system: consumer involvement, consumer-run services, adequate housing, adequate and appropriate funding streams including the use of Medicaid funding to support leadership and skills development training, and adoption of physical health and wellness services.
The Center for Psychiatric Rehabilitation anticipates launching a repository of recovery materials in the Spring of 2004 to help disseminate recovery resources and materials to policymakers at the state level, practitioners in the field of mental health and rehabilitation, and consumer/survivors. If you often use recovery materials, please recommend resources for our repository.
Mental Health and Rehabilitation Practitioners as an Environmental Factor in Facilitating the Recovery Process
Mental health and rehabilitation professionals represent a very important factor that can either facilitate or hinder the recovery process of people with psychiatric disabilities. Practitioners can inspire hope and empower mental health consumers in their efforts to overcome the disabling effects of a mental illness or they can instill hopelessness, dependence, and helplessness. The purpose of this project was two-fold. First, it explored the specific recovery-promoting practices, attitudes, and skills of mental health and rehabilitation providers through an anonymous Internet survey posted on our website. This survey was tailored for three different groups of respondents: mental health consumers, mental health and rehabilitation providers, and consumer providers. Second, based on the information from this survey, we developed and conducted psychometric testing on an instrument assessing practitioners’ ability to promote recovery. Data collection via the online survey has been completed.
This study confirmed the importance of the provider relationship in the recovery of persons with severe mental illness. Using both qualitative and quantitative data from an Internet survey of the provider-client relationship, in terms developed in four domains for the instrument: Instilling hope; promoting client’s empowerment; promoting self-acceptance; and developing and maintaining a respectful, trusting therapeutic relationship. A second survey has been developed based on the Internet survey and is presently being tested.
Russinova, Z. (1999). Providers’ hope-inspiring competence as a factor optimizing psychiatric rehabilitation outcomes. Journal of Rehabilitation, 65(4), 50-57.
A Qualitative Study of the Recovery Process Replicated with Different Samples and Refinement of a Measure of the Recovery Process
Leroy Spaniol, Ph.D.
The purpose of this project was to investigate our understanding of the dimensions, processes, and stages of recovery from mental illness as experienced by people who differ in diagnosis, ethnicity, history of substance abuse, and history of trauma, but who have achieved a moderate to high level of recovery.
This study identified the dimensions of the recovery process for persons with severe mental illness. The process of recovery means multiple shifts/different phases across a number of dimensions (psychological, vocational, social, and cognitive). Active coping is a turning point; those who recover demonstrate high levels of persistence, internal drive, and resourcefulness in the face of tremendous barriers. Developing a trusting relationship with another person and effective treatment (especially medication) seem essential for many people to progress. Individuals of disadvantaged backgrounds and those with substance abuse have greater difficulty in recovering. Non-traditional means of coping (such as prayer, spirituality, and religious practice) and financial and emotional support from one’s family are important aspects of the recovery process.
Spaniol, L., Wewiorski, N. J., Gagne, C., Anthony, W. A. (2002). The Process of Recovery from Schizophrenia. International Review of Psychiatry , 14(4), 327-336.