Recovery model: Difference between revisions

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<ref>{{cite journal | last1 = van Bilsen | first1 = Henck P. J. G. | year = 2016 | title = Lessons to be learned from the oldest community psychiatric service in the world: Geel in Belgium | url = https://www.cambridge.org/core/services/aop-cambridge-core/content/view/696139AC7D0510562534886F4A4763B2/S2056469400002126a.pdf | journal = BJPsych Bulletin | volume = 40 | issue = 4 | pages = 207–211 | doi = 10.1192/pb.bp.115.051631 | pmid = 27512591 | pmc = 4967781 | access-date=March 19, 2023 }}</ref><ref>[https://www.belganewsagency.eu/the-remarkable-story-of-geel-700-years-of-community-based-mental-health-care The remarkable story of Geel: 700 years of community-based mental health care]</ref><ref>{{citation | last1 = Stevis-Gridneff | first1 = Matina | last2 = Ryckewaert | first2 = Koba | url = https://www.nytimes.com/2023/04/21/world/europe/belgium-geel-psychiatric-care.html | archive-url = https://archive.today/20230425140349/https://www.nytimes.com/2023/04/21/world/europe/belgium-geel-psychiatric-care.html | archive-date = 2023-04-25 |title = Radical Experiment in Mental Health Care, Tested Over Centuries | work = New York Times | year=2023}}</ref>

More widespread application of recovery models to psychiatric disorders is comparatively recent. The concept of recovery can be traced back as far as 1840, when [[John Thomas Perceval]], son of Prime Minister [[Spencer Perceval]], wrote of his personal recovery from the psychosis that he experienced from 1830 until 1832, a recovery that he obtained despite the "treatment" he received from the "lunatic" doctors who attended him.<ref>[https://web.archive.org/web/20190919204034/http://www.recoverywithinreach.org:80/Recovery/history History of the Recovery Movement]</ref> But by consensus the main impetus for the development came from within the [[Psychiatric survivors movement|consumer/survivor/ex-patient movement]], a grassroots self-help and advocacy initiative, particularly within the [[United States]] during the late 1980s and early 1990s.<ref name="USsurgeon">Office of the Surgeon General and various United States Government agencies (1999) [https://web.archive.org/web/20200930094830/https://profiles.nlm.nih.gov/spotlight/nn/catalog/nlm:nlmuid-101584932X120-doc Mental Health: A report of the Surgeon General. Section 10: Overview of Recovery]</ref> The professional literature, starting with the [[psychiatric rehabilitation]] movement in particular, began to incorporate the concept from the early 1990s in the United States, followed by New Zealand and more recently across nearly all countries within the "[[First World]]".<ref name="RecoveryEmergent">{{cite journal |vauthors=Ramon S, Healy B, Renouf N |title=Recovery from mental illness as an emergent concept and practice in Australia and the UK |journal=Int J Soc Psychiatry |volume=53 |issue=2 |pages=108–22 |date=March 2007 |pmid=17472085 |doi=10.1177/0020764006075018|s2cid=25732602 }}</ref> Similar approaches developed around the same time, without necessarily using the term recovery, in Italy, the Netherlands and the UK.

Developments were fueled by a number of long-term outcome studies of people with "major mental illnesses" in populations from virtually every continent, including landmark cross-national studies by the [[World Health Organization]] from the 1970s and 1990s, showing unexpectedly high rates of complete or partial recovery, with exact statistics varying by region and the criteria used. The cumulative impact of personal stories or [[testimony]] of recovery has also been a powerful force behind the development of recovery approaches and policies. A key issue became how service consumers could maintain the ownership and authenticity of recovery concepts while also supporting them in professional policy and practice.<ref name="Deegan88">{{cite journal | author = Deegan PE | year = 1988 | title = Recovery: The lived experience of rehabilitation | url = http://www.bu.edu/cpr/repository/articles/pdf/deegan1998.pdf | journal = Psychosocial Rehabilitation Journal | volume = 11 | issue = 4| page = 4 | url-status = dead | archive-url = https://web.archive.org/web/20070926115018/http://www.bu.edu/cpr/repository/articles/pdf/deegan1998.pdf | archive-date = 2007-09-26 | doi = 10.1037/h0099565 }}</ref>

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===Connectedness and supportive relationships===

A common aspect of recovery is said to be the presence of others who believe in the person's potential to recover<ref name=":0">{{Cite journal|last1=Francis East|first1=Jean|last2=Roll|first2=Susan J.|date=2015|title=Women, Poverty, and Trauma: An Empowerment Practice Approach: Figure 1|journal=Social Work|language=en|volume=60|issue=4|pages=279–286|doi=10.1093/sw/swv030|pmid=26489348|issn=0037-8046}}</ref><ref name=":1">{{Cite journal|last1=Hopper|first1=Elizabeth K.|last2=Bassuk|first2=Ellen L.|last3=Olivet|first3=Jeffrey|date=2010-04-07|title=Shelter from the Storm: Trauma-Informed Care in Homelessness Services Settings~!2009-08-20~!2009-09-28~!2010-03-22~!|journal=The Open Health Services and Policy Journal|volume=3|issue=2|pages=80–100|doi= 10.2174/1874924001003020080 |doi-broken-date=221 MarchJuly 2025 |doi-access=free|s2cid=10319681|issn=1874-9240}}</ref> and who stand by them. According to Relational Cultural Theory as developed by Jean Baker Miller, recovery requires mutuality and empathy in relationships.<ref name=":0" /> The theory states this requires relationships that embody respect, authenticity, and emotional availability.<ref name=":0" /><ref name=":2">{{Cite journal|last=Reeves|first=Elizabeth|date=2015-09-02|title=A Synthesis of the Literature on Trauma-Informed Care|journal=Issues in Mental Health Nursing|volume=36|issue=9|pages=698–709|doi=10.3109/01612840.2015.1025319|issn=0161-2840|pmid=26440873|s2cid=36312879}}</ref> Supportive relationships can also be made safer through predictability and avoiding shaming and violence.<ref name=":2" /><ref name=":0" /><ref name=":3">{{Cite journal|last1=Elliott|first1=Denise E.|last2=Bjelajac|first2=Paula|last3=Fallot|first3=Roger D.|last4=Markoff|first4=Laurie S.|last5=Reed|first5=Beth Glover|date=2005|title=Trauma-informed or trauma-denied: Principles and implementation of trauma-informed services for women|journal=Journal of Community Psychology|language=en|volume=33|issue=4|pages=461–477|doi=10.1002/jcop.20063|s2cid=145560079 |issn=0090-4392}}</ref> While [[mental health professional]]s can offer a particular limited kind of relationship and help foster hope, relationships with [[friendship|friends]], [[family]] and the [[community]] are said to often be of wider and longer-term importance.<ref name="Friendships">Hack Thyself (2012) [http://hackthyself.net Recovery Is Impossible Without Friends] {{Webarchive|url=https://web.archive.org/web/20161004024621/http://hackthyself.net/ |date=2016-10-04 }}</ref> Case managers can play the role of connecting recovering persons to services that the recovering person may have limited access to, such as food stamps and medical care.<ref name=":4">{{Cite journal|last1=Heslin|first1=Kevin C.|last2=Andersen|first2=Ronald M.|last3=Gelberg|first3=Lillian|date=2003-01-01|title=Case Management And Access To Services For Homeless Women|journal=Journal of Health Care for the Poor and Underserved|volume=14|issue=1|pages=34–51|doi=10.1177/1049208902238822|pmid=12613067|issn=1049-2089}}</ref><ref>{{Cite journal|title=Services to domestic minor victims of sex trafficking: Opportunities for engagement and support|pages=1–7|journal=Children and Youth Services Review|volume=54|doi=10.1016/j.childyouth.2015.04.003|date=July 2015|last1=Gibbs|first1=Deborah A.|last2=Hardison Walters|first2=Jennifer L.|last3=Lutnick|first3=Alexandra|last4=Miller|first4=Shari|last5=Kluckman|first5=Marianne}}</ref> Others who have experienced similar difficulties and are on a journey of recovery can also play a role in establishing community and combating a recovering person's feelings of isolation.<ref name=":0" /> An example of a recovery approach that fosters a sense of community to combat feelings of isolation is the [[safe house]] or [[transitional housing]] model of rehabilitation. This approach supports victims of trauma through a community-centered, transitional housing method that provides social services, healthcare, and psychological support to navigate through and past experiences. Safe houses aim to support survivors on account of their individual needs and can effectively rehabilitate those recovering from issues such as sexual violence and drug addiction without criminalization.<ref name="NYU Press">{{Cite book |url=https://www.jstor.org/stable/j.ctv12fw97b |title=The Politicization of Safety: Critical Perspectives on Domestic Violence Responses |date=2019 |publisher=NYU Press |isbn=978-1-4798-0564-8 |volume=10|jstor=j.ctv12fw97b }}</ref> Additionally, safe houses provide a comfortable space where survivors can be listened to and uplifted through compassion.<ref>{{Cite journal |last=Harrington |first=Carol |date=November 2019 |title=Neo-liberal Subjectivity, Self-branding and 'My Rape Story' YouTube Videos |url=http://journals.sagepub.com/doi/10.1177/0896920518778107 |journal=Critical Sociology |language=en |volume=45 |issue=7–8 |pages=1181–1194 |doi=10.1177/0896920518778107 |s2cid=149930006 |issn=0896-9205|url-access=subscription }}</ref> In practice, this can be accomplished through one on one interviews with other recovering persons,<ref name=":0" /> engaging in communal story circles,<ref name=":0" /> or peer-led support groups.<ref name=":5">{{Cite journal|last1=Huntington|first1=Nicholas|last2=Moses|first2=Dawn Jahn|last3=Veysey|first3=Bonita M.|date=2005|title=Developing and implementing a comprehensive approach to serving women with co-occurring disorders and histories of trauma|journal=Journal of Community Psychology|language=en|volume=33|issue=4|pages=395–410|doi=10.1002/jcop.20059|issn=0090-4392}}</ref> Those who share the same values and outlooks more generally (not just in the area of mental health) may also be particularly important. It is said that one-way relationships based on being helped can actually be devaluing and potentially re-traumatizing,<ref name=":3" /> and that [[reciprocity (social psychology)|reciprocal]] relationships and mutual support networks can be of more value to [[self-esteem]] and recovery.<ref name="InclusionRecovery"/><ref name=":0" /><ref name=":2" /><ref name=":1" />

===Hope===