In the AA community, days of sobriety and recovery are celebrated with great fanfare. Medallions are given. People are hailed and celebrated. Virtues extolled. Praises sung.
Recovery in the mental health community is a bit more complex, however. While praises and words of encouragement are often exchanged between therapists and clients, the evidence-based Recovery Model, as it is known in psychiatry, is not a linear approach, nor is it a one way 12-step program or “cold turkey” program that Jim Gillis mentioned in his Spare Change column a few weeks ago. Gillis was reviewing a book, “Dopesick” that he had recently read and the way that small towns and cities cannot agree on a uniform way to treat those with addictions.
In the mental health world, the Recovery Model is the method prescribed by Newport Mental Health and one recommended by both the U.S. Institutes of Health and the RI Department of Behavioral Health (BHDDH) for all healthcare organizations to follow. It is not based on one concept or treatment to usher in recovery.
Instead, the Recovery Model is a very individualized “person centered” process based on your personal reasons for seeking help, Therapy starts by not only focusing on your problems and symptoms, but by identifying your unique strengths and resiliency factors to help you attain your goals and learn to adapt to and overcome adversity, stress or trauma.
What does the Recovery Model look like to the average person? At Newport Mental Health, therapists and other clinical teams use the Recovery Model both for clients with mental health disorders and those who have both addiction and mental health disorders. In short, recovery builds upon your strengths and supports, which often include your relationships with your family, friends, coworkers, primary care doctors, and others in the community, along with your therapist. Because mental illness can be disabling at times, any one of these supports or relationships could become disrupted. Thus, helping you find or maintain meaningful relationships are important factors in recovery.
Part of a Recovery Model plan also means that your therapist or team works collaboratively with you to create a well-organized, individualized plan to help you reach your goals This often includes a bevy of approaches based on your choices and needs. For example, one person working with his or her therapist may decide to stick to a medication schedule, attend AA meetings along with several other goals, such as returning to school. Another person may decide on group therapy and no AA meetings. In other words, the Recovery Model is a person-centered process that acknowledges the many pathways to recovery, based on the person’s unique strengths and needs as well as cultural background.
Moreover, the success of a client is not solely whether the client is asymptomatic. Success is more about the client recapturing a meaningful life, despite mental health challenges that may continue to linger. As one NMH client said, “Recovery is discovering who you are and the things that make you happy. It means having the confidence that you can have a hard day and knowing that you don’t have to numb yourself out to get through it.”
Perhaps part of the reason for the confusion surrounding the Recovery Model is rooted in the medical industry and the paternalistic nature of the patient-doctor relationship. In the past, the approach was that “the doctor knows best”. A doctor or psychiatrist “listened to patients’ concerns, examined them, ordered laboratory investigations, diagnosed disease, prescribed medication and prognosticated about course and outcome” and often dismissed the patients’ perspectives, according to the U.S. Library of Medicine 2015 report, “Recovery Model of Mental Illness” by Dr. K.S. Jacob. In the past, a psychiatrist could order patients with severe mental illnesses to asylums. Often away in a country setting, though well meaning, institutionalization often further promoted the disabling effects of mental illness.
Then in 1963 President John F. Kennedy initiated the Community Mental Health Act with the focus to deinstitutionalize the mentally ill and help them to live safely in community settings by establishing community mental health centers to deliver treatment and services. President Kennedy and others believed that the shift from sequestering mentally ill patients to re-introducing them into their communities would render cost savings and higher levels of treatment. Again the focus was on symptoms and treatment and continued to foster dependence on formal mental health programs like day treatment centers.
It was only recently, the late 20th century, the Recovery Model, became more widely recognized and implemented, basically because the research proved it was more effective in helping people recover. Still many agencies and groups espouse a one-size-fits-all medical model to mental health despite the scientific evidence and studies that say otherwise. The modern recovery approach not only treats a person’s clinical symptoms, it addresses a person’s other life domains where they may be struggling, such as housing, work or other community connections, with the intention that mental health professionals do not need to remain in a person’s life. Listening to people and using a collaborative approach to recovery, may be varied and complex, but it’s the approach that works and proven to work. Letting people take the lead in the Recovery Model process leads to lasting empowerment and recovery. Therapy works. The Recovery Model approach works even better.