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Introduction
A wide choice of interventions (treatments, therapies, tools,) need to be developed and practiced by all providers within the recovery and whole life approach.
There has been a revolution over the last two decades in our understanding of what promotes recovery from mental illness. This evidence comes from various sources, from many different cultures, involves both health and social care perspectives and is based on various methodologies. This includes the individual testimony of service users and families, practice based evidence as well as the results of more scientific randomized controlled trials. Research and clinical best practice points to several key areas underpinning contemporary ways of providing effective care and interventions. These include:
- Care and interventions should be provided closer to the individual’s home in normal settings chosen by the person themselves;
- Services must be accessible and available when and where the person needs it, that is on a 24 hour / 7 day a week basis;
- Detection and intervention must happen at an earlier stage in the development of the illness;
- Care and interventions must be person centered and based on individual need and the user must be given a wide range of choice;
- Increased access to individual talking or psychological therapies, such as CBT;
- Access to family interventions and support, such as Psycho-educational and behavioral approaches to family support;
- Effective recovery oriented Care Coordination in the context of Multi-disciplinary Team Work, which promotes access to effective services, continuity and coordination;
- Greater promotion of client self-management and peer support approaches;
- Integration of effective vocational interventions into everyday practice to support greater employment opportunities;
- Improved access to effective modern medications.
- Users need to be listened to and to be a partner in the therapeutic program
It is acknowledged that there are many treatments and therapies that are proofed effective for most mental illnesses. These should be introduced as routines in the daily practice of professionals to maximise the best outcomes for service users. Users should be given a choice and be able to access the most appropriate treatment and therapy to meet their need.
The Recovery Process
It is also important to change the way that the therapeutic process is undertaken with an emphasis on a recovery pathway and also changing the language used.
It is essential to build a trusting relationship between the user and practitioner.
The therapeutic program experienced by users in one part of the service must be the same in all parts of the service.
The Recovery process is outlined below:
1) Knowing the Person (Assessment)
• Building a relationship, time and space
• Personal life story, able and comfortable to tell own story
• Personal approach, start of a recovery journey, guiding the user on their journey
• Self determination and hope,taking responsibility, to regain responsibility for recovery journey
• Belief that the person can recover, self belief
• Common attainable goals, joint ownership
• What does diagnosis really mean? difference with/without labels, we need no labels in
preventing stigma and discrimination?
• What hinders, what fosters recovery in services, organisations?
• The user is the expert,not scarred of own emotions, able to deal with emotions
• Trusting relationship, mutual understanding,mutual agreement
• To find personal strengths and resources for recovery
• What makes you survive, resources,allies
• Structure and summarize the conversation and jointly put it on paper or whiteboard
• Collaborative diagnosis, negotiate about it,mutual agreement
• What the psychiatrist can contribute to the recovery journey,pro’s and con’s, easy access, further information, discussion about responsibility of psychiatrist and user
2) Recovery Plan (Treatment Plan)
• Giving and sharing knowledge and information of best evidence in recovery practice and resources, tools and instruments
• Whole life in all respects, where do you want to be?, hopes and dreams
• Self determination to start a recovery journey as key aspect
• Involving friends and families, their roles and responsibilities
• Choice of treatments/clinical interventions. Giving knowledge
• Local whole life resources available, art and culture, sport and leisure, occupation, employment, volunteering,housing, learning and education, welfare benefit advice
• Self help opportunities, groups, clubs
• Giving and sharing hope by psychiatrist
• Physical health checks
• Healthy life style plan
• Psycho-educational opportunities
= Formulation of recovery plan jointly with user and psychiatrist
3) Celebrating progress and joint ownership of solving set backs (Review)
• Celebrating progress and identifying steps taken in the recovery journey
• Redefining some goals if necessary, who can help?
• Relapse prevention strategy
• Understanding the self
• Providing more alternatives and choice
= Sharing hope again
4) Revised Recovery Plan (Revised Treatment Plan)
• Focus on success and strengths
• Joint ownership and responsibility
Research and Practice
Videos and Presentations
Organisations
Links
Talking Therapies Information from the Mental Health Foundation Talking therapies can help you work out how to deal with negative thoughts and feelings and make positive changes. They can help people who are feeling distressed by difficult events in their lives as well as people with a mental health problem. This information is for anyone who wants to know more about different types of talking therapy or hear the experiences of people who have used them. It advises how to find a therapist who is right for you and suggests where to look for more information.
What is psychotherapy? Information from the National Institute for Mental Health Psychotherapy, or "talk therapy", is a way to treat people with a mental disorder by helping them understand their illness. It teaches people strategies and gives them tools to deal with stress and unhealthy thoughts and behaviors. Psychotherapy helps patients manage their symptoms better and function at their best in everyday life.
Treatment of mental disorders From Wikipedia Mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. Individuals diagnosed with mental disorders are typically deemed unable to function in society. Mental disorders occasionally consist of a combination of affective, behavioral, cognitive and perceptual components. The acknowledgement and understanding of mental health conditions has changed over time and across cultures, and there are still variations in the definition, classification, and treatment of mental disorders.