I want to talk briefly about “recovery.” Many clinicians and program directors were trained, as I was, to think that regaining marginal improvement or downward course were the only two options open for persons with repeated episodes of serious and persistent psychiatric problems, such as the group of schizophrenias, major depressions, or bipolar disorders. However, there have been over 30 follow-up studies, both short and very long, as well as hundreds of former recipients of services all displaying carefully collected data and brilliant examples about the possibilities of significant improvement and even full recovery.
Still today, some clinicians persist in thinking that significant improvement or full recovery for persons, who display profound disabilities and symptoms, is out of the question. These stakeholders persist in this belief even though they have begrudgingly gone along with calling their programs “recovery oriented” and “person centered”, etc. In reality, many programs and clinical staff still provide the same services as usual, which have been relabeled, hoping that this so-called “recovery” nonsense will blow over.In my experience, the challenge is to 1) set up programs “as if everyone will turn around” to maximize what people can get back since there exist now no predictors of who will or will not turn around; and 2) to dare to put aside all that wonderful training received through copious hard work as professionals and sit with recipients, as one human being to another, in order to see the real person underneath the disorder. Finding a person’s old hopes and dreams begins the rebuilding a life of meaning and purpose. Often, having the person begin to help others, no matter how disabled he or she is currently, helps to reclaim hope, resilience, and a life. Let recipients amaze and astonish you!
Some helpful resources:
Davidson, L, Harding, C.M., & Spaniol, L. (Eds.). Research on Recovery from Severe Mental Illness: 30 years of Accumulating Evidence and Its Implications for Practice. (Vol. 1), Center for Psychiatric Rehabilitation, Boston University, 2005.
Davidson, L, Harding, C.M., & Spaniol, L. (Eds.). Research on Recovery from Severe Mental Illness: 30 years of Accumulating Evidence and Its Implications for Practice. (Vol. 2), Center for Psychiatric Rehabilitation, Boston University, 2006.
Harding, C.M.: Changes in schizophrenia across time: paradoxes, patterns, and predictors. In: Carl Cohen (Ed.) SCHIZOPHRENIA INTO LATER LIFE: Treatment, Research and Policy. APPI Press, 2003, pp.19-42.
This article is reprinted from the October 2009 Newsletter, “Director’s New York Minute”, The Center for Rehabilitation and Recovery,
at The Coalition of Behavioral Health Centers, Inc. website.