Psychological Recovery: Beyond Mental Illness

Many countries have introduced policies that stipulate mental health services be ‘recovery–oriented’. However, there is no widespread accepted definition of recovery, an understanding of the process, and how services are to become recovery–oriented, or consensus on how recovery should be assessed. Where conceptual models have been proposed, they tend to be complex and do not lend themselves readily to routine use and research purposes.
This book presents a consumer–orientated, stage–based model of psychological recovery from serious mental illness, synthesizing stories of lived experience to provide a framework for clinical work and research in the field of recovery. Each stage of the recovery process is illustrated with patient experiences, which are then placed in the context of existing theory in fields such as trauma, hope, self–determination, identity, and wellbeing. Three measures of recovery are also presented, providing recovery–based additions to the array of outcome measures commonly used in mental health settings.
Placing recovery within the growing field of positive psychology, this book fills a need in the mental health professional community for a succinct model of recovery from mental illness. It offers a thorough grounding in the history of the concept of recovery, a deep appreciation of the mental health consumer’s experience of psychological recovery, an understanding of the conceptual model, and an awareness of the issues surrounding recovery measurement.

Spis treści:
About the authors xi
Foreword by Jon Strang xiii
Preface xvii
Acknowledgements xix
Part I Recovery in Historical Context
1 Introduction: Recovery from schizophrenia 3
Overview 3
Early conceptualizations of schizophrenia 4
Diagnostic systems and prognostic pessimism 6
Empirical evidence for recovery 7
The persistence of a pessimistic prognosis 13
The r eal possibility of recovery 17
The emergence of the ‘recovery’ movement 18
What do we mean by ‘recovery’? 20
Conclusion 22
Summary 22
2 Conceptualizing recovery: A consumer–oriented approach 23
Overview 23
Developing a consumer–oriented model of recovery 24
The search for common ground 25
Meanings of recovery in the literature 25
Consumer descriptions – psychological recovery 28
Diverse opinions on some aspects of recovery 31
Four component processes of recovery 34
A definition of psychological recovery 40
Steps along the journey of recovery 41
Five stages of psychological recovery 45
Conclusion 45
Summary 48
Appendices 48
Part II Elaboration of the Model: From Hopelessness to Flourishing
3 Moratorium: The first stage of psychological recovery 53
Overview 53
Negative symptoms or psychological sequelae? 53
Hope in the Moratorium stage: Hopelessness 54
Responsibility in the Moratorium stage: Powerlessness 57
Identity in the Moratorium stage: Loss of sense of self 59
Meaning in the Moratorium stage: Loss of purpose in life 63
Conclusion 65
Summary 66
4 Awareness: The second stage of psychological recovery 67
Overview 67
Hope in the Awareness stage: The dawn of hope 67
Responsibility in the Awareness stage: The need to take control 70
Identity in the Awareness stage: I am not the illness 72
Meaning in the Awareness stage: Need for a purpose in life 74
Conclusion 76
Summary 76
5 Preparation: The third stage of psychological recovery 77
Overview 77
Hope in the Preparation stage: Mobilizing resources 77
Responsibility in the Preparation stage: Taking autonomous steps 79
Identity in the Preparation stage: Taking an internal inventory 81
Meaning in the Preparation stage: Reassessing goals 83
Conclusion 85
Summary 85
6 Rebuilding: The fourth stage of psychological recovery 87
Overview 87
Hard work and hopefulness 87
Hope in the Rebuilding stage: Active pursuit of personal goals 88
Responsibility in the Rebuilding stage: Taking control 90
Identity in the Rebuilding stage: Self–redefinition 93
Meaning in the Rebuilding stage: Valued goals 96
Risk–taking, perseverance and resilience 99
Conclusion 100
Summary 101
7 Growth: The fifth stage of psychological recovery 103
Overview 103
Hope in the Growth stage: Optimism about the future 103
Responsibility in the Growth stage: In control of life and wellbeing 105
Identity in the Growth stage: An authentic self 107
Meaning in the Growth stage: Living a meaningful life 109
Resilience, personal growth and wisdom 111
Conclusion 113
Retrospective overview 114
Summary 114
8 Common questions regarding the stage model of psychological recovery 115
Overview 115
Ten questions that have been raised about the model 115
Conclusion 120
Summary 120
Part III Measuring Recovery
9 Recovery–oriented outcome measurement 123
Overview 123
Why the need for measures of recovery? 123
Approaches to operationalizing recovery in research 125
Assessing outcomes in routine clinical practice 126
Outcome measurement from the consumer perspective 127
Measuring consumer–defined recovery 128
Measures based on the stage model of psychological recovery 129
Concluding comment 135
Summary 135
Part IV Towards a Positive Future
10 Psychological recovery and positive psychology 139
Overview 139
A scientific approach to recovery 139
Hope 140
Meaning and purpose 140
Responsibility 141
Identity 142
Resilience 142
Strengths 143
Values 143
Autonomous goals 144
Growth 144
Wellbeing 145
Living with illness and flourishing 145
Summary 146
11 Reflections and future directions 147
From wellness to wellbeing 147
Applications of the model 148
Recovery measures in clin ical work, evaluation and research 151
Current and future research directions 152
A word about words 153
Afterword 155
References 157
Index 179

Nota biograficzna:
Retta Andresen is a Research Fellow at the University of Wollongong, Australia. Her research into the process of recovery and its measurement has received national and international recognition and interest.
Lindsay Oades is a Clinical and Health Psychologist and Director of the Australian Institute of Business Wellbeing at the University of Wollongong, Australia. He has been awarded numerous national awards for his mental health research.
Peter Caputi is an Associate Professor in the School of Psychology at the University of Wollongong, Australia. He is a consulting editor for the Journal of Constructivist Psychology and The Journal of Psychology:  Interdisciplinary and Applied.

Okładka tylna:
Many countries have introduced policies that stipulate mental health services be ‘recovery–oriented’. However, there is no widespread accepted definition of recovery, an understanding of the process, and how services are to become recovery–oriented, or consensus on how recovery should be assessed. Where conceptual models have been proposed, they tend to be complex and do not lend themselves readily to routine use and research purposes.
This book presents a consumer–orientated, stage–based model of psychological recovery from serious mental illness, synthesizing stories of lived experience to provide a framework for clinical work and research in the field of recovery. Each stage of the recovery process is illustrated with patient experiences, which are then placed in the context of existing theory in fields such as trauma, hope, self–determination, identity, and wellbeing. Three measures of recovery are also presented, providing recovery–based additions to the array of outcome measur es commonly used in mental health settings.
Placing recovery within the growing field of positive psychology, this book fills a need in the mental health professional community for a succinct model of recovery from mental illness. It offers a thorough grounding in the history of the concept of recovery, a deep appreciation of the mental health consumer’s experience of psychological recovery, an understanding of the conceptual model, and an awareness of the issues surrounding recovery measurement.