The recovery model, or philosophy, has much in common with the harm reduction approach. Fueled by dissatisfaction with the status quo and the paternalistic “trust me, I’m a doctor” medical model, the recovery model is about giving control back to the person with the psychiatric disability and/or coexisting substance disorder. In the recovery model, the relationship with doctors, therapists, and paraprofessionals becomes consultative and less authoritarian.
Key principles of the recovery model include:
• It is person centered. This means that it’s the person in recovery who sets the goals and the agenda, not the practitioners.
• It is strength-based versus deficit-based. This is quite different from a medical model where the focus is on disease and disability. Here it’s looking at what strengths the person brings to the table in working toward his own recovery.
• Peer involvement is critical. Many excellent trainings and courses on the recovery model are run by individuals who have mental illnesses and are themselves in recovery. Numerous agencies around the country now offer recovery-based groups and courses. Some of these are homegrown and some, like the Illness Management and Recovery Program (IMR), which relies heavily on current research and evidence-based practices and Wellness Recovery Action Planning (WRAP) include well-developed and researched courses with extensive handouts. WRAP materials can be purchased through Mental Health Recovery and WRAP. Their web site is www.mentalhealthrecovery.com
• The IMR materials (resource kits) are available free of charge through SAMHSA’s National Mental Health Information Center at:
Substance Abuse and Mental Health Administration
P.O. Box 42557
Washington, DC 20015 1-800-789-2647
Monday through Friday,
8:30 A.M. to 12:00 A.M., EST
Telecommunication Device for the Deaf (TDD): 866-889-2647 web page: mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/illness
Principles of advocacy are encouraged and taught. The person with the mental illness assumes the role of being his own expert. This will extend into useful strategies that might include:
• Self-driven recovery plans
• Drafting of psychiatric advance directives.
• Learning assertiveness techniques to be direct with providers, and others, in order to get one’s needs met. This includes empowering people in the selection of a provider and letting them know it’s okay to “interview” a potential doctor or therapist before entering into treatment with them.
• There is an emphasis on hope, and that everyone’s process of recovery is highly individual.
• All positive gains are acknowledged.
• People are human and need to be allowed to make mistakes, as this is part of the learning process. Paternalistic strategies to protect the person with mental illness from harm are avoided, and only used when there is a significant risk of imminent danger. Even here, in a recovery model, people may have drafted specific plans about their preferences in a behavioral emergency.
As we discuss various therapeutic strategies and techniques, they can all be embedded inside a recovery model. In other words, a person in recovery can use different therapies, medications, resources, and other supports as tools to help them progress. The key distinction is that they are the ones steering their own ship.