Oil and Water or Oil and Vinegar? Evidence-Based Medicine Meets Recovery

Department of Psychiatry, Program for Recovery and Community Health, Yale University School of Medicine, Erector Square 6 West, Suite #1C, 319 Peck Street, New Haven, CT 06513, USA.
Community Mental Health Journal (Impact Factor: 1.03). 09/2009; 45(5):323-32. DOI: 10.1007/s10597-009-9228-1
Source: PubMed


With the increasing prominence of the notions of "recovery" and "recovery-oriented practice," practitioners, program managers, and system leaders are increasingly asking about the relationship between "evidence-based practices" and recovery. After reviewing the concepts of recovery from mental illness, being in recovery with a mental illness, recovery-oriented care, and evidence-based medicine, the authors argue for a complementary relationship between recovery and evidence-based practices. This relationship is neither simple nor straightforward, but results in a whole that is greater than the sum of its parts through which each element benefits from the influence of the other.

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Available from: Thomas J Dinzeo, Jun 03, 2015
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    • "Emphasis on evidence-based practice and research An empirical approach to training and practice was taken. Characteristics of the learners Indoctrinated in traditional illness views of mental health care Adopted Davidson's " recovery from " and " recovery in " model of care (Davidson et al., 2009). Contrasted and compared models of care. "
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    ABSTRACT: The advocacy of recovery-oriented practices in mental health care with its emphasis on freedom and choice in care has been gaining considerable traction in recent years. In response to the growing recognition and promotion of recovery-oriented services, several training initiatives have been developed to bring about mental health care system transformation. These initiatives, however, have been primarily focused on broad organizational and procedural changes as well as hospital and clinic staff development. Relatively neglected have been initiatives to educate physicians and doctorally trained psychologists in the concepts and practices of recovery-oriented care. This article describes a case study of the efforts of Project GREAT (Georgia Recovery-Based Educational Approach to Treatment) that has aspired to transform the education and practice of an academic department of psychiatry into a recovery-oriented one with the focus on shaping the recovery knowledge, attitudes, and practices of psychiatry and psychology faculty and trainees. Core issues in the transformation effort were identified and led to the implementation of the following change interventions: (a) administrative leadership and support, (b) consumer mediated interventions, (c) educational presentations/materials, (d) interactive small groups/program champions, (e) reminders/prompts/practice tools, (f) newsletters/pamphlets, and (g) educational outreach visits. It is proposed that this transformation experience provided valuable lessons that are generally applicable to other academic programs for psychiatrists and psychologists attempting to adopt recovery-oriented training and care.
    Professional Psychology Research and Practice 08/2014; 45(5). DOI:10.1037/a0037705 · 1.34 Impact Factor
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    • "For professionals, it is important to keep in mind that being recovery-oriented means to not only pay attention to the level of symptoms but also to the individual's life as a whole (Borg and Davidson, 2008). Recovery means to improve well-being/ mental health, where professionals can support the client to find his or her own strategies to achieve balance in life and to develop strategies to manage the symptoms that might occur occasionally (Deegan, 2005, 2007; Davidson et al., 2009; Slade, 2010). It is important to support the client to develop valued social roles such as being a parent, a student, or an employee (Anthony, 1993). "
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    ABSTRACT: Personligt ombud (PO) is a Swedish version of case management that aims to support individuals with psychiatric disabilities. Guidelines to the PO service emphasize the different role that the PO plays with respect to the relationship with clients. The aim of this study was to investigate the components that POs found to be important in the relationship with clients. Telephone interviews with 22 POs across Sweden were carried out. The interviews were recorded, transcribed, and analyzed using qualitative content analysis. The relationship with each client was described as the foundation of the POs' work; it was the only tool' they had. The findings were reflected in a main theme, which showed the importance of creating personal working alliances with each client where POs put the client at the center of the work and adjusted their support according to the client's needs at the time. Important components were that the PO and the client trusted each other, that the power between the PO and the client was balanced, and to be a personal support. Many of the components that POs found to be important are shown as essential in recovery-oriented services. POs followed the client in the process and remained as long as necessary and this is one way of bringing hope to the client's recovery process. However, the personal tone can be fraught with difficulties and to maintain professionalism, it is necessary to reflect, through discussions with colleagues, with the leader and in supervision. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
    International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation 09/2013; 37(1). DOI:10.1097/MRR.0000000000000033 · 1.28 Impact Factor
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    • "One of the often voiced concerns of the systems transformation toward recovery-oriented care is that at times it runs ahead of empirical data (Davidson et al., 2006; Davidson, Drake, Schmutte, Dinzeo, & Andres-Hyman, 2009). However, as recovery-oriented care is one which emphasizes a person's choice, strengths, resiliencies, and the commitment to increase his or her ability to function independently in the community, any evidencebased practice that meets this aim is, by definition, a recoveryoriented intervention (Davidson et al., 2009; Frese, Stanley, Kress, & Vogel-Scibilia, 2001). Moreover, psychologists' research and psychotherapy training provide them with opportunities to be leaders in the development, dissemination, and training of evidence-based (i.e., recovery-oriented) psychosocial interven- tions. "
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    ABSTRACT: A transformation is occurring in mental health services throughout the country that presents opportunities for both seasoned and aspiring psychologists. This paper draws on the experiences of (a) a VA staff psychologist, (b) a psychology postdoctoral fellow, (c) a director of clinical training (and clinical-community psychologist) at an APA-accredited doctoral training program, and (d) a psychologist who leads the Psychosocial Rehabilitation and Recovery Section of the Department of Veterans Affairs' Office of Mental Health Services. We illustrate: (1) Opportunities for psychologists that exist within recovery-oriented systems; (2) How psychologists' skills and training put them in a unique position to be leaders within mental health recovery-oriented systems of care; and (3) Specific recommendations for psychologists to prepare them for roles in a recovery-oriented system of care. We believe that a new dawn has arrived, and interested psychologists are well-suited to be key agents of change and leaders in emerging best practices in mental health care. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Professional Psychology Research and Practice 01/2012; 43(1):24-31. DOI:10.1037/a0024394 · 1.34 Impact Factor
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