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Transforming systems of care: the American Association of Community Psychiatrists Guidelines for Recovery Oriented Services.

Allegheny County Office of Behavioral Health, 304 Wood Street, 5th Floor, Pittsburgh, PA 15222, USA.
Community Mental Health Journal (Impact Factor: 1.03). 01/2006; 41(6):757-74. DOI: 10.1007/s10597-005-6433-4
Source: PubMed

ABSTRACT Thinking about recovery has grown significantly over the last 70 years, and particularly in the past fifteen. Promotion of recovery has recently been recognized as an organizing principle for the transformation of behavioral health services. Recovery is a personal process of growth and change which typically embraces hope, autonomy and affiliation as elements of establishing satisfying and productive lives in spite of disabling conditions or experiences. Recovery oriented services replace paternalistic, illness oriented perspectives with collaborative, autonomy enhancing approaches and represent a major cultural shift in service delivery. Recovery oriented services replace the myth of chronicity and dependence with a message of individualism, empowerment and choice in the context of collaborative relationships with service providers. The American Association of Community Psychiatrists has developed Guidelines for Recovery Oriented Services to facilitate the transformation of services to this new paradigm. The guidelines are divided into three domains: administration, treatment, and supports, each consisting of several elements for which recovery enhancing characteristics are defined. Several example indicators are also provided for each element. This paper presents these guidelines and discusses their application.

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    • "Administrative leadership and support. In the Guidelines for Recovery-Oriented Services developed by the Quality Management Committee of the American Association of Community Psychiatrists, the value of administrative leadership and support for recovery transformation is clearly articulated (Sowers, 2005). In particular, there is an emphasis on the role of administration in promoting an organizational mission and vision that embraces recovery as well as its willingness to commit organizational resources to recovery-oriented education and practice. "
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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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    • "Service user perspectives are essential for the evaluation and development of patient-centred, recovery-oriented mental health services (Sowers, 2005), and are beneficial to both user and provider of care (Priebe et al., 2012). Insights garnered from those with first-hand experience of services identify positive and negative aspects of care, which cannot be detected by service providers alone (Locker & Dunt, 1978). "
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    ABSTRACT: Abstract Background: Service user perspectives are essential for the evaluation and development of mental health services. Service users expressing less satisfaction with services subsequently have poorer treatment outcomes. Aims: To measure satisfaction with services following psychiatric admission, and to explore its relationship with a number of clinical and service factors. Methods: A multi-centre observational study was conducted across three mental health services in Ireland. Service users were interviewed and provided with self-report questionnaires. The Client Satisfaction Questionnaire (CSQ-8) was used to measure treatment satisfaction. Results: The overall level of satisfaction with services was good (CSQ-8 mean score 24.5). Service users who were admitted involuntarily, who experienced physical coercion and lower levels of procedural justice were less satisfied. A better therapeutic relationship, improved insight and better functioning were associated with higher levels of treatment satisfaction. Conclusion: Mental health services should implement strategies to ameliorate the effects of factors associated with lower levels of treatment satisfaction.
    Journal of Mental Health 02/2014; 23(1):38-45. DOI:10.3109/09638237.2013.841864 · 1.01 Impact Factor
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    • "Our analysis draws heavily on theoretical perspectives from social movement theory. It is of course common for recovery advocates and commentators alike to talk about recovery not just as a set of ideas or values, but as a ''movement,'' either in its own right (e.g., McCranie 2010) or, more usually, as an expression of the mental health consumer/survivor movement (e.g., Frese and Davis 1997; Sowers 2005; Tomes 2006). Such usage registers a widely held awareness that the growth of recovery as a policy aim owes at least as much to a groundswell of popular pressure as it does to leadership from the policy elite. "
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    ABSTRACT: “Recovery” has become a key element in Scottish mental health policy and practice, despite continuing uncertainty over just what is meant by the term. This article draws on social movement theory to explore the processes underlying the growth of recovery in Scotland. Based on documentary analysis and semi-structured interviews with key actors, it looks at the emergence of a “recovery movement” in Scotland and in particular at how that movement articulated a “recovery frame” that subsequently came to inform policy and practice. It then reflects on the dilemmas posed by this success, as the recovery movement expanded to intersect with state agencies and the recovery frame was adapted to accommodate the needs of government policy. It concludes that the future of the recovery movement in Scotland will depend on its ability to maintain a sufficiently broad and inclusive framing of recovery even as it becomes associated with specific policies and practice.
    07/2013; 3(2):114-132. DOI:10.1177/2156869313481225
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